Mustafa Al-Zubaidy

Background: Acute kidney injury (AKI) is a serious complication in older patients with hip fractures. However, the prevalence and risk factors for both pre- and postoperative AKI remain poorly characterised. This study aimed to assess AKI prevalence before and after surgery in hip fracture patients and to identify associated clinical and surgical risk factors. Methods: This retrospective observational study was conducted on patients admitted with hip fractures throughout 2020. AKI was defined using KDIGO criteria. Data collected included patient demographics, biochemical markers, perioperative details, and mortality outcomes. Statistical analysis compared AKI and non-AKI groups and examined surgical associations. Results: A total of 190 patients were included. Preoperative AKI occurred in 2.1%, and postoperative AKI in 19.8%, with an overall AKI prevalence of 21.6%. Patients who developed AKI had significantly higher weight ( p = 0.046) and longer hospital stays ( p < 0.001). Postoperative AKI was significantly associated with being an inpatient at the time of fracture ( p = 0.046). AKI development was also significantly associated with increased mortality ( p = 0.001). Conclusion: One in five hip fracture patients developed AKI, which was linked to higher mortality. Key risk factors included higher body weight, inpatient fractures, and prolonged admission. Early identification and tailored perioperative care are vital for improving outcomes.

Background: Patellar instability (PI) is a clinical diagnosis often complicated by symptom overlap with other knee pathologies and spontaneous relocation of the patella. Anatomical variations are key risk factors, highlighting the role of radiological investigations in assessing underlying pathology. Inconsistent measurement parameters and limited comparative data reduce diagnostic reliability. This study aimed to compare radiological parameters between patients with and without PI, and to assess how these parameters change following patellar stabilisation surgery. Methods: This case-control study compared magnetic resonance imaging (MRI) and X-ray radiological parameters between patients with recurrent PI and controls. Pre- and postoperative imaging was analysed in the PI group. Eleven validated radiological measurements, including patellofemoral joint angles and patellar height indices, were evaluated. Results: Fifty-five knees in the PI group and 50 knees in the Control group were analysed. Preoperatively, significant differences were found for all patellar height indices ( p < 0.001) and patellofemoral measurements ( p < 0.05), except for the congruence angle. Postoperatively, all patellar height measurements improved in the PI group ( p < 0.05), with only the sulcus angle improving ( p = 0.005) for patellofemoral measurements. Significant differences were observed between MRI and X-ray measurements ( p < 0.05). Conclusion: Radiological parameters differ significantly between unstable and stable knees, with improvement following surgery. Patellar height was the most consistent marker of instability. Discrepancies between MRI and X-ray findings suggest a need for modality-specific normative values. These results reinforce the value of radiological assessment in PI and support standardisation to improve diagnostic accuracy.