According to our results, locking plate and fibular strut graft in Dormans classification types IB and IIB results in a favorable outcome in managing UBC of the proximal femur in the paediatric population.

Aims The consensus is that bipolar hemiarthroplasty (BHA) in allograft-prosthesis composite (APC) reconstruction of the proximal femur following primary tumour resection provides more stability than total hip arthroplasty (THA). However, no comparative study has been performed. In this study, we have compared the outcome and complication rates of these two methods. Methods In a retrospective study, 57 patients who underwent APC reconstruction of proximal femur following the primary tumour resection, either using BHA (29) or THA (28), were included. Functional outcome was assessed using the Musculoskeletal Tumour Society (MSTS) scoring system and Harris Hip Score (HHS). Postoperative complications of the two techniques were also compared. Results The mean follow-up of the patients was 8.3 years (standard deviation (SD) 5.5) in the BHA and 6.9 years (SD 4.7) in the THA group. The mean HHS was 65 (SD 16.6) in the BHA group and 88 (SD 11.9) in the THA group (p = 0.036). The mean MSTS score of the patients was 73.3% (SD 16.1%) in the BHA and 86.7% (SD 12.2%) in the THA group (p = 0.041). Limping was recorded in 19 patients (65.5%) of the BHA group and five patients (17.8%) of the THA group (p < 0.001). Dislocation occurred in three patients (10.3%) of the BHA group and two patients (7.1%) of the THA group. Conclusion While the dislocation rate was not higher in THA than with BHA, the functional outcome was significantly superior. Based on our results, we recommend THA in APC reconstruction of the proximal femur. Cite this article: Bone Joint J 2020;102-B(4):524–529.

Background:The degree of patient's suffering in association with radiological evidence of osteoarthritis (OA) determines the time point of surgery. Thus, a more clear understanding of the association between clinical and radiological symptoms of OA is necessary. Objectives: Here we aim to evaluate how clinical and radiographic symptoms of patients are associated with each other in an Iranian Knee OA population. Methods: In a cross -sectional study, patients with knee OA were recruited. The diagnosis of OA was made using the criteria of American College of Rheumatology (ACR) Classification. Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) was used as an indicator of self-reported disability. The Kellgren -Lawrence index was used for OA grading.Results: A total of 96 OA patients, including 77 females and 19 males, with a mean age of 53.27 ± 10 years, were included. The OA was graded as I, II, III, and IV in 28, 35, 19, and 14 patients, respectively. The mean WOMAC score was 55.2 ± 20.5, ranging from 6.3 to 100.The WOMAC score was not significantly correlated with the grade of OA (p = 0.1, r = -0.188). When we stratified the patients based on their gender, a strong correlation was observed between WOMAC scores and OA grade in male patients (p < 0.001, r = -0.882), while it was still non -significant in female patients (p = 0.9, r = 0.002). Conclusions: Self -reported disability is associated with radiographic symptoms in male patients with knee OA, but not in females.Hence, the orthopedic surgeons should consider this discrepancy in their decision -making process to decide appropriately about the choice of therapy.Given the role of clinical symptoms in the appropriate selection of OA patients as TKA candidates, a more clear understanding of the association between clinical and radiological symptoms is necessary.

Background: Although carpal tunnel release (CTR) is accepted in severe cases of carpal tunnel syndrome (CTS), it is not clear if CTR overweighs the local steroid injection (LSI) in the treatment of patients with mild symptoms.

No abstract