Hip and groin injuries are common in athletes participating in high level sports. Adductor muscle tendon injuries represent a small but important number of these injuries. Avulsion injuries involving tendons attaching to the symphysis pubis have previously been described and can be managed both operatively and non-operatively. The aim is to describe a rare variant of this injury; complete avulsion of the adductor sleeve complex including adductor longus, pectineus and rectus abdominus. A surgical technique is then outlined which promotes a full return to pre-injury level of sporting activity. Fifteen high level athletes with an MRI confirmed acute adductor complex avulsion injury (6–34 days) were identified from the institution's sports injury database over a 10 year period. All underwent surgical repair. The operative procedure comprised anatomical attachment of the avulsed tissues in all cases (plus mesh reinforcement of the inguinal wall in 7 patients). All underwent a standard format of rehabilitation which was then individualised to be sport specific.Introduction
Patients/Materials & Methods
Technology in Orthopaedic surgery has become more widespread in the past 20 years, with emerging evidence of its benefits in arthroplasty. Although patients are aware of benefits of conventional joint replacement, little is known on patients' knowledge of the prevalence, benefits or drawbacks of surgery involving navigation or robotic systems. In an outpatient arthroplasty clinic, 100 consecutive patients were approached and given questionnaires to assess their knowledge of Navigation and Robotics in Orthopaedic surgery. Participation in the survey was voluntary.Introduction
Materials & Methods
Infected periprosthetic fractures around total hip arthroplasties are increasingly common and extremely challenging problem. The purpose of the study was to review the experience of two tertiary referral units managing infected periprosthetic femoral fractures using interlocking long-stem femoral prostheses either as temporary functional spacers or as definitive implants. A prospective review of 19 patients managed at two tertiary referral units between 2000 and 2011. Each patient was diagnosed and managed according to similar institutional protocols. Investigation through aspiration and biopsy of periprosthetic tissue supplemented haematological tests to confirm infection. The Cannulock uncoated stem was used in 14 cases, and the Kent hip prosthesis in 5 cases. Allograft struts were used in patients with deficient bone stock. The mean follow-up for the series was a 53 months (range, 24–99 months). 13 patients underwent definitive revision within 7.9 months (range, 6–10 months; SD, 2.2 months). In 6 cases we implanted an extensively porous-coated stem, in 4 cases a tapered distally fixed cementless stem was used, and in 3 cases a proximal femoral replacement was used. There were no reinfections after the second stage revisions in these patients. 2 patients were offered further staged surgery due to persistently raised inflammatory markers but being mobile and relatively painfree declined. They are being managed in the community on oral antibiotics. Satisfactory outcome was noted in all cases, and in 13 cases, revision to a definitive stem was undertaken after successful control of infection and fracture union. The average postoperative Harris Hip score was 83 (range 79–89). All patients returned to their low to moderate premorbid functional state after discharge.Methods
Results
The purpose of this study was to evaluate the functional outcome in the medium and long-term of hip resurfacing in comparison with cementless hip replacement in patients under the age of 55. Eighty patients were enrolled between 1999 and 2002. Twenty-four were randomised (11 hip re-surfacing, 13 total hip replacement), 18 refused hip resurfacing and chose cementless total hip replacement with a 32 mm bearing, 38 insisted on re-surfacing. All the patients have been reviewed at a minimum follow-up of 8 years and a mean of 10.1 years. Patients were assessed clinically and radiographically at one year, five years, eight years and ten years. Outcome measures included EQ 5, SF 36, Oxford, Harris hip, UCLA and UCH scores.Introduction
Methods
Technology in Orthopaedic surgery has become more widespread in the past 20 years, with emerging evidence of its benefits in arthroplasty. Although patients are aware of benefits of conventional joint replacement, little is known on patients' knowledge of the prevalence, benefits or drawbacks of surgery involving navigation or robotic systems. In an outpatient arthroplasty clinic, 100 consecutive patients were approached and given questionnaires to assess their knowledge of Navigation and Robotics in Orthopaedic surgery. Participation in the survey was voluntary.Introduction
Materials and methods
Adductor muscle and tendon injuries are commonly seen in sport. Complete adductor avulsions have been described and can be managed non-operatively or operatively. A rare variant of this injury is the complete avulsion of the adductor complex with the pectineus and rectus abdominus amounting to a complete sleeve avulsion from the pubis. This is a severe injury that is increasingly recognised due to improved imaging and lower diagnostic threshold. We describe the surgical management of twelve athletes with this severe injury.Background
Purpose
