Objective: To evaluate the treatment outcomes of enchondroma of the hand with artificial bone substitute versus autologous (iliac) bone graft.Design: Historical cohort study.Setting: Tertiary referral centre, Hong Kong.Patients: A total of 24 patients with hand enchondroma from January 2001 to December 2013 who underwent operation at the Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital in Hong Kong were reviewed. Thorough curettage of the tumour was performed in all patients, followed by either autologous bone graft impaction under general anaesthesia in 13 patients, or artificial bone substitute in 11 patients (10 procedures were performed under local or regional anaesthesia and 1 was done under general anaesthesia). The functional outcomes and bone incorporation were measured by QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire) scores and radiological appearance, respectively. The mean follow-up period was 59 months.Results: There were eight men and 16 women, with a mean age of 40 years. Overall, 17 cases involved phalangeal bones and seven involved metacarpal bones. Among both groups of patients, most of the affected digits had good range of motion and function after surgery. One patient in each study group had complications of local soft tissue inflammation. One

No abstract

Background One factor in the long-term survivorship of unicompartmental knee arthroplasty is the accuracy of implantation. In addition to implant designs, the instrumentation has also evolved in the last three decades to improve the reproducibility of implant placement. There have been limited studies comparing mobile bearing unicompartmental knee arthroplasty with contemporary instrumentation and fixed bearing unicompartmental knee arthroplasty with conventional instrumentation. This study aims to determine whether the Microplasty instrumentation in Oxford unicompartmental knee arthroplasty allows the surgeon to implant the components more precisely and accurately. Methods A total of 150 patients (194 knees) were included between April 2013 and June 2019. Coronal and sagittal alignment of the tibial and femoral components was measured on postoperative radiographs. Component axial rotational alignment was measured on postoperative computer tomography. The knee rotation angle was the difference between the femoral and tibial axial rotation. A rotational mismatch was defined as a knee rotation angle of > 10°. Statistical analysis was performed using Student t test and Mann-Whitney nonparametric test. A p value < 0.05 was considered statistically significant in each analysis. Results Between April 2013 to June 2019, 112 patients (150 knees) received Oxford unicompartmental knee arthroplasty, one patient (2 knees) had Journey unicompartmental knee arthroplasty, and 37 patients (42 knees) received Zimmer unicompartmental knee arthroplasty. All femoral components in the Oxford group were implanted within the reference range, compared with 36.6% in the fixed bearing group ( p < 0.001). 88.3% of Oxford knees had tibial component falling within the reference range, whereas 56.1% of knees in the fixed bearing group fell within the reference range ( p < 0.001). 97.5% of Oxford knees had tibial slope that fell within reference range, whereas 53.7% fell within range for fixed bearing group ( p < 0.001). Femorotibial rotational mismatch of more than 10° was noted in 13.8% in Oxford group and 20.5% in fixed bearing group ( p = 0.04). Conclusion In conclusion, Microplasty instrumentation for Oxford mobile bearing unicompartmental knee arthroplasty is more accurate and precise compared to conventional fixed bearing unicompartmental knee arthroplasty in sagittal, coronal, and axial alignment. Prospective studies with long-term follow-up are warranted to investigate the clinical implications.

No abstract

Periprosthetic fracture around total knee arthroplasty (TKA) is a well-described complication. Yet, report of medial tibial plateau stress fracture after unicompartmental knee arthroplasty (UKA) is limited. One case of delayed stress fracture of medial tibial plateau after UKA, which was salvaged by conversion to TKA was reported. To the best of our knowledge, this is the first report related to Zimmer Unicompartmental High Flex Knee system (fixed bearing). The possible reasons were analysed, and tips and tricks to avoid this complication were shared. With reference to our case, osteoporosis should be considered as one of the relative contraindication for UKA. Meticulous surgical technique and avoiding multiple pin holes for tibial tray cannot be overlooked. 中 文 摘 要 圍繞全膝關節置換術(TKA)的假體周圍骨折是一個充分描述的並發症。 然而, 單室膝蓋關節置換術 (UKA) 的內 側脛骨平台應力骨折報告有限。 我們報告了UKA後內側脛骨平台的延遲疲勞性骨折的一例, 其通過轉化為 TKA而被挽救。 據我們所知, 這是與Zimmer半單室人工膝關節置換術系統 (固定軸承) 有關的第一份報告。 我們分析可能的原因, 並分享我們的提示和技巧, 以避免這種併發症再次發生。我們同時也建議考慮對骨質疏 鬆症進行常規篩查, 以防止這種破壞性並發症。關於我們的情況, 骨質疏鬆症應該被認為是UKA的相對禁忌症 之一。 細膩的手術技術, 避免脛骨託的多針孔不容忽視.