The British Orthopedic Association recommends that patients referred to fracture
Objectives:. To establish the demand, referral pathways, utility and patient satisfaction of a physiotherapy led post operative spinal surgery review
Background: One stop shoulder
Medical Genetics is a transversal discipline with the potential to impact on every specialty and subspecialty in medicine and the allied health sciences. The completion of the human genome project resulted in technical advancements in genomics, genomic testing and our understanding of genetic disorders in general. These advancements have greatly enhanced our understanding of the role of genetics in Orthopaedic practice, with respect to both monogenic and complex disorders. Tygerberg Hospital is currently the only state hospital in South Africa to support genetic testing in the form of gene panels as part of routine care. This is complemented by more comprehensive research testing in the form of exome and genome sequencing as part of the Undiagnosed Disease Programme. We audit the genetic and genomic testing done on patients referred from the Orthopaedic
Introduction. Virtual fracture
Developmental dysplasia of the hip (DDH) is the most common paediatric hip condition and is a major cause of hip replacement or osteoarthritis in young adults. Due to potential impact on quality of life, every child is checked at birth for unstable hips. Should instability be detected, or the infant has other DDH risk factors, they are referred for an ultrasound exam and orthopaedic surgeon consultation. Since the implementation of a DDH screening program at our institution, the Radiology Department has seen a dramatic increase in hip ultrasounds performed. While helping prevent the complications of missed DDH diagnoses, this program has placed strain on radiology resources, and often families must attend multiple appointments before receiving a diagnosis and beginning treatment. To mitigate this, we have implemented a pilot point-of-care DDH
Abstract. Introduction.
It is known that Osteoporosis is the pathology of bone mass and tissue loss resulting in an increase of fragility, risk of fracture occurrence, and risk of fracture recurrence. We noted there was no definitive pathway in our last audit, therefore recommended: availability of the Osteoporosis
In current practice in the UK there are three main approaches to investigating suspected scaphoid fractures not seen on initial plain film x-rays. Early MRI of all cases. Review all cases in
Abstract. Introduction. A spotlight has been placed upon virtual assessment of patients during the coronavirus pandemic. This has been particularly prevalent in the assessment of acute knee injuries. In this study we aim to assess the accuracy of telephone triage, confirmed by Magnetic Resonance Imaging (MRI) in the diagnosis of acute knee injuries. Methods. Case records of patients triaged by telephone in the acute knee
Introduction. Patients undergoing complex limb reconstruction are often under immense physical, psychological and financial stress. We already provide psychological support within our unit. We have identified that patients struggle to obtain proper advice on the financial support to which they are entitled. In September 2019, . rebuildcharity.org. commissioned a Citizens Advice
The purpose of this study was to measure the effect of the implementation of a LEAN continuous process improvement initiative on the waitlist in an ambulatory pediatric orthopaedic
The purpose of this prospective pilot study is to examine the feasibility of a physiotherapist led rapid access shoulder screening
Abstract. INTRODUCTION. Geniculate nerve blocks (GNB) and ablation (GNA) are increasing in popularity as strategies for the management of knee pain in patients unsuitable for surgical intervention. Typically these simple blocks have been performed by specialists in pain medicine. We present the results of a GNB
Background. Due to the overwhelming demand for trauma services, resulting from increasing emergency department attendances over the past decade, virtual fracture
Cell therapies hold significant promise for the treatment of injured or diseased musculoskeletal tissues. However, despite advances in research, there is growing concern about the increasing number of clinical centres around the world that are making unwarranted claims or are performing risky biological procedures. Such providers have been known to recommend, prescribe, or deliver so called ‘stem cell’ preparations without sufficient data to support their true content and efficacy. In this annotation, we outline the current environment of stem cell-based treatments and the strategies of marketing directly to consumers. We also outline the difficulties in the regulation of these
Introduction. Circular frames in the lower limbs have been removed by Specialist nurses in our
To our knowledge, we are the only centre in the UK where Achilles tenotomies (TA) for CTEV Ponseti correction are performed in outpatient
Stem cells represent an exciting biological therapy for the management of many musculoskeletal tissues that suffer degenerative disease and/or where the reparative process results in non-functional tissue (‘failed healing’). The original hypothesis was that implanted cells would differentiate into the target tissue cell type and synthesise new matrix. However, this has been little evidence that this happens in live animals compared to the laboratory, and more recent theories have focussed on the immunomodulatory effects via the release of paracrine factors that can still improve the outcome, especially since inflammation is now considered one of the central processes that drive poor tendon healing. Because of the initial ‘soft’ regulatory environment for the use of stem cells in domestic mammals, bone and fat-derived stem cells quickly established themselves as a useful treatment for naturally occurring musculoskeletal diseases in the horse more than 20 years ago (Smith, Korda et al. 2003). Since the tendinopathy in the horse has many similarities to human tendinopathy, we propose that the following challenges and, the lessons learnt, in this journey are highly relevant to the development of stem cells therapies for human tendinopathy:. Source – while MSCs can be recovered from many tissues, the predominant sources for autologous MSCs have been bone and fat. Other sources, including blood, amnion, synovium, and dental pulp have also been commercialised for allogenic treatments. Preparation – ex vivo culture requires transport from a licensed laboratory while ‘minimally manipulated’ preparations can be prepared patient-side. Cells also need a vehicle for transport and implantation. Delivery – transport of cells from the laboratory to the
Osteoporosis is a disease when bone mass and tissue is lost, with a consequent increase in bone fragility and increase susceptibility to develop fracture. The osteoporosis prevalence increases markedly with age, from 2% at 50 years to more than 25% at 80 years. 1. in women. The vast majority of distal radius fractures (DRFs) can be considered fragility fractures. The DRF is usually the first medical presentation of these fractures. With an aging population, all fracture