Dislocation

Researchers are evaluating the quality of 3D hand modelization using the EOS imaging system compared to the standard computed tomography CT scans. The study focuses on patients who require CT imaging of the hand or wrist to assess the accuracy and potential benefits of the EOS imaging device. Participants will undergo EOS hand imaging, and these images will be compared directly with their standard CT images. The primary goal is to collect and analyze data from both imaging methods at 60 days to determine how well the EOS system performs in creating 3D models of the hand. During the study, participants will have imaging procedures and data collection focused on the hand or wrist area. Researchers will monitor and compare the imaging outcomes from both EOS and CT methods. The total participation duration includes data evaluation at day 60, with no additional treatment or long-term follow-up specified.

Researchers are studying the outcomes of two surgical methods for treating perilunate dislocations, a serious wrist injury. This research aims to compare the clinical and X-ray results between a new internal brace technique using a 4-anchor construct and the traditional Kirschner wire K-wire method. The study also seeks to identify the types and rates of complications associated with each technique, such as pain, numbness, weakness, and range of motion loss. Participants in this observational study have already undergone surgery for perilunate dislocations using either the standard K-wire fixation or the new internal bracing method. Researchers will follow these patients from enrollment through two years after their surgery, monitoring recovery and complications. The study does not involve additional treatments but focuses on collecting data about the surgical outcomes of the two fixation techniques. During the study, participants will undergo clinical functional assessments and complete the Quick DASH questionnaire to measure arm disability. Researchers will track specific complications and their frequency over the two-year follow-up period. The study is led by Bryan D Brown, MD, and aims to improve understanding of surgical options for perilunate dislocation recovery and long-term wrist function.

Atlantoaxial dislocation is a condition involving instability or dislocation of the atlantoaxial joint in the spine. This research aims to update and improve the diagnosis and treatment strategies for atlantoaxial dislocation by collecting data from multiple medical centers. The study includes both retrospective and prospective parts to build a detailed clinical cohort and provide long-term safety and effectiveness information for surgical treatments. The study does not involve any new treatments but observes patients who have undergone surgery for atlantoaxial dislocation. It reviews different surgical approaches, such as anterior, posterior, or combined methods, based on a classification system developed from past cases. The research will analyze outcomes and complications over time to guide future surgical care for this condition. Participants will be followed for at least 12 months after surgery to monitor any adverse events that require special attention. Data collected will include clinical evaluations and long-term follow-up information to assess safety and effectiveness. This observational study spans several years and aims to create a recognized standard for diagnosing and treating atlantoaxial dislocation.

Researchers are evaluating post-operative management approaches after a modified Lapidus arthrodesis surgery for hallux valgus, with or without additional surgeries such as Akin or WeilHohmann procedures. The study aims to compare the effectiveness and safety of immediate full weight-bearing versus partial weight-bearing 10-15 kg during rehabilitation. This randomized controlled trial explores a new rehabilitation method following foot surgery to improve recovery. Participants will be randomly assigned to one of two groups after surgery one group will follow partial weight-bearing with a specialized VACOPASO shoe and use crutches along with antithrombotic medication for 6 weeks, while the other group will have immediate complete weight-bearing with the same shoe and medication for the same period. The surgical operation follows standard clinical practices for hallux valgus correction. During the study, healing progress will be monitored through standard X-rays at 6, 12, and 24 weeks to check bone healing, hardware fixation, and fracture alignment. Pain will be measured using a Visual Analogue Scale at the day of surgery and at follow-up visits. Quality of life and functional recovery will be assessed through established foot and ankle scoring systems at multiple time points. The main outcome is the subjective functional recovery measured by the Olerud and Molander Ankle Score at 6 weeks post-surgery.

Researchers are evaluating whether accelerated flap coverage within 72 hours of injury reduces infection-related complications compared to standard flap coverage timing in patients with severe open fractures andor dislocations below the knee. This randomized controlled trial addresses an important uncertainty in care for these injuries, aiming to provide clear evidence to guide treatment timing and improve patient outcomes. The study includes adult patients 18 years and older who require acute flap coverage for their injury. Participants will be randomly assigned to receive either flap surgery within 72 hours of injury or flap surgery at the standard timing practiced at their medical center. The choice of flap type and management after surgery will be decided by the treating surgeons and recorded. Both groups will have their fracture or dislocation managed according to usual care. Follow-up visits are scheduled at 6 weeks, 3 months, 6 months, and 12 months after randomization to monitor progress. During the study, researchers will assess a combined primary outcome at 6 months that includes overall survival, limb amputation due to injury, re-operations for infection or flap issues, and days spent in acute hospital care. Secondary outcomes include these individual measures at 6 and 12 months, as well as patient-reported quality of life and satisfaction. Safety events will be reviewed regularly by a monitoring committee to ensure participant well-being throughout the trial.

This trial investigates whether a new rehabilitation approach called apprehension-based training leads to better recovery after shoulder dislocation compared to standard physical therapy among military personnel aged 18 to 39 years. The study aims to see if this training helps participants regain shoulder function, improves their shoulder-related quality of life, and reduces the risk of shoulder dislocations recurring. Participants have documented anterior shoulder dislocation confirmed by a medical professional and a positive anterior apprehension test. Participants are randomly assigned to one of two groups. The apprehension-based training involves a 3-phase exercise program progressing from static isometric exercises to dynamic exercises with added cognitive tasks, guided by a physical therapist over up to 8 one-on-one sessions, with daily home exercises. The standard physical therapy group receives individualized treatment by a licensed therapist, which may include various exercises, manual therapy, dry needling, or electrophysiological techniques, also up to 8 sessions with a home exercise program. Throughout the study, participants undergo assessments including shoulder function tests, strength measurements, and quality of life questionnaires at baseline, after 10 weeks of intervention, and up to one year later. Researchers monitor return to preinjury function, recurrence of dislocations, and shoulder instability signs. Additional measures such as muscle strength, pain-related fear, and heart rate variability are recorded. The study involves regular visits and exercises over a 10-week intervention period with follow-up evaluations extending to one year after treatment ends.

Researchers are evaluating whether artificial intelligence AI can help doctors detect broken bones, joint effusions, dislocations, and bone lesions more quickly and accurately in emergency room settings. This prospective, randomized, controlled trial compares traditional diagnostic methods to AI-assisted X-ray interpretation. The study also aims to see if AI can save time and reduce healthcare costs while improving clinical workflows in orthopedic emergency care. Participants will be assigned to one of two groups one using standard physician interpretation of X-rays without AI assistance, and the other using AI tools Aidoc or Gleamer BoneView integrated into the hospitals imaging system to highlight potential injuries in real time. Both groups will receive standard X-ray imaging of injured arms or legs. The AI serves as a diagnostic aid, with physicians making final diagnoses. The study includes around 4,800 patients presenting with isolated extremity injuries or joint complaints. During the study, participants will undergo routine X-ray imaging and have their images reviewed with or without AI support depending on group assignment. Researchers will collect baseline demographic and clinical data and assess diagnostic accuracy, time to diagnosis, physician confidence, and cost efficiency. Diagnoses will be independently reviewed by experts to ensure accuracy. The study adheres to ethical guidelines and requires informed consent from participants. Results may inform future use of AI in emergency care settings.

This research aims to evaluate whether repairing the medial patellofemoral ligament MPFL with the help of a Biobrace4 implant can reduce the chance of the kneecap dislocating again after a first-time patellofemoral dislocation. Patellofemoral dislocation is a common knee injury, especially in young people, with recurrence rates varying widely depending on individual risk factors. Current treatments vary, and no clear consensus exists on the best approach to prevent repeat dislocations in patients with mild to moderate risk. Participants will undergo a surgical procedure within 7 days of their first lateral patellofemoral dislocation. This involves knee arthroscopy combined with MPFL repair that is enhanced by a synthetic Biobrace4 ligament designed to support both mechanical strength and biological healing. This intervention is being studied to see if it better maintains the kneecaps position during healing compared to natural outcomes without surgery. During the study, participants will be monitored for up to two years to assess if the patella dislocates again. Assessments include physical tests such as single-leg hop and balance, muscle strength measurements, and patient-reported outcome questionnaires related to knee instability, pain, medication use, and psychological factors. Close follow-up in the initial two weeks will monitor pain and medication use, while longer-term evaluations will focus on knee function and stability.

This research study investigates whether a new type of physical therapy called blood flow restriction training BFRT can improve recovery for people with patellar instability, a condition involving knee dislocation or injury. The study is designed to answer important questions about BFRTs role in rehabilitation by comparing it with standard physical therapy. Participants eligible for the study are aged 14 to 40 years and have a diagnosis of traumatic patellar instability confirmed by a qualified medical professional. Participants are randomly assigned to one of two groups standard physical therapy alone or standard physical therapy combined with BFRT. BFRT involves using an air cuff inflated around the thigh to limit blood flow during a standardized exercise program, lasting 8 weeks. Physical therapy may include exercises to improve knee strength, hip strength, gait training, and other supportive activities. Both groups receive close monitoring to ensure safety throughout treatment. Participants will attend multiple study visits over two years, starting with screening and enrollment, followed by strength testing, biomechanical assessments, questionnaires, blood and urine sample collection, and MRI scans. These visits occur at 1 week, 5 weeks, 9 weeks, 6 months, 1 year, and 2 years after enrollment. Throughout the study, researchers will measure knee function, strength symmetry, pain levels, and muscle health using tools like the Norwich Patellar Instability Scale and MRI imaging to assess recovery progress.

Researchers are evaluating the effect of a student-led multimodal prehabilitation service called BoneFit for people preparing for total hip or knee replacement surgery. The study aims to improve physical and mental health, quality of life, and reduce hospital stay length, complications, and readmission rates for patients undergoing orthopedic surgery in the Hull region. This pilot feasibility study will compare BoneFit to usual care, as no prehabilitation service is currently offered locally. Participants in the BoneFit intervention group will receive a personalized care plan that includes exercise, nutrition, and psychological support tailored to their needs during the 8 weeks before surgery. A control group will receive usual care without intervention. The groups will be compared to assess the impact of the prehabilitation service. During the study, participants will undergo baseline tests and will be invited to repeat these assessments 3 months after surgery. Researchers will monitor recruitment, attendance, and acceptability over several years. They will also measure physical fitness, hospital length of stay, readmission rates, overall quality of life, and specific pain and function related to the knee or hip. The study will last up to 3 years, with ongoing follow-up assessments to evaluate outcomes.