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Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_12 | Pages 19 - 19
1 Nov 2015
Middleton R Findlay I Onafowokan O Parmar D Bartlett G Fern E Norton M
Full Access

Introduction

Open hip debridement surgery has been used for treatment of femoral acetabular impingement pain for over ten years in our unit. While literature has reported promising short term outcomes, longer term outcomes are more sparsely reported. We aim to assess survivorship and functional outcome at ten years, in patients who have undergone open hip debridement.

Patients/Materials & Methods

All patients who had undergone open debridement surgery were identified on our database. The electronic, radiographic and paper records were reviewed. Demographic data, radiological and operative findings were recorded. All patients underwent ten year review with a standardised AP hips radiograph, questionnaire, non-arthritic hip score (NAHS), oxford hip score (OHS) and SF12 score.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_20 | Pages 10 - 10
1 Apr 2013
Lahoti O Findlay I Abhishetty N
Full Access

Purpose of the study

To use a simple way of manipulating Taylor Spatial Frame to achieve soft tissue closure by acute intentional deformation and then gradually achieving anatomical alignment of the fracture without complex deformity and frame parameters.

Methods and end results

10 consecutive cases of Gustillo III B open fractures of tibia and of soft tissue defect due to infected implant were treated with a new technique of acute intentional deformation using Taylor Spatial frame to successfully close the soft tissue defect without plastic surgery. We describe a new simple technique of achieving anatomical alignment of the fracture after creating complex deformity to close the soft tissue defect. We achieved complete full thickness cover of the exposed bone in all cases without plastic surgery and restored the bone to anatomical alignment. Only one patient needed additional Taylor Spatial Frame total residual prescription to correct minor residual deformity.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_7 | Pages 16 - 16
1 Feb 2013
Lahoti O Findlay I Abhishetty N
Full Access

Purpose of the study

To use a simple way of manipulating Taylor Spatial Frame to achieve soft tissue closure by acute intentional deformation and then gradually achieving anatomical alignment of the fracture without complex deformity and frame parameters.

Methods and end results

10 consecutive cases of Gustillo III B open fractures of tibia and of soft tissue defect due to infected implant were treated with a new technique of acute intentional deformation using Taylor Spatial frame to successfully close the soft tissue defect without plastic surgery. We describe a new simple technique of achieving anatomical alignment of the fracture after creating complex deformity to close the soft tissue defect. We achieved complete full thickness cover of the exposed bone in all cases without plastic surgery and restored the bone to anatomical alignment. Only one patient needed additional Taylor Spatial Frame total residual prescription to correct minor residual deformity.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_X | Pages 52 - 52
1 Apr 2012
Findlay I Mahir S Marsh G
Full Access

Male retrograde ejaculation is a well-documented but rare complication of anterior approach lumbar spine surgery. Retraction of the soft tissues which encase the superior hypogastric plexus leads to dysfunction of the sympathetic control of the bladder neck sphincter. We postulated that similar nerve root dysfunction in females may lead to bladder problems and sexual dysfunction.

The Female Sexual Function Index Questionnaire was sent to 20 consecutive women who had undergone anterior spinal surgery by the senior author (GM).

Questionnaires were returned by 11 of the 20 subjects. 6 had undergone disc replacement surgery and 5 anterior lumbar interbody fusion. All procedures used an anterior retroperitoneal approach. The age range was 20 to 49 years (mean 40.2 years). There were no immediate peri-operative complications. The mean time since surgery was 4.9 years (range 3.1 to 5.8 years).

The Female Sexual Function Index is a validated questionnaire used internationally as the gold standard measure of sexual dysfunction in women. Urinary frequency and incontinence were also recorded.

9 women (82%) described a degree of post-operative sexual dysfunction with 7 (64%) recording urinary frequency and urge incontinence.

Although some sexual dysfunction may be expected from pre-existing conditions, we highlight this complication following anterior lumbar spine surgery in females. We plan to further investigate its incidence and possible resolution of symptoms after a prolonged period in a larger case series.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_II | Pages 297 - 297
1 May 2010
Findlay I Miles K East D Apthorp H
Full Access

Introduction: Minimally Invasive Hip surgery has been described using several different surgical techniques. These can be divided into two broad groups, those that utilise smaller incision version of a conventional approach (mini-posterior) and those that use a muscle-sparing technique (direct anterior). The muscle-sparing technique has been promoted as the only true Minimally-invasive Total Hip Replacement (MISTHR) as it intuitively appears more minimally invasive with less soft tissue disruption. We have therefore carried out a prospective analysis of 60 consecutive direct anterior MISTHRs case-matched to 60 mini-posterior MISTHRs.

Materials and Methods: We prospectively analysed 60 consecutive, direct anterior approach patients with case-matched mini-posterior approach patients. Functional outcome was assessed with the Visual Analogue Pain Score (VAS), Merle d’Aubigne Postel (MDP), the Oxford Hip (OHQ) and SF-36 questionnaires at 6 weeks and 6 months post-operatively. Peri-operative blood loss, length of surgery and length of stay were recorded.

Results: (table removed)

Conclusions: Our conclusions are that both approaches are safe, with low complication rates and offer excellent clinical outcomes. However, there is no significant difference between the two approaches justifying the more technically difficult, but muscle-sparing anterior approach.