Aims Perthes' disease (PD) is an uncommon childhood condition. Few recent studies have reported the outcomes following non-surgical management of children with PD. Methods This retrospective cohort study investigated the radiological development of an aspherical femoral head and the risk of requiring salvage surgery in these children. An analysis of risk factors was undertaken using age, sex, the Herring

Aims Previous studies have highlighted differences in the risk of periprosthetic fractures (PPFs) in patients undergoing total hip arthroplasty with either a cemented taper slip (TS) stem or a composite beam (CB) stem. This biomechanical study explored the occurrence of PPF around these stems, and the protective effect of adding a 16-gauge prophylactic calcar or diaphyseal wire to the TS stems to increase

Aims Highly cross-linked polyethylene (XLPE) was developed in an attempt to address the problems of wear and osteolysis causing failure in patients who undergo total hip arthroplasty (THA). The aim of this study was to compare the rates of PE wear and revision, and the clinical outcomes of conventional polyethylene (CPE) and XLPE, in a prospective double-blind randomized controlled trial (RCT) with

Aims The aim of this study was to compare the efficacy and safety of biportal endoscopic discectomy (BED) with microdiscectomy (MD) in patients with a single-level lumbar disc herniation, and to determine whether BED gives similar clinical outcomes to MD but with potential additional benefits. Methods Included in this multicentre, prospective, assessor-blind, randomized controlled trial were patients

Aims Dislocation after total hip arthroplasty (THA) is a frequent cause of revision. Patients with intrinsic risk factors have been identified. The use of a dual-mobility (DM) acetabular component has shown great effectiveness in preventing dislocation, with questions regarding selective or absolute use. The aim of this study was to compare the outcome of conventional THA (C-THA) and DM-THA, when used

Aims There have been few studies that have investigated the effect of surgical approach on femoral component version in total hip arthroplasty (THA). The purpose of this study was to investigate the influence of the direct anterior approach (DAA) and the posterior approach (PA) on femoral component version in THA. Methods A retrospective database review of 807 THAs in 807 patients who had both preoperative

Aims The aim of this study was to evaluate the long-term outcomes of computer navigation-assisted resection for primary pelvic bone tumours. Methods Using our prospectively collected oncology database, a retrospective case control study was conducted on 63 patients who underwent computer navigation-assisted resection and 145 patients who underwent non-navigated resection for primary pelvic sarcomas

Aims The surgical options for patients with osteoarthritis (OA) of the patellofemoral joint (PFJ) involve a patellofemoral joint arthroplasty (PFA) or a total knee arthroplasy (TKA). The aim of this study was to describe and compare the safety profile and risk of revision of these two procedures. Methods The records of patients from the UK National Joint Registry who underwent PFA or TKA between April

Aims We set out to determine, when using either the collared Corail cementless stem or the Exeter polished taper-slip cemented stem, the incidence of intraoperative periprosthetic femoral fracture (IOPFF), postoperative periprosthetic femoral fracture (POPFF), and femoral prosthetic fracture. Methods This was a retrospective review of a consecutive series of 11,018 total hip arthroplasties (THAs) over

Aims In the absence of neurological deficits, the decision for surgery in spinal tuberculosis (STB) depends on the individual experiences of the surgeons, which may differ widely. There is currently no universal consensus on an objective definition of instability in STB. The Tuberculosis Spine Instability Score (TSIS) was developed to discriminate between the stable and unstable spine in STB. In the

Aims Musculoskeletal injuries are more common in sub-Saharan Africa than anywhere else in the world, yet there is limited evidence to guide the management of these injuries in low- and middle-income countries. We aimed to evaluate the outcomes of lower limb intramedullary nailing (IMN) for long bone fractures in South Africa and identify predictors of these outcomes. Methods Adults who sustained tibia

Aims Highly cross-linked polyethylene (HXLPE) has reduced wear and revision rates in total hip arthroplasty (THA) in the long term. However, the effect of HXLPE manufacturing characteristics on femoral head penetration has not yet been clearly defined. We report this single-institution study to investigate the clinical and radiological results of various HXLPE liners in THA. Methods Between January

Aims Periprosthetic fractures (PPFs) are a significant complication in total hip arthroplasty (THA), with their incidence varying from 0.1% to 5.2% in registries. The use of a collared femoral stem may reduce the risk of PPF by enhancing the distribution of load and the stability of the implant. The aim of this study was to compare the effect of collared versus collarless stems on the incidence of

Aims It is not unusual for patients, prior to their total hip arthroplasty (THA), to indicate that their symptoms worsen with certain meteorological conditions. However, the prevalence and evolution of weather-related pain (WRP) following THA remain poorly understood. The aim of this study was to investigate the prevalence of WRP both before and after primary THA, assess the impact of THA on pre-existing

Aims Periprosthetic joint infections (PJIs) represent a significant complication of total knee arthroplasty (TKAs). However, the influence of drug or beta-lactam (BL) antibiotic allergy labelling of patients on PJI remains largely unknown. In this study, we examine the association between patients labelled with a BL allergy and the occurrence of PJI among patients undergoing TKA. We also assess the

Aims Megaprostheses are commonly used in patients with primary bone tumours or metastases. The identification of loosening of megaprostheses in these patients using conventional radiography can be difficult. The use of CT-based Implant Motion Analysis (IMA) has been shown to identify loosening of conventional hip prostheses with great accuracy. The aim of this study was to investigate the accuracy

Aims The aim of this study was to report the implant survival, quality of life, and patient-reported outcome measures (PROMs) in a cohort of adolescent patients who underwent total hip arthroplasty (THA). Methods This was retrospective review of all adolescent patients treated with THA in a single centre. Survival was estimated using the Kaplan-Meier method. Hip-specific PROMs included the Oxford Hip

Aims As the number of patients who undergo total joint replacement as an outpatient continues to increase, it is essential that the safety and efficacy of this form of treatment is maintained. The aim of this study was to examine the outcome in a series of very obese patients who underwent total hip arthroplasty (THA) as an outpatient. Methods A prospective database was used to identify 381 patients

Aims The aim of this study was to assess the variations in the positioning of components between sides in patients who underwent staged bilateral total hip arthroplasty (THA), and whether these variations affected patient-reported outcome measures (PROMs). Methods A retrospective review included 207 patients who underwent staged bilateral THA between June 2017 and November 2022. Leg length, the height

Aims The aim of this study was to determine the values for knee torsion in healthy knees, and explore predictive thresholds of torsion in grades of the J-sign in patients with recurrent dislocation of the patella. Methods A five-year prospective study was conducted involving healthy volunteers and patients with recurrent dislocation of the patella. The knees of the patients were categorized into four

Aims While obesity is associated with an increased risk of complications after total hip arthroplasty (THA), the relationship between BMI and the risk of early postoperative complications has not been fully characterized. This study sought to describe the relationship between BMI and the risk of early postoperative complications, including periprosthetic joint infection (PJI), and composite surgical

Aims The length of time for which children, who are treated successfully for developmental dysplasia of the hip (DDH) in a Pavlik harness should be followed up, remains uncertain. The aim of this study was to examine whether children who are treated in this way, who have normal clinical and radiological findings at the age of two years, can be safely discharged from routine follow-up. Methods Data

Aims This study aimed to report the surgical techniques and early clinical results of robotic arm-assisted acetabular reconstruction in revision total hip arthroplasty (THA). Methods Between October 2019 and May 2021, we used the Mako robotic system to perform 62 revision THAs at our hospital. This study included 54 patients who underwent robotic arm-assisted revision THA for acetabular reconstruction

Aims Perthes' disease is a hip disorder that presents in childhood but can lead to diminished quality of life (QoL) in adulthood from hip deformities and secondary arthritis. Little is known about adult outcomes following total hip arthroplasty (THA) from the patient's perspective. We employed a web-based survey to gather data on treatment history, demographic details, and patient-reported outcome

Aims Previous research on knee kinematics has demonstrated that achieving a tibial joint line angle (TJLA) parallel to the floor in the single-leg stance phase of gait may restore native knee kinematics and optimize compartmental compressive loads in total knee arthroplasty (TKA). However, it is currently unclear which surgical alignment strategy best achieves this. Therefore, this study sought to

Aims To evaluate the impact and risk factors of robotic-assisted surgery (RAS) on noise generation in total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) bearings in comparison to conventional (CON) manual methods. Methods A secondary analysis of a prospective multicentre randomized controlled trial - conducted from June 2021 to July 2022 - included 74 patients with CoC bearings, equally divided

Aims This study reports the outcome of a modern total knee arthroplasty design using a cementless tibial baseplate compared to the full-cemented version. Methods Consecutive cohorts with 12-month follow-up were evaluated. Patients receiving a cementless tibial baseplate were compared to those who received a cemented tibial component. Endpoints included revision rates and reason for revision, patient-reported

Aims Hip hemiarthroplasty is a common procedure in the treatment of intracapsular displaced femoral neck fractures. Modular hemiarthroplasties have a separate stem, neck, and head component which gives the surgeon more combinations to try and accurately recreate the patient's original hip geometry. Despite regular use, little is known regarding susceptibility to metal-on-metal debris wear in this specific

Aims Contemporary outcomes of total femoral arthroplasties (TFAs) in the non-oncological setting are limited. This study aimed to assess implant survival free from revision and reoperation, clinical outcomes, and radiological results associated with TFAs for non-oncological conditions. Methods We identified 24 patients who received TFAs between 1 January 2007 and 31 December 2021 through our institutional

Aims Mixed clinical results have been reported following the use of lateral unicompartmental knee arthroplasty (UKA) in patients with isolated lateral compartment osteoarthritis (OA) of the knee. Although this procedure may be appropriate for use in about 10% of knees needing arthroplasty, it is only used in about 1%. The aim of this study was to determine the medium-term results for the Fixed Lateral

Aims Treatment using bone-anchored prostheses (BAPs) with press-fit femoral osseointegration implants (OIs) has been used in patients with lower limb amputations for more than two decades. The development of these OIs has enabled treatment in patients with a short transfemoral and a transtibial amputation. The aim of this follow-up study was to report the safety of this treatment at five years postoperatively

Aims Delirium is common in hip fracture patients, but large-scale routine data studies examining the prevalence and associations of delirium at the time of initial presentation with a hip fracture are rare. This study aimed to describe the prevalence and outcomes of delirium on initial presentation with a hip fracture in a large national population sample. Methods This study analyzed routinely collected

Aims Guidelines for treatment of posterior malleolar fragments (PMFs) in trimalleolar fractures are scarce, mainly based on retrospective studies, and show varying advice. The need for fixation of smaller (< 25%) PMFs remains particularly controversial. This study aims to evaluate the superiority of fixation of medium-sized PMFs versus no fixation of the fragment. Methods A multicentre randomized controlled

Aims Periprosthetic joint infection (PJI) is a devastating complication of arthroplasty, with substantial morbidity, mortality, and healthcare costs. Despite advances in diagnosis and treatment, inconsistencies in outcome reporting have hindered evidence synthesis, limiting progress in understanding and management. This study aimed to develop a core outcome set (COS) for PJI to standardize outcome

Aims Functional alignment (FA) and adjusted mechanical alignment (aMA) are recognized techniques for performing total knee arthroplasty (TKA). The native femur rolls back further on the lateral tibial plateau than the medial side during flexion, resulting in a medial pivot pattern of movement. We have assessed whether an individualized alignment technique affects the kinematic pattern observed and

Aims The use of patient-reported outcome measures (PROMs) to assess the outcome after total knee (TKA) and total hip arthroplasty (THA) is increasing, with associated regulatory mandates. However, the robustness and clinical relevance of long-term data are often questionable. It is important to determine whether using long-term PROMs data justify the resources, costs, and difficulties associated with

The last five years have seen notable advancements in foot and ankle surgery as a result of technical innovations and more consistent reporting of results. Much progress has been made in improving patient-reported outcome measures, in the development of basic research in this area, and in the development of personalized approaches which optimize outcomes for specific groups of patients. This review

Aims The T1 pelvic angle (T1PA) provides a consistent global measure of sagittal alignment independent of compensatory mechanisms and positional changes. However, it may not explicitly reflect alignment goals that correlate with a lower risk of complications. This study assessed the value of T1PA in achieving sagittal alignment goals in patients with an adult spinal deformity (ASD). Methods Patients

Aims The risk of mortality after a hip fracture has been extensively investigated, but there is little high-quality information available dealing with the overall risk of complications. The aim of this study was to report the risk of complications in the first 120 days after a hip fracture. Methods This was a multicentre, prospective cohort study of patients aged > 60 years with a hip fracture, involving

Aim One of the most common patient-reported complaints following intramedullary nailing (IMN) of tibial shaft fractures is anterior knee pain reported by 10% to 80% of patients. The present study aimed to compare the 12-month Knee injury and Osteoarthritis Outcome Score (KOOS) sport and recreation activities subscale (sport/rec) scores after IMN with external ring fixation (RF) to adult patients with

Aims Soft-tissue sarcomas (STSs) are rare cancers with centralized care advocated to consolidate resources and expertise. However, geographical challenges, particularly in countries like Canada, can increase travel distances for patients. The impact of travel distance on sarcoma presentation and outcomes remains unclear, particularly in single-payer healthcare systems with centralized care. Methods

Aims Unicompartmental knee arthroplasty (UKA) is one option in the treatment of isolated unicompartmental advanced osteoarthritis (OA). While long-term results exist for medial mobile-bearing (MB) UKA, evidence regarding lateral MB-UKA is still limited. The Oxford Domed Lateral (ODL) implant aims to reduce the bearing dislocation rate in lateral MB-UKA through enhanced bearing entrapment. However,

Aims Adult spinal deformity (ASD) surgery can reduce pain and disability. However, the actual surgical efficacy of ASD in doing so is far from desirable, with frequent complications and limited improvement in quality of life. The accurate prediction of surgical outcome is crucial to the process of clinical decision-making. Consequently, the aim of this study was to develop and validate a model for

The use of arthroscopy of the hand and wrist has recently increased sharply in the elective setting and this, not surprisingly, has been followed by an increasing use in the trauma setting. Advocates for the use of arthroscopy in these patients cite the improved assessment of the displacement and reduction of fractures and the early diagnosis of associated injuries, while others temper this with concerns

Aims Core decompression is a commonly performed procedure to treat osteonecrosis of the femoral head (ONFH) prior to femoral head collapse. The aim of the study was to identify the incidence of hip arthroplasty after core decompression and the potential risk factors for conversion through a nationwide population-based study. Methods Patients who received core decompression for ONFH between 1 January

Aims The primary objective of this study was to compare short-term implant survival between cemented and cementless fixation for the mobile-bearing Oxford medial unicompartmental knee arthroplasty (UKA) across various age groups. The secondary objectives were to compare modes of failure and to evaluate patient-reported outcomes. Methods A total of 25,762 patients, comprising 8,022 cemented (31.1%)

Aims The aim of this study was to examine the indications for further surgery and the characteristics of the patients within one year of medial unicompartmental knee arthroplasty (mUKA), providing an assessment of everyday clinical practice and outcomes in a high-volume country. Methods All mUKAs which were performed between 1 April 2020 and 31 March 2021 and underwent further surgery within one year

Hip fractures commonly occur in older patients, with high levels of frailty and comorbidity. Many of these patients have limited mobility before their fracture, and even after surgery, their mobility may remain limited. It is therefore not surprising that they are at a high risk of developing pressure sores, particularly on their heels, and a variety of devices and interventions have been proposed

Aims The aim of this study was to assess the necessity of revising the acetabular component in revision total hip arthroplasty (THA) in patients with a Vancouver type B2 periprosthetic femoral fracture (PFF) who require revision of the femoral component. The hypothesis was that revision of both the acetabular and femoral components and using a dual-mobility acetabular component would provide a lower

Aims The Birmingham Orthopaedic Oncology Meeting (BOOM), held in January 2024, convened 309 delegates from 53 countries to discuss and refine 21 consensus statements on the optimal management of chondrosarcoma. Methods With representation from Europe (43%; n = 133), North America (17%; n = 53), South America (16%; n = 49), Asia (13%; n = 40), Australasia (5%; n = 16), the Middle East (4%; n = 12),

Aims Sagittal lumbar pelvic alignment alters with posterior pelvic tilt (PT) following total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH). The individual value of pelvic sagittal inclination (PSI) following rebalancing of lumbar-pelvic alignment is unknown. In different populations, PT regresses in a linear relationship with pelvic incidence (PI). PSI and PT have a direct relationship

Aims Worldwide controversy exists on the optimal treatment of stable dysplastic hips. The most common treatment options are abduction brace treatment and active surveillance. The primary aim of this study was to assess the effect of active surveillance in stable hip dysplasia, by investigating the percentage of Graf IIb stable dysplastic hips that recover spontaneously without abduction brace treatment

Aims Radiostereometric analysis (RSA) is considered the gold standard for in vivo migration analysis, but CT-based alternatives show comparable results in the shoulder and hip. We have previously validated a CT-based migration analysis method (CTMA) in a knee phantom compared to RSA. In this study, we validated the method in patients undergoing total knee arthroplasty (TKA). Our primary outcome measure

Aims The aim of this study was to assess the incidence of reinfection in patients after two-stage revision of an infected megaprosthesis (MPR) implanted after resection of a bone tumour. Methods A retrospective study was carried out of 186 patients from 16 bone sarcoma centres treated between January 2010 and December 2020. The median age at the time of tumour diagnosis was 26 years (IQR 17 to 33);