Approximately 30000 total knee replacements are performed annually in the UK. Standard practice is to obtain a radiograph during the initial post-operative period. We performed a retrospective review of 638 total knee replacements and found no significant complications were visible on post-operative radiographs. There were 4 cases of mild femoral notching. Cessation of initial radiographs could save the NHS two million pounds annually. We suggest check radiographs in the initial post-operative period are unnecessary and waste valuable resources which could be distributed elsewhere.

Literature searches are commonly performed by medical professionals when carrying out research and during study of a particular topic. Traditionally this was performed manually in a library using a system called index medicus, developed in the early years of the 20th century, and was an arduous task. Over recent years, this has commonly been performed online using electronic search engines, which has drastically reduced the difficulty and time involved in performing a thorough literature search.

Electronic versions of index medicus began in 1964 and were termed MEDLARS. Medline was developed soon after and for many years available on CD-ROM within libraries. In 1997, PUBMED became free to all online, incorporating Medline. (1) Use of online electronic search engines has increased enormously over recent years. In 1996 7 million searches were performed per annum, increasing to 400 million searches per annum in 2001. (1)

The researcher has the ability online to identify articles dating back to 1966, some 39 years of published research and articles to digest.

We performed a retrospective study of 100 medical professionals in a busy district general hospital in the UK with the purpose of identifying how retrospective many of the searches were.

Results showed only 29% of subjects researched papers more than 15 years old, with 65% of subjects only looking at papers 10 years old or younger.

Our study shows that many researchers are now ignoring articles beyond a certain age, and as a result much important research is being largely ignored and possibly repeated.

Introduction: With the introduction of out-patient waiting time targets, there has been increasing pressure on clinics to accommodate both new referrals and follow-up patients. Departments have found it increasingly difficult to continue long-term follow-up of patients post arthroplasty.

We have piloted a new system of purely therapist led clinics and assessed this with an anonymous patient survey.

Method: Since 2005 and following a training program for the therapists involved, 110 arthroplasty patients have passed through the new clinics. They are seen at 6 weeks, 6 and 12 months and then 3, 5 and 10 years. Their ROM, stability and XRAY findings are documented and each patient completes Oxford Knee, SF 12 and WOMAC scores. If there are problems at any stage they are seen in the surgeon led clinic.

Results: 69% of patients responded to the survey and in general they were very satisfied with the new system. 75% felt that been seen by the therapist alone still fully addressed their needs with 79% having an overall impression of either excellent or very good. The patients rated the therapists professionalism, assessment and information delivery as good to excellent in over 80%.

Conclusion: We feel that with the introduction of this new system, we will be able to continue long-term follow-up of all our patients post arthroplasty. With their regular assessments and scoring we will be able to monitor the success of their replacements and theoretically identify early any problems.

Aims: Aim of the work is evaluation of outcome after reconstruction of acetabular bone stock deþcit in revision hip alloplastics. Methods: Material consists 113 patients with septic and aseptic acetabulum loosening after THA, 31 (27,4%) with cementless and 82 (72,6%) with cemented THA. For evaluation of the functional outcome has been used AAOS scale. Loosening was evaluated on X-rays on behalf of symptoms described by De Lee and Charnley. Surgical tactic was based on Paprosky anatomical bone stock deþcit evaluation Results: Functional Harris hip scores after realloplastic showed improving in passive motion and lowering of pain complaints. There has been concluded full graft in osteointegration in cases with stabile placement of thick cancellous bone graft, with good contact between graft-bone interface and cup. Conclusions: Solid liophylized and milled cancellous bone grafts, used in reconstruction of acetabulum, can remodel and osteointegrate even in cemented technique if there is a sufþcient contact between acetabulum wall and graft. It is possible to obtain good long-term functional and radiological results with usage of operative technique based on remodeling of bone grafts.

Aims: The aim of the paper is evaluation of hip joint formation after Pertheñs disease treated conservatively as well as estimation of diagnostic value of self-elaborated trochanter-head (T-H) and radius of head (R-H) coefþcients, in relation to Heyman-Herdonñs and Klisicñs methods. Methods: Hip joint radiograms of 33 persons after Perthesñs disease were underestimated, mean 9,23 years after termination of treatment. Measurements performed accordingly to Heyman-Herdonñs and Klisicñs methods and T-H and R-H coefþcients were referred to sex, age of the patient at the moment of start of treatment, Catterall groups, Catterall risk factors and side of necrosis appearance. Results: Since lesser trochanter is left intact in course of the disease, it was assumed as point of reference for self-elaborated T-H and R-H coefþcients, which were measured in A-P and axial projection. Statistic analysis of rentgenmetric methods revealed positive correlation between T-H coefþcient and H-H method as well as between R-H coefþcient and Klisicñs method. Conclusions: Time consuming Heyman-Herdonñs and Klisicñs methods of estimation are burdened with high measuring error. Used self-elaborated coefþcients are easy to trace and calculate, and measurements are precise. Above coefþcients are repetitive irrespectively of patient age and multiplanar, hence allow for more precise estimation of hip joint deformities after the treatment than used up to present H-H and Klisicñs methods.