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Purpose: The aim of this study was to determine the survival rate, the causes of failure, and the functional outcomes of an all-polyethylene tibial unicompartmental knee prosthesis., Methods: One hundred (100) nonselected, consecutive patients indicated for unicompartmental knee replacement for isolated medial knee compartment osteoarthritis by a single surgeon at a single institution from 2000 to 2004 were included in this study. Data was collected retrospectively at final follow-up from the hospital electronic database, including progress notes, demographic information, Hospital for Special Surgery (HSS) Knee Score, details on the surgical procedure, reoperations/revisions, and mortality. A survival analysis was performed to estimate the probability of survival over time., Results: The survival probability of the all-polyethylene UKA implant was 95.4 % after a mean follow-up of 8 years, which is comparable to reports from studies using metal-backed modular designs for UKA. The causes of failure were progression of arthritis in adjacent compartments (2 %) and loosening of the tibial component (2 %). The mean preoperative HSS knee score improved from 36.6 ± 14.3 to 76.6 ± 21.6 at latest follow-up (p < 0.0001)., Conclusions: In summary, an all-polyethylene tibial component has equivalent survivorship to modular designs. Implant selection does not seem to have great influence on the outcome, but rather the success depends on appropriate indications and surgical technique.

Purpose: Managing a deficient acetabulum in patients with developmental dysplasia of the hip (DDH) can be challenging. The purpose of the study was to determine the mid-term results of total hip arthroplasty (THA) using a bulk structural autograft for reconstruction of the acetabular roof in patients with DDH., Methods: Between 1982 and 1999, 112 patients underwent THA with acetabular roof-plasty using a bulk structural autograft for secondary osteoarthritis related to DDH. A total of 106 patients (115 hips) met inclusion criteria and were followed for an average of 11.6 years (seven to 24 years). The mean age was 52.5 years at the index operation. Clinical and radiological evaluations were performed according to the methods of Merle d'Aubigné and Postel, Johnston et al. and DeLee and Charnley., Results: The overall Merle d'Aubigné hip score significantly improved (3.7 vs 10.4, p < 0.01). The limb length discrepancy decreased from 30 to 6 mm (p < 0.01). The average distance that the hip centre was distalised was 22.3 mm (0-56 mm). However, radiolucent lines were observed in 27 % of patients at final follow-up, and the overall rate of revision for aseptic loosening was 16 %. Further, Kaplan-Meier survivorship curves predicted a rapid increase in the failure rate at 15 years., Conclusions: The mid-term functional outcome of THA with an acetabular roof-plasty using a bulk autograft is satisfactory; however, the long-term results are questionable.

Purpose: Several techniques for chronic distal biceps tendon repair have been reported; however, the literature is sparse., Methods: Seven male patients who underwent chronic distal biceps tendon reconstruction were retrospectively evaluated. All patients had significant retraction necessitating the use of an allograft for reconstruction. The procedure was done through a single incision using suture anchors and a tibialis anterior allograft. In each case, the graft was first fixed to the radial tuberosity with suture anchors, and then the allograft was sutured to the remnant of the native biceps tendon at 60° of elbow flexion. Patients were evaluated with the Mayo Elbow Performance Score (MEPS), Disabilities of Arm, Shoulder and Hand (DASH) scores and elbow range of motion (ROM)., Results: The average time from injury to surgery was 25 (12-56) weeks, and the average follow-up was 16 (minimum 12) months. Average postoperative elbow ROM was as follows: extension 4° (0-12°), flexion 134° (130-140°), pronation 82° (75-85°) and supination 80° (70-85°); average MEPS was 94 (80-100); average DASH score was 6.67 (0-19.8). One patient developed a lateral antebrachial cutaneous neuritis postoperatively that resolved by three months., Conclusion: Though many reported techniques for chronic distal biceps tendon repair achieve satisfactory outcomes with limited complications, we present a technique with theoretical advantages of a single incision, use of suture anchors, use of a tibialis anterior allograft and tensioning after attachment of the graft to the radial tuberosity. In a series of complicated patients, early results were good to excellent.

Purpose: Unicompartmental knee arthroplasty (UKA) has a faster short-term recovery than total knee arthroplasty (TKA). The purpose of this study was to determine the feasibility and safety of performing outpatient UKAs in a consecutive group of patients presenting with unicompartmental knee osteoarthritis., Methods: A total of 105 consecutive patients underwent unicompartmental arthroplasty before noon with the intention of being discharged as an outpatient. All patients followed an established rapid recovery pathway to facilitate a same-day discharge. Post-operative complications and hospital readmissions were retrospectively recorded for all patients at one week and at three months after surgery., Results: All of the 105 patients (100 %) indicated for outpatient UKA could be discharged home on the same day of surgery. No patients required readmission within the first week post-operatively, while one patient required readmission between week one and week 12. The single patient who required readmission developed a post-operative infection requiring irrigation/debridement with polyethylene liner exchange and intravenous antibiotics., Conclusion: Using an established, multidisciplinary, rapid recovery protocol, outpatient UKA is safe and feasible in the vast majority of patients.

Introduction: Total ankle arthroplasty is increasingly used as an alternative to arthrodesis to treat advanced ankle arthritis. However, the outcomes and postoperative complications are poorly described., Patients and Methods: Between March 2005 and May 2010 114 S.T.A.R. prostheses were implanted by one surgeon at our institution. We retrospectively analysed the demographics, clinical outcomes and radiographic characteristics of 100 ankle prostheses (97 patients)., Results: The average follow up was 36 months. The average preoperative AOFAS score of 36.87 (22-58) significantly increased to 75.99 postoperative. A total of 87 % of the patients reported a better life quality. Twenty-seven ankles incurred complications after primary surgery, and 21 prostheses required revision surgery, including four patients who required arthrodesis., Conclusion: Our study shows a high satisfaction rate after total ankle replacement and clear pain relief. Patients with a body mass Index higher than 30 showed a higher rate of complications. Compared with ankle fusion, the rates of complications are comparable.