Aims

Glenoid bone loss is a significant problem in the management of shoulder instability. The threshold at which the bone loss is considered “critical” requiring bony reconstruction has steadily dropped and is now approximately 15%. This necessitates accurate measurement in order that the correct operation is performed. CT scanning is the most commonly used modality and there are a number of techniques described to measure the bone loss however few have been validated. The aim of this study was to assess the accuracy of the most commonly used techniques for measuring glenoid bone loss on CT.

Aims

Recurrent dislocation is both a cause and consequence of glenoid bone loss, and the extent of the bony defect is an indicator guiding operative intervention. Literature suggests that loss greater than 25% requires glenoid reconstruction. Measuring bone loss is controversial; studies use different methods to determine this, with no clear evidence of reproducibility. A systematic review was performed to identify existing CT-based methods of quantifying glenoid bone loss and establish their reliability and reproducibility

Aims

The new COVID-19 variant was reported by the authorities of the UK to the World Health Organization (WHO) on 14 December 2020. We aim to describe the clinical characteristics and nosocomial infection rates in major trauma and orthopaedic patients comparing the first and second wave of COVID-19 infection.

Aims

The first death in the UK caused by COVID-19 occurred on 5 March 2020. We aim to describe the clinical characteristics and outcomes of major trauma and orthopaedic patients admitted in the early COVID-19 era.

Introduction: Arthroplasty infection is both devastating for the individual and expensive for the healthcare system. Many measures are taken during a patient’s pathway to try and prevent this complication. Ring fencing beds is perceived to be beneficial in this struggle, but due to complexity it is difficult to identify the effect of ringfencing on infection rates; furthermore to date there is little published data to support it’s use. We present our data of infection rates before and after the introduction of a ringfence policy. The antibiotic prophylaxis regime was the only other variable to change.

Methods: Two 24 month periods were selected before and after the introduction of a strict ringfence policy. In the first period (pre-ringfence period) patients were MRSA screened pre operatively but not placed in a ward with a ringfence policy. Cefuroxime was administered as prophylaxis. In the second period (ringfence period) screened patients were only admitted to a ward where all patients were known to be MRSA free. Tei-coplanin prophylaxis was administered. The hospital building, operating theatres, implants and surgeons were the same for both groups. Infections were identified retrospectively by analysing clinical notes and laboratory results. Statistical analysis was performed using Fisher’s exact test.

Results: Both patient groups had similar demographics. More joints were performed in the ringfence period compared to the pre-ringfence period (870 vs 590), with a shorter average length of stay (7 vs 11 days). In the ring-fencing period there was an overall significant reduction in early infections (1.26% vs 3.05%, p< 0.05). MRSA was eliminated (2.2% vs 0%, p< 0.05)

Conclusions: A combination of these two interventions led to a significant reduction in early infection rates and the elimination of MRSA in primary joint arthroplasty patients, even though the exact contribution of each intervention could not be established.