Introduction

Trochanteric bursitis is described as pain over the lateral side of the hip and thigh. The usual treatment is rest, administration of NSAIDs and injection of local anaesthetic and corticosteroid. Occasionally it is resistant to these measures.

Background: There are no evidence based guidelines on the surveillance of cemented total hip arthroplasty. We reviewed the outcomes of those patients undergoing this procedure in 1996 & 1997.

Methods: The patients were identified from theatre log books. The follow up date was then retrieved from the electronic patient record system used at our institution. From these we recorded the age, sex, side of procedure, evidence of radiological loosening & time of revision surgery. The data with regards to radiological evidence of loosening & revision surgery were then analysed using a ® statistical software package. From this we were able to plot Kaplan-Meier survival & hazard plots.

Results: We identified 425 primary total hip arthroplasties. Using radiological evidence of loosening as the end point we found that there was an initial peak and a peak at 8 years. There was a 10 year survival rate of 85.8%. Using revision surgery as the end point we found that there was, again, an initial peak & a peak at 8 years. There was a 10 year survival rate of 91.5%.

Conclusions: Once the patient has made it through the first post operative year they do not need to be followed up again until 8 years assuming they remain asymptomatic.

The treatment of unstable distal radius fractures remains controversial. Volar locking plates provide stable fixation using the fixed angle device principle. More recently this technique has gained increasing popularity with several reports demonstrating good results. We present our experience from the first 259 patients performed at this institution.

Method: Local Ethics Committee approval was obtained prior to the onset of the study. Theatre records and implant forms were used to recruit all patients in whom a Distal Volar Radius (DVR) Plate, (DePuy, Leeds, United Kingdom) was used for an unstable distal radius fracture between August 2005 and February 2008. Surgery was performed either by a consultant, or a specialist registrar. Two hundred and fifty nine consecutive patients were identified. Six patients had bilateral distal radius fractures. Patient records were reviewed, and each patient contacted via a postal questionnaire and Patient-Rated Wrist Evaluation (PRWE). Other outcome measures included return to work and complication rate.

Results: Of the 259 patients 160 responses were received, response rate 62%. The mean follow up was 30.8 months, (Range 18–48). The mean age of the patients was 57.3 years (Range 16–93). The mean inpatient stay was 1.6 days, (mode 1 day). The median PRWE was 3; (range 0–83) and the mode was 0. Ninety four of the patients had a PRWE of ≤5. Seventy one out of 78 patients (91%) returned to the same job. The mean return to work was 40.6 days (SD37.5).

There were 13 minor complications in total (7.8%). Six patients had extensor tendon irritation, of which two patients required extensor tendon reconstruction. One further patient had a spontaneous EPL rupture which was not associated with prominent metal work. Four (2.4%) patients had median nerve symptoms postoperatively. Two patients subsequently required carpal tunnel decompression, the other two settled spontaneously. Two (1.2%), patients developed Complex Regional Pain Syndrome. One patient developed a minor superficial wound infection.

In all, 9 (5.4%) patients had removal of their metalwork, 6 for tendon irritation, 2 for wrist stiffness (one which was positioned too distally) and 1 for pin penetration into the joint.

Discussion: Our results show that the DVR plate can be used reliably with good results and an early return to high levels of function. This is the largest series to date of the use of this distal volar locking plate.

Background: There are no evidence based guidelines on the surveillance of cemented total hip arthroplasty. We reviewed the outcomes of those patients undergoing this procedure in 1996 & 1997.

Methods: The patients were identified from theatre log books. The follow up date was then retrieved from the electronic patient record system used at our institution. From these we recorded the age, sex, side of procedure, evidence of radiological loosening & time of revision surgery. The data with regards to radiological evidence of loosening & revision surgery were then analysed using a XXX statistical software package. From this we were able to plot Kaplan-Meier survival & hazard plots.

Results: We identified 425 primary total hip arthroplasties. Using radiological evidence of loosening as the end point we found that there was a peak initially and a peak at 8 years. There was a 10 year survival rate of 85.8%. Using revision surgery as the end point we found that there was, again, an initial peak & a peak at 8 years. There was a 10 year survival rate of 91.5%.

Conclusions: Once the patient has made it through the first post operative year they do not need to be followed up again until 8 years assuming they remain asymptomatic.