Robert Din

Publications (3)3.63 Total impact

• Article: An unusual cause of pain post ankle arthrodesis in patients with rheumatoid arthritis.

  Neil G Burke, Cathal Moran, Robert Din, James Walsh, William R Quinlan
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  ABSTRACT: Rheumatoid arthritis is an autoimmune disease which frequently affects the ankle and foot. End stage ankle arthritis from rheumatic disease is commonly managed by the established practice of ankle arthrodesis. Among the adverse sequelae causing pain following this surgery is infection, pseudo-arthrosis and non-union. Stress fracture of the distal third is a recognised but unusual cause of pain of tibia following ankle arthrodesis. The authors' present three patients with rheumatoid arthritis who sustained a stress fracture of the distal tibia following arthrodesis, and discuss the contributing factors and highlight the need for orthopaedic surgeons to be suspicious of this complication post surgery.
  The Foot 05/2010; 20(2-3):81-4.
• Article: Skin protection beneath the tourniquet. A prospective randomized trial.

  Robert Din, Tony Geddes
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  ABSTRACT: Complications have been reported as a consequence of tourniquet application. These include skin abrasions, blisters and, breaks. The purpose of the present study was to evaluate the difference in clinical outcome using tourniquets with and without skin protection. A prospective randomized trial was performed on consecutive patients undergoing elective total knee replacement or knee arthroscopy. The patients were randomly allocated to one of three treatment groups: group 1, tourniquet without skin protection; group 2, tourniquet with Soffban skin protection (BSN Medical, Melbourne, Australia); and group 3, tourniquet with the Atlantech skin protection drape (Atlantech Medical Devices, Harrogate, UK). All patients had identical tourniquets, tourniquet pressure and skin sterilization method. At the conclusion of the case, the tourniquet was removed and the skin beneath the tourniquet was inspected and recorded into one of four categories: skin normal, skin abrasions, skin blisters and skin break. One hundred and fifty consecutive eligible patients having a total knee replacement or arthroscopy were included in the present study. There were 82 total knee replacements and 68 knee arthroscopies There were 89 women and 61 men, the mean age was 51 years. No significant difference in patient demographics were found between the groups. The overall skin complication rate was lower in the tourniquet skin protected groups. Total skin complication rate in the non-skin tourniquet protected group was 12 patients out of 50. In the skin protected tourniquet groups, the number of skin complications was six out of 100. This was statistically significant P = 0.0034 (chi2-test). We recommend that lower limb tourniquets should be used with skin protection beneath them.
  ANZ Journal of Surgery 10/2004; 74(9):721-2. · 1.25 Impact Factor
• Article: Medium-term results of the ABG total hip arthroplasty in young patients.

  Konstantinos A Giannikas, Robert Din, Sahzad Sadiq, Timothy H Dunningham
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  ABSTRACT: A total of 66 patients (71 hips) <65 years old (average age, 55.4 years; range, 26-65 years) received a proximally hydroxyapatite-coated femoral prosthesis with a hemispheric metal-backed, hydroxyapatite-coated acetabular cup (ABG hip, Howmedica International, Staines, UK), with an average follow-up of 4.8 years (range, 2-7 years). All operations were performed by 1 surgeon in a district general hospital. The average preoperative Harris hip score and Merle d'Aubigné score were 59.8 and 9.6, which rose to 92.7 and 16.3 at the longest follow-up. Most patients were satisfied with the outcome, with only 2 patients complaining of intermittent thigh pain. Survivorship analysis predicted a survival rate of 96.87% at 7 years. There were 2 revisions, one to reposition an acetabular cup and one for an undersized femoral component. Radiographic changes were consistent with bone remodeling. There were no radiolucencies around the acetabular cup, but we noted eccentric polyethylene wear in 37 (60%) inserts ranging from 0.4 to 4 mm (annual wear average, 0.25 mm/y; range, 0.063-0.76 mm/y). There were no loose femoral stems. Osseointegration was achieved in all cases, with only 1 case developing endosteal cavitation in Gruen zone 2. Cancellous densification was found to be mainly in zones 2 and 6 (67.2% and 55.7%), extending distally in zones 3 and 5 (52.4% and 50.8%). Hypertrophy of the femoral shaft was less prominent and was noted mostly distally, in zones 3, 4, and 5 (11.4%, 18.3%, and 18.3%), extending proximally in zones 2 and 6 (8.1% and 13.1%). The ABG hip can achieve excellent results in the medium term, but polyethylene wear of the acetabular insert should be noted with concern.
  The Journal of Arthroplasty 02/2002; 17(2):184-8. · 2.38 Impact Factor