Search Results
Academic Department of Trauma and Orthopaedics, LGI, University of Leeds, Leeds, UK
Leeds Teaching Hospitals Trust, UK
Search for other papers by Sohail Nisar in
Google Scholar
PubMed
Search for other papers by Jeya Palan in
Google Scholar
PubMed
The Lister Hospital, Chelsea Bridge, London, UK
Centre de l’Arthrose - Clinique du Sport, Bordeaux-Mérignac, France
Search for other papers by Charles Rivière in
Google Scholar
PubMed
Search for other papers by Mark Emerton in
Google Scholar
PubMed
Leeds Teaching Hospitals Trust, UK
Search for other papers by Hemant Pandit in
Google Scholar
PubMed
-
Kinematic alignment (KA) is an alternative philosophy for aligning a total knee replacement (TKR) which aims to restore all three kinematic axes of the native knee.
-
Many of the studies on KA have actually described non-KA techniques, which has led to much confusion about what actually fits the definition of KA.
-
Alignment should only be measured using three-dimensional cross-sectional imaging. Many of the studies looking at the influence of implants/limb alignment on total knee arthroplasty outcomes are of limited value because of the use of two-dimensional imaging to measure alignment, potentially leading to inaccuracy.
-
No studies have shown KA to be associated with higher complication rates or with worse implant survival; and the clinical outcomes following KA tend to be at least as good as mechanical alignment.
-
Further high-quality multi-centre randomized controlled trials are needed to establish whether KA provides better function and without adversely impacting implant survival.
Cite this article: EFORT Open Rev 2020;5:380-390. DOI: 10.1302/2058-5241.5.200010
Search for other papers by Feng Xie in
Google Scholar
PubMed
Search for other papers by Shuya Sheng in
Google Scholar
PubMed
Search for other papers by Jeya Palan in
Google Scholar
PubMed
Search for other papers by Hemant G Pandit in
Google Scholar
PubMed
-
This paper discusses the existing literature in the field of metal-on-metal (MoM) hip resurfacing arthroplasty (HRA), the background (why was it developed), the past (what was the evidence leading to its rise and fall in clinical use), the present situation (why a potential resurgence), and the future directions for potential improvements.
-
All literature relevant to MoM HRA was reviewed and summarized to provide a comprehensive summary. Furthermore, a detailed literature search was performed on PubMeD, MEDLINE, and Google Scholar to identify all clinical studies reporting a minimum 10 years of outcomes for modern MoM HRA devices from February 2018 to February 2023.
-
In addition, joint registry data over the same time period, available in the public domain, was examined to extract related information on MoM HRA.
-
Metal ions are present in almost all types of hip replacement; on the whole, however, the risk of revision for resurfacing due to metal-related pathologies is very low, but higher than in other types of bearings.
-
There are studies that show that some brands of MoM resurfacing prostheses have achieved excellent clinical outcomes in long-term follow-up studies and are still in use although less commonly than in early 2000s.
-
Use of alternative bearing surfaces has demonstrated excellent results in the short-term and a very critical long-term follow-up of these cases still will help establish their place in the hip arthroplasty world.
-
HRA deserves a permanent place in the armamentarium of orthopedic surgeons and in the hand of experienced surgeons.
Search for other papers by Ashoklal Ramavath in
Google Scholar
PubMed
University of Leeds, Leeds, UK
Search for other papers by Jonathan N. Lamb in
Google Scholar
PubMed
Search for other papers by Jeya Palan in
Google Scholar
PubMed
University of Leeds, Leeds, UK
Search for other papers by Hemant G. Pandit in
Google Scholar
PubMed
Search for other papers by Sameer Jain in
Google Scholar
PubMed
-
The rising incidence of postoperative periprosthetic femoral fracture (PFF) presents a significant clinical and economic burden.
-
A detailed understanding of risk factors is required in order to guide preventative strategies.
-
Different femoral stems have unique characteristics and management strategies must be tailored appropriately.
-
Consensus regarding treatment of PFFs around well-fixed stems is lacking, but revision surgery may provide more predictable outcomes for unstable fracture patterns and fractures around polished taper-slip stems.
-
Future research should focus on implant-related risk factors, treatment of concurrent metabolic bone disease and the use of large endoprostheses.
Cite this article: EFORT Open Rev 2020;5:558-567. DOI: 10.1302/2058-5241.5.200003
Search for other papers by Mehnoor Khaliq in
Google Scholar
PubMed
Search for other papers by Vasileios P Giannoudis in
Google Scholar
PubMed
Search for other papers by Jeya Palan in
Google Scholar
PubMed
Search for other papers by Hemant G Pandit in
Google Scholar
PubMed
Search for other papers by Bernard H van Duren in
Google Scholar
PubMed
-
Patients undergoing planned or unplanned orthopaedic procedures involving their upper or lower extremity can prevent them from safe and timely return to driving, where they commonly ask, ‘Doctor, when can I drive?’ Driving recommendations after such procedures are varied. The current evidence available is based on a heterogenous data set with varying degrees of sample size and markedly differing study designs.
-
This instructional review article provides a scoping overview of studies looking at return to driving after upper or lower extremity surgery in both trauma and elective settings and, where possible, to provide clinical recommendations for return to driving.
-
Medline, EMBASE, SCOPUS, and Web of Science databases were searched according to a defined search protocol to elicit eligible studies. Articles were included if they reviewed adult drivers who underwent upper or lower extremity orthopaedic procedures, were written in English, and offered recommendations about driving.
-
A total of 68 articles were included in the analysis, with 36 assessing the lower extremity and 37 reviewing the upper extremity. The evidence available from the studies reviewed was of poor methodological quality. There was a lack of adequately powered, high quality, randomised controlled trials (RCTs) with large sample sizes to assess safe return to driving for differing subset of injuries.
-
Many articles provide generic guidelines on return to driving when patients feel safe to perform an emergency stop procedure with adequate steering wheel control.
-
In future, RCTs should be performed to develop definitive return to driving protocols in patients undergoing upper and lower extremity procedures.
