Effect of COVID-19 on Orthopaedic Trauma Admissions and Operating in a London District General Hospital.

 The coronavirus disease 2019 (COVID-19) has presented orthopaedic departments around the world with unprecedented challenges across all aspects of health care service delivery. This study explores the effect of the COVID-19 lockdown on trauma admissions and trauma theater utilization at a London District General Hospital.  Data was collected retrospectively from electronic patient records for 4 weeks from the initiation of two lockdown periods beginning March 16, 2020 and December 23, 2020.

Bioabsorbable Versus Titanium Screws in Anterior Cruciate Ligament Reconstruction Using Hamstring Autograft: A Prospective, Blinded, Randomized Controlled Trial With 5-Year Follow-up.

Background: Longer-term results of bioabsorbable screws for anterior cruciate ligament reconstruction (ACLR) have been reported, but results are specific to the exact screw material and design. Titanium and poly-L-lactic acid with hydroxyapatite (PLLA-HA) screw outcomes have been compared only to 2 years.

Purpose/hypothesis: The purpose of this study was to compare the clinical and radiologic outcomes of the PLLA-HA screw versus titanium screw for hamstring tendon ACLR over a 5-year follow-up period.

The incidence of secondary pathology after anterior cruciate ligament rupture in 5086 patients requiring ligament reconstruction.

We reviewed 5086 patients with a mean age of 30 years (9 to 69) undergoing primary reconstruction of the anterior cruciate ligament (ACL) in order to determine the incidence of secondary pathology with respect to the time between injury and reconstruction. There was an increasing incidence of medial meniscal tears and chondral damage, but not lateral meniscal tears, with increasing intervals before surgery. The chances of requiring medial meniscal surgery was increased by a factor of two if ACL reconstruction was delayed more than five months, and increased by a factor of six if surgery was delayed by > 12 months.

The effect of femoral head size on functional outcome in primary total hip arthroplasty: a single-blinded randomised controlled trial.

We conducted a prospective single-blinded randomised controlled trial to compare the functional and quality of life outcomes in two groups of patients between 60 and 80 years of age undergoing THR; the first receiving a small head (28-32 mm) metal on polyethylene (MoP) articulation, and the second receiving a large head (44-54 mm) metal on metal (MoM) articulation. We recruited 49 patients and randomised them into one of the two groups (22 MoP and 27 MoM). The results demonstrated no statistical difference in any of the assessed functional outcomes at any follow-up point (p>0.

A new technique of endoprosthetic replacement for osteosarcoma of proximal femur with intra-articular extension.

Introduction: Osteosarcoma is the most common primary malignant tumour of bone and commonly involved sites are the distal femur, proximal tibia, and humerus. Osteosarcoma of proximal femur usually arises at the metaphysis and articular cartilage acts as a relative barrier to tumour spread, with extension into the hip joint being extremely rare.

Presentation Of Case: A previously fit and well sixteen-year-old male presented with a 2month history of right hip pain and a limp.

The outcome of extra-abdominal fibromatosis treated at a tertiary referral centre.

Purpose: To review the outcomes of patients with extra-abdominal fibromatosis treated at a tertiary referral centre.

Methods: A retrospective review of a series of 72 patients with fibromatosis treated at the Royal National Orthopaedic Hospital (RNOH) between 1980 and 2009, with a median follow up of 4 years (1-17 years).

Results: Forty patients were primary referrals, and 32 more had operations at the referring hospital.

The relationship between the presence of metallosis and massive infection in metal-on-metal hip replacements.

With the increased use of metal-on-metal as a bearing surface, complications and side effects are being recognised more frequently. We present a small series of a previously unreported complication, which appears specific to metal-on-metal bearing surface arthroplasties: three cases of infection in the presence of local metal debris and histological features of aseptic lymphocytic vasculitis associated lesions (ALVAL). Each case is associated with significant soft tissue loss and bone destruction to such an extent that pelvic discontinuity has occurred.

Use of a distal radius endoprosthesis following resection of a bone tumour: a case report.

Limited literature is available on the reconstruction of the distal radius using prosthetic replacement following resection of a bone tumour. We present the first reported case, in the English literature, of the use of an entirely metal endoprosthesis for the reconstruction of the distal radius. This case involves a 66-year-old male who was treated for giant cell tumour of the distal radius with surgical excision of the lesion and replacement of the defect using a predominantly titanium endoprosthesis.

Carpal tunnel syndrome in lysosomal storage disorders: simple decompression or external neurolysis?

Thirty-two patients (61 limbs) with lysosomal storage disorders underwent surgery for 'carpal tunnel syndrome'. Twenty-two limbs underwent a simple decompression whereas 39 limbs underwent additional neurolysis and tenosynovectomy. Data were incomplete for six patients (12 limbs).

Variation of the distal metatarsal articular angle with axial rotation and inclination of the first metatarsal.

Background: The distal metatarsal articular angle (DMAA) is a radiographic measure of the orientation of the first metatarsal articular surface. There is debate with regards to the accuracy, reproducibility, and validity of measurement of the DMAA in the literature. This study aimed to test the validity of the measurement of the DMAA from standard radiographs, to explore the trigonometric relationship of the first metatarsal rotation and the DMAA, and to assess interobserver reliability.

Arthroscopic assessment of the syndesmosis following ankle fracture.

A Maisonneuve ankle fracture without convincing evidence of syndesmotic injury on plain radiographs is described. Stress views and computerised tomography (CT) were also negative. A high index of suspicion led to ankle arthroscopy, which revealed a diastasis, and also an osteochondral fragment.