Abstract
Introduction: Measurement of outcome after THR is becoming increasingly important. NICE guidelines have been established and ODEP have stipulated target criteria for the successful evaluation of novel implants. To date, a streamlined, efficient Outcome Programme has not been developed which satisfies the required follow-up criteria. A Programme has been developed at our unit and its evolution is reported.
Methods: A database was created with the assistance of a database developer and an “Outcome Co-ordinator” was appointed to operate the database and manage the programme.
Operation data is now entered onto the database by the surgeon or co-ordinator at the time of surgery. Thereafter, the database automatically produces annual Oxford Hip Questionnaires, EQ-5D questionnaires and invite letters to patients for clinical review at stipulated time-points.
Questionnaires are returned by patients and scanned. This data is then electronically imported to the database without transcription error. Patients attend special Outcome clinics, staffed by Research Fellows and SpR’s, who examine the relevant hip and review their radiographs. The findings are recorded and the paper forms scanned and imported into the database. Non-responders are identified from the database and are chased up via telephone by the coordinator.
Data is extracted from the database with queries and presented using database reports.
Results: 2455 THR’s have been recorded on the database (2127 primaries, 328 revisions) 1937 patients continue under active review for THR. The percentage of patients lost to follow-up is only 2%, 10%, 15% at 2, 5 and 10 years respectively.
Discussion: An efficient system has been developed to maximise the follow-up of patients post THR. The burden on outpatient clinics is reduced and meaningful outcome measures are obtained. The programme could easily be extended to other centres throughout the UK and the benchmarks set by ODEP and NICE can also be attained.
Correspondence should be addressed to The Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
