Is it safe for patients to drive after intra-articular knee injection?

Background: Intra-articular knee injection is a central component in the current management of knee pain. While this is a routinely performed outpatient procedure, institutional policies for driving post injection differ. This study examines brake response times (BRTs) before and after intra-articular knee injection.

Mineral rich algae with pine bark improved pain, physical function and analgesic use in mild-knee joint osteoarthritis, compared to Glucosamine: A randomized controlled pilot trial.

Introduction: Osteoarthritis (OA) is characterised by synovial joint pain, functional disability and affects ∼13 % of people worldwide, of which ∼16-27 % report Knee-OA (KOA). Glucosamine (Glu) is the most widely used nutraceutical treatment for OA despite a lack of scientific consensus, therefore alternative nutraceutical treatments are required. The aim of this study was to investigate the effect of Lithothamnion species, seawater-derived magnesium and pine bark (Aq) on pain, symptoms and improve physical function in symptomatic (sKOA), compared to Glu.

Current concepts and outcomes in cemented femoral stem design and cementation techniques: the argument for a new classification system.

Cemented implant fixation design principles have evolved since the 1950s, and various femoral stem designs are currently in use to provide a stable construct between the implant-cement and cement-bone interfaces.Cemented stems have classically been classified into two broad categories: taper slip or force closed, and composite beams or shaped closed designs. While these simplifications are acceptable general categories, there are other important surgical details that need to be taken into consideration such as different broaching techniques, cementing techniques and mantle thickness.

Aspirin compared to enoxaparin or rivaroxaban for thromboprophylaxis following hip and knee replacement.

Background The risk of venous thromboembolism following major orthopaedic surgery is among the highest for all surgical specialties. Our hospital guidelines for thromboprophylaxis following elective primary total hip or knee replacement are based on American College of Chest Physicians guidance. The most recent change to local guidelines was the introduction of the extended aspirin regimen as standard thromboprophylaxis.

Prognostic Importance of Pathological Fractures in Osteosarcomas.

Aims To investigate whether pathological fractures impact on osteosarcoma patient prognosis in Ireland. Methods This was a retrospective study over 22 years in a National Orthopaedic Oncology Centre. There were 117 nonfracture cases and 15 fracture cases.

BMI is a Better Predictor of Periprosthetic Joint Infection Risk Than Local Measures of Adipose Tissue After TKA.

Background: Both body mass index (BMI) and local measures of adiposity at the surgical site have been identified as independent risk factors for periprosthetic joint infection (PJI) (periprosthetic joint infection) after total knee arthroplasty (TKA). We aimed to 1) evaluate previously used measures of assessing knee adiposity and 2) determine the best measure for predicting both surgical duration and PJI after TKA.

Methods: We performed a multicentre retrospective review of 4745 patients who underwent primary TKA between January 2013 and December 2016.

Does Google™ Have the Answers? The Internet-based Information on Pelvic and Acetabular Fractures.

Introduction The aim of this study is to assess the readability and reliability of internet-based information on pelvic and acetabular fractures. Methods The three most popular English-based internet search engines are Google, Yahoo, and Bing. Quality was assessed using the DISCERN tool, the Journal of the American Medical Association tool, and the presence of the Health on the Net Code (HONcode) seal.

Geographical variation in musculoskeletal surgical care in public hospitals in Ireland: a repeated cross-sectional study.

Objective: To examine the extent of geographical variation across musculoskeletal surgical procedures and associated factors in Ireland.

Design: Repeated cross-sectional study.

Setting: 36 public hospitals in Ireland.

Use of a novel corrective device for correction of deformities in adolescent idiopathic scoliosis.

Background: Adolescent idiopathic scoliosis (AIS), with an incidence of 3%, is a common deformity. Correction of severe curvature of the deformity has attracted much investigation to achieve safe, reproducible results. We present our experience with a novel device for the correction of deformities across a spectrum of curve types, the rod link reducer.

Preoperative Patient Preparation Audit: Completed Loop Cycle.

Introduction Nurses usually check patients scheduled for surgery while the patients are still in the ward. A lack of complete preoperative patient preparation can cause delayed care and disastrous outcomes. The objective of this study was to assess the number of patients en route to surgery who had been fully preoperatively prepared and evaluate any change in that number once a proforma was introduced as part of the preparation protocol.

Outcome of total hip and knee arthroplasty in HIV-infected patients: A systematic review.

Significant advances in the treatment of Human Immunodeficiency Virus (HIV) have occurred in recent times, with life expectancy now approaching the normal population. Therefore, patients with HIV will increasingly be undergoing joint replacement in the future, however concerns remain regarding the complications and outcome in this patient cohort. The aim was to assess the outcome of total hip and knee arthroplasty in HIV-infected patients.

Degenerative tears of the posterior horn of the medial meniscus: correlation between MRI findings and outcome following intra-articular steroid/bupivacaine injection of the knee.

Aim: To evaluate the response of symptomatic degenerative tears of the posterior horn of the medial meniscus to guided intra-articular knee steroid/bupivacaine injection and to correlate clinical outcomes with preprocedural findings at magnetic resonance imaging (MRI).

Materials And Methods: Sixty patients who had clinical and MRI evidence of a symptomatic degenerative tear of the posterior horn of the medial meniscus, isolated or accompanied by additional features of degenerative arthritis, who had failed conservative approaches (physiotherapy, non-steroidal anti-inflammatories, and 3 months rest/knee bracing) were included in the study. Patients underwent intra-articular knee steroid/bupivacaine injection and were followed clinically for a minimum of 6 months.

Satisfaction of the Irish Trauma and Orthopaedic training programme with the Intercollegiate Surgical Curriculum Programme.

Background: Surgical training has undergone extensive changes in recent years. The Intercollegiate Surgical Curriculum Programme (ISCP) has been utilised in the UK for many years to facilitate the education and assessment of trainees. It was adopted by the Irish Trauma and Orthopaedics (T&O) training programme in July 2015.

Comparison of 4 different techniques in first metatarsophalangeal joint arthrodesis.

Aims: The aim of this study was to evaluate outcomes and fusion rates of 4 different methods of first metatarsophalangeal joint (MTPJ) arthrodesis.

Methods: We performed a retrospective analysis of first MTPJ fusion using Bold® and Acutrak® compression screws, universal 1/3 tubular plate and Hallu®-S non-locking plate in 6 hospitals in Dublin over 4 years. A cohort of 300 patients (351 feet) was operated on by 3 feet and ankle fellowship trained orthopaedic surgeons (PK, MMS, JVMcK) over 4 years.

Total hip replacement-the cause of failure in patients under 50 years old?

Aim: To establish the mode of failure of primary total hip replacement in patients under 50 years old.

Methods: A total of 1062 revision total hip arthroplasties were performed over a 5-year period, with 146 on patients under 50 years old. These were subdivided into early (< 5 years) and late (> 5 years) failures from the index procedure.

Primary total hip arthroplasty: registry data for fixation methods and bearing options at a minimum of 10 years.

Background: Registry data for total hip arthroplasty (THA) has allowed optimal fixation methods, bearing surfaces and many other factors to be assessed. We describe 10-year THA outcomes from an Irish perspective using regional THA registry data for the first time.

Aims: We assess the main predictors of revision in primary total hip arthroplasty (THA) using regional registry data.

Consent documentation for elective orthopaedic surgery.

Objectives: Currently in Ireland, there is a lack of uniformity regarding the method in which the consent process is routinely documented. The purpose of this study was to evaluate the standard consent forms used in elective orthopaedic hospitals in Ireland. In addition, this paper explores the relevant guidelines from the UK and Ireland relating to consent documentation.

Role of Musculoskeletal Radiology in Modern Sports Medicine.

Musculoskeletal radiology's role in the recent and continued evolution of sports medicine is an exciting and expanding one. In this article we explore a variety of the ways that musculoskeletal radiology contributes to current practices in modern sports medicine, discussing advances across a variety of imaging modalities in the care of both elite athletes and so-called weekend warriors. We describe the technical and ethical factors pertaining to image-guided therapeutic intervention in athletes and speculate on the potential for future developments in the role of imaging in deciding when an athlete may return to participation.

Musculoskeletal Imaging: Current Practice and Future Directions.

Musculoskeletal (MSK) radiology plays a crucial role in the diagnosis and management of MSK disorders and has rapidly expanded in tandem with advances in technology and improved access to imaging. Although anatomical imaging remains the mainstay of MSK radiology, significant progress has been made in functional and molecular imaging as well as in hybrid imaging with an expanding armament of technologies becoming available or in development. A vast array of research is occurring in MSK imaging, and this review article highlights some of the most promising current and future clinical applications in development in each of the major imaging modalities.

Vertebroplasty in the treatment of recalcitrant lower back pain attributed to Modic 1 changes.

Vertebroplasty is a recognised treatment for osteoporotic and pathological compression fractures. We present the case of TF, a 70-year-old male patient with a history of poor left ventricular function presenting with refractory lower back pain, thought to be secondary to Modic Type1 changes in the L2 and L3 vertebrae, accompanying L2-L3 degenerative disc disease. He was treated conservatively for approximately 9 months without success.

An assessment of the quality of clinical records in elective orthopaedics using the STAR score.

Background: Litigation claims related to surgery have increased significantly in recent years. Despite the medico-legal importance of clinical records, there have been few published studies describing the quality of medical records in orthopaedic surgery. This study aimed to evaluate the quality of clinical note taking in an elective orthopaedic setting over a 10-year period by comparing medical records from 2003 and 2013.

Differing MRI appearances of symptomatic proximal hamstring tendinopathy with ageing: a comparison of appearances in patients below and above 45 years.

Aim: To compare magnetic resonance imaging (MRI) appearances of symptomatic proximal hamstring tendinopathy (PHT) in younger (<45 years) and older (>45 years) patients.

Materials And Methods: MRI of patients with symptomatic PHT were reviewed and compared to asymptomatic age- and sex-matched controls. Appearances recorded were as: type 0, normal tendon; type I, intra-substance signal abnormality; type II, ischial bone and soft-tissue oedema with/without type I findings; type III, curvilinear fluid signal tearing with/without type II findings; type IV, bony avulsion.

Femoral offset found not to affect metal ion levels in metal-on-metal total hip arthroplasty.

Background: Failure to restore femoral offset in metal on polyethylene total hip arthroplasty (THA) causes polyethylene wear and aseptic loosening. To our knowledge, no study to date has investigated the relationship between femoral offset and wear in metal-on-metal (MOM) THA.

Aims: In this study, we investigated the relationship between femoral offset and wear by measuring circulating metal ion levels in MOM THA.