• Total joint arthroplasty in nonagenarians--a retrospective review of complications and resource use.

      Baker, Joseph F; Stoyanov, Veselin; Shafqat, Aseer; Lui, Darren F; Mulhall, Kevin J; Cappagh National Orthopaedic Hospital, Dublin, Ireland. joseph.f.baker@gmail.com (Acta orthopaedica Belgica, 2012-12)
      Increased age brings with it the potential for increased surgical risk. Assessment of specific age cohorts is necessary to plan future service provision and this is the case in hip and knee arthroplasty as the demand for these procedures is anticipated to increase. We retrospectively reviewed the outcomes, including complications, length of stay and blood transfusion rate, in a cohort of 35 nonagenarians undergoing primary or revision total hip and knee arthroplasty. All patients were pre-assessed by anaesthetists before being deemed suitable to undergo surgery in the unit. The mean length of hospital stay was 13.7 +/- 10 days (range 2-56). Thirty-one percent of patients required a blood transfusion. Patients who underwent primary total hip arthroplasty reported improved joint specific functional scores. In this appropriately selected group of nonagenarians, we found no evidence to suggest surgery be withheld on the basis of age alone. However, patients with multiple medical comorbidities warrant appropriate assessment and surgical intervention in an institution with appropriate support. Future planning needs to take into account the predicted increase in demand for arthroplasty surgery in this age group.
    • Transstyloid, transscaphoid, transcapitate fracture: a variant of scaphocapitate fractures.

      Burke, Neil G; Cosgrave, Ciaran H; O'Neill, Barry James; Kelly, Eamonn P; Department of Orthopaedics, Cappagh National Orthopaedic Hospital, Dublin, Ireland. (BMJ case reports, 2014)
      Transstyloid, transscaphoid, transcapitate fractures are uncommon. We report the case of a 28-year-old man who sustained this fracture following direct trauma. The patient was successfully treated by open reduction internal fixation of the scaphoid and proximal capitate fragment, with a good clinical outcome at 1-year follow-up. This pattern is a new variant of scaphocapitate fracture as involves a fracture of the radial styloid as well.
    • Unusual presentation of sacral fatigue fractures.

      Kilcoyne, Aoife; Kavanagh, Eoin C; Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland. (The spine journal : official journal of the North American Spine Society, 2014-06-01)
    • The use of postoperative suction drainage in total knee arthroplasty: a systematic review.

      Quinn, Mark; Bowe, Andrea; Galvin, Rose; Dawson, Peter; O'Byrne, John; Professorial Unit, National Orthopaedic Hospital, Cappagh, Finglas, Dublin 11, Republic of Ireland. (International orthopaedics, 2014-07-16)
      The purpose of this systematic review and meta-analysis of randomised controlled trials is to assess the effectiveness of no drainage when compared to drainage in total knee arthroplasty, in terms of recovery of knee flexion, reduction in swelling, length of hospital stay and haemoglobin levels following TKA.