The aim of our study was to determine the current incidence and outcome infected total knee arthroplasty (TKA) in unit comparing them with earlier audit 1986, which had revealed infection rates 4.4% after 471 primary TKAs 15% 23 revision at a mean follow-up 2.8 years. In interim we introduced stringent antibiotic prophylaxis, routine use occlusive clothing within vertical laminar flow theatres 0.05% chlorhexidine lavage during surgery. We followed up 931 69 for 6.5 years (5 8). Patients were...

Our aim in this study was to determine the outcome of hip arthroplasty with regard infection at our unit. Infection after total joint is a devastating complication. The MRC 1984 recommended using vertical laminar flow and prophylactic antibiotics reduce rates. These measures are now routinely used. Between 1993 1996, 1727 primary arthroplasties 305 revision were performed 1567 284 reviewed between five eight years surgery by means postal questionnaire, telephone interview or examination...

Background: Hemiarthroplasty and total hip arthroplasty are commonly used to treat displaced intracapsular fractures of the femoral neck, but each has disadvantages optimal treatment these remains controversial. Methods: In present prospectively randomized study, eighty-one patients who had been mobile lived independently before they sustained a fracture neck were receive either or hemiarthroplasty. The mean age was seventy-five years. Outcome assessed with use Oxford score, final...

We assessed leg length discrepancy and hip function in 90 patients undergoing primary total arthroplasty before surgery at three 12 months after. Function was measured using the Oxford score (OHS). After mean OHS improved by 26 points after 30 12. operation 56 (62%) limbs were long a of 9 mm this perceived 24 (43%) 18 (33%) The who true lengthening 27% worse than rest population 18% In 55 (98%) patients, occurred femoral component. Appropriate placement component could significantly reduce...

In a prospective study, 60 patients with acute acromioclavicular dislocation were randomly allocated to treatment broad arm sling or reduction and fixation coracoclavicular screw. Of these 54 followed for four years. Conservatively-treated regained movement significantly more quickly fully, returned work sport earlier had fewer unsatisfactory results than those having early operation. For severe dislocations, displacement of 2 cm more, surgery produced better results. Conservative management...

We compared the five- to seven-year clinical and radiological results of metal-on-metal Birmingham hip resurfacing with a hybrid total arthroplasty in two groups 54 hips, matched for gender, age, body mass index activity level. Function was excellent both groups, as measured by Oxford score, but resurfacings had higher University California at Los Angeles scores better EuroQol quality life scores. The arthroplasties revision or intention-to-revise rate 8%, 6%. Both demonstrated impending...

We studied 1162 consecutive total hip replacements (THR) to establish the incidence of fatal pulmonary embolism (PE), clinical non-fatal PE and deep-vein thrombosis (DVT) in six months after surgery. Chemical thromboprophylaxis had not been routinely used. used a validated questionnaire supplemented by post-mortem records review notes. Follow-up was 100%. The death rate from 0.34% (95% CI 0.09 0.88), with one discharge 40 days operation. confirmed imaging 1.20% (CI 0.65 2.02), 0.7% patients...

OBJECTIVE: To evaluate the effectiveness and cost of specially trained physiotherapists in assessment management defined referrals to hospital orthopaedic departments. DESIGN: Randomised controlled trial. SETTING: Orthopaedic outpatient departments two hospitals. SUBJECTS: 481 patients with musculoskeletal problems referred for specialist opinion. INTERVENTIONS: Initial undertaken by post-Fellowship junior surgeons, or working an extended role (orthopaedic physiotherapy specialists). MAIN...

In order to define the predisposing factors and outcome of infected arthroplasty knee, a retrospective analysis consecutive series 471 knee arthroplasties was performed. There were 23 cases superficial wound infection 25 deep infection. Superficial alone resulted in painfree gait, with little limitation movement. Rheumatoid arthritis, use constrained prostheses presence infection, all predisposed Deep eradicated by long-term antibiotics only two patients whom skin cover successfully provided...

We reviewed the seven- to ten-year results of our previously reported prospective randomised controlled trial comparing total hip replacement and hemiarthroplasty for treatment displaced intracapsular fracture femoral neck. Of original study group 81 patients, 47 were still alive. After a mean follow up nine years (7 10) overall mortality was 32.5% 51.2% after hemiarthroplasty, respectively (p = 0.09). At 100 months postoperatively significantly greater proportion patients had died 0.026)....

We studied 50 consecutive patients presenting at an accident department after rear-end vehicle collisions and recorded symptoms psychological test scores within one week of injury, three months two years. The range neck movement was noted months. Within were normal in 82% the group but became abnormal 81% with intrusive or disabling over (p < 0.001) remained 69% clinical outcome years could be predicted 76% accuracy by stiffness, 74% score a combination these variables. severity whiplash...

We reviewed 43 patients who had sustained soft-tissue injuries of the neck after a mean 10.8 years. Of these, only 12% recovered completely. Residual symptoms were intrusive in 28% and severe 12%. Pain lower back was commonest complaint older worse prognosis. After two years, did not alter with further passage time.

We have reviewed 107 patients of 80 years or over who underwent primary total hip replacement. They had many more complications than younger patients. Thus, acute dislocation occurred in 15%, and became chronic 9%; there were femoral shaft fractures 4.6% these, with perforation gave universally poor results. Nevertheless, 75% a satisfactory outcome, worthwhile relief pain. It would seem sensible to warn elderly their relatives the increased risks this age group.

A review of 66 cases and a survey the literature indicates that survival rates around 90% should now be expected from patients with subdural empyema. Factors affecting outcome are discussed. In addition to prompt surgical treatment appropriate antibiotic therapy, most important step seems extensive craniotomy direct removal pus, particularly interhemispheric fissure. Treatment through burr holes is not acceptable. absence culture organisms known sensitivities, chloramphenicol recommended as...

A randomized prospective controlled trial of 155 patients with trochanteric fractures compared the AO dynamic hip screw and Jewett nail plate. The showed significantly less evidence mechanical failure a lower incidence reoperation. implant had no effect on mortality or success rehabilitation. Mortality was associated social dependence before fracture hospital attended. Capacity to return home walk again were mobility age. While fate majority appeared be determined by their state fracture,...

We undertook a prospective, randomised study to compare the analgesic effect of injection steroid and extracorporeal shock-wave therapy (ESWT) for treatment tennis elbow. Group 1 received single 20 mg triamcinolone with lignocaine while group 2 2000 shock waves in three sessions at weekly intervals. After six weeks there was significant difference between groups mean pain score falling from 66 21 compared decrease 61 35 (p = 0.05). months, 84% patients were considered have had successful 60% 2.

Percutaneous repair of the ruptured tendo Achillis has a low rate failure and negligible complications with wound, but sural nerve may be damaged. We describe new technique which minimises risk injury to this nerve.