Third and fourth generation ceramic-on-ceramic total hip arthroplasty at a minimum of ten years.

Background: Ceramic on Ceramic bearings in Total Hip Arthroplasty (THA) afford a low friction coefficient, low wear rates and extreme hardness. Significant complications include hip squeak, ceramic fracture and poor polyethylene performance in revision procedures due to imbedding of abrasive microscopic ceramic fragments. We report on the results of this bearing at a minimum of 10 years.

Assessment of previous fracture and anti-osteoporotic medication prescription in hip fracture patients.

Introduction: Hip fracture prevention is an essential component in elderly patient care. History of prior fracture is a significant risk factor for subsequent hip fracture. There are variable rates of treatment for these groups of patients.

The effect of indirect admission via hospital transfer on hip fracture patients in Ireland.

Background And Aims: Current best practice states that hip fracture patients should undergo surgery within 48 hours to minimise perioperative complications. There are 10 emergency departments (EDs) in Ireland that receive hip fracture patients without a trauma and orthopaedic surgery unit on site. Idle periods and duplicated preoperative investigations can lead to a prolonged time to surgery.

Total knee replacement under tourniquet control: A prospective study of the peripheral arterial vasculature using colour-assisted duplex ultrasonography.

Background And Purpose: A tourniquet may potentiate rare and devastating arterial complications after total knee replacement (TKR) in patients with peripheral vascular disease (PVD). Most prior studies that evaluated peripheral arterial blood flow primarily used the ankle-brachial index (ABI).

Methods: We assessed the prevalence and risk factors for PVD in a cohort undergoing TKR.

The conundrum of calcaneal spurs: do they matter?

Background: Chronic plantar heel pain is a common and potentially debilitating condition, often caused by plantar fasciitis. Plantar calcaneal spurs were originally considered the cause of plantar fasciitis but are now regarded as an incidental finding by most authors. We aimed to test this hypothesis and to investigate predisposing factors for the development of spurs.

Intramedullary versus extramedullary alignment of the tibial component in the Triathlon knee.

Background: Long term survivorship in total knee arthroplasty is significantly dependant on prosthesis alignment. Our aim was determine which alignment guide was more accurate in positioning of the tibial component in total knee arthroplasty. We also aimed to assess whether there was any difference in short term patient outcome.

Acetabular impaction grafting in total hip replacement.

Background And Purpose: Acetabular impaction grafting has been shown to be very effective, but concerns regarding its suitability for larger defects have been highlighted. We report the use of this technique in a large cohort of patients, and address possible limitations of the technique.

Methods: We investigated a consecutive group of 339 cases of impaction grafting of the cup with morcellised impacted allograft bone for survivorship and mechanisms for early failure.

Femoral impaction grafting in revision total hip arthroplasty: a follow-up of 540 hips.

Between 1987 and 1999, 540 revision total hip arthroplasties in 487 patients were performed at our institution using the femoral impaction grafting technique with a cemented femoral stem. All patients were prospectively followed up for 2 to 15 years postoperatively with no loss to follow-up. A total of 494 hips remained successfully in situ at an average of 6.

The threshold force required for femoral impaction grafting in revision hip surgery.

Background And Purpose: Femoral impaction grafting requires vigorous impaction to obtain adequate stability without risk of fracture, but the force of impaction has not been determined. We determined this threshold force in a preliminary study using animal femurs.

Methods: Adult sow femurs were used because of their morphological similarity to human femurs in revision hip arthroplasty.