Midfoot arthritis- current concepts review.

Midfoot arthritis causes chronic foot pain and significant impairment of daily activities. Although post traumatic arthritis and primary osteoarthritis are the most common pathologies encountered, surgeons need to rule out inflammatory causes and neuropathic aetiology before starting treatment. Steroid Injections are invaluable in conservative management and have diagnostic value in guiding surgical treatment.

Correction of ankle and hind foot deformity in Charcot neuroarthropathy using a retrograde hind foot nail-The Kings' Experience.

Background: Corrective fusion for the unstable deformed hind foot and mid foot in Charcot Neuroarthropathy (CN) is quite challenging and is best done in tertiary centres under the supervision of multidisciplinary teams.

Methods: We present a follow up to our initial report with a series of 42 hind foot corrections in 40 patients from a tertiary level teaching hospital in the United Kingdom. The mean patient age was 59 (33-82).

Operative treatment of calcaneal fractures: improved outcomes and low complications rates with a strict management protocol.

This is a retrospective review of 80 intra-articular calcaneal fractures treated with open reduction and internal fixation by a specialist team under supervision of a single surgeon in a tertiary centre between 2005 and 2014. The fractures were evaluated with plain radiography and computed tomography, and graded using the Eastwood-Atkins classification. A lateral approach was used and all fractures were fixed with calcaneal plates.

Systemic effects of cobalt toxicity after revision hip replacement can manifest in intermediate to long term follow-up.

Introduction: Metal toxicity from metal-on-metal hip replacements is now well documented and several large series have reported local reactions. Although less common, there are reports of similar reactions from failed ceramic liners. Systemic effects documented in literature have been grouped into cardiac, neuro-ocular and thyroid signs.

A double mobility acetabular implant for primary hip arthroplasty in patients at high risk of dislocation.

Introduction: Dislocation following total hip replacement continues to be a problem for which no completely satisfactory solution has been found. Several methods have been proposed to reduce the incidence of hip dislocations with varying degrees of success, including elevated rim liners, constrained liners and large diameter bearings. We present our experience with the double mobility acetabular component in patients at high risk of instability.

Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty.

Purpose: This study explored whether a relationship exists between preoperative pinch and power grip strength, and length of hospital stay in patients undergoing hip and knee arthroplasty at a busy UK hospital. We investigated whether handgrip dynamometry could be used preoperatively to identify patients at greater risk of longer inpatient stays. This would allow focussed intervention preoperatively and facilitate predictors of length of stay postoperatively.

Primary and revision THA using a stemless metaphyseal-loading implant above distorted proximal femoral anatomy.

Total hip arthroplasty is well established as a successful treatment for end stage arthritis, with a wide variety of components currently available. Using traditional stemmed implants in patients with a distorted proximal femur can be technically challenging with an increased risk of complications. We present seven patients with distorted proximal femoral anatomy or failed hip arthroplasty in whom a short, metaphyseal loading implant was utilised.

Candida glabrata: an unusual fungal infection following a total hip replacement.

A 60-year-old woman, after a femoral neck fracture and joint replacement, underwent a Girdlestone's procedure and received aggressive antimicrobial therapy in order to completely eradicate the fungal infection Candida glabrata. In the majority of such cases, a revised hip arthroplasty would be considered following debridement. However, due to the recurrence of this infection and a key associated risk factor, radical removal with concurrent drug therapy was the only option.

The double-mobility acetabular component in revision total hip replacement: the United Kingdom experience.

We present our experience with a double-mobility acetabular component in 155 consecutive revision total hip replacements in 149 patients undertaken between 2005 and 2009, with particular emphasis on the incidence of further dislocation. The mean age of the patients was 77 years (42 to 89) with 59 males and 90 females. In all, five patients died and seven were lost to follow-up.

Ankle arthroscopy in children.

Introduction: Arthroscopy of the ankle has gained acceptance as a procedure for diagnosing and treating chronic and post-traumatic ankle problems. The senior author's perception is that magnetic resonance imaging (MRI) under-diagnoses anterior soft tissue impingement lesions in children. The purpose of this study was retrospectively to analyse the outcome of ankle arthroscopy in the paediatric age group.

Dislocation of large diameter metal-on-metal bearings an indicator of metal reaction?

We report 3 patients who underwent total hip arthroplasty (THA) using large diameter metal-on-metal bearing. These patients initially presented with pain but went on to develop dislocation of the THA while awaiting investigations. Any pain following metal-on-metal bearing THA should be taken seriously and should trigger investigations to identify a metal reaction.