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Article ; Online: Cementless total knee arthroplasty in young patients using tantalum trabecular implants results in significantly lower rates of aseptic loosening.

Khetan, Vatsal / Baxter, Ian / Hampton, Matthew / Spencer, Amy / Anderson, Alexander

Bone & joint open

2024 Volume 5, Issue 4, Page(s) 277–285

Abstract: Aims: The mean age of patients undergoing total knee arthroplasty (TKA) has reduced with time. Younger patients have increased expectations following TKA. Aseptic loosening of the tibial component is the most common cause of failure of TKA in the UK. ... ...

Abstract	Aims: The mean age of patients undergoing total knee arthroplasty (TKA) has reduced with time. Younger patients have increased expectations following TKA. Aseptic loosening of the tibial component is the most common cause of failure of TKA in the UK. Interest in cementless TKA has re-emerged due to its encouraging results in the younger patient population. We review a large series of tantalum trabecular metal cementless implants in patients who are at the highest risk of revision surgery. Methods: A total of 454 consecutive patients who underwent cementless TKA between August 2004 and December 2021 were reviewed. The mean follow-up was ten years. Plain radiographs were analyzed for radiolucent lines. Patients who underwent revision TKA were recorded, and the cause for revision was determined. Data from the National Joint Registry for England, Wales, Northern Island, the Isle of Man and the States of Guernsey (NJR) were compared with our series. Results: No patients in our series had evidence of radiolucent lines on their latest radiological assessment. Only eight patients out of 454 required revision arthroplasty, and none of these revisions were indicated for aseptic loosening of the tibial baseplate. When compared to data from the NJR annual report, Kaplan-Meier estimates from our series (2.94 (95% confidence interval (CI) 1.24 to 5.87)) show a significant reduction in cumulative estimates of revision compared to all cemented (4.82 (95% CI 4.69 to 4.96)) or cementless TKA (5.65 (95% CI 5.23 to 6.10)). Our data (2.94 (95% CI 1.24 to 5.87)) also show lower cumulative revision rates compared to the most popular implant (PFC Sigma Cemented Knee implant fixation, 4.03 (95% CI 3.75 to 4.33)). The prosthesis time revision rate (PTIR) estimates for our series (2.07 (95% CI 0.95 to 3.83)) were lower than those of cemented cases (4.53 (95% CI 4.49 to 4.57)) from NJR. Conclusion: The NexGen trabecular (tantalum) cementless implant has lower revision rates in our series compared to all cemented implants and other types of cementless implants, and its use in younger patients should be encouraged.
Language	English
Publishing date	2024-04-08
Publishing country	England
Document type	Journal Article
ISSN	2633-1462
ISSN (online)	2633-1462
DOI	10.1302/2633-1462.54.BJO-2023-0132.R1
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Article: The Use of a High Offset Fully Coated Collarless Cementless Stem Does Not Result in Early Failures in Total Hip Arthroplasty.

Madhvani, Kiran R / Hampton, Matthew / Garneti, Naren

Cureus

2023 Volume 15, Issue 9, Page(s) e45982

Abstract: Introduction: The Corail femoral stem has excellent long-term survivorship in total hip arthroplasty (THA). However, there remains a paucity of information on the specific performance of the high offset collarless stem in relation to subsidence, ... ...

Abstract	Introduction: The Corail femoral stem has excellent long-term survivorship in total hip arthroplasty (THA). However, there remains a paucity of information on the specific performance of the high offset collarless stem in relation to subsidence, loosening, offset, and failure rates. Methods: Retrospective data were collected on all consecutive high offset collarless Corail stems implanted at a single centre in the UK. Data included patient demographics, femoral Dorr classification, radiographic analysis for radiolucent lines, and stem subsidence. The postoperative femoral offset was measured against the native offset of the contralateral hip. Any early failures, re-operations, or requirements for revision surgery were recorded. Results: We identified 162 stems for inclusion in the study. Ninety-five patients were male. The mean age was 60.5 (40 to 78) years, and the mean BMI was 29.8 (21 to 50) kg/m Conclusion: The use of a high offset stem can accurately reproduce native femoral offset when chosen for THA. The high offset collarless Corail stem does not result in early failures in THA, and we support its use.
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.45982
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Article ; Online: Cementing Techniques In Knee Surgery (CeTIKS): a UK expert consensus study.

Hampton, Matthew / Balachandar, Vivek / Charalambous, Charalambos P / Sutton, Paul M

Bone & joint open

2023 Volume 4, Issue 9, Page(s) 682–688

Abstract: Aims: Aseptic loosening is the most common cause of failure following cemented total knee arthroplasty (TKA), and has been linked to poor cementation technique. We aimed to develop a consensus on the optimal technique for component cementation in TKA.!## ...

Abstract	Aims: Aseptic loosening is the most common cause of failure following cemented total knee arthroplasty (TKA), and has been linked to poor cementation technique. We aimed to develop a consensus on the optimal technique for component cementation in TKA. Methods: A UK-based, three-round, online modified Delphi Expert Consensus Study was completed focusing on cementation technique in TKA. Experts were identified as having a minimum of five years' consultant experience in the NHS and fulfilling any one of the following criteria: a 'high volume' knee arthroplasty practice (> 150 TKAs per annum) as identified from the National joint Registry of England, Wales, Northern Ireland and the Isle of Man; a senior author of at least five peer reviewed articles related to TKA in the previous five years; a surgeon who is named trainer for a post-certificate of comletion of training fellowship in TKA. Results: In total, 81 experts (round 1) and 80 experts (round 2 and 3) completed the Delphi Study. Four domains with a total of 24 statements were identified. 100% consensus was reached within the cement preparation, pressurization, and cement curing domains. 90% consensus was reached within the cement application domain. Consensus was not reached with only one statement regarding the handling of cement during initial application to the tibial and/or femoral bone surfaces. Conclusion: The Cementing Techniques In Knee Surgery (CeTIKS) Delphi consensus study presents comprehensive recommendations on the optimal technique for component cementing in TKA. Expert opinion has a place in the hierarchy of evidence and, until better evidence is available these recommendations should be considered when cementing a TKA.
Language	English
Publishing date	2023-09-06
Publishing country	England
Document type	Journal Article
ISSN	2633-1462
ISSN (online)	2633-1462
DOI	10.1302/2633-1462.49.BJO-2023-0032.R1
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Article ; Online: Functional Walker Boots are Preferred to Synthetic Casts by Patients and Carers in the Management of Pediatric Stable Ankle Injuries.

Hampton, Matthew James / Hilton, Camila / Nicolaou, Nicolas / Flowers, Mark J

Journal of pediatric orthopedics

2023 Volume 44, Issue 2, Page(s) 99–105

Abstract: Introduction: Traditionally children who presented with a stable ankle injury have been managed in a below-knee synthetic cast. No previous study has investigated patient and parents/carer preference between synthetic casts and walker boots.: Methods!# ...

Abstract	Introduction: Traditionally children who presented with a stable ankle injury have been managed in a below-knee synthetic cast. No previous study has investigated patient and parents/carer preference between synthetic casts and walker boots. Methods: Children aged between 6 and 16 years who presented with stable ankle injuries (ankle sprains, small fragment avulsions, and fibular Salter-Harris 1 injuries) were randomized to receive treatment with either a synthetic cast or a walker boot. A tailored, study-specific questionnaire was designed and completed at 4 weeks from injury to evaluate both patient and parents/carer preference. An analysis of costs associated with both treatments was performed. Results: Ninety-one patients were available for final analysis. Forty-seven received synthetic cast treatment and 44 walker boot treatment. Patient demographics and injury types were matched between groups.Statistical significance was found in favor of the walker boot with regard to comfort, reduction in activity during treatment, and patient-reported problems at the end of treatment. There was a strong and significant preference toward treatment with the walker boot, both from patients and parents/carers. There was no difference between groups with regard to walking ability, analgesia requirement, and patient-reported pain scores.Unplanned attendances to the hospital during the treatment period were higher in the synthetic cast group. The overall treatment cost per patient was lower with the walker boot. Conclusions: In children who present with stable ankle injuries, treatment in a walker boot is preferred by both patients and parents/carers. It results in fewer unplanned attendances to the hospital, is less expensive, and we recommend it as the treatment of choice in stable pediatric ankle injuries. Level of evidence: Level II.
MeSH term(s)	Humans ; Child ; Adolescent ; Caregivers ; Ankle Injuries/therapy ; Pain ; Casts, Surgical
Language	English
Publishing date	2023-11-20
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	604642-3
ISSN	1539-2570 ; 0271-6798
ISSN (online)	1539-2570
ISSN	0271-6798
DOI	10.1097/BPO.0000000000002570
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Zs.A 1681: Show issues

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Article ; Online: Supra tubercular tibial osteotomy and gradual correction with Taylor spatial frame for the management of Torsional malalignment syndrome - surgical technique and outcomes.

Hogg, Jack / Hampton, Matthew / Madan, Sanjeev

The Knee

2022 Volume 40, Page(s) 8–15

Abstract: Background: Surgical management of Torsional Malalignment Syndrome (TMS) traditionally consists of simultaneous correction of both femoral anteversion and external tibial torsion. We hypothesise that a single supra tubercular osteotomy followed by ... ...

Abstract	Background: Surgical management of Torsional Malalignment Syndrome (TMS) traditionally consists of simultaneous correction of both femoral anteversion and external tibial torsion. We hypothesise that a single supra tubercular osteotomy followed by tibial derotation with Taylor Spatial Frame (TSF) is sufficient to provide significant improvement in both appearance and function. Method: This is a retrospective single surgeon case series performed at a tertiary referral centre in the UK. Data collected included patient demographics, clinical findings and CT rotational profile measurements. All patients completed pre and post-operative Oxford Knee Score (OKS) and Kujala Anterior Knee Pain Scale (AKPS) functional outcome scores for analysis. Results: There were 16 osteotomies in 11 patients with complete data sets for analysis performed between 2006 and 2017. Mean age of 16.7 ± 0.8 years. The results show significant improvements in post-operative functional assessment scores, with mean OKS increasing by 18.3 and mean AKPS increasing by 31.4. Average pre-operative thigh-foot angle (TFA) was 44.7°, this was reduced to 12.8° post-operatively, representing an average correction of 31.9°. Conclusion: The results show that supra tubercular osteotomy, followed by gradual correction with TSF, can be used to provide a significant improvement in both appearance and function for patients suffering from TMS.
MeSH term(s)	Humans ; Adolescent ; Retrospective Studies ; Tibia/diagnostic imaging ; Tibia/surgery ; Femur/diagnostic imaging ; Femur/surgery ; Knee Joint/diagnostic imaging ; Knee Joint/surgery ; Osteotomy/methods ; Pain
Language	English
Publishing date	2022-11-18
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	1200476-5
ISSN	1873-5800 ; 0968-0160
ISSN (online)	1873-5800
ISSN	0968-0160
DOI	10.1016/j.knee.2022.11.004
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Zs.A 4043: Show issues

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Article: A modification of the Bereiter trochleoplasty: indications, technique and outcomes.

Hampton, Matthew / Pigott, Thomas / Sutton, Paul Mark

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

2020 Volume 31, Issue 3, Page(s) 571–578

Abstract: Introduction: The Bereiter technique is one recognised method of trochleoplasty that was described using a lateral para-patellar approach. We present our surgical technique and outcomes of this procedure using a medial para-patellar approach allowing ... ...

Abstract	Introduction: The Bereiter technique is one recognised method of trochleoplasty that was described using a lateral para-patellar approach. We present our surgical technique and outcomes of this procedure using a medial para-patellar approach allowing for accurate soft tissue balancing of the patella. Methods: In total, 27 consecutive patients underwent a Bereiter trochleoplasty using a medial approach. Patients completed pre- and post-operative Kujala scores. All patients' medical records and imaging were reviewed to identify pre-operative indications, complications and re-dislocations. Results: Data were collected on 31 trochleoplasty procedures in the 27 patients. Mean age at time of surgery was 25 (17-39), and 16 patients were females. Follow-up ranged from 13 to 60 months. All patients had severe trochlea dysplasia with recurrent instability. Three patients underwent a planned tibial tubercle transfer for a pre-operative raised TT-TG distance. The mean pre-operative Kujala score was 53.9 (26-79) rising to 91.2 (88.6-100) post-operatively. A low post-operative Kujala score seen in patients had a significantly lower than average pre-operative score. No patients had any further dislocations following surgery. Two patients complained of significant stiffness in the early post-operative period. No patients required additional procedures to adequately balance the patella following the trochleoplasty combined with medial reefing plus lateral release involved in this modified technique. Conclusion: A modified Bereiter trochleoplasty using a medial rather than a lateral para-patella approach gives excellent results. Level of evidence: Level II evidence.
MeSH term(s)	Female ; Femur ; Humans ; Joint Dislocations ; Joint Instability/surgery ; Knee Joint/surgery ; Patella/surgery ; Patellar Dislocation/surgery ; Patellofemoral Joint ; Tibia/surgery
Language	English
Publishing date	2020-10-15
Publishing country	France
Document type	Journal Article
ZDB-ID	1231084-0
ISSN	1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
ISSN (online)	1432-1068
ISSN	1633-8065 ; 0948-4817 ; 0940-3264
DOI	10.1007/s00590-020-02800-5
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Zs.A 3479: Show issues

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Article ; Online: The orthopaedic waiting list crisis : two sides of the story.

Hampton, Matthew / Riley, Ella / Garneti, Naren / Anderson, Alexander / Wembridge, Kevin

Bone & joint open

2021 Volume 2, Issue 7, Page(s) 530–534

Abstract: Aims: Due to widespread cancellations in elective orthopaedic procedures, the number of patients on waiting list for surgery is rising. We aim to determine and quantify if disparities exist between inpatient and day-case orthopaedic waiting list numbers; ...

Abstract	Aims: Due to widespread cancellations in elective orthopaedic procedures, the number of patients on waiting list for surgery is rising. We aim to determine and quantify if disparities exist between inpatient and day-case orthopaedic waiting list numbers; we also aim to determine if there is a 'hidden burden' that already exists due to reductions in elective secondary care referrals. Methods: Retrospective data were collected between 1 April 2020 and 31 December 2020 and compared with the same nine-month period the previous year. Data collected included surgeries performed (day-case vs inpatient), number of patients currently on the orthopaedic waiting list (day-case vs inpatient), and number of new patient referrals from primary care and therapy services. Results: There was a 52.8% reduction in our elective surgical workload in 2020. The majority of surgeries performed in 2020 were day case surgeries (739; 86.6%) with 47.2% of these performed in the independent sector on a 'lift and shift' service. The total number of patients on our waiting lists has risen by 30.1% in just 12 months. As we have been restricted in performing inpatient surgery, the inpatient waiting lists have risen by 73.2%, compared to a 1.6% rise in our day-case waiting list. New patient referral from primary care and therapy services have reduced from 3,357 in 2019 to 1,722 in 2020 (49.7% reduction). Conclusion: This study further exposes the increasing number of patients on orthopaedic waiting lists. We observed disparities between inpatient and day-case waiting lists, with dramatic increases in the number of inpatients on the waiting lists. The number of new patient referrals has decreased, and we predict an influx of referrals as the pandemic eases, further adding to the pressure on inpatient waiting lists. Robust planning and allocation of adequate resources is essential to deal with this backlog. Cite this article:
Language	English
Publishing date	2021-07-14
Publishing country	England
Document type	Journal Article
ISSN	2633-1462
ISSN (online)	2633-1462
DOI	10.1302/2633-1462.27.BJO-2021-0044.R1
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Article ; Online: Development of a Cell Co-Culture Model to Mimic Cardiac Ischemia/Reperfusion In Vitro.

Li, Zhu / Hampton, Matthew J W / Barajas, Matthew B / Riess, Matthias L

Journal of visualized experiments : JoVE

2021 , Issue 176

Abstract: Ischemic heart disease is the leading cause of death and disability worldwide. Reperfusion causes additional injury beyond ischemia. Endothelial cells (ECs) can protect cardiomyocytes (CMs) from reperfusion injury through cell-cell interactions. Co- ... ...

Abstract	Ischemic heart disease is the leading cause of death and disability worldwide. Reperfusion causes additional injury beyond ischemia. Endothelial cells (ECs) can protect cardiomyocytes (CMs) from reperfusion injury through cell-cell interactions. Co-cultures can help investigate the role of cell-cell interactions. A mixed co-culture is the simplest approach but is limited as isolated treatments and downstream analyses of single cell types are not feasible. To investigate whether ECs can dose-dependently attenuate CM cell damage and whether this protection can be further optimized by varying the contact distance between the two cell lines, we used Mouse Primary Coronary Artery Endothelial Cells and Adult Mouse Cardiomyocytes to test three types of cell culture inserts which varied in their inter-cell layer distance at 0.5, 1.0, and 2.0 mm, respectively. In CMs-only, cellular injury as assessed by lactate dehydrogenase (LDH) release increased significantly during hypoxia and further upon reoxygenation when the distance was 2.0 mm compared to 0.5 and 1.0 mm. When ECs and CMs were in nearly direct contact (0.5 mm), there was only a mild attenuation of the reoxygenation injury of CMs following hypoxia. This attenuation was significantly increased when the spatial distance was 1.0 mm. With 2.0 mm distance, ECs attenuated CM injury during both hypoxia and hypoxia/reoxygenation, indicating that sufficient culture distancing is necessary for ECs to crosstalk with CMs, so that secreted signal molecules can circulate and fully stimulate protective pathways. Our findings suggest, for the first time, that optimizing the EC/CM co-culture spatial environment is necessary to provide a favorable in vitro model for testing the role of ECs in CM-protection against simulated ischemia/reperfusion injury. The goal of this report is to provide a step-by-step approach for investigators to use this important model to their advantage.
MeSH term(s)	Animals ; Cell Culture Techniques ; Cell Hypoxia ; Cells, Cultured ; Coculture Techniques ; Endothelial Cells/metabolism ; Ischemia/metabolism ; Mice ; Myocardial Ischemia ; Myocardial Reperfusion ; Myocytes, Cardiac
Language	English
Publishing date	2021-10-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/62913
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Article ; Online: Clinical presentation, MRI and clinical outcome scores do not accurately predict an important meniscal tear in a symptomatic discoid meniscus.

Hampton, Matthew / Hancock, Graeme / Christou, Antonios / Ali, Fazal / Nicolaou, Nicolas

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

2021 Volume 29, Issue 9, Page(s) 3133–3138

Abstract: Purpose: Discoid menisci can be symptomatic from instability or a tear. A torn discoid meniscus is likely to require repair to preserve meniscal function and should not be missed. This is the first study to evaluate a range of pre-operative methods to ... ...

Abstract	Purpose: Discoid menisci can be symptomatic from instability or a tear. A torn discoid meniscus is likely to require repair to preserve meniscal function and should not be missed. This is the first study to evaluate a range of pre-operative methods to predict the likelihood of a torn discoid meniscus. Methods: A retrospective analysis of prospectively collected data was performed. Clinical, radiographic and operative data were reviewed. Patients were grouped based on the presence of a tear or not during surgery. All patients underwent MRI scans pre-operatively which were validated with arthroscopy findings to calculate sensitivity. All patients completed Pedi-KOOS and Pedi-IKDC pre-operative scores. Results: There were 32 discoid menisci in 27 patients. Mean age at surgery was 10.4 years (6-16). Nineteen patients were female. Seventeen menisci were identified as torn at time of arthroscopy (53%), 15 were unstable but not torn. Clinical findings did not differentiate between the torn or unstable menisci. MRI was only 75% sensitive and 50% specific at identifying a torn discoid meniscus. There was no statistical difference between KOOS-child (n.s.) and Pedi-IKDC (n.s.) scores between the groups. Conclusion: MRI is neither sensitive nor specific at identifying tears in discoid menisci. There is no difference in pre-operative outcome scores for patients with a torn or unstable discoid meniscus; pre-operative PROMs are a poor predictor of a meniscal tear. This study emphasises that pre-operative tests and clinical findings are not conclusive for identifying a meniscal tear and the operating surgeon should be vigilant in identifying and repairing tears at the time of surgery. Pre-operative findings poorly correlate to arthroscopic findings and potential surgical interventions required. Patients and parents/carers should, therefore, be appropriately counselled prior to surgery that post-operative measures are dependent on intra-operative findings and not pre-operative findings in patients. Level of evidence: III.
MeSH term(s)	Arthroscopy ; Female ; Humans ; Magnetic Resonance Imaging ; Menisci, Tibial/diagnostic imaging ; Menisci, Tibial/surgery ; Meniscus ; Retrospective Studies ; Tibial Meniscus Injuries/diagnostic imaging ; Tibial Meniscus Injuries/surgery
Language	English
Publishing date	2021-01-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1159064-6
ISSN	1433-7347 ; 0942-2056
ISSN (online)	1433-7347
ISSN	0942-2056
DOI	10.1007/s00167-020-06375-w
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Zs.A 3742: Show issues

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Article: Prevalence and Significance of Vitamin D Deficiency in Patients Undergoing Corrective Surgery for Adolescent Idiopathic Scoliosis.

Hampton, Matthew / Brewer, Paul / Athanassacopoulos, Michael / Breakwell, Lee M / Cole, Ashley A / Michael, Anthony L R

International journal of spine surgery

2022 Volume 16, Issue 1, Page(s) 202–207

Language	English
Publishing date	2022-03-10
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4599
ISSN	2211-4599
DOI	10.14444/8189
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