Publications

The Role of Anterolateral Ligament Reconstruction or Lateral Extra-articular Tenodesis for Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Comparative Clinical Studies – Khalis Boksh, Nomaan Sheikh, Han Hong Chong, Arijit Ghosh, Randeep Aujla, 2024

Background: After its success in restoring rotational stability and reducing failure rates in primary anterior cruciate ligament reconstruction (ACLR), lateral extra-articular tenodesis (LET) or anterolateral ligament reconstruction (ALLR) has been endorsed for use in revision ACLR surgery, where failure rates are historically higher.

Combined quadriceps medial patellofemoral ligament reconstruction and osteochondral fixation offers good patient-reported outcomes and low rates of recurrent instability for osteochondral defects secondary to acute patella dislocation – Knee Surgery, Sports Traumatology, Arthroscopy

Background: Chondral injuries secondary to traumatic patella dislocation are common, and a subgroup of these are significant defects with fragments amenable to fixation. There is a paucity of published evidence assessing patients managed with combined acute patellofemoral stabilisation and osteochondral fixation. The purpose of this study is to report the outcomes of patients with osteochondral injuries secondary to acute traumatic patella dislocation treated with combined early fragment fixation and MPFL reconstruction using a quadriceps tendon turndown technique which has distinct advantages for this cohort, including preventing chondral overloading and non-violation of the patella bone.

Fibular- Versus Tibiofibular-Based Reconstruction of the Posterolateral Corner of the Knee: A Systematic Review and Meta-analysis – Khalis Boksh, Arijit Ghosh, Prithish Narayan, Pip Divall, Randeep Aujla, 2023

Background: Fibular- and tibiofibular-based reconstructions are the gold standard treatment for posterolateral corner (PLC) injuries of the knee. Despite comparable outcomes in biomechanical studies, clinical results comparing these constructs remain elusive with no consensus reached regarding the best treatment option.

The Effect of a Formal Nonoperative Management Program Combining a Hip Injection With Structured Adjunctive Exercise Rehabilitation in Patients With Symptomatic Femoroacetabular Impingement Syndrome – Jay R. Ebert, Antony C. Raymond, Randeep S. Aujla, Peter D’Alessandro, 2023

Background: Although the initial treatment recommendations for femoroacetabular impingement syndrome (FAIS) may include nonsurgical therapies such as injections and rehabilitation, many patients undergo isolated injections or a rudimentary exercise regimen.

Eighty-two per cent of male professional football (soccer) players return to play at the previous level two seasons after Achilles tendon rupture treated with surgical repair

Background: Objective To evaluate the time to return to playing following acute Achilles tendon rupture (ATR) and surgical repair in professional male football (soccer) players.

Fibular-Versus Tibiofibular-Based Reconstruction of the Posterolateral Corner of the Knee: A Systematic Review and Meta-analysis.

Background: Fibular- and tibiofibular-based reconstructions are the gold standard treatment for posterolateral corner (PLC) injuries of the knee. Despite comparable outcomes in biomechanical studies, clinical results comparing these constructs remain elusive with no consensus reached regarding the best treatment option.

The Effect of a Formal Nonoperative Management Program Combining a Hip Injection With Structured Adjunctive Exercise Rehabilitation in Patients With Symptomatic Femoroacetabular Impingement Syndrome.

Background: Although the initial treatment recommendations for femoroacetabular impingement syndrome (FAIS) may include nonsurgical therapies such as injections and rehabilitation, many patients undergo isolated injections or a rudimentary exercise regimen.

A systematic review on management and outcome of irreducible knee dislocations.

Background: Irreducible knee dislocations (IKD) are rare and can often be missed or mis-daignosed. The incidence of knee dislocation is quoted between 0.01% and 0.2% of all orthopaedic injuries, with up to 4% of these dislocations sub-classified as irreducible. The primary aim of this systematic review was to analyse cases of IKD described in the literature, with a secondary aim of producing a streamlined approach for managing these patients.

Bone and Soft Tissue Tumours. InCurrent Orthopaedic Practice 2022 (pp. 343-376). Springer, Cham.

Bone and Soft Tissue Tumours

Anterior Cruciate Ligament Reconstruction Using Autologous Hamstrings Augmented With the Ligament Augmentation and Reconstruction System Versus Hamstrings Alone: A Comparative Cohort Study

Background Few studies have reported the return-to-sports (RTS) rate in patients after augmentation of autologous anterior cruciate ligament reconstruction (ACLR) with the Ligament Augmentation and Reconstruction System (LARS). Purpose/Hypothesis The purpose of this study was to compare postoperative outcomes in patients who underwent ACLR with si...

Outcomes of Unconstrained Proximal Interphalangeal Joint Arthroplasty: A Systematic Review

Background: Unconstrained pyrocarbon and metal-on-polyethylene (MoP) proximal interphalangeal (PIP) joint arthroplasty is an increasingly popular alternative to silicone implants and arthrodesis. This systematic review appraises their outcomes. Methods: 30 studies comprising 1,324 joints (813 pyrocarbon, 511 MoP) were included. Mean patient age was...

Journey-Deuce bicompartmental knee arthroplasty with the addition of computer navigation achieves good clinical outcomes and implant survival at 10 years

PurposeTo report 10-year outcomes and survivorship in patients undergoing bicompartmental knee arthroplasty (BCKA) using the Journey-Deuce prosthesis in a consecutive prospective case series.Methods Between November 2006 and November 2009, 41 patients with a mean age of 69.6 years (range 51–86) underwent 51 bicompartmental knee arthroplasties with...

Distal Tibial Osteotomy for Varus Ankle Arthritis: A Meta-Analysis and Systematic Review

Joint preserving surgical options are essential in modern orthopaedic care. The aim of this study was to review current literature about distal tibial osteotomies for varus osteoarthritis of the ankle joint. A clinical librarian searched electronic from inception to August 2019 using standard terms. Studies that assessed distal tibial osteotomy out...

Vitamin D and the athlete-patient: State of the art review

Vitamin D deficiency is common in athletes. The conventional measurement of vitamin D levels provides a general indicator of body stores. However, there are nuances in its interpretation as values of 25(OH)D do not correlate absolutely with the amount of 'bioavailable' vitamin to the cells. Vitamin D should be regarded as a hormone and influences b...

An analysis of the impact of COVID-19 on Trauma and Orthopaedic services at Fiona Stanley and Fremantle Hospitals

COVID-19 Global Pandemic devastated many healthcare systems around the world. In a response to contain the spread of the virus in Western Australia, lockdown restrictions were imposed between 30th March to 6thJune. During this period, our institutions underwent a significant reorganisation of our department. We evaluated our Trauma and Orthopaedic...

Medium-Term Results of Corticosteroid Injections for Morton’s Neuroma

Background: The objective of this study was to evaluate the medium-term results of corticosteroid injections for Morton’s neuroma. Methods: This was a prospective follow-up study of a previous randomized controlled trial (RCT). Forty-five neuromas in 36 patients were injected with a single corticosteroid injection either with or without ultrasound...

Modern Management of Ankle Arthritis Including Primary Ankle Replacement

About 1% of the world’s population is affected by ankle osteoarthritis (OA). It is nine times less prevalent than hip and knee OA. Around 80% of cases are secondary to previous trauma, with 12% due to inflammatory diseases and only 7% occurring primarily. Various radiological classifications exist and these will be discussed in the chapter. Nonoper...

Peri‐operative administration of tranexamic acid in lower limb arthroplasty: a multicentre, prospective cohort study

In the UK , tranexamic acid is recommended for all surgical procedures where expected blood loss exceeds 500 ml. However, the optimal dose, route and timing of administration are not known. This study aimed to evaluate current practice of peri‐operative tranexamic acid administration. Patients undergoing primary total hip arthroplasty, total knee a...

Corrigendum to ‘Is regional ankle block needed in conjunction with general anaesthesia for first ray surgery? A randomised controlled trial of ultrasound guided ankle block versus “blind” local infiltration’ [Foot and Ankle Surgery 26 (2020) 66–70]

Non-surgical treatments for Morton's neuroma: A systematic review

Title: Non-surgical treatment for Morton's neuroma: a systematic review. Background: Morton's neuroma (MN) is an entrapment degenerative neuropathy with a strong predilection for the 3rd interdigital web space. The objective of our study was to identify the most significant evidence produced for the non-operative treatment of Morton's neuroma an...

Eighty-two per cent of male professional football (soccer) players return to play at the previous level two seasons after Achilles tendon rupture treated with surgical repair

Objective To evaluate the time to return to playing following acute Achilles tendon rupture (ATR) and surgical repair in professional male football (soccer) players. Methods Professional male football (soccer) players who sustained an ATR and underwent surgical repair were identified through internet-based injury reports from January 2008 to Augus...

Musculoskeletal Injections and Alternative Options: A practical guide to 'what, when and how?'

Musculoskeletal injections for joint or tendon problems are performed commonly and their use is on the rise. This book helps doctors from various disciplines including orthopaedics, sports medicine, rheumatology radiology and primary care as well as allied health care professionals understand the indications and local anatomy to safely perform inje...

Non-Operative Functional Treatment for Acute Achilles Tendon Ruptures: The Leicester Achilles Management Protocol (LAMP)

Objectives: The purpose of this study is to present outcomes and objective measures of assessment for acute Achilles tendon (AT) ruptures treated with an eight-week functional dynamic treatment protocol in a VACOped® boot with immediate full weight bearing mobilisation, the Leicester Achilles Management Protocol (LAMP). Methods: A prospective st...

Extracorporeal shock wave therapy

Objectives: The purpose of this study is to present outcomes and objective measures of assessment for acute Achilles tendon (AT) ruptures treated with an eight-week functional dynamic treatment protocol in a VACOped® boot with immediate full weight bearing mobilisation, the Leicester Achilles Management Protocol (LAMP). Methods: A prospective st...

Extracorporeal shock wave therapy

Vitamin D and foot and ankle trauma: An individual or societal problem

Background: Vitamin D deficiency is a worldwide health concern. Hypovitaminosis D may adversely affect recovery from bone injury. The authors aimed to perform an audit of the Vitamin D status of patients in three centres in the United Kingdom presenting with foot and ankle osseous damage. Methods: Serum 25-hydroxyvitamin-D (vitamin D) levels wer...

Is regional ankle block needed in conjunction with general anaesthesia for first ray surgery? A randomised controlled trial of ultrasound guided ankle block versus “blind” local infiltration

Background: Regional anaesthesia is commonly utilised for foot and ankle surgery. Debate remains at to the level of regional anaesthesia that is required. The objective of this study was to evaluate whether surgeon-delivered "blind" local anaesthetic infiltration around the first ray (metatarsal block without ultrasound guidance) was as effective...

Acute Achilles Tendon Rupture Treatment: Where are we now?

Objective Our objective was to review the current literature regarding acute Achilles tendon ruptures and provide a succinct summary of the use of clinicians treating Achilles tendon ruptures. We aim to provide guidance for treatment based upon current literature. Methods We reviewed current literature and subjectively assessed for quality and inf...

Vitamin D Levels in 577 Consecutive Elective Foot & Ankle Surgery Patients

Background: Vitamin D deficiency is a global concern impacting upon large communities and certain disease populations. It can adversely affect the outcome of orthopaedic operations. We aimed to perform an audit of the Vitamin D status of patients in two centres in the United Kingdom undergoing elective foot and ankle surgery. Methods: Serum 25-h...

Leicester Achilles Management Programme (LAMP)

Introduction Conservative treatment of acute AT ruptures with functional rehabilitation has demonstrated superior results to surgery with equal reported re-rupture rates without the added complications of surgical treatment. The variation in patient selection for functional rehabilitation as well as the duration and type of rehabilitation regime u...

Total Knee Arthroplasty for Osteoarthritis in Patients

Background The proportion of younger patients undergoing total knee arthroplasty (TKA) is increasing and predictions state that the <55 age group will be the fastest growing group by 2030. We aim to collate data across studies to assess functional outcomes following TKA in patients <55 years of age using a systematic review. Methods The search ide...

Predictors of Functional Outcome in Non-Operatively Managed Achilles Tendon Ruptures

Background Acute Achilles tendon (AT) rupture management remains debatable but non-operative functional regimes are beginning to gain popularity. The aim of this study was to identify predictors of functional outcome in patients with AT ruptures treated non-operatively with an immediate weight bearing functional regime in an orthosis. Methods Anal...

Unconstrained metacarpophalangeal joint arthroplasties: a systematic review

Aims: We performed a systematic review of the current literature regarding the outcomes of unconstrained metacarpophalangeal joint (MCPJ) arthroplasty. Materials and methods: We initially identified 1305 studies, and 406 were found to be duplicates. After exclusion criteria were applied, seven studies were included. Outcomes extracted included p...

2015 The management of TL burst fractures

2016 A review of current surgical practice in the operative treatment of proximal humeral fractures

A review of current surgical practice in the operative treatment of proximal humeral fractures: Does the PROFHER trial demonstrate a need for change?

Objectives: The PROximal Fracture of the Humerus: Evaluation by Randomisation (PROFHER) trial has recently demonstrated that surgery is non-superior to non-operative treatment in the management of displaced proximal humeral fractures. The objective of this study was to assess current surgical practice in the context of the PROFHER trial in terms o...

The management of thoracolumbar burst fractures: a prospective study between conservative management, traditional open spinal surgery and minimally interventional spinal surgery

The objective of this study was to assess which patient group had better outcomes for management of single level thoracolumbar spinal fractures. We prospectively collected data on the outcomes of patients having either conservatively managed, traditional open surgery, or minimally interventional surgery (MIS) for treatment of a single level thoraco...

Non-Surgical Treatment of Achilles Rupture: Does Duration in Functional Weight Bearing Orthosis Matter?

Background: The treatment of acute Achilles tendon ruptures is continually being debated. The success of non-surgical regimes is now evident yet there remains a high rate of surgery in the United States of America and Scandinavia. Recent studies have investigated functional outcome rather than complication rates as primary outcome but the current...

Extra-abdominal desmoid fibromatosis - A sarcoma unit review of practice, long term recurrence rates and survival

Introduction Desmoid fibromatosis (DF) carries a significant morbidity and a recognised mortality. Despite this there are currently limited diagnostic or treatment algorithms specific to cases of extra-abdominal DF. Historically surgical excision has formed the cornerstone of treatment. Recently however a paradigm shift has meant many practitioners...

The hip fracture best practice tariff: early surgery and the implications for MRSA screening and antibiotic prophylaxis

In April 2010, the Department of Health introduced the hip fracture best practice. Among the clinical criteria required to earn remuneration is surgery within 36 h of admission. However, early surgery may mean that methicillin-resistant Staphylococcus aureus (MRSA) colonisation status is not known before surgery, and therefore, appropriate antibiot...

Trends in orthopaedic antimicrobial prophylaxis in the UK between 2005 and 2011

Antimicrobial prophylaxis remains the most powerful tool used to reduce infection rates in orthopaedics but the choice of antibiotic is complex. The aim of this study was to examine trends in antimicrobial prophylaxis in orthopaedic surgery involving the insertion of metalwork between 2005 and 2011. Two questionnaires (one in 2008 and one in 2011)...

Specialist Orthopaedic Nurses: Frontline for Fracture Clinic Referrals

Emergency department (ED) and general practitioner (GP) referrals to orthopaedic fracture clinics are increasing. As a consequence, these clinics regularly operate at or beyond full capacity. In many institutions, all ED referrals are booked into and seen in the fracture clinic within 24 hours of presentation to the ED. A proportion of these appoin...

Trends in antimicrobial prophylaxis in trauma in the United Kingdom

The hip fracture best practice tariff: Early surgery and the implications for MRSA screening and antibiotic prophylaxis

Radiographs late in the follow up of uncomplicated distal radius fractures – Are they worth it? Clinical outcome and financial implications

Fractures of the distal radius are common. Displacement can quickly lead to secondary osteoarthritis. Early follow up radiographs are subsequently paramount to facilitate for early attempts at reduction. Developing callus eventually makes this impractical. In the absence of complications we propose that radiographs may become obsolete at the later...

Total Hip Arthroplasty—Over 100 years of operative history

Total hip arthroplasty (THA) has completely revolutionized the nature in which the arthritic hip is treated, and is considered to be one of the most successful orthopaedic interventions of its generation. With over 100 years of operative history, this review examines the progression of the operation from its origins, together with highlighting the...

Total Hip Arthroplasty -over 100 years of operative history

Total hip arthroplasty (THA) has completely revolutionized the nature in which the arthritic hip is treated, and is considered to be one of the most successful orthopaedic interventions of its generation. With over 100 years of operative history, this review examines the progression of the operation from its origins, together with highlighting the...

Outcome of operative management of extra-articular mid-shaft and distal tibial fractures in a district general hospital

A near miss: An uncommon injury following a common mechanism

Subtalar dislocation is an uncommon injury involving the simultaneous dislocation of the talocalcaneal and talonavicular joints. Radiographic images can be difficult to interpret for the inexperienced clinician because of the obliquity of the foot and the overlap of tarsal bones. The authors describe the case of a 24-year-old male who presented to...

Orthopaedic antimicrobial prophylaxis in the United Kingdom

Using the Freedom of Information Act, a five-point questionnaire was sent to all NHS Trusts in the United Kingdom: Eighty two per cent of NHS Trusts in the UK who had an orthopaedic department replied. The top three antimicrobial prophylaxis regimes in orthopaedic surgery were cefuroxime alone (trauma 48%, elective 56%), flucloxacillin plus gentami...

Can we save a follow up appointment by leaving nylon sutures under plaster for 6 weeks

Can we save a follow up appointment by leaving nylon sutures under plaster for 6 weeks

Randeep Aujla, Abhinav Gulihar, Andrew Chandraraj, Graham TaylorOrthopaedic Department, Glenfield Hospital, Groby Road, Leicester, EnglandBackground: The purpose of this study was to highlight the potential resource saving method of leaving nylon sutures under plaster for 6 weeks after forefoot surgery. Methods: We gathered patient data from 72 cas...

Acromial stress fracture in a young wheelchair user with Charcot-Marie-Tooth disease: a case report

: Acromial stress fractures are rare and have not been highlighted as a potential complication of wheelchair use. We report the case of a 22-year old female wheelchair bound patient with Charcot-Marie-Tooth disease who presented with a four-year history of shoulder pain which impaired mobility and quality of life. Plain radiographs showed a cortica...