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Biomedical subjects

A J Edge

Publications and source records attributed to A J Edge.

10 recordsLinked to original sources

Hydroxyapatite-ceramic-coated femoral stems in revision hip surgery.

We describe the clinical and radiological results of 120 consecutive revision hip replacements in 107 patients, using the JRI Furlong hydroxyapatite-ceramic-coated femoral component. The mean age of the patients at operation was 71 years (36 to 92) and the mean length of follow-up 8.0 years (5.0 to 12.4). We included patients on whom previous revision hip surgery had taken place. The patients were independently reviewed and scored using the Harris hip score, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the Charnley modification of the Merle d'Aubigné and Postel score. Radiographs were assessed by three reviewers for the formation of new bone, osteolysis, osseointegration and radiolucent lines in each Gruen zone. The mean Harris hip score was 85.8 (42 to 100) at the latest post-operative review. The mean WOMAC and Merle d'Aubigné and Postel scores were 34.5 and 14.8, respectively. The mean visual analogue score for pain (possible range 0 to 10) was 1.2 overall, but 0.5 specifically for mid-thigh pain. There were no revisions of the femoral component for aseptic loosening. There were four re-revisions, three for infection and one for recurrent dislocation. Radiological review of all the femoral components, including the four re-revisions showed stable bony ingrowth and no new radiolucent lines in any zone. Using revision or impending revision for aseptic loosening as an end-point, the cumulative survival of the femoral component at ten years was 100% (95% confidence interval 94 to 100). We present excellent medium- to long-term clinical, radiological and survivorship results with the fully hydroxyapatite-ceramic-coated femoral component in revision hip surgery.

Adult↗

Hydroxyapatite ceramic-coated femoral stems in young patients. A prospective ten-year study.

We describe the clinical and radiological results of 38 total hip replacements (THR) using the JRI Furlong hydroxyapatite-ceramic (HAC)-coated femoral component in patients younger than 50 years. The mean age at the time of operation was 42 years (22 to 49) and the mean length of follow-up was ten years (63 to 170 months). All patients receiving a Furlong HAC THR were entered into the study regardless of the primary pathology including patients who had undergone previous hip surgery. The mean Harris hip score improved from 44 before operation to 92 at the last post-operative review. After 12 years the cumulative surivival for the stem was 100% (95% confidence interval 89 to 100). No femoral component was revised. Our results show that the Furlong HAC implant gives excellent long-term results in young patients with high demands.

Adult↗

Outcome following a second hip fracture.

Hip fracture has a significant impact on medical resources and patient morbidity and mortality. Few patients admitted with a hip fracture are considered for prophylactic measures aimed at the reduction of further fracture risk. Currently, 10-13% of patients will later sustain a second hip fracture. In considering the possible role of prophylactic measures in the prevention of second hip fracture, we investigated whether second hip fracture has a significant further impact on patients' mobility and social independence. We also sought to identify a pattern to second hip fracture that may allow targeting of those patients who are most likely to benefit from currently available prophylactic measures. We undertook a retrospective review of 49 consecutive patients admitted with a second hip fracture between August 1999 and September 2000. Fewer patients maintained their ability to walk independently after the second fracture than did so after the first (53 and 91% respectively, P<0.0005). Following second hip fracture, patients' level of mobility determined their future social independence. Older patients and those with a history of multiple falls had a shorter time interval between fractures. Second hip fracture has a significant further impact on patients' mobility and social independence. Younger patients and those without a history of multiple falls are most likely to benefit from medical prophylaxis.

Aged↗

Pasteurella multocida infection of a total hip arthroplasty following cat scratch.

Pasteurella multocida is a well recognized cause of sepsis following animal contact particularly bites and scratches. Spread to prosthetic joints may occur particularly in immunocompromised patients. Immunocompromised patients with prosthetic joints should be warned that animals are potential sources of serious infection and urgent medical advice should be sought if bitten or scratched.

Animals↗

Lateral mass fusion. A prospective study of a consecutive series with long-term follow-up.

A prospective study of a consecutive series of lateral mass fusion operations was undertaken between 1972 and 1982 in 144 patients, of whom 129 were available for review. The main indications for operation were persistent back pain associated with spondylolisthesis, localized degenerative disease of the lumbar spine and previous laminectomy and disc excision. The minimum follow-up was 2 years. Although 83% of patients were improved overall, the results in spondylolisthesis and degenerative disease without previous surgery were much better than in those who had previously had disc excision. A pseudarthrosis was found in 13% of patients and was significantly more likely (P less than 0.05) when fusion at more than one level was attempted. There were no serious long-term complications.

Adolescent↗

External fixation for complicated tibial fractures.

An account is given of 38 patients with complicated tibial fractures who were treated by the Portsmouth method of external fixation. Twenty-one patients had multiple injuries and 30 had compound fractures of the tibia. Eighteen fractures wounds were infected, 17 cases required bone grafts and 13 had skin grafts. Thirty-four fractures united in an average time of six months; three patients underwent below-knee amputations; one with neurofibromatosis remains ununited. Those treated primarily by external fixation did better than those in whom external fixation was used after failure of another method. Most fresh fractures united with external callus; and the significance of this in relation to the rigidity of fixation is discussed. The method is easy to use, effective and economical. Improvements to permit adjustment of position and testing for union are suggested. We advise the use of this method of external fixation as the primary treatment for complicated tibial fractures where there is a significant risk of infection or non-union.

Adolescent↗

The Portsmouth method of external fixation of complicated tibial fractures.

A New method of external fixation for complicated fractures of the tibia is described. The use of acrylic cement to secure the tibial transfixing pins to the external bar and the ability to apply compression across the fracture site are the salient features of this technique, which is simple to use and inexpensive.

Bone Nails↗