• Anaphylaxis at image-guided epidural pain block secondary to corticosteroid compound.

      Moran, Deirdre E; Moynagh, Michael R; Alzanki, Majedah; Chan, Victoria O; Eustace, Stephen J; Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland. deirdreradiology@gmail.com (Skeletal radiology, 2012-09)
      Anaphylaxis during image-guided interventional procedures is a rare but potentially fatal event. Anaphylaxis to iodinated contrast is an established and well-recognized adverse effect. However, anaphylaxis to some of the other frequently administered medications given during interventional procedures, such as corticosteroids, is not common knowledge. During caudal epidural injection, iodinated contrast is used to confirm needle placement in the epidural space at the level of the sacral hiatus. A combination of corticosteroid, local anesthetic, and saline is subsequently injected. We describe a very rare case of anaphylaxis to a component of the steroid medication instilled in the caudal epidural space.
    • Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

      Brennan, S A; Harty, J A; Gormley, C; O'Rourke, S K; Department of Orthopaedics, Cappagh Hospital, Finglas, Dublin, Ireland. stevobrennan@hotmail.com (2009-04)
      PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.
    • Diagnosing the doctors' departure: survey on sources of dissatisfaction among Irish junior doctors.

      Bruce-Brand, R; Broderick, J; Ong, J; O'Byrne, J; Cappagh National Orthopaedic Hospital, Finglas, Dublin 11. robbrucebrand@gmail.com (Irish Medical Journal (IMJ), 2012-01)
      There has been a significant decline in the number of applications for non-consultant hospital doctor (NCHD) posts in Ireland over the last 18 months. We conducted an online, anonymous survey of Irish NCHDs to establish levels of satisfaction, sources of dissatisfaction and the major reasons for junior doctors seeking work abroad. 522 NCHDs took the survey, including 64 (12.3%) currently working outside of the Republic. 219 (45.8%) were slightly dissatisfied and 142 (29.7%) were extremely dissatisfied with practising medicine in Ireland. Major sources of dissatisfaction included the state of the health care system, staffing cover for leave and illness, the dearth of consultant posts and the need to move around Ireland. The most important reason for NCHDs wishing to leave was to seek better training and career opportunities abroad.
    • Diagnostic gait pattern of a patient with longstanding left femoral nerve palsy: a case report.

      Burke, Neil G; Walsh, Michael; O'Brien, Tim; Synnott, Keith; Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Dublin, Ireland. nei1burke@yahoo.co.uk (2010-12)
      The gait pattern of a 35-year-old man with longstanding, left femoral nerve palsy was assessed using 3-dimensional kinematic and kinetic analysis. Stability of his left knee in stance was achieved by manipulating the external moments of the limb so that the ground reaction force passes in front of the knee joint. This compensatory mechanism of locking the knee in extension is reliant on the posterior capsular structures. The patient was managed conservatively and continued to walk without aids.
    • Dislocation of primary total hip arthroplasty and the risk of redislocation.

      Brennan, Stephen A; Khan, Fahim; Kiernan, Christine; Queally, Joseph M; McQuillan, Janette; Gormley, Isobel C; O'Byrne, John M; Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland. stevobrennan@hotmail.com (Hip international : the journal of clinical and experimental research on hip pathology and therapy, 2012-09)
      6554 primary total hip arthroplasties were reviewed. Risk factors for dislocation were analysed to assess which were important in terms of predicting recurrent instability. The patients risk of having a second dislocation was independently associated with the surgical approach adopted (p = 0.03) and the time to first dislocation from the primary hip replacement (p = 0.002). Early dislocators whose surgery was performed through an anterolateral approach had less recurrence than late dislocators through a posterior or transtrochanteric approach. None of the other risk factors including head size (p = 0.59), modularity (p = 0.54), mechanism of dislocation (p = 0.23), leg length discrepancy (p = 0.69) and acetabular inclination (p = 0.31) were influential. The use of an abduction brace was not useful in preventing a further dislocation with 69.2% of those braced re-dislocating compared to 68.5% who were not braced (p = 0.96).
    • Effect of prehabilitation on the outcome of anterior cruciate ligament reconstruction.

      Shaarani, Shahril R; O'Hare, Christopher; Quinn, Alison; Moyna, Niall; Moran, Raymond; O'Byrne, John M; Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Republic of Ireland. delphaex@gmail.com (The American journal of sports medicine, 2013-09)
      Prehabilitation is defined as preparing an individual to withstand a stressful event through enhancement of functional capacity.
    • Medial joint line bone bruising at MRI complicating acute ankle inversion injury: what is its clinical significance?

      Chan, VO; Moran, DE; Shine, S; Eustace, SJ; Department of Radiology, Cappagh National Orthopaedic Hospital, Dublin, Ireland. vikki_chan12@hotmail.com (Clinical radiology, 2013-10)
      To assess the incidence and clinical significance of medial joint line bone bruising following acute ankle inversion injury.
    • Neck narrowing in resurfacing hip arthroplasty: a vascular insult?

      Brennan, S A; Khan, F; McQuillan, J; O'Neill, C J; Kenny, P; O'Rourke, S K; O'Byrne, J M; Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland. stevobrennan@hotmail.com (Irish journal of medical science, 2013-06)
      Recent reports show increased failure rates in hip resurfacings that display >10 % neck narrowing. The etiology of neck narrowing remains unknown.
    • Prevalence and clinical significance of chondromalacia isolated to the anterior margin of the lateral femoral condyle as a component of patellofemoral disease: observations at MR imaging.

      Chan, V O; Moran, D E; Mwangi, I; Eustace, S J; Department of Radiology, Cappagh National Orthopaedic Hospital, Dublin, Ireland. vikki_chan12@hotmail.com (Skeletal radiology, 2013-08)
      To determine the prevalence of chondromalacia isolated to the anterior margin of the lateral femoral condyle as a component of patellofemoral disease in patients with anterior knee pain and to correlate it with patient demographics, patellar shape, and patellofemoral alignment.
    • Quality of life in individuals with chronic foot conditions: a cross sectional observational study.

      Groarke, Patrick; Galvin, Rose; Kelly, John; Stephens, Michael M; National Orthopaedic Hospital, Cappagh, Finglas, Dublin 9, Ireland. patrick groarke@yahoo.co.uk (Foot, 2012-06)
      Chronic foot conditions have been reported to be a significant cause of impairment and disability to individuals affected. However, studies to date have particularly focussed on patient satisfaction with outcomes following surgery.
    • "Superior cleft sign" as a marker of rectus abdominus/adductor longus tear in patients with suspected sportsman's hernia.

      Murphy, Grainne; Foran, Paul; Murphy, Darra; Tobin, Oliver; Moynagh, Michael; Eustace, Stephen; Radiology Department, Cappagh National Orthopaedic Hospital, Cappagh Road, Finglas, Dublin 11, Ireland. (Skeletal radiology, 2013-06)
      We describe a new imaging sign, the "superior cleft sign", identified at both symphysography and MRI, which should be used as a marker of rectus abdominis/adductor longus attachment tearing.