Study Aim

To assess the impact of two oral thromboprophylaxis agents against Clexane with regard to range of movement (ROM) following TKR with or without haemostasis following tourniquet release.

Aims: To assess the usefulness of wrist arthroscopy in the assessment of symptomatic scaphoid non-unions and associated injuries and to evaluate the implications on the definitive treatment.

Methods: A prospective cohort study of patients undergoing wrist arthroscopy with established scaphoid non-union was performed between January 2006 and April 2009. This study included 17 men and 6 women with a mean age of 39 years.

Results: Majority of the study population (61%) had normal radiocarpal articular cartilage. Articular cartilage wear was mostly limited to the radial styloid and could be effectively debrided. Injuries to the TFCC (39%) followed by the LT joint (35%) and the SL joint (26%) were the most common arthroscopic findings. Other identified pathologies included: Loose bodies, protruding Herbert screw from previous fixation, Chondrocalcinosis, Distal Radio-ulnar joint (DRUJ) instability, Capitohamate (CH) instability and Ulnar styloid fracture non-union. Assessment of the state of the fracture union was best done from the mid carpal joint rather than the radiocarpal joint due to a more prominent fibrocartilage covering of the fracture site from the radiocarpal side Concomitant procedures performed during the wrist arthroscopy included debridement of synovitis (48%) and TFCC repair (4%). Post wrist arthroscopy 6 patients (26%) required a further course of conservative treatment (Physiotherapy +/− local anaesthetic and steroid injection) prior to discharge. In the remaining patients, based upon clinical and arthroscopic findings, a range of other therapeutic and salvage procedures were performed.

Conclusion: This study demonstrates an important role for the wrist arthroscopy in patients with symptomatic scaphoid non-union and in assessing the true extent of the articular cartilage wear and associated carpal injuries. Further it helped in most cases with the decision making in choosing the appropriate definitive surgical option when required.

We performed a prospective cohort study to investigate the comparability of subjective and objective assessment scores of shoulder function following surgery for rotator cuff pathology.

A consecutive series of 372 patients underwent surgery for rotator cuff disorders with post-operative follow up over 24 months. 248 patients only had subacromial decompression, whereas 124 patients had rotator cuff repair additionally (93 arthroscopic; 31 open). Assessments were made pre-operatively, and at 3, 6, 12, and 24 months post-operatively using the Disabilities of the Arm, Shoulder, and Hand (DASH) score; Oxford Shoulder Questionnaire (OSQ); and the Constant score, which was used as a reference. Standardisation calculations were performed to convert all scores into a 0 to 100 scale, with 100 representing a normal shoulder. The student’s t test was used to compare the mean score for each subjective tool (DASH and OSQ) with the objective score (Constant) at each time point. Pearson’s Correlation coefficient was used to analyse the changes with time post-operatively. The statistical tests were used for the individual surgery types as well as all surgeries collectively. The relationship between the DASH and the Constant score was strongly correlated in all types of surgery.

The relationship between the Oxford and Constant scores was similar, except in the open rotator cuff repair group. There was no statistical difference between the mean DASH and Constant scores for all interventions at any time point. A significant difference was seen between the mean Oxford and Constant scores for at least one time point in all but the open rotator cuff repair group.

We demonstrate that the DASH and Oxford scoring systems would be useful substitutes for the Constant score, eliminating the need for a trained investigator and specialist equipment required to perform the Constant score with the associated cost benefits.

We performed a prospective audit to investigate the comparability of subjective and objective assessment scores of shoulder function following surgery for rotator cuff pathology. A consecutive series of 372 patients underwent surgery for rotator cuff disorders with post-operative follow up over 24 months. 248 patients solely underwent subacromial decompression, whereas 124 had additional rotator cuff repair (93 arthroscopic; 31 open).

Assessments were made pre-operatively, and at 3, 6, 12, and 24 post-operative months using the Disabilities of the Arm, Shoulder, and Hand (DASH) score; Oxford Shoulder Questionnaire (OSQ); and the Constant score, which was used as a reference. Standardisation calculations were performed to convert all scores into a 0 to 100 scale, with 100 representing a normal shoulder. The student’s t-test was used to compare the mean score for each subjective tool (DASH and OSQ) with the objective score (Constant) at each time point. Correlation coefficients (Pearson’s) were used to analyse the changes with time (post-operative course). Each statistical test was used for all surgeries collectively and for the individual surgery types.

The relationship between the DASH and the Constant score was robust in all types of surgery. The relationship between the Oxford and Constant was generally robust, except in the open rotator cuff group. There was no statistical difference between the mean DASH and Constant scores for all interventions at each time point. A significant difference was seen between the mean Oxford and Constant scores for at least one time point in all but the open rotator cuff repair group.

We demonstrate the DASH and Oxford scoring systems would be useful substitutes for the Constant score, obviating the need for the trained investigator and specialist equipment required to perform the Constant score, alongside the associated cost benefits. Further it provides evidence of service, aids appraisal and revalidation.

Introduction: We performed a prospective cohort study to investigate the comparability of subjective and objective assessment scores of shoulder function following surgery for rotator cuff pathology.

Materials and Methods: A consecutive series of 372 patients underwent surgery for rotator cuff disorders with post-operative follow up over 24 months. 248 patients solely underwent subacromial decompression, whereas 124 had additional rotator cuff repair (93 arthroscopic; 31 open). Assessments were made pre-operatively, and at 3, 6, 12, and 24 post-operative months using the Disabilities of the Arm, Shoulder, and Hand (DASH) score; Oxford Shoulder Questionnaire (OSQ); and the Constant score, which was used as a reference. Standardisation calculations were performed to convert all scores into a 0 to 100 scale, with 100 representing a normal shoulder. The student’s t test was used to compare the mean score for each subjective tool (DASH and OSQ) with the objective score (Constant) at each time point. Correlation coefficients (Pearson’s) were used to analyse the changes with time (post-operative course). Each statistical test was used for all surgeries collectively and for the individual surgery types.

Results: The relationship between the DASH and the Constant score was robust in all types of surgery. The relationship between the Oxford and Constant was generally robust, except in the open rotator cuff group. There was no statistical difference between the mean DASH and Constant scores for all interventions at each time point. A significant difference was seen between the mean Oxford and Constant scores for at least one time point in all but the open rotator cuff repair group.

Conclusion: We demonstrate the DASH and Oxford scoring systems would be useful substitutes for the Constant score, obviating the need for the trained investigator and specialist equipment required to perform the Constant score, alongside the associated cost benefits.