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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 75 - 75
1 Jul 2012
Bird J Carmont M Dalton H Crane T Clewer G Dhillon M Thompson P Spalding T
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Purpose

To critically evaluate exciting new technology to reconstruct menisci for the treatment of post menisectomy pain and relate results to indication and surgical technique in a non-inventor's general knee practice.

Methods

We present our early experience of two non-comparative series with different meniscal implants.

Series 1: Thirteen patients received a Menaflex implant (Regen Bio, USA). Mean age 30, male/female 11/2, mean length of implant 44mm, mean chondral grade 1.9 (Outerbridge). At 24 months clinical scores showed improvement in 12. Second look arthroscopy in 5 however showed disappointing amounts of regenerative tissue. One patient has been revised.

Series 2: Twelve patients received an Actifit implant (Orteq, UK). Mean age 38, male/female 8/4, mean length implant 43 mm, mean chondral grade 1.3. At 12 months all have improved clinical scores. We have performed two second looks, one of these showed excellent integration. However one showed only 50% regeneration. Critical review of the initial implantation shows that there may not have been adequate preparation of the host meniscus tissue.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_IX | Pages 40 - 40
1 Mar 2012
Spalding T Thompson P Clewer G Bird J Smith N Dhillon M
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Hypothesis

Recent advances in understanding of ACL insertional anatomy has led to new concepts of anatomical positioning of tunnels for ACL reconstruction. Femoral tunnel position has been defined in terms of the lateral intercondylar ridge and the bifurcate ridge but these can be difficult to identify at surgery. Measurements of the lateral wall either using C-arm x-ray control or specific arthroscopic rulers have also been advocated.

Method

30 patients undergoing ACL reconstruction before and after introduction of a new anatomical technique of ACL reconstruction were evaluated using 3D CT scan imaging with cut away views of the lateral aspect of the femoral notch and the radiological quadrant grid. In the new technique, with the knee at 90 degrees flexion, the femoral tunnel was centred 50% from deep to shallow as seen from the medial portal (Group A). Group B consisted of patients where the femoral tunnel was drilled through the antero-medial portal and offset from the posterior wall using a 5mm jig.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 295 - 295
1 Jul 2011
Bird J Kitson J
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Background: Our Trust consists of two separate hospitals with duplicated Orthopaedic services at both sites. Sterile Services were centralised to one site in February 2006. Various problems were encountered leading to cancelled cases. What have been the financial implications of these cancellations?

It is difficult to estimate the true cost to the Trust for a cancelled case. Each cancelled case is a ‘slot’ on an operating list that has not been filled. There are regular Waiting List Initiative (WLI) Lists – the number of these have increased. Could an empty slot on a regular list have been filled by a WLI case? Would the cost of the WLI case theoretically performed in the empty slot be the cost of the cancelled case? The model is basic and has many assumptions. Patients are allocated a slot on a WLI list for a variety of reasons, however with enough numbers and across enough time, the true cost must be somewhere near these figures.

Method: Every cancelled case coded as “Surgical Equipment: checking/malfunction/unavailable” between April 2006 and Mar 2008 (2 financial years).

The total number of WLI cases in the same period and the total cost of those cases.

Results: There were 239 cancelled cases for Sterile Services reasons across Trust April 2006 – March 2008. During the same period, there were 1,566 Waiting List Initiative

Cases Cost: £3,234,000 (£2,065 per case)

Conclusions: If all of the cancelled slots had been filled by WLI cases this would have avoided a total cost to the Trust of £493,535


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 258 - 258
1 Sep 2005
Luke D Bird J Grainge C
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The Clinical Medical Group in Southern Iraq was opened on 24 March 2003.

Since then the hospital has received 4583 inpatients of which 1762 have been surgical admissions.

The aim of this paper is to discuss the number, severity, mechanism of injury and overall outcome of all the orthopaedic admissions seen within the hospital complex, including all serving personnel, foreign employed nationals and foreign civilians treated. Particular reference will be made to the percentage of admissions returned to front line activities and a comparison of this percentage made with general surgical and medical admissions.

Data for this retrospective review has been obtained from the hospital, operating theatre and patient records currently held in theatre.