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Answers to CME questions based on the Mini-Symposium on “Children’s Hip Disorders”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Tags: CME Section Source Type: journals

CME questions based on the Mini-Symposium “Revision Hip Surgery”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Tags: CME Section Source Type: journals

Safer surgery: how a checklist can make orthopaedic surgery saferEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: “Medicine today has entered its B-17 phase. Substantial parts of what hospitals (do) ……. are now too complex for clinicians to carry them out reliably from memory alone.” 6In January 2007 the World Health Organization (WHO) began a programme aimed at improving the safety of surgical care globally. The initiative, called “Safe Surgery Saves Lives” aimed to identify minimum standards of surgical care that could be universally applied across countries and settings. One component of the initiative was the introduction of a peri-operative checklist.In February 2009 the National Patient Safety Agency (NPSA)...
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Mark Emerton, Sukhmeet S. Panesar, Kirsty Forrest Tags: Principles Source Type: journals

Shoulder arthroscopy, anatomy and variants – part 2Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: In part 1 of this article we have described the history of shoulder arthroscopy and its current indications. We introduced concepts useful in the execution and interpretation of shoulder arthroscopy and introduced some technical tips to help those starting out, or developing their expertise, in this surgical skill. In part 2 we will focus on the range of findings that arthroscopy can yield, which can at first be daunting and confusing. The spectrum of normal findings is quite wide and substantial experience is needed simply to recognise what is within this spectrum and what should be considered pathological. Furt...
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Simon Boyle, Manuel Haag, David Limb, Laurent Lafosse Tags: Shoulder Source Type: journals

Nail-patella syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the latest scientific information available and high-lights the key features. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Charlotte Jones, Donna Diamond, Rouin Amirfeyz, Martin Gargan Tags: Syndrome Source Type: journals

Arthroscopic powered instruments: a review of shavers and burrsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the types of blades and burrs available and the principles underlying the mechanism of how they work. A better understanding of the subject should hopefully make the surgery easier and also minimize the potential damage these instruments can cause. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: S. Singh, A. Tavakkolizadeh, A. Arya, J. Compson Tags: Basic Science Source Type: journals

(vii) Management of periprosthetic fractures in the lower limbEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article outlines the principles of the management of periprosthetic fractures of the lower limb. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Panos Makrides, Harpal Singh Uppal, Steve Krikler Tags: Mini-Symposium: Revision Hip Surgery Source Type: journals

(vi) Management of periprosthetic infection in total hip arthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Total hip arthroplasty (THA) is one of the most commonly preferred orthopaedic procedures. Although the rate of deep infection after primary hip arthroplasty is relatively low, the economic burden, associated morbidity and mortality make it potentially devastating. Because of an ageing population will need an increasing number of arthroplasties, prevention, diagnosis and treatment of infection must be optimised in order to reduce both direct and indirect costs to patients and healthcare systems. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: M.T.S. Sukeik, F.S. Haddad Tags: Mini-Symposium: Revision Hip Surgery Source Type: journals

(v) The management of dislocation in hip arthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article concentrates on the assessment and surgical management of hip instability following THA. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: R. Yarlagadda, S.A. Jones Tags: Mini-Symposium: Revision Hip Surgery Source Type: journals

(iv) Reconstruction and revision of femoral failure in revision hip arthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Suitable techniques for femoral reconstruction and revision are dependent on the status of femoral bone stock. The pre-operative planning and operative strategies utilised increase in complexity as the bone stock diminishes. The options range from proximal to distal fixation techniques using cemented or cementless prostheses. Bone stock augmentation in the form of impacted morcellised or structural strut allografts may be required. In the most severe cases bone stock may need to be restored with bulk allograft or restored with a mega-endoprosthesis.A structured reconstruction cascade discussing these options is p...
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Alexander Acornley, Robin Banerjee, Robert Kerry Tags: Mini-Symposium: Revision Hip Surgery Source Type: journals

(iii) Reconstruction/revision of acetabular failure in revision hip replacementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Reconstruction of the acetabulum following acetabular failure in hip arthroplasty presents a wide array of challenges. The extent of bone loss present at revision may require a number of different potential techniques, aiming wherever possible to restore bone stock to that of the primary arthroplasty situation. Gaining primary implant stability is the key to success for all revision methods. Success rates are generally inferior to primary hip arthroplasty, and more so the greater the loss of bone stock. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Peter W. Howard Tags: Mini-Symposium: Revision Hip Surgery Source Type: journals

(ii) Implant removal in revision hip surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Implant removal is a major part of revision hip surgery. A complication, such as fracture or perforation during implant removal, more common in the presence of surrounding osteopenia, can compromise subsequent reconstruction. Similarly, care must be taken to avoid additional bone loss during implant removal. Various techniques are available on both the femoral and acetabular sides that can facilitate the procedure. Recent developments in instrumentation can prove helpful.In this article the techniques are reviewed. In addition, the importance of pre-operative planning and exposure is discussed. The techniques use...
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Andrew R.J. Manktelow Tags: Mini-Symposium: Revision Hip Surgery Source Type: journals

(i) Evaluation of a painful total hip replacementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the aetiology and evaluation of persisting pain after total hip replacement. A thorough history and physical examination and appropriate investigation can determine the cause of the painful total hip replacement in most patients, allowing appropriate treatment. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Authors: Ardeshir Y. Bonshahi, Anil K. Gambhir Tags: Mini-Symposium: Revision Hip Surgery Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - October 1, 2009 Category: Orthopaedics Source Type: journals

Answers to CME questions based on the Mini-Symposium on “Imaging for Joint Replacement”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Tags: CME Section Source Type: journals

CME questions based on the Mini-Symposium “Orthopaedic Oncology”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Tags: CME Section Source Type: journals

Shoulder arthroscopy, anatomy and variants - part 1Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article therefore describes the technicalities of shoulder arthroscopy and introduces the many structures that are encountered. In part 1 we will discuss the indications for arthroscopy and the process of setting up and performing the procedure in a clinical setting, with useful concepts and technical tips. In part 2 we will move on to discuss the range of findings that can be encountered, both normal and pathological, as correct recognition is critical to safe subsequent management. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Simon Boyle, Manuel Haag, David Limb, Laurent Lafosse Tags: Shoulder Source Type: journals

The use and abuse of locking platesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The concept of locking plates is now more than 15 years old and represents a clear advance in the management of fractures by internal fixation using plate technology. Fractures in osteoporotic bone, fractures with short metaphyseal segments and fractures treated with biological fixation are all better managed with lockable plates. There are, of course, additional and unique problems that arise from their use.Locking plates evolved through the recognition that in order to get a fracture to heal quickly and satisfactorily it was not always necessary to achieve rigid internal fixation and absolute stability. The bio...
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Paul Szypryt, Daren Forward Tags: Trauma Source Type: journals

Ollier’s disease and Maffucci syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Enchondromata are benign cartilaginous tumours which arise in intramedullary bone, predominantly affecting the metaphyses of long bones. Lesions can occur in isolation or at numerous sites, with the latter termed multiple enchondromatosis. Ollier’s disease (WHO terminology), named after French surgeon Louis Ollier who first reported on the condition in 1898, is defined as the presence of multiple enchondromata with predominantly unilateral distribution. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Sean Fang, Donna Dimond, Rouin Amirfeyz, Martin Gargan Tags: Syndromes Source Type: journals

Charcot Marie Tooth DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Charcot Marie Tooth (CMT) disease was first described in 1886. It describes a spectrum of genetic disorders that affects peripheral nerves, either by slowing action potential transmission along the axons, or by reducing the amplitude, or both.It is this variety of underlying genetic findings and subtleties of clinical presentation that has resulted in the varying nomenclature over the years. Patients with CMT commonly present to orthopaedic surgeons with lower and upper limb symptoms including ankle sprains, cavus feet and weakness of the intrinsic hand muscles. More rarely, they present with spinal and hip manif...
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: D.W.J. Howcroft, S. Kumar, N. Makwana Tags: Adult Pathology Source Type: journals

Management of articular cartilage defectsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: This paper discusses the management of articular cartilage defects. Osteochondral defects (OCD) may be traumatic or degenerative in origin. Arthroscopic surgery is the gold standard diagnostic and therapeutic tool for the management of OCD. The management of OCD remains controversial and over the last five decades various treatment options and surgical techniques have been tried to maximise the clinical outcome. In this article we review the current practice of management of OCD. We also highlight the most recent approaches and research and look to the future of management of OCD. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Ehab Kheir, David Shaw Tags: Basic Science Source Type: journals

(v) The non-surgical management of musculoskeletal malignancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Metastatic bone disease is a common clinical problem that requires a multidisciplinary approach in order to reduce patient suffering and maintain quality of life. Almost all patients with metastatic bone disease will have incurable cancer and this needs to be remembered when considering how to treat these patients. Conversely primary musculoskeletal cancers are rare conditions that need to be managed by specialist centres. Multimodality treatment is needed which may last for many months and may be associated with considerable toxicity. Patients with localised disease can possibly be cured but those with sarcoma r...
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Claire Esler Tags: Mini-symposium: Orthopaedic Oncology Source Type: journals

(iv) Management of benign bone tumoursEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Benign primary bone tumours are rare, occurring most commonly in skeletally immature patients, arising from cartilage or bone. The commonest locations are the distal femur, proximal tibia and proximal humerus. They present with pain, swelling or pathological fracture. Diagnosis is by plain x-rays, MRI scans and a core needle biopsy if indicated. More aggressive tumours may appear radiologically to be similar to malignant tumours. Treatment depends on the anatomical location, symptoms, the natural history of the tumour and the morbidity of treatment and in most cases involves either simple excision or curettage al...
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Rob Pollock Tags: Mini-symposium: Orthopaedic Oncology Source Type: journals

(iii) The management of soft-tissue sarcomasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Soft-tissue sarcomas are a heterogeneous group of malignant tumours of connective tissue. The investigation, diagnosis and treatment of these rare tumours should be co-ordinated by specialist multi-disciplinary teams. Here we discuss the surgical principles involved in the management of these tumours, and explore the literature on surgical margins and adjuvant treatment. The management of local and systemic recurrence and prognosis are discussed and the evidence base reviewed. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Thomas B. Beckingsale, Craig H. Gerrand Tags: Mini-symposium: Orthopaedic Oncology Source Type: journals

(ii) Investigation of musculoskeletal malignancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Diagnosis and assessment of the extent of tumour burden are key to managing musculoskeletal malignancy to avoid the risk of inappropriate treatment when palliation would be appropriate. This review sets out the principles of investigating suspected musculoskeletal malignancies for the non-specialist with a focus also on the musculoskeletal imaging rather than oncological staging. It is not intended to be a comprehensive review of all musculoskeletal malignancies. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Robert U. Ashford, K. Julia Fairbairn Tags: Mini-symposium: Orthopaedic Oncology Source Type: journals

(i) Epidemiology of bone and soft-tissue sarcomasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the epidemiology of bone and soft-tissue sarcomas and highlights its relevance with regard to sarcoma diagnosis and the potential development of new treatments. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Authors: Benjamin J.F. Dean, Duncan Whitwell Tags: Mini-symposium: Orthopaedic Oncology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - July 31, 2009 Category: Orthopaedics Source Type: journals

Answers to CME questions based on the Mini-Symposium on “What’s new in hip replacement — basic principles”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Tags: CME Sections Source Type: journals

CME questions based on the Mini-Symposium on “Children's Hip Problems”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Tags: CME Sections Source Type: journals

Why do joints swell?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Orthopaedic surgeons see patients with effusions in joints very frequently. The reasons why effusions occur in joints, and sometimes remain in joints, requires an understanding of the physiology of production of synovial fluid, and the ways in which it enters and leaves joints. Most orthopaedic surgeons do not understand the basic physiology of this common clinical sign, and this article attempts to answer the question of “why do joints swell?”. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: Les Grujic, Sydney Nade Tags: Science and Symptoms Source Type: journals

Computer assisted hip resurfacingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article is a review of the characteristics of computer assisted navigation systems which aim to achieve best possible alignment of the femoral head surface replacement in relation to the individual head-neck axis. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: Wolfram H. Kluge Tags: Hip Arthroplasty Source Type: journals

The management of spastic equinus in cerebral palsyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Equinus of the foot is the most common deformity in children with spastic cerebral palsy. Patients with cerebral palsy who are able to walk may have different problems because of an equinus deformity. They may have a clumsy gait and often stumble, fall and suffer injuries. Secondary hip and knee deformities, forefoot callosities and pain, shoe fitting problems and excessive wear on shoes are common. The treatment of equinus is either nonoperative or operative. Nonoperative treatment is indicated in dynamic equinus, during the fast-growth phase of a child's development. The most favourable results can be expected ...
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: Goran Cobeljic, Marko Bumbasirevic, Aleksandar Lesic, Zoran Bajin Tags: Children Source Type: journals

Current concepts in articular cartilage repairEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Our knowledge of articular cartilage pathophysiology has advanced hugely in the last 20 years. Although once thought of as a structure incapable of intrinsic repair, we now have a selection of treatment options available in clinical practice, which we can use to attempt to reproduce the specific zonal architecture and mechanical composition of hyaline cartilage. This review will focus on the structure and function of articular cartilage, the aetiology of cartilage injury, and how the disease process can be investigated and treated. Different treatment options will be described providing an up to date review of th...
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: A. Getgood, T.P.S. Bhullar, N. Rushton Tags: Musculoskeletal Tissues Source Type: journals

Ætiology of extraosseous wrist ganglia; the published evidenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Ganglia represent the most common soft-tissue tumour in the hand. They usually occur singly and although they arise in specific locations, they have been reported to arise from almost every joint of the hand and wrist. The ætiology of ganglia remains controversial. They may develop from connective tissue by myxoid degeneration and disintegration of collagen fibres. However, there is no evidence in the literature to support trauma as an ætiologic factor. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: A.J. Thurston Tags: Wrist Source Type: journals

Facioscapulohumeral muscular dystrophy assessment and treatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Facioscapulohumeral dystrophy (FSHD), is a muscular dystrophy that classically affects the shoulder girdle and facial muscles. It should be considered in the differential diagnosis of patients presenting with limb girdle weakness. Progression is usually slow, and the condition is rarely fatal. Treatment is mostly supportive, although a number of patients can be helped with scapulo-thoracic fusion. This paper summarises the current understanding of this form of muscular dystrophy. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: Samuel J. Parsons, Andrew McMurtrie, Stephen Cooke, Birender Balain, David Jaffray Tags: Syndrome Source Type: journals

Biofilm and orthopaedic practice: the world of microbes in a world of implantsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Biofilms are complex communities of surface-attached micro-organisms made up of single or multiple species. They grow in three stages, attachment of bacteria to the substratum followed by bacterial growth and division and then colonization of the surrounding area and the formation of the biofilm. While the basic mechanisms of biofilm-associated antimicrobial resistance are understood, research continues into biofilm- associated antimicrobial resistance. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: Spyridon P. Galanakos, Stamatios A. Papadakis, Konstantinos Kateros, Ioannis Papakostas, George Macheras Tags: Basic Science Source Type: journals

(iv) Slipped upper femoral epiphysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The incidence of slipped upper femoral epiphysis is 10 per 100 000 in the age groups most at risk. The commonest presenting features include groin, thigh, or knee pain, with limp, hip ‘irritability’, external rotation, and restriction of flexion and abduction. In girls the peak incidence is between 10 and 13 and in boys between the ages of 12 and 15. Most cases are idiopathic and associated with a high body mass index. Slips usually occur through the proliferative and hypertrophic zones of the growth plate. The chief complications are avascular necrosis and chondrolysis. The treatment of a slip is usually b...
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: Richard J. Montgomery Tags: Mini-symposium: Children's Hip Problems Source Type: journals

(iii) Developmental dysplasia of the hipEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Developmental dysplasia of the hip (DDH) is a spectrum of pathologies affecting the infant hip ranging from asymptomatic subtle radiographic signs through mild instability to frank dislocations with an abnormal acetabulum.Patients with developmental hip dysplasia account for around 10% of all primary hip arthroplasties, and around 30% in those under sixty. Early detection and appropriate management can prevent or delay the requirement for total hip replacement.In this article we aim to provide a broad overview of the aetiology, natural history, pathology and management of developmental dysplasia of the hip. (Sour...
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: Benjamin Holroyd, John Wedge Tags: Mini-symposium: Children's Hip Problems Source Type: journals

(ii) Surgical approaches to the hip in childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The relevant anatomical structures around the hip are considered in relation to medial, anterolateral and posterior approaches to the joint. Paediatric conditions that make this surgical facility necessary include developmental dysplasia and dislocation of the hip, septic arthritis, slipped upper femoral epiphysis and the removal of benign tumours and loose bodies. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: M.F. Macnicol Tags: Mini-symposium: Children's Hip Problems Source Type: journals

(i) Irritable hip and septic arthritis of the hipEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Transient synovitis needs to be differentiated from septic arthritis of the hip when a child presents with features of an irritable hip. Although there is considerable overlap in the clinical presentation of the two conditions, the natural history, treatment strategy and potential range of outcomes are quite distinct. While transient synovitis is a self limiting condition, emergent surgical intervention in the form of arthrotomy and wash out of joint is the mainstay of treatment of septic arthritis. Clinical decision algorithms have been developed using a combination of clinical and laboratory parameters to help ...
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Authors: M. Padman, B.W. Scott Tags: Mini-symposium: Children's Hip Problems Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - May 31, 2009 Category: Orthopaedics Source Type: journals

Answers to CME questions based on the Mini-Symposium on “Osteoporosis”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Tags: CME Section Source Type: journals

CME questions based on the Mini-Symposium on “Imaging for Joint Replacement”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Tags: CME Section Source Type: journals

Patello-femoral arthrosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Patello-femoral arthrosis is common but poorly understood and its pathophysiology and even clinical significance remain controversial. The aetiology, diagnosis and management are reviewed. To achieve a successful treatment outcome it is vital to differentiate between global and patello-femoral knee arthrosis, requiring careful clinical and radiological assessment before selecting appropriate treatment for each patient. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Authors: F. Rayan, F.S. Haddad Tags: Knee Source Type: journals

Stress fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Stress fractures are a major cause of morbidity in the athletic and military population. Long distance running and female sex are major risk factors. Clinicians must have a high index of suspicion as early diagnosis and treatment is crucial. Provocative tests such as one-foot hopping are helpful in diagnosis. MRI (or isotope bone scanning) is much more useful than plain radiography. Treatment is usually by avoidance or modification of the stressful activity, but some fractures may need internal fixation and possibly bone grafting. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Authors: Mark R. Philipson, Paul J. Parker Tags: Trauma Source Type: journals

Hip pain in young adults and the role of hip arthroscopyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The spectrum of recognisable hip conditions has broadened significantly over the past five years through improved imaging techniques and hip arthroscopy. Hip arthroscopy may increasingly provide new treatment options for the plethora of hip pathologies. Femoro-acetabular impingement (FAI), a condition relatively unknown until its introduction by Ganz, is now thought to be the most common cause of hip pain in the young adult with an incidence around 10–15% of the population. FAI is responsible for labral tears and chondral injuries and there is growing evidence that it is a precursor of osteoarthritis. Although ...
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Authors: Ernest Schilders, Alexandra Dimitrakopoulou, J. Charles Talbot, Quamar Bismil Tags: Adult Hip Source Type: journals

Radiology quizEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Authors: Asha Ramakrishnan, Philip Robinson Tags: Quiz Source Type: journals

Is infection inevitable in some arthroplasty patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Infection is a rare complication of arthroplasty surgery, yet the consequences of such an event lead to significant costs both in terms of finance and patient morbidity. This review describes the current literature examining a possible genetic link between post-surgical infections, cytokines and polymorphisms in the gene encoding the acute phase protein mannose binding lectin. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Authors: R.J. Langley, D.I. Rowley Tags: Arthroplasty Source Type: journals

Lumbar pars injury or spondylolysis – diagnosis and managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Lumbar pars injury or spondylolysis is a unique lesion occurring only in human beings representing a stress fracture of the pars interarticularis and occurs most commonly at L5. Symptoms of low back pain relating to this lesion are more common in young athletes involved in trunk twisting sports. Diagnosis is dependent on plain radiography, computed tomography (CT) scan and magnetic resonance imaging (MRI) scans. Unilateral pars defect are less common than bilateral defects and run a more benign course. Treatment is dependent on symptoms as well as radiographic stage of the lesion. Conservative management is the m...
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Authors: Ujjwal K. Debnath, N. Harshavardhana, Brigitte E. Scammell, Brian J.C. Freeman Tags: Spine Source Type: journals

(iii) CT and MRI of hip replacementsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Computed tomography (CT) and magnetic resonance imaging (MRI) are now useful imaging techniques in the evaluation of hip arthroplasty. The recognised problems of beam hardening in CT and magnetic susceptibility artefact in MRI have been significantly reduced.MRI is useful for assessing the peri-prosthetic soft tissues and in evaluation of the painful replacement with normal plain films.CT is better than plain films in evaluating bone stock around a hip replacement. (Source: Orthopaedics and Trauma)
Source: Orthopaedics and Trauma - April 1, 2009 Category: Orthopaedics Authors: John G. Cahir, Andoni P. Toms Tags: Mini-symposium: Imaging for joint replacement Source Type: journals