ABSTRACT
OBJECTIVES: The purpose of this study was to evaluate the existing literature from 2005 to 2016 reporting on the efficacy of surgical management of patients with femoroacetabular impingement (FAI) secondary to slipped capital femoral epiphysis (SCFE). METHODS: The electronic databases MEDLINE, EMBASE, and PubMed were searched and screened in duplicate. Data such as patient demographics, surgical technique, surgical outcomes and complications were retrieved from eligible studies. RESULTS: Fifteen eligible level IV studies were included in this review comprising 261 patients (266 hips). Treatment groups included arthroscopic osteochondroplasty, surgical hip dislocation, and traditional open osteotomy. The mean alpha angle corrections were 32.14° (standard deviation (sd) 7.02°), 41.45° (sd 10.5°) and 6.0° (sd 5.21°), for arthroscopy, surgical hip dislocation, and open osteotomy groups, respectively (p < 0.05). Each group demonstrated satisfactory clinical outcomes across their respective scoring systems. Major complication rates were 1.6%, 10.7%, and 6.7%, for arthroscopy, surgical dislocation and osteotomy treatments, respectively. CONCLUSION: In the context of SCFE-related FAI, surgical hip dislocation demonstrated improved correction of the alpha angle, albeit at higher complication and revision rates than both arthroscopic and open osteotomy treatments. Further investigation, including high-quality trials with standardised radiological and clinical outcome measures for young patients, is warranted to clarify treatment approaches and safety.Cite this article: K. O. Oduwole, D. de Sa, J. Kay, F. Findakli, A. Duong, N. Simunovic, Y. Yi-Meng, O. R. Ayeni. Surgical treatment of femoroacetabular impingement following slipped capital femoral epiphysis: A systematic review. Bone Joint Res 2017;6:472-480. DOI: 10.1302/2046-3758.68.BJR-2017-0018.R1.
ABSTRACT
INTRODUCTION: Unicondylar knee arthroplasty (UKA) is argued to be a conservative procedure which permits a later total knee arthroplasty (TKA) should it be required. AIM: The aims of the study were to assess the modes of early failure of UKA and see whether the conversion to TKA improved the functional scores, range of motion, pain and patient satisfaction. METHOD: Fourteen revision procedures performed after failed unicompartmental knee arthroplasty (UKA) were evaluated. Patient demographics, modes of failure and technical issues relating to revision were noted. Post-operative functional outcome was assessed using WOMAC osteoarthritis index and SF-36 scores. RESULTS: Thirteen percent of primary UKA performed were revised to TKA. Eighty-six percent of the revisions were required within the first 12 months. Revision procedure was complex in nearly half of the cases. There was no significant improvement in post-operative functional scores. CONCLUSION: Results of conversion of UKA to TKA are less satisfactory than primary TKA.
Subject(s)
Arthroplasty, Replacement, Knee/methods , Female , Health Status Indicators , Humans , Knee Joint/physiopathology , Length of Stay , Male , Middle Aged , Osteoarthritis, Knee/surgery , Pain, Postoperative/epidemiology , Patient Satisfaction , Recovery of Function , ReoperationABSTRACT
Despite the well-documented benefits, some countries have yet to agree on the establishment of a national joint register. A questionnaire study was undertaken to ascertain the opinions of the consultant orthopaedic surgeons and specialist registrars, regarding establishment of an Irish National Joint Register. The aim was to find out the possible reasons why a national joint register has not been established in Ireland. A 69% first response rate was recorded. Ninety-seven percent believe it is time to set up a registry and 81% say it should be made compulsory for unwilling surgeons and hospitals to participate. Despite the overwhelming support, privacy and liability issues were major concerns. Fifty-eight percent agree that access to registry report by general public can expose surgeons and hospitals to medico-legal implications. Legislation may be required to protect the integrity of a national joint replacement registry to ensure that the data are used as intended.
