Patient experiences with a smartphone application dedicated to postoperative recovery after elective arthroplasty.

Introduction: In the rapidly evolving landscape of digital health technologies, the widespread use of smartphones has paved the way for innovative applications designed to enhance healthcare experiences. This introduction underscores the global prevalence of smartphone users and their potential in healthcare, particularly exemplified by therapeutic apps such as the 'Post Op' smartphone application. Focused on postoperative support, this app prioritises user-friendly design, data recording, and adherence to national standards.

Recent technological advancements in Artificial Intelligence for orthopaedic wound management.

In orthopaedics, wound care is crucial as surgical site infections carry disease burden due to increased length of stay, decreased quality of life and poorer patient outcomes. Artificial Intelligence (AI) has a vital role in revolutionising wound care in orthopaedics: ranging from wound assessment, early detection of complications, risk stratifying patients, and remote patient monitoring. Incorporating AI in orthopaedics has reduced dependency on manual physician assessment which is time-consuming.

Centralizing the Cemented Exeter Femoral Stem Using the Direct Lateral Approach: Surgical Tips and Radiological Evaluation.

Varus malalignment in total hip arthroplasty has been associated with poor long-term outcomes and complications including abnormal load distribution, endosteal osteolysis, frank loosening, and periprosthetic fractures. Postoperative radiographic assessment was performed on 224 patients from our case series who underwent cemented Exeter total hip arthroplasty using the direct lateral approach alone. No patient had a true varus-aligned stem (ie, ≤-5° on the coronal assessment).

Hypoxic Air Inhalation and Ischemia Interventions Both Elicit Preconditioning Which Attenuate Subsequent Cellular Stress Following Blood Flow Occlusion and Reperfusion.

Ischemic preconditioning (IPC) is valid technique which elicits reductions in femoral blood flow occlusion mediated reperfusion stress (oxidative stress, Hsp gene transcripts) within the systemic blood circulation and/or skeletal muscle. It is unknown whether systemic hypoxia, evoked by hypoxic preconditioning (HPC) has efficacy in priming the heat shock protein (Hsp) system thus reducing reperfusion stress following blood flow occlusion, in the same manner as IPC. The comparison between IPC and HPC being relevant as a preconditioning strategy prior to orthopedic surgery.

Review of evolution of tunnel position in anterior cruciate ligament reconstruction.

Anterior cruciate ligament (ACL) rupture is one of the commonest knee sport injuries. The annual incidence of the ACL injury is between 100000-200000 in the United States. Worldwide around 400000 ACL reconstructions are performed in a year.

Stem cell engineered bone with calcium-phosphate coated porous titanium scaffold or silicon hydroxyapatite granules for revision total joint arthroplasty.

Aseptic loosening in total joint replacements (TJRs) is mainly caused by osteolysis which leads to a reduction of the bone stock necessary for implant fixation in revision TJRs. Our aim was to develop bone tissue-engineered constructs based on scaffolds of clinical relevance in revision TJRs to reconstitute the bone stock at revision operations by using a perfusion bioreactor system (PBRS). The hypothesis was that a PBRS will enhance mesenchymal stem cells (MSCs) proliferation and osteogenic differentiation and will provide an even distribution of MSCs throughout the scaffolds when compared to static cultures.

An osteoconductive, osteoinductive, and osteogenic tissue-engineered product for trauma and orthopaedic surgery: how far are we?

The management of large bone defects due to trauma, degenerative disease, congenital deformities, and tumor resection remains a complex issue for the orthopaedic reconstructive surgeons. The requirement is for an ideal bone replacement which is osteoconductive, osteoinductive, and osteogenic. Autologous bone grafts are still considered the gold standard for reconstruction of bone defects, but donor site morbidity and size limitations are major concern.

The use of interlocking prostheses for both temporary and definitive management of infected periprosthetic femoral fractures.

Infected periprosthetic fractures around total hip arthroplasties are an extremely challenging problem. We describe our experience of managing infected periprosthetic femoral fractures using interlocking long-stem femoral prostheses either as temporary functional spacers or as definitive implants. The Cannulock (Orthodesign, Christchurch, United Kingdom) uncoated stem was used in 12 cases, and the Kent hip prosthesis (Biomet Merck, Bridgend, United Kingdom), in 5 cases.

Validation of the classification system for acetabular chondral lesions identified at arthroscopy in patients with femoroacetabular impingement.

There have been considerable recent advances in the understanding and management of femoroacetabular impingement and associated labral and chondral pathology. We have developed a classification system for acetabular chondral lesions. In our system, we use the six acetabular zones previously described by Ilizaliturri et al.

Gluteus medius tears: an under-diagnosed pathology.

Tears of the gluteus medius tendon contribute to greater trochanteric pain syndrome, but they are often overlooked as a cause of lateral hip pain and tenderness. This review presents the relevant anatomy, pathophysiology, diagnostic workup, differential diagnosis and management of these tears.

Periprosthetic femoral fractures in total hip arthroplasty - a review.

Periprosthetic femoral fractures (PFF) are among the more difficult and expensive complications of total hip arthroplasty. A rise in the elderly population and increase use of primary hip replacement has led to an escalating incidence. They can occur intra operatively and post operatively.

"Mini-open" repair of acute tendo Achilles ruptures--the solution?

Background: The standard surgical exposure for repair of acute tendo Achilles rupture gives favourable results, but such extensive exposure increases the possibility of peritendinous adhesion, wound breakdown and infections which increases morbidity and impairs functional outcome. Open repair also increases post-operative hospital stay and hence encroaches on valuable bed space availability. To evade this mini-open technique was developed which provide anatomic apposition of the tendon ends and minimal damage to epitendon.

Common extensor origin release in recalcitrant lateral epicondylitis - role justified?

The aim of our study was to analyse the efficacy of operative management in recalcitrant lateral epicondylitis of elbow. Forty patients included in this study were referred by general practitioners with a diagnosis of tennis elbow to the orthopaedic department at a district general hospital over a five year period. All had two or more steroid injections at the tender spot, without permanent relief of pain.

Preoperative digital templating of Birmingham hip resurfacing.

The aim of our study was to determine the usefulness of preoperative digital templating of Birmingham hip resurfacing (BHR). This prospective cohort of 30 consecutive Birmingham hip resurfacings was templated digitally by two senior hip arthroplasty fellows (GM, JG) independently. A blinded observer then collated information on the actual implant sizes intraoperatively and used this to statistically analyse the correlation (Interclass correlation coefficient) between the digitally templated implant sizes and the actual implant sizes used.

Uncemented revision hip arthroplasty in B2 and B3 periprosthetic femoral fractures - A prospective analysis.

Periprosthetic femoral fractures are an increasingly common complication of total hip arthroplasty. If there is a fracture of the femur in the presence of an unstable prosthesis (Vancouver type B2 and B3), revision of the stem is imperative. We describe our experience of cementless femoral revision in management of twenty-six patients who sustained periprosthetic fractures of the Vancouver type B2 or B3, between February 1999 and March 2005.

Is the frog lateral plain radiograph a reliable predictor of the alpha angle in femoroacetabular impingement?

The radiological evaluation of the anterolateral femoral head is an essential tool for the assessment of the cam type of femoroacetabular impingement. CT, MRI and frog lateral plain radiographs have all been suggested as imaging options for this type of lesion. The alpha angle is accepted as a reliable indicator of the cam type of impingement and may also be used as an assessment for the successful operative correction of the cam lesion.

Odontoid metastasis: a potential lethal complication.

Nearly one third of cervical spine metastasis has a primary breast malignancy. Patients with cervical metastasis have higher mortality due to advanced stage of the malignancy. Treatment is palliative to relieve pain, prevent pathological fracture, improve mobility and function, and prolong survival.

The role of impaction grafting: the when and how.

The challenges of acetabular revision include bone loss and poor bone biology. Favorable 10-year reports exist of uncemented acetabular revision using hemispherical uncemented sockets. In the presence of bone stock deficiency, adjunctive morsellized impaction bone grafting is a recognized means of restoring bone stock.

Management of late periprosthetic femur fractures: a retrospective cohort of 72 patients.

We present our series of 72 patients with periprosthetic fractures. The Vancouver classification was used to evaluate the fractures; there was one type A, seven type B1, 42 type B2, 17 type B3 and five type C fractures. Demographics, pre and postoperative data using Charnley-D'Aubigne-Postel score for assessment of function were recorded.

Do physical diagnostic tests accurately detect meniscal tears?

Numerous physical tests have been described but their diagnostic accuracy is often questioned. Karachalios et al. described the new 'Thessaly test' and concluded that it could be safely used as a first line screening test for the selection of patients who need arthroscopic meniscal surgery.

A case of relapsing Salmonella osteomyelitis in a thalassaemia trait patient.

We report a case of chronic relapsing osteomyelitis caused by Salmonella Stanley in a beta-thalassaemia trait patient who is otherwise normal. The importance of obtaining definitive bacteriological diagnosis and timely intervention to treat bone infection effectively is emphasised here.

Correction of neglected clubfoot deformity in children with Moebius syndrome.

The aim of this study was to present the functional results of treatment of neglected clubfoot in children with Moebius syndrome. A prospective analysis of seven patients with Moebius syndrome who had corrective surgery for clubfoot deformity was performed. Functional result using a modified American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire at an average follow-up of 58 months was analysed.

European validation of the Vancouver classification of periprosthetic proximal femoral fractures.

The Vancouver classification has been shown by its developers to be a valid and reliable method for categorising the configuration of periprosthetic proximal femoral fractures and for planning their management. We have re-validated this classification system independently using the radiographs of 30 patients with periprosthetic fractures. These were reviewed by six experienced consultant orthopaedic surgeons, six trainee surgeons and six medical students in order to assess intra- and interobserver reliability and reproducibility.

Clinical, MRI, and arthroscopic correlation in meniscal and anterior cruciate ligament injuries.

The aim of this prospective study was to compare and correlate clinical, magnetic resonance imaging (MRI), and arthroscopic findings in cases of meniscal tear and anterior cruciate ligament (ACL) injuries. MRI scan results and clinical diagnosis are compared against the arthroscopic confirmation of the diagnosis. One hundred and thirty-one patients had suspected traumatic meniscal or anterior cruciate ligament (ACL) injury.