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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_6 | Pages 1 - 1
1 May 2019
Watkins C Ghosh K Bhatnagar S Rankin K Weir D Hashmi M Holland J
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Background

Total hip arthroplasty (THA) in patients with congenital dysplasia of the hip (CDH) is complex and challenging. The Crowe and Hartofilakidis classification systems are the most commonly used. However, neither encompasses the whole spectrum of disease and deformity and therefore does not guide modern surgical options.

We present a new classification system which aims to guide surgical strategy by focusing on the three main areas of disease and deformity: Cup defect; De-rotation of femoral neck ante-version; Height of femoral subluxation. Each component is graded from 1–3 based on the severity of deformity and the potential surgical strategy required (with 3 being the most severe). A total numerical score will reflect the overall degree of difficulty which may be used when assessing surgical outcomes.

The aim of this study is to assess the reliability of this new adult CDH classification system in the setting of THA.

Study design and Methods

A sample size calculation showed 28 evaluations were required to reach a power of 85% (based on a kappa value of 0.4). The anterior-posterior pelvis and lateral hip radiographs of 30 hips, in 26 patients were evaluated by three Consultant Orthopaedic Surgeons using the classification detailed in table 1. A second evaluation, with the case order randomised, was performed after a minimum period of 1month. Randolph's free multi-rater Kappa co-efficient was used to assess for inter and intra- observer reliability and 95% confidence intervals were calculated.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_20 | Pages 24 - 24
1 Apr 2013
Haughton BA Kadakia A Watkins C Moran K Booty L Shetty A Lateef A
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Introduction

Recent UK national guidelines advocate using a combination of mechanical and pharmacological VTE prophylaxis in patients undergoing lower limb arthroplasty. We compared the results from our two series of patients: one treated with clexane and the other treated with rivaroxaban.

Methods

Both groups received mechanical prophylaxis. In the first group 89 patients were given 40 mg subcutaneous clexane once daily from the day prior to surgery until they were independently mobile. The second group comprised 99 patients who were given 10 mg of oral rivaroxaban.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 36 - 36
1 Jan 2013
Kadakia A Haughton B Watkins C Moran K Booty L Shetty A
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Introduction

Recent UK national guidelines advocate using a combination of mechanical and pharmacological VTE prophylaxis in patients undergoing lower limb arthroplasty but do not recommend one particular pharmacotherapy over another.

Objectives

We compared the results from our two series of patients: one treated with clexane and the other treated with rivaroxaban, with respect to average length of stay, postoperative wound leakage, readmission within 30 days of surgery and re-do surgery