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A survey conducted by the UK Aortic Society aimed to assess the current state of aortic disease treatment in the UK and its compliance with best practices. The survey revealed significant variations in how aortic services are provided across the UK, with some centers offering advanced treatments while others lack crucial resources. The findings highlight the need for improvement in several areas, including concentrating complex aortic surgeries in high-volume centers, establishing regional rotas, implementing standardized protocols, and investing in regional educational programs for aortic diseases. A dedicated database for aortic surgeries would allow for outcome tracking and continuous improvement. [Extracted from the article]

Background: Reverse shoulder arthroplasty is the mainstay of treatment for symptomatic irreparable rotator cuff tears in elderly patients without arthritis. However, this treatment incurs significant costs and is a major surgical undertaking. This study explores an alternative that involves the reconstruction of irreparable rotator cuff tears using an acellular dermal matrix in elderly patients without established joint arthritis. Methods: We prospectively evaluated the reconstruction of massive irreparable rotator cuff tears in 21 patients aged 68 years and over without radiographic glenohumeral joint osteoarthritis in whom conservative management had failed. A human dermal acellular matrix graft was used as a bridging graft for reconstruction. Pain scores, Oxford Shoulder Scores and ranges of movement were all assessed preoperatively and postoperatively. The mean follow-up period was 5.8 years (range 2.6 to 8.9 years). Results: Statistically significant (p < 0.05) improvements were observed in Oxford Shoulder Scores (mean preoperative score, 21; mean postoperative score, 46), pain scores (mean preoperative score, 6; mean postoperative score, 0) and ranges of movement. Patients also reported a high satisfaction rate with the procedure. Discussion: Human tissue matrix allografts could serve as a suitable option for the treatment of elderly patients with massive irreparable rotator cuff tears without arthritis. [ABSTRACT FROM AUTHOR]

Introduction: Indications for surgical management of displaced humeral shaft fractures are not clearly established, leading to variations in practice. The aim of this study was to determine the scale of these variations in the UK practice to help design a future national trial. Methods: An online survey was sent to all surgeon members of British Elbow and Shoulder Society to help define humeral shaft fractures, fracture displacement as well as indications for operative and non-operative management. Patient and injury related factors considered important when managing humeral shaft fractures were investigated. Results: The survey achieved a response rate of 32% (104/327). There was a lack of consensus on definitions for humeral shaft fractures and fracture displacement. A functional brace was the most common form of non-operative treatment (63%). Majority immobilise humeral shaft fractures for 4–8 weeks or until callus are visible (62%) with a similar number considering operative treatment if adequate signs of healing are not present at around 12–16 weeks. Around half of our respondents exclusively use plates with variations in preference of approach and a minority (2%) exclusively use intra-medullary nails. Conclusion: The significant variation in management of displaced humeral shaft fractures in the UK suggests a clear need to evaluate clinical and cost effectiveness through a multi-centre randomised trial. [ABSTRACT FROM AUTHOR]

AIM: The purpose of this Study to analysed to study whether the dysfunction on various subscales of Dysfunctional Analysis Questionnaire (DAQ) - social, vocational, personal, familial, and cognitive is affected by the degree of social support. METHODS: This was a Questionnaire Based cross-sectional study conducted from March 2018 to September 2019. The study wear conducted in Rama Medical College Hospital & Research Centre, Ghaziabad, Uttar Pradesh. Used structured test - Dysfunctional Analysis Questionnaire (DAQ). The randomly selected children (Age 7 to 12 Years), referred by doctors, teachers, tuition teacher, and parents for psychological evaluation and management. Total n 57). Used IBMSPSS-25 software to analysed Average, percentile, mean, variance, frequency, and paired t-test. RESULTS: The current study found statistically significant changes in Social (t value 3.291), Vocational (t value 4.769), Personal (t value 3.334), Family (t value 3.664), and Cognitive (t value 1.727), statistically significant at p<0.05 level). CONCLUSION: Our findings showed that social support training had a significant and positive effect on social, vocational, personal, family, and cognitive skills. The social support-based training relevant outcome, in this approach and beneficial changes seen in parents' mental health specially in mothers' reduction of frustration, depression, anxiety, and negative effects of life stress and enhanced self-esteem. [ABSTRACT FROM AUTHOR]

Abstract Background The uncemented Nottingham Total Shoulder Replacement prosthesis system (Nottingham TSR) was developed from the previous BioModular® shoulder prosthesis taking into consideration the causes of the initial implant's failure. We investigated the impact of changes in the design of Nottingham TSR prosthesis on its survivorship rate. Methods Survivorship analyses of three types of uncemented total shoulder arthroplasty prostheses (BioModular®, initial Nottingham TSR and current Nottingham TSR systems with 11, 8 and 4 year survivorship data respectively) were compared. All these prostheses were implanted for the treatment of disabling pain in the shoulder due to primary and secondary osteoarthritis or rheumatoid arthritis. Each type of the prosthesis studied was implanted in consecutive group of patients – 90 patients with BioModular® system, 103 with the initial Nottingham TSR and 34 patients with the current Nottingham TSR system. The comparison of the annual cumulative survivorship values in the compatible time range between the three groups was done according to the paired t test. Results The 8-year and 11-year survivorship rates for the initially used modified BioModular® uncemented prosthesis were relatively low (75.6% and 71.7% respectively) comparing to the reported survivorship of the conventional cemented implants. The 8-year survivorship for the uncemented Nottingham TSR prosthesis was significantly higher (81.8%), but still not in the desired range of above 90%, that is found in other cemented designs. Glenoid component loosening was the main factor of prosthesis failure in both prostheses and mainly occurred in the first 4 postoperative years. The 4-year survivorship of the currently re-designed Nottingham TSR prosthesis, with hydroxylapatite coating of the glenoid baseplate, was significantly higher, 93.1% as compared to 85.1% of the previous Nottingham TSR. Conclusion The initial Nottingham shoulder prosthesis showed significantly higher survivorship than the BioModular® uncemented prosthesis, but lower than expected. Subsequently re-designed Nottingham TSR system presented a high short term survivorship rate that encourages its ongoing use

Background The surgical management of massive rotator cuff tears remains a challenge. It is suggested that, even in a massive tear that appears irreparable, attempting to repair it as much as possible can be helpful in improving functional outcomes. However the results can be short term and variable. The purpose of our study was to determine if human tissue allograft bridged repair of massive irreparable rotator cuff tears to achieve a complete repair produces similar outcomes compared to partial repair alone. Methods We prospectively reviewed outcome scores in 13 patients who underwent partial repair alone for massive irreparable rotator cuff tears and compared them to 13 patients who had partial repairs bridged with allograft. Oxford and Constant scores were compared pre-operatively and at a minimum follow-up of 2 years (range 2 years to 5 years). Results The mean improvement in the Constant score at final follow-up compared to pre-operative scores was 27.7 points in the partial repair group and 42.8 points in the allograft group (p < 0.01). The Oxford Shoulder Score improved mean of 19.3 points in the partial repair group and 29 points in the allograft group (p < 0.02) at 2 years. Conclusions Human tissue matrix allograft provides a better outcome for open bridging of irreparable rotator cuff tears than partial repair alone. [ABSTRACT FROM AUTHOR]