Christopher Little
Nuffield Orthopaedic Centre
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Journal of Bone and Joint Surgery-british Volume | 2005
Christopher Little; A J Graham; A J Carr
Prosthetic total elbow arthroplasty (TEA) is a recognised treatment for the painful arthritic elbow. The available implants can be broadly grouped into linked, where the humeral and ulnar components are physically connected, and unlinked. The former group can be subdivided further depending on
Journal of Bone and Joint Surgery, American Volume | 2005
Christopher Little; Alastair J. Graham; Georgios Karatzas; David A. Woods; A J Carr
BACKGROUND As the English-language literature on prosthetic elbow arthroplasty contains only two comparative studies of implants in contemporary use, to our knowledge, comparisons of prosthetic performance is difficult. An improved knowledge of comparative outcomes would be valuable in guiding implant selection. METHODS We identified three groups of consecutive patients who had undergone prosthetic elbow arthroplasty with the Souter-Strathclyde, Kudo, or Coonrad-Morrey implant for the treatment of rheumatoid arthritis. There were thirty-three elbows in each group. All procedures were done by or under the supervision of one surgeon. Surviving patients in whom the elbow had not been revised were followed for a mean of sixty-one months after treatment with the Souter-Strathclyde implant, sixty-seven months after treatment with the Kudo implant, and sixty-eight months after treatment with the Coonrad-Morrey implant. Clinical function was assessed on the basis of pain relief and the range of flexion. Survivorship was assessed with use of a life-table method, with revision surgery and radiographic signs of loosening as the end points. RESULTS The groups were comparable in terms of age, sex, and mean duration of follow-up. All three implant procedures relieved pain. Sustained improvement in the range of flexion was comparable among the three groups, with no implant procedure dramatically changing the fixed flexion deformity and all three improving maximum flexion. Revision surgery was needed because of infection, dislocation, and aseptic loosening. Survival of the Coonrad-Morrey implant was better than that of the other two implants. The five-year survival rates, with revision and radiographic signs of loosening as the end points, were 85% and 81% for the Souter-Strathclyde implant, 93% and 82% for the Kudo implant, and 90% and 86% for the Coonrad-Morrey implant. While radiographic evidence of loosening of the Coonrad-Morrey implants was less common, we noted focal osteolysis adjacent to 16% of these ulnar components and half of these cases progressed to frank loosening. CONCLUSIONS The clinical function of these implants was similar in terms of pain relief and range of motion. We believe that component linkage with the Coonrad-Morrey implant prevents dislocation without increasing the risk of loosening.
Hand Surgery | 2012
Benjamin Dean; Giles W. Becker; Christopher Little
There is no consensus regarding the optimal mode of managing the acute traumatic subungual haematoma in the hand. In this context the medical literature was searched systematically and the results analysed. The final dataset consisted of four articles. The complication rates of all forms of treatment were low. The outcome in terms of nail cosmesis was generally good, although the method of outcome measurement was variable in nature. There was no difference in cosmetic outcome when comparing nail bed repair with simple decompression. In conclusion the outcome in terms of nail cosmesis does not appear to be affected by the mode of treatment. The acutely painful subungual haematoma should be decompressed, whether this be done by trephining or nail removal. Future research includes the potential for a randomised controlled trial to compare nail bed repair with trephination.
Shoulder & Elbow | 2018
Stuart Hay; Rohit Kulkarni; Adam C. Watts; David Stanley; I. A. Trail; Lee van Rensburg; Christopher Little; Vas Samdanis; P. J. Jenkins; Michael Eames; Joideep Phadnis; Amjid Ali; Amar Rangan; Steve Drew; Rouin Amirfeyz; Veronica Conboy; David I. Clark; Peter Brownson; Clare Connor; Val Jones; Duncan Tennent; Mark Falworth; Michael Thomas; Jonathan Rees
BESS Surgical Procedure Guidelines (SPGs). Optimising Surgical Outcomes for Shoulder and Elbow patients. The British Elbow and Shoulder Society (BESS) SPGs are a series of evidence and consensus Best Practice Recommendations developed by BESS surgeons and physiotherapists to help drive quality improvement and achieve the best possible surgical outcomes for UK patients. This SPG on primary and revision elbow replacement surgery is supported and endorsed by both the British Orthopaedic Association (BOA) and the Getting It Right First Time (GIRFT) Programme.
Journal of Bone and Joint Surgery-british Volume | 2008
Jill Dawson; Helen Doll; I Boller; Ray Fitzpatrick; Christopher Little; Jonathan Rees; Crispin Jenkinson; A J Carr
Quality of Life Research | 2008
Jill Dawson; Helen Doll; Irene Boller; Ray Fitzpatrick; Christopher Little; Jonathan Rees; A J Carr
Journal of Shoulder and Elbow Surgery | 2010
Jill Dawson; Helen Doll; Irene Boller; Ray Fitzpatrick; Christopher Little; Jonathan Rees; Andrew Carr
Orthopaedics and Trauma | 2011
Benjamin Dean; Christopher Little
Orthopaedics & Traumatology-surgery & Research | 2012
Jill Dawson; Helen Doll; Irene Boller; Ray Fitzpatrick; Christopher Little; Jonathan Rees; Andrew Carr
F1000Research | 2018
Benjamin Dean; Shwan Henari; Neal Thurley; Christopher Little; Ian McNab; Nicholas Riley