Whilst the literature abounds with patient reported outcomes following total knee replacement (TKR) there is a paucity of literature covering objective functional outcomes. Awareness of objective functional outcomes following TKR is key to the consent process and relating it to pre-operative function enables a tailored approach to consent. Identify trends in a range of functional outcomes prior to and following TKR up to one year post-operatively.Abstract
Background
Objectives
To calculate the cost of investigation of a painful Total Knee Replacement (TKR) to the hospital trust and Primary Care Trust (PCT). 28 patients, over a year period, with painful Total Knee replacements were collected. Costs were calculated only of those patients who had an improvement in their symptoms such that they no longer had a painful TKR. The numbers of appointments, number of serological and radiological investigations were calculated along with any further investigations such as aspirations and arthroscopies. Costs were calculated from hospital records and charges to the PCT. An average cost per patient of investigations was calculatedPurpose
Method
We describe our technique and the early results of compaction morselised bone grafting (CMBG) for displaced tibial plateau fractures using fresh frozen allograft. This technique has been performed by the senior author since July 2006 on eight patients. Clinical and radiological follow-up was performed on seven remaining patients at an average 12 months (range 4–19) following surgery. One patient died of an unrelated cause three months following surgery. One patient underwent a manipulation under anaesthesia at three months for knee stiffness. One patient developed a painless valgus deformity and underwent corrective osteotomy at 15 months. The height of the tibial plateau on radiographs has been maintained to an excellent grade (less than 2 mm depression) in all but one patient. CMBG using fresh frozen allograft in depressed tibial plateau fractures provides structural support sufficient to maintain the height of the tibial plateau, is associated with few complications in complex patients with large bone loss and has theoretical advantages of graft incorporation and remodelling.
