The study was started in 2004 to determine the best bearing surface in the long term, and to measure the metal ion levels generated by each of the bearing surfaces. We present the latest updated results. A prospective randomised study was started in 2004 to compare the wear characteristics of Ceramic on X linked Polyethylene (C.O.P.), Ceramic on Ceramic (C.O.C), Ceramic on Metal (C.O.M.) and Metal on Metal (M.O.M) bearings. The level of Cobalt and Chrome ions in red blood cells have been documented at serial intervals, using the ICP – MS method. Aside from the bearing surfaces the rest of the implant is standard, using a Pinnacle Cup, Corail Stem and 28mm heads. 256 Cases were enrolled on the study. To date 71 cases have been lost due to death (26), revision (9) and lost to follow up (36), leaving us with 185 for follow-up. An even spread of cases in each bearing surface are still available for follow up, viz. 46 C.O.P, 48 C.O.C., 44 C.O.M. and 47 M.O.M. Average follow up is currently 4.8 years, ranging up to 9 years.Purpose Of Study
Material and methods
In October 2008, CMS instituted a new “No payment for preventable complications“ programme and has released a list of conditions for which it intends to expand the programme in 2009. Although not reimbursing for preventable complications is justifiable, some of the proposed target conditions are lacking in both adequate diagnostic testing accuracy and preventability. This study examines the effects of imperfect sensitivity and specificity of diagnostic testing, the prevalence of condition, and the rate of surveillance on the ratio of numbers of DVT/PE diagnosed and those that actually occur.Background
Aims
A wide variety of hospital data is reported to and published by national groups intending to compare quality of care between institutions. The rate of deep venous thrombosis and pulmonary embolism (DVT/PE) after orthopaedic surgery is among those reported. In an effort to examine the validity of hospital data reported to these national groups, we looked deeper into the cases of DVT reported by our hospital to the University Health Services Consortium (UHC). The rate of DVT/PE after orthopaedic surgical procedures reported to UHC for 2007 was 2.6% (33 cases). This rate is over twice the UHC mean for this same time period. Review of the 33 reported cases of DVT/PE revealed that only 12 were appropriately coded; if appropriately coded and reported, the DVT/PE rate would have been 0.95%. The rates of DVT/PE reported by this institution to UHC result in that institution being characterised as having comparatively high rates of this complication. However, the validity of this characterisation should be questioned, based on inconsistencies seen in the institution's diagnostic coding. This investigation raises concerns that coding variations between institutions may prohibit accurate quantification of hospital complications and ought not be used for the purpose of benchmarking.
Fractures of the radial head result from an axial force that causes impaction against the capitellum. Associated lesions of the capitellum in this pattern of injury have been previously reported in the orthopaedic literature as an uncommon occurrence. All patients presenting to the clinics of the senior surgeon between 1998-2008 with radial head fractures requiring surgery were included. Data collected included demographics (age, gender, side of injury), mechanism, timing of injury and injury type (Mason classification). Intraoperative findings including evidence of union, capitellar injury, associated joint dislocation, collateral ligament injury, and any other fractures around the elbow were documented.Background
Methods
