The EQ-5D-3L administered by text message compared to the paper version for hard-to-reach populations in a rural South African trauma setting: a measurement equivalence study.

Introduction: Administering patient-reported outcome measures (PROMs) by text message may improve response rate in hard-to-reach populations. This study explored cultural acceptability of PROMs and compared measurement equivalence of the EQ-5D-3L administered on paper and by text message in a rural South African setting.

Materials And Methods: Participants with upper or lower limb orthopaedic pathology were recruited.

Predictors of mortality following shoulder arthroplasty.

Introduction: This study aims to determine 30-day, 90-day and 1 year mortality following shoulder arthroplasty and identify predictors of mortality.

Materials And Methods: All shoulder arthroplasty cases performed at the host institution, between 2012 and 2018 were included. A review of patient records was completed to identify demographic data, Charlson comorbidity index, date of death and factors associated with mortality.

Knotless Anchor Fixation for Transosseous Meniscal Root Repair Using Suture Tape Is Inferior Compared With Button or Screw Fixation: A Biomechanical Study.

Background: A 2 mm-wide ultrahigh-molecular-weight polyethylene (UHMWPE) tape improves the contact pressure at root repair sites compared with high-strength suture and provides a stronger repair construct. UHMWPE tape is commonly used in rotator cuff repair, and fixation is often achieved with knotless suture anchors. The optimal method for tape fixation for meniscal root repair has not been established.

The superficial medial collateral ligament is the major restraint to anteromedial instability of the knee.

Purpose: The purpose of the present study was to determine how the medial structures and ACL contribute to restraining anteromedial instability of the knee.

Methods: Twenty-eight paired, fresh-frozen human cadaveric knees were tested in a six-degree of freedom robotic setup. After sequentially cutting the dMCL, sMCL, POL and ACL in four different cutting orders, the following simulated clinical laxity tests were applied at 0°, 30°, 60° and 90° of knee flexion: 4 Nm external tibial rotation (ER), 4 Nm internal tibial rotation (IR), 8 Nm valgus rotation (VR) and anteromedial rotation (AMR)-combined 89 N anterior tibial translation and 4 Nm ER.

Large variability exists in the management of posterolateral corner injuries in the global surgical community.

Purpose: The management of posterolateral corner (PLC) injuries has significantly evolved over the past 2 decades. The purpose of this study was to determine the current worldview of key concepts on the diagnosis, treatment strategy, and rehabilitation for patients presenting with PLC injuries.

Methods: A 12-question multiple-choice online survey was designed to address key questions in the diagnosis, treatment, and rehabilitation of PLC injuries.

Anterior Cruciate Ligament Femoral Tunnel Placement: An Analysis of the Intended Versus Achieved Position for 221 International High-Volume ACL Surgeons.

Background: Femoral tunnels that are not anatomically placed within the native anterior cruciate ligament (ACL) footprint during ACL reconstruction are associated with residual instability, graft rupture, and poor clinical outcomes. Although surgeons may intend to place their femoral tunnels within the native ACL attachment, this is not always achieved. This study assesses the variation between intended and achieved femoral tunnel positions in a large cohort of experienced ACL surgeons.

The space available for the anterior cruciate ligament in the intercondylar notch is less in patients with ACL injury.

Purpose: The aim of this study was to determine if a difference exists in the relationship between the femoral intercondylar notch volume, and the volumes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in ACL injured patients and healthy subjects.

Methods: Intact knees of 19 healthy subjects and bilateral knees of 18 ipsilateral ACL reconstructed patients were scanned using 3-tesla high-resolution magnetic resonance imaging. The intercondylar notch, ACL, PCL and hamstring graft were segmented using three-dimensional (3D) processing software.

Resuscitation in hip fractures: The practicality and clinical effectiveness of pre-operative resuscitation of patients with hip fracture using blood products.

Introduction: This study aimed to determine the practicality and estimate the effect of administering pre-operative blood product resuscitation to a consecutive, prospectively recruited cohort of 100 patients admitted to a single centre with a hip fracture with all other treatment unchanged.

Method: 100 patients aged 65 years or over admitted acutely to our unit with unilateral fractured femoral neck during the study period were included in this study, regardless of cognitive function. Patients were excluded only if there were relevant medical comorbidities or consent was declined.

Endoscopic Flexor Hallucis Longus Transfer for Achilles Noninsertional Tendinopathy: Description of Surgical Technique and Functional Outcomes.

. The transfer of the flexor hallucis longus (FHL) tendon is an established treatment for replacing a dysfunctional Achilles tendon. .

The porosity of the bone cement interface of 96 human femoral heads prepared for hip resurfacing.

Purpose: The porosity of the femoral head prepared for hip resurfacing has not been previously described. This is important as greater pore size increases the penetration of bone cement and excessive cement penetration can cause osteonecrosis.

Methods: 96 osteoarthritic femoral heads were harvested at total hip arthroplasty and prepared for hip resurfacing.

Plate and screw fixation of arthroscopically assisted tibial tuberosity osteotomy: technique and results.

Introduction: We describe a fixation technique for tibial tuberosity osteotomies (TTO) utilising a plate and screw construct which adheres to established principles of bone healing. We record and discuss the complication profile and benefits of this technique.

Method: The technique is outlined, and thirty consecutive case of TTO fixed with this combination of plate and screws were analysed during a study period from January 2018 to October 2018.

Blood transfusion rates following shoulder arthroplasty in a high volume UK centre and analysis of risk factors associated with transfusion.

Aims: To determine the blood transfusion rates following shoulder arthroplasty and to establish risk factors associated with increased risk of transfusion.

Materials And Methods: All shoulder arthroplasty cases performed between January 2012 and March 2017 in a tertiary upper limb unit were identified. Patients who received perioperative tranexamic acid were excluded.

Correlation of MARS MRI findings with cup position, metal ion levels and function in metal-on-metal total hip arthroplasty.

Introduction: Metal-on-metal (MoM) total hip arthroplasties (THAs) have been linked with increased incidence of pseudotumours and revision rate. magnetic resonance imaging (MRI) is useful in diagnosing adverse reaction to metal debris (ARMD) disease but it is not known if MRI findings correlate with cup position.

Patients And Methods: From a cohort of 79 MoM THA, 34 MRI studies were available.

Mapping the contact area of the patellofemoral joint: the relationship between stability and joint congruence.

Aims: The aim of this study was to determine and compare the congruency of the articular surface contact area of the patellofemoral joint (PFJ) during both active and passive movement of the knee with the use of an MRI mapping technique in both the stable and unstable PFJ.

Patients And Methods: A prospective case-control MRI imaging study of patients with a history of PFJ instability and a control group of volunteers without knee symptoms was performed. The PFJs were imaged with the use of an MRI scan during both passive and active movement from 0° through to 40° of flexion.

Anatomic Posterolateral Corner Reconstruction Using Single Graft Plus Adjustable-Loop Suspensory Fixation Device.

The original description of the LaPrade technique for anatomic posterolateral corner reconstruction addresses the 3 main stabilizing structures: the fibular collateral ligament, the popliteus, and the popliteofibular ligament. The use of two separate grafts (originally described with a tendo-Achilles allograft) may restrict the utility of the technique when sources of allograft may be limited and autografts must be used, particularly in the context of multiligament reconstruction. We present a modification of the technique, in which an adjustable cortical button is used for tibial fixation, which allows for the use of a single graft while maintaining the ability to independently tension the popliteus, popliteofibular ligament, and fibular collateral ligament limbs of the graft.

Preparing the femur before the acetabulum does not reduce total blood loss in primary total hip replacement.

Introduction: Total hip replacement is a common and effective surgical intervention for patients with debilitating joint pain but it does represent a significant surgical intervention. For such interventions, blood loss is a potential cause of morbidity and mortality. Optimisation of surgical interventions focuses on reducing such risks.

Health state utilities associated with post-surgical Staphylococcus aureus infections.

Introduction: Surgical site infections (SSIs) are among the most common and potentially serious complications after surgery. Staphylococcus aureus is a virulent pathogen frequently identified as a cause of SSI. As vaccines and other infection control measures are developed to reduce SSI risk, cost-utility analyses (CUA) of these interventions are needed to inform resource allocation decisions.

Outcome of revision UKR to TKR when compared to a matched group of TKR of same total arthroplasty lifespan.

Aim: To compare outcomes of revision uni-compartmental knee replacement (UKR) with a defined revision cause with a matched group of primary total knee replacements (TKR).

Background: UKR accounts for 8.7% of knee arthroplasty in the UK each year.

Investigation of thermally induced damage to surrounding nerve tissue when using curettage and cementation of long bone tumours, modelled in cadaveric porcine femurs.

Introduction: Curettage with cement augmentation is a technique used in the treatment of bone tumours. Thermal energy released during the cement polymerisation process can damage surrounding tissues. This study aims to record temperature changes at various sites on and around bone during the cementing process.

An 18-year comparison of hybrid total hip replacement and Birmingham hip resurfacing in active young patients.

Aim: To compare the long-term clinical and radiological results of metal-on-polyethylene hybrid total hip replacement (THA) with metal-on-metal Birmingham hip resurfacing (BHR) in young, active patients.

Patients And Methods: From the 1st consecutive 63 hips in young, active patients who underwent BHR by the senior author, 54 (51 patients) were matched to patients who had undergone THA with regard to age, gender, body mass index and preoperative levels of activity. Radiologically, all hips were assessed for migration and osteolysis, THAs for polyethylene wear and BHRs for a pedestal sign.

2018 international consensus meeting on musculoskeletal infection: Summary from the biofilm workgroup and consensus on biofilm related musculoskeletal infections.

Biofilm-associated implant-related bone and joint infections are clinically important due to the extensive morbidity, cost of care and socioeconomic burden that they cause. Research in the field of biofilms has expanded in the past two decades, however, there is still an immense knowledge gap related to many clinical challenges of these biofilm-associated infections. This subject was assigned to the Biofilm Workgroup during the second International Consensus Meeting on Musculoskeletal Infection held in Philadelphia USA (ICM 2018) (https://icmphilly.

Higher 30-day mortality associated with the use of intramedullary nails compared with sliding hip screws for the treatment of trochanteric hip fractures: a prospective national registry study.

Aims: The aim of this study was to investigate the association between the type of operation used to treat a trochanteric fracture of the hip and 30-day mortality.

Patients And Methods: Data on 82 990 patients from the National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical and surgical characteristics, and socioeconomic factors.

Results: The use of short and long intramedullary nails was associated with an increase in 30-day mortality (adjusted odds ratio (OR) 1.

The Knee Osteoarthritis Grading System for Arthroplasty.

Background: The aim of this study is to validate the Knee Osteoarthritis Grading System (KOGS) of progressive osteoarthritic degeneration for the tri-compartmental knee. This system defines the site and severity of osteoarthritis to determine a specific knee arthroplasty.

Methods: The radiographic sequence for KOGS includes standing coronal (anteroposterior), lateral, 30° skyline patella, 15° and 45° Rosenberg and stress views in 20° of flexion.