Background:Mobile bearing knee arthroplasty is an alternative to a fixed bearing knee arthroplasty, we present the results of a retrospective study of a fully congruent, multi-directional mobile bearing knee with a tibial post: the Rotaglide Total Knee System.

Methods: Patients were clinically and radiologically assessed at dedicated follow up clinics. The Hospital for Special Surgery (HSS) and Knee Society Score (KSS) systems were used to describe the clinical and radiological findings. The results were analysed by an independent statistician.

Results: The study group included 88 knees. The Prosthesis had a survival rate of 93,5 % at nine years. It is associated with good rates of patient satisfaction and high scores on the HSS and the KSS System. No knees were revised for aseptic loosening.

Conclusions: This, fully congruent, multidirectional mobile bearing knee replacement has survival equivalent to other prosthesis. It is a safe, reliable prosthesis associated with good clinical outcome.

We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 2.5cm.

Method: The technique is performed using a standard dynamic hip screw set and requires no additional equipment. We compared the results to those of an age and sex matched group who had undergone the operation through a traditional approach. We compared the time spent in theatre, the pre and post-operative haemoglobin concentration, haematocrit, and prevalence of wound infection.

Results: 13 consecutive intertrochanteric hip fractures were treated with a dynamic hip screw and 4-hole plate by one surgeon using the percutaneous technique. There were 9 females and 4 males with a mean age of 84 years (range 62 to 96 years).

The mean post-operative drop in haemoglobin concentration in the percutaneous group was 2.2 g/dl (range 0 to 4.4 g/dl) compared to 3.5 g/dl (range 1.2–5.4) in the control group (p=0.014). The mean haematocrit drop was 0.07 (range 0 to 0.12) in the percutaneous group compared to 0.10 (range 0.03 to 0.17) in the control group (p=0.017)

The mean theatre time with the percutaneous technique was 57 minutes (range 40–75 minutes) and in the control group, 60 minutes (range 30–95). There were no wound problems.

Conclusion: To our knowledge, this technique has not been previously reported. The percutaneous technique offers a better clinical outcome at no extra expense and warrants further evaluation in a larger study

We report a prospective, randomised, controlled trial of the effect of either a non-steroidal anti-inflammatory drug (diclofenac sodium) or physiotherapy on the recovery of knee function after arthroscopy. At 42 days after surgery there was no significant benefit from either form of postoperative treatment compared with the control group. Complications attributable to the anti-inflammatory drug occurred in 9.6% of the patients so treated. Neither the routine administration of a non-steroidal anti-inflammatory agent nor routine physiotherapy is justified after arthroscopy of the knee.

We report a prospective study of 198 cases of subcapital fracture of the femur treated by closed reduction and fixation with a sliding compression screw-plate. This was done without regard to the patient's age or the Garden stage of the fracture. Early weight-bearing was encouraged. Of the displaced fractures 23% failed in the first year because of non-union or infection. Of the fractures which united 27% had developed avascular necrosis after three years. Despite this we believe that the sliding compression screw-plate, of proven value in the treatment of intertrochanteric fractures, is also useful for the fixation of subcapital fractures.