Purpose of study: To assess the effect of 18-month waiting list, on the subsequent requirement of knee arthros-copy.

Materials and methods: Medical records of 310 patients with knee pain, who had been placed on the non-urgent arthroscopy waiting list in 2003, were assessed. Diagnoses and the grade of doctor placing the patients on the list were also noted. The percentages of patients undergoing surgery as planned, as well as of those being cancelled were looked at.

Results: 61% of patients underwent knee arthroscopy as planned. 12% considered their symptoms insignificant as to require operation. 11% wanted a later operation date because of personal reasons, 7% had their surgery privately or had been expedited through the waiting list scheme because of deterioration in their condition but remained on NHS waiting list, and 9% patients had their surgeries postponed because of other medical reasons.

Conclusion: For a group of patients having been placed on an 18-month waiting list for knee arthroscopy, 40% did not subsequently have surgery within the NHS setting, as planned initially.

Introduction Pan-talar nailing for ankle arthrodesis has been advocated as a salvage procedure for post-traumatic arthrosis and Charcot’s joint. This study evaluates the outcome of pan-talar nails over a 4-year period.

Method This is a retrospective study of 11 patients (13 ankles) who underwent pan-talar nailing between 2000 and 2004. Various factors including patient demographics, indications for surgery, operation details, complications, time to fusion and need for re-operation were recorded. Nine were reviewed at a mean follow-up of 22 months for clinical and radiological assessment; two patients had died. American Orthopaedic Foot and Ankle (AOFAS) hindfoot and SF-36 scoring systems were also used for evaluation.

Results There were seven males and four females, with a mean age of 57 and 71 years, respectively. Eight patients had a pre-operative diagnosis of Charcot’s joint, one avascular necrosis of talus, one fixed deformity with polio, and one following fracture non-union.

All 13 nails were locked at both ends. The average duration of operation was 2 hours and tourniquet time 1 hour 8 minutes. All patients were kept non-weight bearing in cast post-operatively for an average of 6 weeks.

There were two cases of wound infection, one pulmonary embolism and one calcaneal fracture with infected non-union, which was treated with external fixation. There were no cases of nerve damage or septic arthritis.

All nine patients were satisfied with the operation outcome at follow-up with a mean fusion duration of 28 weeks and an average AOFAS score of 75.

Conclusion We conclude from this study that pan-talar nailing when performed for ankle arthrodesis as a salvage procedure produces a high rate of fusion with fewer complications.