We present a case series of patients that underwent knee ligament reconstruction with graft reinforcement using FibreTape (Arthrex), a 2mm wide non-biodegradable polyethylene tape. Outcomes and safety of this novel technique are reported. Data were collected from a prospectively maintained database from 03/2011 to 11/2019. All skeletally mature patients that underwent reinforced knee ligament reconstruction surgery at Basingstoke and North Hampshire Hospital were included. The cohort was interrogated for outcomes including failure, complications, and subjective patient reported outcomes at 6,12 and 24 months postoperatively.Abstract
Introduction
Methods
Healthcare practitioners' (HCPs) attitudes and beliefs about MSK pain influence their practice behaviour. The Pain Attitudes and Beliefs Scale (PABS), developed for use in the context of LBP, consists of two subscales (biomedical and biopsychosocial) is the most widely used measure. However, poor performance of the biopsychosocial orientation scale is attributed, in part, to inadequate conceptualisation of the orientation. To develop a new biopsychosocial scale and adapt the PABS to assess HCPs' attitudes and beliefs about common MSK pain.Purpose of the study and background
Purpose
Delay to theatre after hip fracture is common in order to medically optimise the patient prior to surgery. The association between delay to surgery and mortality after hip fracture remains a contentious issue. We aimed to investigate how medical postponement, time to surgery and correction of medical abnormalities prior to surgery affect peri-operative mortality after hip fracture. From February to December 2007 prospective data was collected from all acute trauma units in Scotland relating to hip fracture patients' fitness for theatre, reasons for postponement of surgery and subsequent plans of action. The data-set recorded whether medical abnormalities were identified following criteria reported by McLaughlin et al. Survival at 30-days post-operation was used as primary outcome measure. Multivariable logistic regression models were used to control for differences in case-mix between patients. Data were available for 4284 patients. Patients postponed for medical reasons were less likely to survive to 30 days compared to patients who were not postponed (87% (122/947) versus 93% (3098/3337)). Survival also decreased as time to theatre increased - 92% of patients operated on during the same/next day vs. 89% of those operated on admission day four. However, after controlling for differences in case-mix variables and co-morbidities, neither variable significantly affected survival. We then analysed whether delaying surgery to resolve medical problems improved survival. Adjusted survival was not significantly different between those patients who had their medical problem resolved prior to surgery compared to those patients who were not postponed. Individuals who were postponed but did not have their clinical abnormality resolved prior to surgery had significantly lower adjusted 30 day survival. The possible benefits of postponement need to be weighed against prolonged discomfort and the possibility of developing other complications. Postponing patients who cannot be medically improved should be avoided.
