Publications by authors named "N McGoldrick"

32 Publications

Mode I and II Wear in Ceramic on Ceramic Total Hip Arthroplasty: A Case Report.

J Orthop Case Rep 2021 Mar;11(3):16-20

Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin D24NROA, Ireland.

Introduction: Elective total hip arthroplasty (THA) is a common procedure and has been associated with favorable outcomes in both elderly and younger patients. A variety of implant and articular components exist so to allow surgeons to make a patient-specific choice with the intent of maximizing both patient outcomes and implant survival.The utilization of ceramic bearing surfaces during THA has become increasingly prevalent, with their tribological profile conveying favorable wear and osteolysis-resistant properties. Typically, ceramic articulating components are most susceptible to failure through brittle fracture or complications such as squeaking.

Case Report: This case describes a 68-year-old Caucasian male who underwent revision of ceramic on ceramic THA due to pain, with intraoperative analysis revealing evidence of gross Mode I acetabular ceramic component wear with a resultant Mode II wear articulation between the ceramic femoral head and acetabular liner.

Conclusion: Wear between ceramic implants in THA is infrequently reported, and as such awareness of this uncommon phenomena as well as its potential causative factors is important when considering either primary or revision THA involving ceramic bearing components.
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http://dx.doi.org/10.13107/jocr.2021.v11.i03.2068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8241264PMC
March 2021

Cementing a collarless polished tapered femoral stem through the anterior approach : evaluation of cement mantle quality and component alignment.

Bone Joint J 2021 Jul;103-B(7 Supple B):46-52

Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Canada.

Aims: The aim of this study was to radiologically evaluate the quality of cement mantle and alignment achieved with a polished tapered cemented femoral stem inserted through the anterior approach and compared with the posterior approach.

Methods: A comparative retrospective study of 115 consecutive hybrid total hip arthroplasties or cemented hemiarthroplasties in 110 patients, performed through anterior (n = 58) or posterior approach (n = 57) using a collarless polished taper-slip femoral stem, was conducted. Cement mantle quality and thickness were assessed in both planes. Radiological outcomes were compared between groups.

Results: No significant differences were identified between groups in Barrack grade on the anteroposterior (AP) (p = 0.640) or lateral views (p = 0.306), or for alignment on the AP (p = 0.603) or lateral views (p = 0.254). An adequate cement mantle (Barrack A or B) was achieved in 77.6% (anterior group, n = 45) and in 86% (posterior group, n = 49), respectively. Multivariate analysis revealed factors associated with unsatisfactory cement mantle (Barrack C or D) included higher BMI, left side, and Dorr Type C morphology. A mean cement mantle thickness of ≥ 2 mm was achieved in all Gruen zones for both approaches. The mean cement mantle was thicker in zone 7 (p < 0.001) and thinner in zone 9 for the anterior approach (p = 0.032). Incidence of cement mantle defects between groups was similar (6.9% (n = 4) vs 8.8% (n = 5), respectively; p = 0.489).

Conclusion: An adequate cement mantle and good alignment can be achieved using a collarless polished tapered femoral component inserted through the anterior approach. Cite this article:  2021;103-B(7 Supple B):46-52.
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http://dx.doi.org/10.1302/0301-620X.103B7.BJJ-2020-2394.R1DOI Listing
July 2021

The accuracy in determining pelvic tilt from anteroposterior pelvic radiographs in patients awaiting hip arthroplasty.

J Orthop Res 2021 Jun 3. Epub 2021 Jun 3.

Division of Orthopaedic Surgery, The Ottawa Hospital, Critical Care Wing, Ottawa, Ontario, Canada.

Spinopelvic mobility affects outcome after THA. Whether the sacro-femoral-pubic (SFP) angle, measured on AP radiographs, can be reliably used to estimate pelvic tilt (PT) in hip osteoarthritis patients is unknown. This study aimed to (1) validate the use of the SFP angle in the calculation of PT from AP radiographs, and (2) identify individual patient factors affecting the estimation of PT. A cohort of 100 patients awaiting THA for end-stage hip osteoarthritis was prospectively studied. AP and lateral radiographs, taken in the standing and relaxed-seated positions were evaluated for spinopelvic measurements (SFP, PT, and pelvic incidence [PI]). To validate the SFP angle, estimated PT values using the formula [PT = 75°-SFP] were compared to the true, measured values from the lateral radiographs. Despite good agreement for the estimated and true PT (16.2 ± 5.9° vs. 15.5 ± 8.6°; p = .315), a significantly poorer agreement could be found between the two methods at high or low values of PT. Patient-specific PI correlated with the difference between the two measurement methods (Pearson's r = -0.644; p < .001). However, the change in SFP angle equaled approximately the change in pelvic tilt (∆PT = 2°-∆SFP; Pearson's r = -0.934; p < .001). Absolute values for the sagittal PT should not be estimated from AP pelvic radiographs in patients awaiting total hip arthroplasty. However, the relative change in PT between different positions equals approximately the change in SFP angle. This may allow functional cup orientation after THA to be determined between different postures from an AP radiograph of the pelvis. The SFP angle has moderate accuracy in determining a patient's pelvic tilt; however, it can accurately determine a patient's change in pelvic tilt in different positions.
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http://dx.doi.org/10.1002/jor.25115DOI Listing
June 2021

SARS-CoV-2 Positivity in Asymptomatic-Screened Dental Patients.

J Dent Res 2021 06 29;100(6):583-590. Epub 2021 Mar 29.

West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, UK.

Enhanced community surveillance is a key pillar of the public health response to coronavirus disease 2019 (COVID-19). Asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include preappointment and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centers across Scotland invited asymptomatic-screened patients aged over 5 y to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardized Viral Transport Medium-containing test kits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/email with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-wk period (from August 3, 2020, to October 31, 2020), 4,032 patients, largely representative of the population, were tested. Of these, 22 (0.5%; 95% CI, 0.5%-0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To our knowledge, this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing infection prevention control and PPE vigilance, which is relevant as health care team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.
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http://dx.doi.org/10.1177/00220345211004849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138329PMC
June 2021

Triplane Fracture of the Distal Femur in the Paediatric Population: A Case Report and Literature Review.

Cureus 2020 Mar 25;12(3):e7416. Epub 2020 Mar 25.

Paediatric Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, IRL.

Triplane fractures of the distal femur in paediatric populations are extremely rare. Only three cases of paediatric triplane fractures of the distal femur are described in the literature. Our aim is to add to the scant literature on triplane fractures of the distal femur in the paediatric population. The majority of trauma and orthopaedic surgeons are not expected to come across this injury throughout their careers. A CT is recommended to plan surgery, and subsequent follow up is crucial to provide the child with the best possible outcome. In particular, follow up is important to monitor for any abnormal growth or deformities.
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http://dx.doi.org/10.7759/cureus.7416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182168PMC
March 2020