Background: A recent report has suggested that local injection of botulinum toxin type is an effective method treatment for chronic tennis elbow. The thought to provide temporary paralysis the painful common extensor origin, thereby allowing a healing response occur. To test this theory, we performed double-blind, randomized, controlled, pilot trial comparing injections with those placebo (normal saline solution) in Methods: Forty patients history elbow which all conservative measures,...

The following suture materials have been evaluated for their suitability use in flexor tendon repairs: 4/0 gauge monofilament and multifilament stainless steel, mono-filament nylon, polypropylene, polybutestor, braided polyester, polyglycolic acid a polyglyconate. These were investigated tensile strength (both knotted unknotted), extension to failure knot-holding properties. Stainless steel polyglyconate appeared be the most suitable that they had high strengths, both unknotted, good...

Introduction Four-corner arthrodesis with excision of the scaphoid is an accepted salvage procedure for scapholunate advanced collapse (SLAC) and nonunion (SNAC) has been performed in our unit over 20 years. We have undertaken a retrospective review 116 these procedures 110 patients between 1992 2009. Fifty-eight attended clinical evaluation, 29 responded by postal questionnaire. Methods The surgical technique was standard. That is, through dorsal approach tip radial styloid were excised....

The aim of this study was to ascertain the long-term revision rates Universal 2 wrist prosthesis in a previously published cohort patients with rheumatoid arthritis. time to, and reasons for were determined. Radiographs analysed determine whether loosening had occurred according Wrightington zonal classification loosening. Seventy-eight wrists from original 85 could be identified analysis. longest follow-up 16 years 29 beyond 10 years. Seventeen been revised or on waiting list revision, an...

This is a prospective case review on 100 MatOrtho proximal interphalangeal joint arthroplasties in 50 patients with previously published 2-year outcomes. We report the outcomes at minimum of 10-years’ follow-up. Sixty-three implants 29 were available for analysis. The visual analogue scale score pain revealed significant improvement 10 years (mean 0.7, SD 1.3) compared preoperatively 4.3, 0.8) and 2 1.1, 1.8). There was no statistically mean grip strength (10, 6.7), range motion (27°,...

We present our experience of using a metal-backed prosthesis and autologous bone graft to treat gross glenoid deficiency.A prospective cohort study the first 45 shoulder arthroplasties SMR Axioma Trabecular Titanium (TT) with graft. Between May 2013 December 2014, were carried out in 44 patients mean age 64 years (35 89). The indications 23 complex primary arthroplasties, 12 revise hemiarthroplasty or resurfacing, five for aseptic loosening glenoid, infection.Of patients, 16 had anatomical...

The in vivo forces human digital flexor tendons were determined 33 patients undergoing a carpal tunnel decompression surgery using newly developed device. tested passive and active flexion, flexing against resistance of up to 500 g. Forces the range 0.2 50 N noted. Whilst mean these remained below force normally required dehisce fresh modified Kessler repair, values was such that we would only recommend early movement with great caution under supervision.

Background: A recent report has suggested that local injection of botulinum toxin type is an effective method treatment for chronic tennis elbow. The thought to provide temporary paralysis the painful common extensor origin, thereby allowing a healing response occur. To test this theory, we performed double-blind, randomized, controlled, pilot trial comparing injections with those placebo (normal saline solution) in Methods: Forty patients history elbow which all conservative measures,...

We have implanted 76 biaxial total wrist prostheses as a primary procedure in patients with rheumatoid arthritis of the wrist. A 66 was reviewed at mean follow-up time 52 months. Pain relieved 67% surviving replacements. On basis Hospital for Special Surgery scoring system, 49 wrists (74%) were graded fair to excellent. More than half 27 who had an arthrodesis on contralateral would preferred second arthroplasty. Five replacements revised or fused because loosening and further nine showed...

We undertook a radiological analysis of 186 standard Souter implants to determine survivorship and analyse the pattern failure in those needing revision. The had been inserted as primary procedure patients with rheumatoid arthritis elbow at our hospital over last 12 years. Taking revision an endpoint, after years was 87%. If, however, loosening, defined Hindex value equivalent demarcation 1 mm around whole implant, are also included, falls 80%. Of 24 revised, 18 (75%) were for problems...

Background We report on the medium- to long-term results of a randomized controlled trial (RCT) aiming determine whether rotator cuff repair confers any advantage over arthroscopic sub-acromial decompression (ASAD) alone in management medium-sized tears. Methods Ethical approval was sought follow-up patients previously enrolled completed and published RCT comparing outcome ASAD with mini-open for treatment tear. Forty-two were original study, mean 64 years (range 54 77 years). Results...

Two groups of patients with symptomatic Osgood-Schlatter disease were compared over a 4-5 year follow-up period. One group was treated surgically by tibial sequestrectomy and the other managed conservatively. Tibial found to offer no significant benefit simple conservative methods treatment. In addition, complication rate identified this procedure.

A finger prosthesis consisting of a Cobalt-chromium (CoCr) proximal component and an Ultra-high-molecular-weight-polyethylene (UHMWPE) medial (both mounted on hydroxyapatite coated stems) was evaluated to 5,000,000 cycles in vitro simulator. One “test” cycled through flexion-extension (90°–30°) with dynamic load 10 N, whilst immersed lubricant dilute bovine serum. Additionally, static 100 N applied for 45 s every 3000 simulate gripping force. second “control” the same account absorption....

Postoperative traction, using the "S" Quattro external fixation device, improved initial correction in 17 of 18 fingers treated by limited fasciectomy for severe proximal interphalangeal joint contracture Dupuytren's disease. Unfortunately significant recurrence occurred eight within 1 year and only five maintained function. Complications included infection, loosening, recurrence, stiffiness amputation.

Resurfacing of the humeral head is commonly used within UK to treat osteoarthritis (OA) shoulder. We present results a small prospective randomised study this procedure using Global CAP prosthesis with two different coatings, Porocoat and DuoFix hydroxyapatite (HA). followed groups ten patients OA shoulder for years after insertion tantalum marker beads, recording pain, Constant–Murley American Shoulder Elbow Surgeons (ASES) outcome scores, radiostereometric analysis assess migration. The...

Sternoclavicular joint injuries represent 5% of all to the shoulder complex. We report a safe and reproducible technique for reconstruction anterior sternoclavicular dislocations, employing synthetic graft using unicortical with minimal dissection joint.

Background: The MatOrtho implant is a cementless, mobile-bearing surface arthroplasty with cobalt–chromium metal-on polyethylene articulation designed to treat osteoarthritis of the PIP joint. Early results for prosthesis inserted through dorsal approach have demonstrated good pain relief but no significant improvement in range motion. In an attempt improve motion senior author has changed his surgical practice inserting via lateral approach. purpose this study assess outcome change...