Bilateral functional popliteal artery entrapment in a young athlete.

Popliteal artery entrapment syndrome is a frequent cause of intermittent claudication in young patients. We present a case of a bilateral functional entrapment, where static imaging did not demonstrate the occlusion until the patient's feet were placed in forced plantar flexion. A high index of clinical suspicion and dynamic tests with provocative manoeuvres are needed to diagnose this condition.

Multiparameter quantitative computer-assisted tomography assessment of unicompartmental knee arthroplasties.

Background: Unicompartmental knee arthroplasty is a popular alternative to total knee replacement in selected patients. Component alignment has not yet been described by computer-assisted tomography (CAT) imaging techniques; these have been developed for total knee arthroplasty analysis. The aims of this study were to report two new technologies; a new unicompartmental knee arthroplasty system was radiographically assessed with a new CAT scan protocol.

Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty.

Few reports have been published about patient-perceived outcomes and return to sport following total knee arthroplasty (TKA) compared with unicompartmental knee arthroplasty (UKA). This article compares the two procedures using self-assessment questionnaires to determine whether there was a difference in patient-perceived Oxford scores, return to sport, and return to work. Patient-perceived outcomes of mini-incision UKA (Oxford; Biomet Inc, Warsaw, Ind) and TKA were retrospectively reviewed at a minimum of 12 months after surgery.

An isolated osteochondroma with underlying non-Hodgkin's lymphoma of bone.

Osteochondroma is the most common benign bone tumour. The risk of sarcomatous change in an isolated lesion is approximately 1%. We report a case of an isolated osteochondroma which appeared benign on clinical and plain radiographic examination but routine histological analysis revealed non-Hodgkin's lymphoma in the underlying bone.

The effect of screw taper on interference fit during load to failure at the soft tissue/bone interface.

The effect of screw geometry on the pullout strength of an anterior cruciate ligament reconstruction is well documented. The effect of a truly tapered screw has not been previously investigated. Thirty bovine knees in right and left knee pairs were collected.

Effect of total knee arthroplasty on recreational and sporting activity.

Background: Common concerns of patients undergoing total knee arthroplasty (TKA) are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present study was designed to determine preoperative and postoperative activities, the numbers participating and the time to resume these activities.

Methods: Between 1 and 2 years after TKA, patients who had undergone 144 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability.

Arthrofibrosis following total knee replacement; does therapeutic warfarin make a difference?

Arthrofibrosis following total knee replacement (TKR) is a relatively common complication which results in a reduction in knee range of movement and patient dissatisfaction. A retrospective study examined the relationship between anticoagulation with therapeutic warfarin and rates of arthrofibrosis following TKR. Arthrofibrosis was defined as less than 80 degrees of knee flexion 6-8 weeks post-TKR.

Chondral degeneration and therapeutic hip arthroscopy.

Therapeutic hip arthroscopy for the treatment of chondral degeneration remains controversial. A retrospective cohort study examined 70 patients of mean age 47 (range 22-87) years who had undergone hip arthroscopy and assessed them for evidence of chondral degeneration using radiological and arthroscopic means. Clinical outcome was assessed using a modified Farjo and Glick classification.

Patient-perceived outcome measures following unicompartmental knee arthroplasty with mini-incision.

We reviewed 150 patients (183 knees) who underwent mini-incision unicompartmental knee arthroplasty (Oxford). Mean age was 71.5 (36-92) years.

Effect of total hip arthroplasty on recreational and sporting activity.

Background: Common concerns of patients undergoing total hip arthroplasty are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present paper describes preoperative and postoperative activities, the numbers participating and the time to resume these activities.

Methods: Between 1 and 2 years after total hip arthroplasty, 216 patients, who had undergone a total of 235 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability.

Tibial plateau stress fracture: a complication of unicompartmental knee arthroplasty using 4 guide pinholes.

Unicompartmental knee arthroplasty has gained popularity recently as a treatment for unicompartmental tibiofemoral non inflammatory arthritis. Tibial plateau stress fracture after unicompartmental knee arthroplasty (UKA) through guide pin holes placed in the proximal tibia has not been previously reported. In each case in this report, the compressive strength of the proximal tibia was reduced by the drilling of multiple holes for the placement of guide pins and holes for the lugs of the tibia component resulting in fracture through these holes between 3 and 18 weeks (median 8 weeks) post-operatively.

Technique for arthroscopic assisted revision hip arthroplasty.

We describe a new technique in which the arthroscope is used to assist the preparation of the cement mantle for cemented revision hip arthroplasty. We present two case reports demonstrating the method and its rationale.

A long-term review of a modified Evans procedure.

Of 111 primary ankle ligament arthroplasties (modified Evans procedure) performed between 1983 and 1994, we were able to identify 89 patients (94 ankles) for follow-up. All were under 50 years of age. Two had died and one refused to co-operate; 86 patients (91 ankles) were therefore reviewed, 25 by telephone and the remainder by clinical examination with all but three also undergoing radiological review.

Suprascapular nerve rotator cuff compression syndrome in volleyball players.

Selective denervation of the infraspinatus muscle producing weakness and wasting has been reported in certain sports (eg, volleyball and baseball). Nerve kinking or friction caused by excessive infraspinatus motion and compression by superior or inferior transverse scapular ligament or ganglions have been proposed as possible causes. However, in extreme abduction with full external rotation of the shoulder, the medial tendinous margin between the infraspinatus and supraspinatus muscles impinges strongly against the lateral edge of scapular spine, compressing the intervening infraspinatus branch of the suprascapular nerve.

Proximal scaphoid costo-osteochondral replacement arthroplasty.

Deficiency of the proximal pole of the scaphoid due to fracture or necrosis was treated by costo-osteochondral replacement arthroplasty using rib bone/cartilage autografts in 22 patients who were followed prospectively and assessed at a median 24 month follow-up (range, 12-72 months). Improvement of wrist function occurred in all patients with increased motion, improved grip strength and less pain. The average modified Green and O'Brien Wrist Function Score improved from 53 out of 100 preoperatively to 80 at the most recent review.

A further tendon retrieval trick.

Atraumatic delivery of the retracted flexor tendon ends following laceration is crucial for accurate tenorrhaphy. Sourmelis and McGrouther (1987) developed a useful method of delivering the proximal flexor tendon and a modification is presented here which further aids atraumatic tenorrhaphy.

Screw osteolysis after cementless total knee replacement.

A comparative radiographic review of 217 cementless total knee replacements was done 4 years after surgery to look for radiographic change at the screw-bone interface. There were 102 Miller Galante I knee prostheses, 59 Miller Galante II prostheses, and 56 Anatomic Modular Knee prostheses studied. If the appearance of the screw-bone interface had changed, this was classified according to the width of the lucency.