Publications (3)5.05 Total impact
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ABSTRACT: Despite improvements in implant technology and surgical technique, failure of total hip arthroplasty (THA) remains a persistent problem. This article reports clinical outcomes at a mean follow-up of 42 months using the Restoration cone/conical modular femoral revision stem (Stryker, Newbury, United Kingdom). A prospective cohort study was performed of 46 consecutive patients who underwent revision THA between January 2004 and June 2007. Patients were reviewed pre- and postoperatively at regular intervals for clinical and radiological assessment. Forty-six patients (17 men, 29 women) with a mean age of 72 years (range, 44-93 years) were observed for a mean of 42 months (range, 28-66 months). Indications for surgery included aseptic loosening/osteolysis (38/46 [83%]), periprosthetic fracture (4/46 [9%]), and infection (4/46 [8%]). Median time from index procedure was 16 years (range, 1-26 years). No patient was lost to follow-up. Two patients (4%) with well-fixed asymptomatic stems died during follow-up. Three patients (7%) sustained an early postoperative dislocation. One patient sustained a periprosthetic fracture after a fall. This was treated by osteosynthesis, and stem revision was not required. Mean Oxford Hip Score improved from 42 points (range, 24-57 points) to 28 points (range, 18-51 points) at 3-month follow-up (P=.003). Median stem subsidence was 1.0 mm (standard error of the mean, ±1.7 mm; range, 0-7mm) at last follow-up. No patient developed loosening or osteolysis around the stem. The Restoration femoral revision system has favorable clinical and radiological outcomes at a mean follow-up of 42 months.Orthopedics 01/2011; 34(1):11. · 2.66 Impact Factor
Article: A prospective comparison of two treatment options for tuberosity fractures of the proximal fifth metatarsal.[show abstract] [hide abstract]
ABSTRACT: Tuberosity 'avulsion' fractures of the proximal fifth metatarsal are common injuries, but with few comparisons of conservative treatment options. This study prospectively compared two commonly used conservative treatment methods. 37 patients were allocated to treatment in either a plaster slipper (n=20) or tubi-grip support (n=17) for a period of 6 weeks. Patients were assessed at 2, 6 and 12 weeks after injury using a modified foot score which measured the level of pain and dysfunction. A radiograph was taken at 12 weeks. A Mann-Whitney U test compared median foot scores between the treatment groups at each review (p-value of 0.05 or less was deemed significant). A significantly (p=0.02) better foot score was measured in the plaster group at 2 weeks after injury (median score 68 (plaster group) compared to 57 (tubi-grip group)). However by the 6- and 12-week stages, the scores were comparable. Radiographs indicated two patients in each group with no clear evidence of union after 12 weeks. One patient remained symptomatic and required surgical treatment. The eventual clinical and radiological outcomes were comparable. During the initial 2 weeks, patients treated in plaster had a better-combined level of pain and function.The Foot 09/2008; 18(3):156-8.
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ABSTRACT: We evaluated the potential use of the Hemocue (Hemocue AB, Sweden) portable hemoglobinometer on the 1st postoperative evening after major joint arthroplasty. We compared hemoglobinometer values with conventional Coulter counter laboratory analysis in a population of 67 patients. The hemoglobinometer proved practical, economical, and accurate in general, although 2 outlying values were severe enough as potentially to influence clinical decision making. Potential causes and solutions are discussed.The Journal of Arthroplasty 03/2002; 17(2):224-6. · 2.38 Impact Factor