The impact of adjuvant antibiotic hydrogel application on the primary stability of uncemented hip stems.

Objectives: To assess the effect of adjuvant antibiotic-loaded hydrogel application on the primary stability of implanted uncemented hip stems.

Design: Biomechanical study.

Setting: An electro-mechanic material test system (#5866, Instron, Norwood, MA, USA) equipped with a 10-kN load cell was used.

Assessment of the effectiveness of weight-adjusted antibiotic administration, for reduced duration, in surgical prophylaxis of primary hip and knee arthroplasty.

Background: Prophylactic antibiotics have significantly led to a reduction in the risk of post-operative surgical site infections (SSI) in orthopaedic surgery. The aim of using antibiotics for this purpose is to achieve serum and tissue drug levels that exceed, for the duration of the operation, the minimum inhibitory concentration of the likely organisms that are encountered. Prophylactic antibiotics reduce the rate of SSIs in lower limb arthroplasty from between 4% and 8% to between 1% and 3%.

Clinical outcome of open ankle fractures in patients above 70 years of age.

Background: Open fractures of the ankle are complex injuries requiring multidisciplinary input and are associated with significant morbidity and mortality. However, data on the clinical outcomes of open ankle fracture management in patients older than 70 is minimal.

Aim: To evaluate the clinical outcomes following open ankle fracture management in patients older than 70.

Is there a Difference in Interfragmentary Compression Strength Between Fully or Partially Threaded Screws? Results of an Experimental Biomechanical Pilot Study.

 This study assessed differences between fully- and partially-threaded screws in the initial interfragmentary compression strength. Our hypothesis was that there would be an increased loss in initial compression strength with the partially-threaded screw.  A 45-degree oblique fracture line was created in artificial bone samples.

An Assessment of Factors That Influence Outcome Following Fixation of Periprosthetic Distal Femur Fractures Associated with Total Knee Arthroplasty.

Background: Periprosthetic distal femur fractures following total knee arthroplasty (PDFFTKA) are increasingly common [1], mainly in elderly patients with significant co-morbidities [2]. Surgical management usually requires balancing prompt fixation for early mobilization with the need to consider the least physiologically demanding option [3].The aim of this study was to assess predictors of clinical and radiological outcome in patients with PDFFTKA treated with open reduction and internal fixation (ORIF).

Analysis of the relationship between surgeon procedure volume and complications after total knee arthroplasty using a propensity-matched cohort study.

Objectives: This study aimed to identify a threshold in annual surgeon volume associated with increased risk of revision (for any cause) and deep infection requiring surgery following primary elective total knee arthroplasty (TKA).

Design: A propensity score matched cohort study.

Setting: Ontario, Canada.

Fibula pro-tibia standard locking plate fixation in an ankle fracture saw bone model.

Background: Locking plate fixation in osteoporotic ankle fractures may fail due to cut-out or metalwork failure. Fibula pro-tibia fixation was a technique prior to the advent of locking plates that was used to enhance stability in ankle fractures by achieving tri or tetra-cortical fixation. With locking plates, the strength of this fixation construct can be further enhanced.

Distress in orthopedic trainees and attending surgeons: a Canadian national survey.

Background: Physician health is of increasing concern in health care systems. The purpose of this study was to determine the prevalence of distress among orthopedic surgeons and trainees and to identify factors associated with distress.

Methods: Voluntary, anonymous online surveys were sent to attending orthopedic surgeons and orthopedic trainees across Canada.

The Use of Cryotherapy in the Early Postoperative Period after Total Hip Arthroplasty.

Background: Recent evidence suggests that cryotherapy may be beneficial in reducing postoperative pain and blood loss in joint arthroplasty. The objective of this study was to review the use of cryotherapy in the early postoperative phase after total hip arthroplasty to assess the benefits in terms of pain relief and reduction in postoperative blood loss.

Material And Methods: A prospective cohort study of the use of a cryotherapy device (Hilotherm) was performed in patients following total hip arthroplasty.

Do Trampoline Injuries Result in More Hospital Intervention Compared to Other Mechanisms of Injury?

Background: A significant proportion of emergency department (ED) presentations are related to trampoline injuries. The aims of this study were to assess whether presentations to the ED as a result of a trampoline injury have an increased incidence of requiring intervention as opposed to other mechanisms of injury in children under 9 years old.

Materials And Methods: Retrospective observational assessment of ED presentations of children under 9 years old recorded in the European Injuries Database (EU IDB) in 2014.

Trauma assessment and follow up with integration of modern communication devices (TRAFIC). A pilot study.

Objectives: This pilot study aimed to evaluate the feasibility of prospectively collecting electronic PROMs on patients being assessed as a result of musculoskeletal trauma, using a web-based application (APP), administered onto tablet and desktop computers (TCs or DCs) in the outpatient setting.

Methods: Following local research ethics approval, a web-based APP (TRAFIC) was developed. It consisted of a total of 12 questions (demographic information, employment, and rehabilitation status as well as quality of life (EQ5D)).

Does an early home-based progressive resistance training program improve function following total hip replacement? Results of a randomized controlled study.

Background: In-hospital progressive resistance training (PRT) has been shown to be an effective method of rehabilitation following hip surgery. The aim of this study was to assess whether a home-based PRT program would be beneficial in improving patients' muscle strength and physical function compared to standard rehabilitation.

Methods: Subjects (n = 49) either received home-based PRT rehabilitation (n = 25) or standard rehabilitation (n = 24) in a prospective single blinded randomized trial carried out over a two-year period.

What does standard rehabilitation practice after total hip replacement in the UK entail? Results of a mixed methods study.

Background: There is evidence of prolonged poor function in patients following total hip replacement (THR). Studies of progressive resistance training (PRT) interventions to improve function are often compared to 'standard' practice which is not well defined. This study aimed to investigate 'standard' rehabilitation care in the UK after total hip replacement (THR) as well as determine whether PRT was part of 'standard' care.

An appraisal of rehabilitation regimes used for improving functional outcome after total hip replacement surgery.

This study aimed to systematically review the literature with regards to studies of rehabilitation programmes that have tried to improve function after total hip replacement (THR) surgery. 15 randomised controlled trials were identified of which 11 were centre-based, 2 were home based and 2 were trials comparing home and centre based interventions. The use of a progressive resistance training (PRT) programme led to significant improvement in muscle strength and function if the intervention was carried out early (< 1 month following surgery) in a centre (6/11 centre-based studies used PRT), or late (> 1 month following surgery) in a home based setting (2/2 home based studies used PRT).

Hypertrophic non-union of a pathological forearm fracture secondary to multiple myeloma: a case report.

Skeletal lesions in multiple myeloma are predominantly lytic and when non-union of pathological fractures occur it is typically atrophic. We report a lady of 61 years of age with myeloma who presented with a pathological fracture through an ulnar myeloma deposit. The fracture was immobilised initially then irradiated.

A short report comparing outcomes between L4/L5 and L5/S1 single-level discectomy surgery.

Study Design: Prospective cohort study.

Objective: To assess whether there is a difference in outcome between single-level discectomy at L4/L5 and L5/S1.

Summary Of Background Data: There is sound biomechanical reasoning to suspect a difference between spinal levels.

Tumor necrosis alpha-blocking agent (etanercept): a triple blind randomized controlled trial of its use in treatment of sciatica.

Study Design: Triple blind randomized controlled study.

Objective: To establish the treatment effect of etanercept in acute sciatica secondary to lumbar disc herniation.

Summary Of Background Data: Etanercept is a selective competitor of tumor necrosis factor-alpha which is a proinflammatory cytokine.

The accuracy of assessment of walking distance in the elective spinal outpatients setting.

Self reported walking distance is a clinically relevant measure of function. The aim of this study was to define patient accuracy and understand factors that might influence perceived walking distance in an elective spinal outpatients setting. A prospective cohort study.

Is conservative treatment really effective for Legg-Calvé-Perthes disease? A critical review of the literature.

Introduction: The treatment of Legg-Calvé-Perthes Disease (LCPD) is controversial and not well defined. This literature review aimed to assess the quality of the evidence available to support the effectiveness of conservative LCPD treatment advocated by orthopaedic surgeons and(or) paediatricians. A secondary aim was to see if conservative treatments really modify the natural history of LCPD.