#TKR + Neuropathic pain - 363 (of 5000) pts had pain at 3mth (OKS ≤ 14 /48) - 3/4 neuropathic - 1/4 to 1/2 continued at 15 months Recommend STAR care pathway - Assessment with ESP - 6x telephone Fup calls over 12 months. The Bone & Joint Journal buff.ly/4b8fvh5

Anti-Inflammatory diet v #Knee OA Feasibility study n=48 '..promising response in self-reported symptoms, function, QoL and weight loss over a relatively short 9-week' BMC buff.ly/4ctvY0A

#Knee OA Physio led Diet + exercise v exercise alone Bodyweight loss Mean (SD) -8.1% (5.2) v -1.0% (3.2) ⬆️ global knee score 27/38 (71.1%) v 20/42 (47.6%)(p=0.02) British Journal of Sports Medicine (BJSM) buff.ly/3WiRTCf

Intertrochanteric femur fractures Tip-apex distance remains key in double-screw nailing >29mm confirmed as a risk factor for cut-out The Bone & Joint Journal buff.ly/4crLeew

MoM THA at 10.9 years (2.0 to 20.4) Infection = 3.5% (41/1,171) MRI cohort at 12.2 years (2.3 to 20.4) Infection = 8.2% (27/328) Confirmed pseudotumour Infection = 14.7% (15/102) Justin Leal Duke Bonedoc Michael P. Bolognesi Duke Orthopaedics The Bone & Joint Journal buff.ly/3Rtsnan

'6-10 days of in-hopsital inactivity ⬇️ leg lean mass by >10%' Here 570pts age 87.3yrs (SD4.8) Exercise groups ⬆️ function scores v controls +1.09 after 3d +1.97 after 4d + 2.02 after 5–7 'inpt exercise.. ⬆️ muscle weakness, cog + phys function' buff.ly/4bAd332

13,787 #Hip OA 30,524 #Knee OA First-line education + exercise pain (0-10) @ 3mth How many joint replacement @ 5 years? Responder ≥ 2 v Non ≤ 1/10 Hip OA 35% v 48% Knee OA 14% v 20% buff.ly/3zKkyat

OA imaging abnormalities in asymptomatic healthy adults Osteoarthritis and Cartilage Journals via Physio Meets Science 🙏 2022 NICE guidance - no evidence for imaging typical first OA symptoms. buff.ly/3ysWyYZ

Oral antibiotic therapy noninferior to intravenous antibiotics - used during the first 6 weeks - 1054 complex orthopedic infections - assessed by treatment failure at 1 year NEJM buff.ly/4bPh5or

'Robot' v Conventional #TKR 60 patients RCT No difference pain, WOMAC stiffness, pROM, blood loss ' Robot' group ⬆️ aROM ⬆️ KSS 1mth ⬆️ WOMAC function 1yr ⬆️ Op time via OrthoEvidence buff.ly/3X0Hiff

Hyperglycaemia => mouse knee joint capsule: ⬆ fibrosis-related genes ⬆ fibrosis-related proteins Inhibited by metformin @bonejointres buff.ly/46c2Hp6

Belief about Chronic #Hip Pain 28 studies, 352 people - labelled hip as damaged - avoided / modified activity - attributed to age / 'wear & tear' - not educated about treatments - treatment that failed to improve pain - surgery inevitable via Alessio Bricca buff.ly/3WEHqjs

Hip Abductor strengthening in #KNEE OA 7RCTS + 3 studies ⬇ VAS [ SMD = -0.60[-0.88, -0.33] p < 0.0001] ⬆ WOMAC scores [SMD – 0.75[-1.05,-0.45] p < 0.0001] 'All.. concluded that strengthening the hip abductor.. +ve knee pain + functional outcomes' buff.ly/3Z67ruG

Prosthetic joint infections: Are these ratios better than CRP alone ? - Albumin-to-globulin - CRP-to-albumin No '..neither parameter can be recommended' 144 / 275 consecutive infected revision hip + knee @bonejointres buff.ly/3XaqeTa

'Microbiological testing should be carried out routinely during operations as part of clinical audit' - Guidance recommends volumetric sampling => challenging - Settle plate sampling => good alternative 👍 The Bone & Joint Journal buff.ly/4cO4Rwz