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Article ; Online: Liposomal Bupivacaine-A Boon for Opioid-Sparing Surgery?-Reply.

Hamilton, Thomas W / Pandit, Hemant G

2022 Volume 157, Issue 10, Page(s) 968–969

MeSH term(s)	Analgesics, Opioid/therapeutic use ; Anesthetics, Local ; Bupivacaine/therapeutic use ; Humans ; Liposomes ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control
Chemical Substances	Analgesics, Opioid ; Anesthetics, Local ; Liposomes ; Bupivacaine (Y8335394RO)
Language	English
Publishing date	2022-07-20
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2022.2814
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Article: Return to driving post upper or lower extremity orthopaedic surgical procedures: a scoping review of current published literature.

Khaliq, Mehnoor / Giannoudis, Vasileios P / Palan, Jeya / Pandit, Hemant G / van Duren, Bernard H

EFORT open reviews

2023 Volume 8, Issue 12, Page(s) 936–947

Abstract: Patients undergoing planned or unplanned orthopaedic procedures involving their upper or lower extremity can prevent them from safe and timely return to driving, where they commonly ask, 'Doctor, when can I drive?' Driving recommendations after such ... ...

Abstract	Patients undergoing planned or unplanned orthopaedic procedures involving their upper or lower extremity can prevent them from safe and timely return to driving, where they commonly ask, 'Doctor, when can I drive?' Driving recommendations after such procedures are varied. The current evidence available is based on a heterogenous data set with varying degrees of sample size and markedly differing study designs. This instructional review article provides a scoping overview of studies looking at return to driving after upper or lower extremity surgery in both trauma and elective settings and, where possible, to provide clinical recommendations for return to driving. Medline, EMBASE, SCOPUS, and Web of Science databases were searched according to a defined search protocol to elicit eligible studies. Articles were included if they reviewed adult drivers who underwent upper or lower extremity orthopaedic procedures, were written in English, and offered recommendations about driving. A total of 68 articles were included in the analysis, with 36 assessing the lower extremity and 37 reviewing the upper extremity. The evidence available from the studies reviewed was of poor methodological quality. There was a lack of adequately powered, high quality, randomised controlled trials (RCTs) with large sample sizes to assess safe return to driving for differing subset of injuries. Many articles provide generic guidelines on return to driving when patients feel safe to perform an emergency stop procedure with adequate steering wheel control. In future, RCTs should be performed to develop definitive return to driving protocols in patients undergoing upper and lower extremity procedures.
Language	English
Publishing date	2023-12-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2844421-8
ISSN	2058-5241 ; 2058-5241 ; 2396-7544
ISSN (online)	2058-5241
ISSN	2058-5241 ; 2396-7544
DOI	10.1530/EOR-23-0117
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Article ; Online: Comparison of axial-rotational postoperative periprosthetic fracture of the femur in composite osteoporotic femur versus human cadaveric specimens: A validation study.

Lamb, Jonathan N / Coltart, Oliver / Adekanmbi, Isaiah / Pandit, Hemant G / Stewart, Todd

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine

2022 Volume 236, Issue 7, Page(s) 973–978

Abstract: Postoperative periprosthetic femoral fracture following hip replacement has been the subject of many varied experimental approaches. Cadaveric samples offer realistic fit and fracture patterns but are subject to large between-sample variation. Composite ... ...

Abstract	Postoperative periprosthetic femoral fracture following hip replacement has been the subject of many varied experimental approaches. Cadaveric samples offer realistic fit and fracture patterns but are subject to large between-sample variation. Composite femurs have not yet been validated for this purpose. We compared the results of composite femurs to cadaveric femurs using an established methodology. In vitro postoperative periprosthetic fracture results using axial-rotational loading were compared between 12 composite femurs and nine fresh frozen femurs, which were implanted with an otherwise identical collarless (6 composite vs 4 cadaveric) or collared (6 composite vs 5 cadaveric) cementless femoral stem using identical methodology. Fracture torque and rotational displacement were measured and torsional stiffness and rotational work prior to fracture were estimated. Fractures patterns were graded according to the Unified Classification System. Fracture torque, displacement, torsional stiffness and fracture patterns for cadaveric and composite femurs were similar between groups. There was a trend for a greater rotational displacement in the cadaveric groups, which lead to a decrease in torsional stiffness and a significantly greater rotational work prior to fracture for all cadaveric specimens (collarless stems: 10.51 [9.71 to 12.57] vs 5.21 [4.25 to 6.04],
MeSH term(s)	Biomechanical Phenomena ; Cadaver ; Femoral Fractures/surgery ; Femur/surgery ; Hip Prosthesis ; Humans ; Periprosthetic Fractures/surgery
Language	English
Publishing date	2022-05-21
Publishing country	England
Document type	Journal Article
ZDB-ID	1065942-0
ISSN	2041-3033 ; 0046-2039 ; 0954-4119
ISSN (online)	2041-3033
ISSN	0046-2039 ; 0954-4119
DOI	10.1177/09544119221092842
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Zs.A 2652: Show issues

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Article ; Online: Development of a patient-reported outcome measure (PROM) and change measure for use in early recovery following hip or knee replacement.

Strickland, Louise H / Murray, David W / Pandit, Hemant G / Jenkinson, Crispin

Journal of patient-reported outcomes

2020 Volume 4, Issue 1, Page(s) 91

Abstract: Background: Hip and knee replacement are effective procedures for end-stage arthritis that has not responded to medical management. However, until now, there have been no validated, patient-reported tools to measure early recovery in this growing ... ...

Abstract	Background: Hip and knee replacement are effective procedures for end-stage arthritis that has not responded to medical management. However, until now, there have been no validated, patient-reported tools to measure early recovery in this growing patient population. The process of development and psychometric evaluation of the Oxford Arthroplasty Early Recovery Score (OARS), a 14-item patient-reported outcome measure (PROM) measuring health status, and the Oxford Arthroplasty Early Change Score (OACS) a 14-item measure to assess change during the first 6 weeks following surgery is reported. Patients and methods: A five-phased, best practice, iterative approach was used. From a literature based starting point, qualitative interviews with orthopaedic healthcare professionals, were then performed ascertaining if and how clinicians would use such a PROM and change measure. Analysis of in-depth patient-interviews in phase one identified important patient-reported factors in early recovery which were used to provide questionnaire themes. In Phase two, candidate items from Phase One interviews were generated and pilot questionnaires developed and tested. Exploratory factor analysis with item reduction and final testing of the questionnaires was performed in phase three. Phase Four involved validation testing. Results: Qualitative interviews (n = 22) with orthopaedic healthcare professionals, helped determine views of potential users, and guide structure. In Phase One, factors from patient interviews (n = 30) were used to find questionnaire themes and generate items. Pilot questionnaires were developed and tested in Phase Two. Items were refined in the context of cognitive debrief interviews (n = 34) for potential inclusion in the final tools. Final testing of questionnaire properties with item reduction (n = 168) was carried out in phase three. Validation of the OARS and OACS was performed in phase four. Both measures were administered to consecutive patients (n = 155) in an independent cohort. Validity and reliability were assessed. Psychometric testing showed positive results, in terms of internal consistency and sensitivity to change, content validity and relevance to patients and clinicians. In addition, these measures have been found to be acceptable to patients throughout early recovery with validation across the 6 week period. Conclusions: These brief, easy-to-use tools could be of great use in assessing recovery pathways and interventions in arthroplasty surgery.
Language	English
Publishing date	2020-11-07
Publishing country	Germany
Document type	Journal Article
ISSN	2509-8020
ISSN (online)	2509-8020
DOI	10.1186/s41687-020-00262-1
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Article ; Online: The Cobalt-To-Chromium Ratio "May Be" a Key Marker for Adverse Local Tissue Reactions in Metal-On-Metal Hips.

Matharu, Gulraj S / Pandit, Hemant G

The Journal of arthroplasty

2016 Volume 31, Issue 6, Page(s) 1374–1375

MeSH term(s)	Arthroplasty, Replacement, Hip ; Chromium ; Cobalt ; Hip/surgery ; Hip Prosthesis ; Humans ; Metal-on-Metal Joint Prostheses ; Prosthesis Design
Chemical Substances	Chromium (0R0008Q3JB) ; Cobalt (3G0H8C9362)
Language	English
Publishing date	2016
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2015.09.047
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Zs.A 2134: Show issues

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Article: Comparison of Mechanical Performance between Circular Frames and Biplanar Distraction Devices for Knee Joint Distraction.

Chowdhury, James My / Lineham, Beth / Pallett, Matthew / Pandit, Hemant G / Stewart, Todd D / Harwood, Paul J

Strategies in trauma and limb reconstruction

2021 Volume 16, Issue 2, Page(s) 71–77

Abstract: Aim and objective: This study was designed to test and compare the mechanical performance of the biplanar ArthroSave KneeReviver and a circular frame construct with the intended use of providing a mechanically favourable environment for cartilage ... ...

Abstract	Aim and objective: This study was designed to test and compare the mechanical performance of the biplanar ArthroSave KneeReviver and a circular frame construct with the intended use of providing a mechanically favourable environment for cartilage regeneration across a knee joint. Materials and methods: Three similar constructs of the two devices were applied to biomechanical testing sawbones, with the knee distracted by 8 mm. The constructs were vertically loaded to 800 N in an Instron testing machine at 20 mm/minute. Tests were conducted in neutral hip flexion and at 12° of hip flexion and extension, to mimic leg position in gait. Displacement measurements were taken from the Instron machine, and three-dimensional joint motion was recorded using an Optotrak Certus motion capture system. Results: Overall axial rigidity was similar between the two devices (circular frame, 81.6 N/mm ± 5.9; and KneeReviver, 79.5 N/mm ± 25.1 with hip neutral) and similar in different hip positions. At the point of joint contact, the overall rigidity of the circular frame increased significantly more than the KneeReviver (491 N/mm ± 27 and 93 N/mm ± 32, respectively, Conclusion: The circular frame provides a similar mechanical environment to the novel KneeReviver device, for which most clinical data are available. These findings suggest that both devices appear a viable option for knee joint distraction (KJD). Further clinical data will help inform mode of application. Clinical significance: KJD is a relatively novel technique for use in osteoarthritis (OA), and it remains unclear which distraction devices provide appropriate mechanics. Our testing gives evidence to support either option for further use. How to cite this article: Chowdhury JMY, Lineham B, Pallett M,
Language	English
Publishing date	2021-11-15
Publishing country	India
Document type	Journal Article
ZDB-ID	2387508-2
ISSN	1828-8928 ; 1828-8936
ISSN (online)	1828-8928
ISSN	1828-8936
DOI	10.5005/jp-journals-10080-1530
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Article ; Online: Early Recovery Following Total and Unicompartmental Knee Arthroplasty Assessed Using Novel Patient-Reported Measures.

Strickland, Louise H / Rahman, Azmi / Jenkinson, Crispin / Pandit, Hemant G / Murray, David W

The Journal of arthroplasty

2021 Volume 36, Issue 10, Page(s) 3413–3420

Abstract: Background: The early postoperative recovery period following unicompartmental (UKA) and total knee arthroplasty (TKA) is an important area for research with increasingly sensitive metrics and new technologies. This study uses 2 recently developed ... ...

Abstract	Background: The early postoperative recovery period following unicompartmental (UKA) and total knee arthroplasty (TKA) is an important area for research with increasingly sensitive metrics and new technologies. This study uses 2 recently developed patient-reported scores to compare the recovery following UKA and TKA. Methods: Two consecutive cohorts of 37 UKAs and 33 TKAs completed the Oxford Arthroplasty Early Recovery Score (OARS) and the Oxford Arthroplasty Early Change Score (OACS) on days 1, 2, 3, 7, 14, and week 6. The Short Form-36 version 2 was also completed on weeks 1, 2, and 6. Improvements within cohorts and comparisons between cohorts were assessed. Results: For both UKA and TKA the speed of recovery was rapid early on and then progressively decreased. At all time points, the UKA cohort reported similar or significantly better scores than the TKA cohort. The overall OARS (P < .001) showed that UKA recovered, shown as improvement on the OARS, 2-3 times faster than TKA. OARS subscales demonstrated that UKA had better Function/Mobility (P = .003) particularly early in the recovery, and better Nausea/Feeling Unwell (P < .001) and Fatigue/Sleep (P = .009) later in the recovery. UKA also had less pain at 2 weeks (P = .03). There was no significant difference between UKA and TKA OACS. UKA had significantly better scores in 3 of the 8 Short Form-36 domains, with the largest difference being in Role-Emotional (P = .003). Conclusion: The OARS is useful for the assessment of postoperative recovery. This study provides direct evidence that recovery following UKA is better and 2-3 times faster than following TKA. All differences may be explained by the less invasive nature of UKA.
MeSH term(s)	Arthroplasty, Replacement, Knee ; Cohort Studies ; Humans ; Knee Joint/surgery ; Osteoarthritis, Knee/surgery ; Patient Reported Outcome Measures ; Treatment Outcome
Language	English
Publishing date	2021-05-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2021.05.025
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Article ; Online: Calcar-collar contact during simulated periprosthetic femoral fractures increases resistance to fracture and depends on the initial separation on implantation: A composite femur in vitro study.

Lamb, Jonathan N / Coltart, Oliver / Adekanmbi, Isaiah / Pandit, Hemant G / Stewart, Todd

Clinical biomechanics (Bristol, Avon)

2021 Volume 87, Page(s) 105411

Abstract: Background: A calcar collar may reduce risk of periprosthetic fracture of the femur, through collar contact. We estimated the effect of collar contact on periprosthetic fracture mechanics using a collared fully coated cementless femoral stem and then ... ...

Abstract	Background: A calcar collar may reduce risk of periprosthetic fracture of the femur, through collar contact. We estimated the effect of collar contact on periprosthetic fracture mechanics using a collared fully coated cementless femoral stem and then estimated the effect of initial calcar-collar separation on the likelihood of collar contact. Methods: Three groups of six composite left femurs with increasing calcar-collar separation in each group, underwent periprosthetic fracture simulation in a materials testing machine. Fracture torque and rotational displacement were measured and torsional stiffness and rotational work prior to fracture were estimated. Calcar collar contact prior to fracture was identified using high speed camera footage. Findings: Where calcar-collar contact occurred fracture torque was greater (47.33 [41.03 to 50.45] Nm versus 38.26 [33.70 to 43.60] Nm, p = 0.05), Rotational displacement was less (16.6 [15.5 to 22.3] degrees versus 21.2 [18.9 to 28.1] degrees, p = 0.07), torsional stiffness was greater (151.38 [123.04 to 160.42] rad.Nm Interpretation: Surgeons should reduce calcar-collar separation at stem implantation to a maximum of 1 mm to increase the chance of calcar-collar contact during injury and reduce the risk of early post-operative femoral fracture.
MeSH term(s)	Arthroplasty, Replacement, Hip/adverse effects ; Femoral Fractures/etiology ; Femoral Fractures/surgery ; Femur/diagnostic imaging ; Femur/surgery ; Hip Prosthesis ; Humans ; Periprosthetic Fractures/etiology ; Periprosthetic Fractures/surgery
Language	English
Publishing date	2021-06-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632747-3
ISSN	1879-1271 ; 0268-0033
ISSN (online)	1879-1271
ISSN	0268-0033
DOI	10.1016/j.clinbiomech.2021.105411
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Zs.B 2876: Show issues

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Article ; Online: Kinematically Aligned Total Knee Arthroplasty or Mechanically Aligned Total Knee Arthroplasty.

Takahashi, Tsuneari / Ansari, Juned / Pandit, Hemant G

The journal of knee surgery

2018 Volume 31, Issue 10, Page(s) 999–1006

Abstract: Kinematically aligned total knee arthroplasty (KATKA) was developed to more anatomically align the knee prosthesis to restore the native alignment of the knee and promote physiological kinematics. Even though there are concerns with implant survival, and ...

Abstract	Kinematically aligned total knee arthroplasty (KATKA) was developed to more anatomically align the knee prosthesis to restore the native alignment of the knee and promote physiological kinematics. Even though there are concerns with implant survival, and follow-up at 10 years or more after KATKA has not been reported, there is a negligible incidence of failure of a tibial component at 2 to 9 years. Early clinical results with this technique are encouraging and demonstrate better functional outcomes compared with mechanically aligned TKA (MATKA). The purpose of this study is to perform a systematic review and meta-analysis of the literature to determine whether there are any clinical differences between KATKA and MATKA. The authors conducted a systematic review of the English literature. Five randomized controlled trials (RCTs) which compared clinical outcomes of KATKA and MATKA were finally included. Four RCTs used patient-specific instrument, and one RCT used navigation. Data were extracted and meta-analysis was conducted. KATKA patients had better outcomes: Mean difference between KATKA and MATKA and
MeSH term(s)	Arthroplasty, Replacement, Knee/methods ; Biomechanical Phenomena ; Humans ; Knee Joint/surgery ; Knee Prosthesis ; Osteoarthritis, Knee/physiopathology ; Osteoarthritis, Knee/surgery ; Randomized Controlled Trials as Topic ; Range of Motion, Articular/physiology
Language	English
Publishing date	2018-02-14
Publishing country	Germany
Document type	Comparative Study ; Journal Article ; Meta-Analysis ; Review
ZDB-ID	2075354-8
ISSN	1938-2480 ; 1538-8506 ; 0899-7403
ISSN (online)	1938-2480
ISSN	1538-8506 ; 0899-7403
DOI	10.1055/s-0038-1632378
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Zs.A 3867: Show issues

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Article ; Online: The Oxford Medial Unicompartmental Knee Arthroplasty: The South African Experience.

Campi, Stefano / Pandit, Hemant G / Oosthuizen, Christiaan R

The Journal of arthroplasty

2018 Volume 33, Issue 6, Page(s) 1727–1731

Abstract: Background: The Oxford unicompartmental knee arthroplasty (OUKA) is a successful treatment for endstage, symptomatic anteromedial osteoarthritis. This study reports the results of a cohort of consecutive cemented and cementless medial OUKAs from an ... ...

Abstract	Background: The Oxford unicompartmental knee arthroplasty (OUKA) is a successful treatment for endstage, symptomatic anteromedial osteoarthritis. This study reports the results of a cohort of consecutive cemented and cementless medial OUKAs from an independent center and aims to answer the following questions: what is the survival of OUKA in the hands of a nondesigner surgeon? Are there any differences in the survival of cementless and cemented OUKA? Are the failure modes any different with the cementless and cemented OUKA? Methods: One thousand one hundred twenty consecutive OUKAs were implanted in a single center for the recommended indications. Patients were prospectively identified and followed up. Survival was calculated with revision as the end point. Results: There were 522 cemented and 598 cementless implants. The mean follow-up was 8.3 years for cemented implants (range 0.5-17, standard deviation [SD] 2.9) and 2.7 years (range 0.5-7, SD 1.8) for cementless implants. The Oxford knee score improved from a preoperative mean of 22 (SD 8.1) to 40 (SD 7.9) at the last follow-up (P < .001). There were 59 failures requiring revision surgery, with a 5.3% cumulative revision rate. The most common reason for failure was progression of osteoarthritis in the lateral compartment, occurred in 26 cases (2.3%). The cumulative 10-year survival was 91% (95% confidence interval 87.3-95.2). Conclusion: The results of this prospective, consecutive case series from the African continent demonstrated that excellent results are achievable with the OUKA in independent centers if the correct indications and surgical technique are used.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/methods ; Arthroplasty, Replacement, Knee/statistics & numerical data ; Bone Cements ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Knee Prosthesis/adverse effects ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery ; Prospective Studies ; Prosthesis Failure/etiology ; Reoperation/statistics & numerical data ; South Africa ; Treatment Outcome
Chemical Substances	Bone Cements
Language	English
Publishing date	2018-02-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2018.01.035
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