Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty.

Aims: Arthroplasty has been shown to generate the most waste among all orthopaedic subspecialties, and it is estimated that hip and knee arthroplasty generate in excess of three million kg of waste annually in the UK. Infectious waste generates up to ten times more CO2 compared with recycled waste, and previous studies have shown that over 90% of waste in the infectious stream is misallocated. We assessed the effect of real-time waste segregation by an unscrubbed team member on waste generation in knee and hip arthroplasty cases, and compared this with a simple educational intervention during the 'team brief' at the start of the operating list across two sites.

Is It Time to Rethink the Relationship Between Subscapularis Tears and the Long Head of Biceps Tendon?

Introduction Pre-operative diagnosis of subscapularis tears remains a difficult challenge. Ultrasound has been shown to be ineffective at directly detecting subscapularis tears. It has been widely accepted that medial subluxation of the long head of biceps tendon (LHBT) is associated with full-thickness subscapularis tears.

Experience of Spinal Surgery for the Over 70s During the COVID-19 Pandemic in a Tertiary Referral Centre in the United Kingdom and Ramifications for Future Management.

Introduction: The aim of this study was to assess the safety of our spinal surgery pathways for patients over the age of 70 years during the COVID-19 pandemic, to guide future management.

Methods: A retrospective, single-centre, observational cohort study of all patients over 70 years of age undergoing spinal surgery between June 1 to September 30, 2020, was performed. All patients were stratified by the British Orthopaedic Association (BOA) COVID-19 Patient Risk Assessment Tool.

Role of single-ring oval disposable wound protecting device in preventing surgical site infection in laparoscopic colorectal resections.

Context: Surgical site infections (SSI) continue to be a major cause of morbidity, mortality, prolonged hospital stays and a major reason of financial burden to health-care providers and patients after major abdominal surgeries. Along with infection control practices and care bundles, additional use of devices which protect the wound from contamination is believed to decrease the burden of SSI.

Aims: This study aims to assess the benefit of single-ring disposable wound protector in preventing SSI, overall complications, hospitals stay and morbidity data in laparoscopic colorectal resection.

The Environmental Impact and Sustainability of Total Hip and Knee Arthroplasty.

Background: Operating room waste is disposed of in landfill sites, recycled, or undergoes costly, energy-intensive incineration processes. By assessing the quantity and recyclability of waste in primary hip (THA) and knee arthroplasty (TKA), we aim to identify strategies to improve sustainability.

Methods: A prospective waste audit of 15 primary THA and 16 primary TKA cases was conducted at a tertiary orthopedic hospital between April and July 2022.

'Experience days': promoting interprofessional collaboration and understanding for postgraduate doctors in training.

An 'experience day' is a novel concept in medical education, targeted at postgraduate doctors in training. In this article, the term postgraduate doctors in training includes all junior doctors, ranging from foundation year level to junior specialist doctors to higher specialist registrars. Experience days offer postgraduate doctors in training the opportunity to shadow other healthcare professionals in their working environment, to enhance their perspective of their role as a clinician and their understanding of the complex interplay of services.

Predictors of mortality in periprosthetic fractures of the hip: Results from the national PPF study.

Introduction: Periprosthetic fractures (PPFs) around the hip joint are increasing in prevalence. In this collaborative study, we aimed to investigate the impact of patient demographics, fracture characteristics, and modes of management on in-hospital mortality of PPFs involving the hip.

Methods: Using a multi-centre cohort study design, we retrospectively identified adults presenting with a PPF around the hip over a 10-year period.

Tips from the shop floor: postgraduate doctors working in trauma and orthopaedics.

Trauma and orthopaedics is a useful rotation for junior doctors to undertake. Experience in the specialty allows doctors to feel more confident in the diagnosis and treatment of conditions affecting the entire musculoskeletal system. Many junior doctors cover on-calls in trauma and orthopaedics departments, often with no prior specialist experience.

Characteristics and risk factors of UCS fracture subtypes in periprosthetic fractures around the hip.

Aims: Periprosthetic fractures (PPFs) following hip arthroplasty are complex injuries. This study evaluates patient demographic characteristics, management, outcomes, and risk factors associated with PPF subtypes over a decade.

Methods: Using a multicentre collaborative study design, independent of registry data, we identified adults from 29 centres with PPFs around the hip between January 2010 and December 2019.

Robotic technology in total knee arthroplasty.

Key factors for successful total knee arthroplasty include accurate implant positioning with precise tibial and femoral resection, combined with appropriate soft tissue balancing to achieve the desired alignment. Robotic-assisted total knee arthroplasty allows surgeons to execute pre-planned strategies with precision, with growing evidence suggesting that robotic-assisted-total knee arthroplasty reduces radiological outliers. This has yet to be proven to translate into long-term improvements in patient-reported outcomes and implant survivorship.

Erratum to 'Adverse Reaction to Zirconia in a Modern Total Hip Arthroplasty With Ceramic Head' [Arthroplasty Today 6 (2020) 612-616].

[This corrects the article DOI: 10.1016/j.artd.

Mucinous adenocarcinoma of the lung presenting as pathological humeral fracture: a case report and novel surgical treatment.

We present a 73-year-old woman who presented with a pathological fracture of her right humerus. Further imaging and biopsy indicated a mucinous adenocarcinoma of the lung as the primary neoplasm. This represents the first published case of a mucinous adenocarcinoma of the lung presenting as a metastatic lesion of the humerus.

Adverse Reaction to Zirconia in a Modern Total Hip Arthroplasty with Ceramic Head.

Hypersensitivity reactions to zirconia (ZrO2) or similar ceramics is highly unusual. Owing to the stable oxide formed between the base metal and oxygen, ceramics are considered relatively biologically inert. We report the case of an otherwise healthy 50-year-old woman with a 5-year history of progressively worsening right hip pain who underwent a ceramic-on-polyethylene total hip replacement and subsequently developed hypersensitivity reaction.

An Extensive Volar Forearm Laceration - The Spaghetti Wrist: A Systematic Review.

Purpose: 'Spaghetti wrist' is an extensive laceration that involves multiple structures in the volar wrist, including tendons, nerves and arteries. This injury is frequently encountered in trauma units, but despite its complex nature, management is often handled by junior surgeons.Furthermore, the guidance on how to approach these injuries is limited, with a relatively poor evidence base on management and outcomes.

Mesenchymal stem cells in human meniscal regeneration: A systematic review.

Background: Stem cell regeneration is the holy grail of meniscal tissue repair. Currently, the best treatment is to preserve the original meniscus but if it fails, a partial meniscectomy is indicated to delay the onset of osteoarthritis.

Materials And Methods: The authors present a systematic review to determine the up-to-date evidence underlying the use of mesenchymal stem cells for meniscal regeneration in humans.

Apathy and Its Response to Antipsychotic Review and Nonpharmacological Interventions in People With Dementia Living in Nursing Homes: WHELD, a Factorial Cluster Randomized Controlled Trial.

Objectives: Apathy is common, impactful, and difficult to manage in people with dementia. We evaluated the efficacy of nonpharmacological interventions, exercise, and social interaction, in combination with antipsychotic review, to reduce apathy in people with dementia living in nursing homes in a cluster randomized controlled trial (RCT).

Methods: Well-being and health for people with dementia (WHELD) program included a 2 × 2 × 2 factorial cluster RCT involving people with dementia living in 16 nursing homes in the United Kingdom.