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  1. Rao RP, Lim ATT, Ho JPY, Ong LH, Kamaruddin F
    Cureus, 2024 Nov;16(11):e73707.
    PMID: 39677165 DOI: 10.7759/cureus.73707
    Background  In the presence of distal femoral condyle bone loss, estimation and restoration of the joint line (JL) position can be guided by extraarticular bony landmarks with the aid of mathematical formulas that rely on the innate correlations between periarticular measurements. To prevent JL elevation, the formula should incorporate the thickness of distal femoral articular cartilage. The aim of this study was to derive a formula to estimate native JL position. Methods One hundred and fifty knee magnetic resonance imaging (MRI) studies belonging to 150 patients were chosen from a database of scans. Multiple periarticular measurements were taken. Based on the strongest correlation between measurements, linear regression analysis was used to derive a regression equation to estimate the JL position. This formula was then tested to determine its accuracy and reliability in estimating the JL. Results  Using the Pearson correlation test, the strongest correlation was identified to be between adductor tubercle to joint line distance (ATJL) and transepicondylar width (TEW) with r = 0.723, p
  2. Ho JPY, Wong AYF, Ong LH, Rutel A, Abdullah S, Jaffar MSA, et al.
    Geriatr Orthop Surg Rehabil, 2023;14:21514593231164245.
    PMID: 36923160 DOI: 10.1177/21514593231164245
    BACKGROUND: Neck of femur fractures result in impaired function for older people. Despite surgery, many patients experience a decrease in functional level and poorer health status after the injury. The objectives of this study were (1) to determine the short-term mobility and hip function of geriatric patients who underwent hip replacement surgery for a displaced neck of femur fracture in our local population and (2) to identify factors which affect the functional outcome of these patients.

    METHODS: Patients aged 60 years and above, who were admitted for neck of femur fracture from January 2017 to December 2020, and treated surgically with arthroplasty, were included. Information on patient demography, comorbidities, perioperative data, mobility, hip function and complications were retrospectively collected. Outcome measures used were independent ambulation and recovery of pre-fracture mobility at 1 year after surgery while hip function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, pain, stiffness, and physical function scores. Factors associated with these outcomes were analyzed.

    RESULTS: 168 patients with a mean age of 75.2 (SD 8.4) years met the inclusion criteria. 32.1% of patients regained their pre-fracture mobility and 59.6% remained independent 1 year after surgery. Logistic regression analysis identified age, gender, surgical procedure, and time to surgery as significant contributors to recovery of pre-fracture mobility. Older age and increasing requirement for postoperative ambulatory aid resulted in worse WOMAC total and physical function scores. No significant differences were observed in patient-reported hip function between those who had a total hip arthroplasty and those who had a hemiarthroplasty.

    CONCLUSION: Most geriatric patients with displaced neck of femur fractures did not regain pre-fracture mobility despite surgical treatment with arthroplasty.

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