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William J Hart

Publications and source records attributed to William J Hart.

4 recordsLinked to original sources

Wear debris associated with a large lateral femoral condyle cyst following an Oxford medial unicompartmental knee replacement.

A 63-year-old gentleman presented with a history of worsening left knee pain almost 5 years following bilateral uni-compartmental knee replacements. X-Rays revealed a fracture of the medial tibial plateau and revision surgery was undertaken. A large cyst was found in the lateral femoral condyle, which extended from the weight bearing area in the lateral compartment to the margin of the trochlea. Histology of the lesion revealed a central degenerate cyst with multiple particles of polyethylene and cement debris around its periphery. Cyst progression in association with wear debris is a rare problem following unicompartmental knee replacement. The findings at the time of revision in this case demonstrate that the complications of unicompartmental arthroplasty may affect all compartments of the knee.

Arthroplasty, Replacement, Knee↗

Arthroscopic observation of capsulolabral reduction after shoulder dislocation.

The standard treatment for most first-time anterior shoulder dislocations is reduction and immobilization. This places the arm in a position of adduction and internal rotation. We question whether this position assists or hinders reduction of a displaced capsulolabral injury (Bankart lesion). This study examined the pathology present after traumatic first-time anterior shoulder dislocations and looked at the reduction of the Bankart lesion in internal and external rotation. A series of 25 patients with Bankart lesions were identified who underwent arthroscopy at a mean of 10.5 days after first-time anterior shoulder dislocations. We found that there is wide variation in pathology after anterior dislocation. In 23 of 25 patients in whom the capsulolabral complex was detached (Bankart lesion), we found that external rotation of the arm improved the reduction of the labrum (92%). We conclude that in patients with a displaced Bankart lesion, the standard treatment of immobilization in internal rotation may hinder anatomic healing of this injury.

Adolescent↗