Background: Chronic renal failure is increasing in prevalence and reported to have deleterious effects on the outcome of total hip arthroplasty (THA). Aim: To investigate the clinical and functional outcomes of THA in patients receiving haemodialysis or who have previously undergone renal transplantation. Methods: Systematic review of the literature using bibliographic databases up to July 2018 to determine the functional outcome, complications and revision rates of THA in patients receiving haemodialysis for end-stage renal failure and those with a previous renal transplant. Results: 25 studies were identified with a total of 797 THAs. 166 patients (20.8%) were receiving haemodialysis and 631 patients (79.2%) had undergone transplantation. All studies reported a marked improvement in hip function following THA. There were 27 failures (15.7% revision rate) in the haemodialysis group and 101 failures (16.0% revision rate) in the transplant group. The revision rate for cemented implants was higher in haemodialysis versus transplant patients (23% vs. 15%), with the converse being true for uncemented implants (3.8% vs. 6.9%). The deep infection rate was higher in the haemodialysis group (10.8% vs. 2.1%). Conclusions: Patients receiving haemodialysis or with a history of renal transplantation can expect good functional outcome following THA. However, the revision rate and deep infection rate are higher than would be expected in patients receiving THA for primary OA. Aseptic loosening is the most common reason for revision. Uncemented implants appear to be associated with lower failure rates both in haemodialysis patients and those who have had a transplant.

Background Radiostereometric analysis (RSA) is the gold standard to measure early implant migration which is a predictive factor for implant survival. Purpose To validate an alternative computed tomography (CT) technique to measure implant migration in shoulder arthroplasty. Material and Methods A cadaver proximal humerus and a scapula, which had tantalum beads incorporated within them, were prepared to accept a short-stemmed humeral component and a two-pegged glenoid component of a commercial total shoulder arthroplasty (TSA) system. A five degree of freedom micrometer and goniometer equipped rig was used to translate and rotate the implant components relative to the respective bone to predetermined positions. Double CT examinations were performed for each position and CT motion analysis software (CTMA) was used to assess these movements. The accuracy and precision of the software was estimated using the rig’s micrometers and goniometers as the gold standard. The technique’s effective dose was also assessed. Results The accuracy was in the range of 0.07–0.23 mm in translation and 0.22–0.71° in rotation. The precision was in the range of 0.08–0.15 mm in translation and 0.23–0.54° in rotation. The mean effective dose for the CT scans was calculated to be 0.27 mSv. Conclusion In this experimental setting, accuracy, precision, and effective dose of the CTMA technique were found to be comparable to that of RSA. Therefore, we believe clinical studies are warranted to determine if CTMA is a suitable alternative to traditional RSA for migration measurements in TSA.

Radiographic examination remains the mainstay of the initial assessment of the young adult hip; however, common parameters are required to assist in the formation of accurate diagnoses and appropriate management plans. This paper aims to summarise the most important aspects of the assessment of plain radiographs performed on the young adult hip joint.

Substantial elevation in GCF levels of MMP-1 and reduction in TIMP-1 were found in periodontitis as compared to healthy subjects. GCF levels of MMP-1 and TIMP-1 improved significantly after treatment.

This article gives a practical guide to the management of supracondylar fractures of the humerus in paediatric patients, from initial presentation to definitive treatment. It reviews the optimal management of this common and serious injury based on current evidence including the British Orthopaedic Association Standards for Trauma (BOAST) 11 standard.