Patient related outcome measures (PROMS) are now routinely undertaken in patients undergoing hip arthroplasty. These are in the form of the Oxford Hip Score (OHS) and EQ5D questionnaires pre-operation and at 6 months' post operation. MYMOPS is a patient specific outcome measure that allows patients to list their individualised symptoms and activities that are limited and is used is other medical specialities but not currently within orthopaedic surgery. The aim of this study was to validate the MYMOPS questionnaire for use in hip arthroplasty by comparing it to the OHS. At a single centre, 50 patients were recruited to our prospective trial after ethical approval. A MYMOPS questionnaire and an OHS was filled in pre-operation and then at 6 months post-operatively. 6 patients filled in either form incorrectly and were excluded. The remaining 44 included 30 females and 14 males with an average age of 68.5 (range 35–90).Introduction
Patients/Materials & Methods
The study was designed to gauge adequacy of pain relief in the first 5 days following TKA, in particular comparing the Painbuster device (B Braun, Sheffield, UK) with more routine modalities. In a prospective, multi-disciplinary audit, all post-operative in-patients completed a pain diary. Pain was recorded as none (0), mild (1), moderate (2) or severe (3), three times a day. This information was collated, along with the pre-operative Oxford knee score, type of anaesthetic, and use of post-operative analgesia. This included oral and intravenous medication, local anaesthetic infiltration and the Painbuster, a continuous infusion device which delivers bupivacaine into the knee for 48 hours.Aims
Methods
We prospectively studied 15 proximal tibial and 30 distal femoral fractures treated with the Less Invasive Stabilisation System for periarticular fractures about the knee. Of these 45 fractures, one patient returned to Russia and was thus lost to follow up. The mean age of the remaining patients was 64.4 years (range 15–94 years). There were 26 females and 13 males. All fractures were classified according to the AO classification. We found the use of temporary external fixation and mobile radiolucent wedge leg supports very helpful during surgery for these cases. We developed an increasingly aggressive postoperative mobilisation regime with increased experience of using this fixation technique. Functional assessment was performed using the Schatzker and Lambert scores. The average time to union was 14.78 weeks (range 10– 28 weeks). 43 fractures have united with one fracture showing signs of delayed union. There were two implant failures, two deep vein thrombosis and two compartment syndromes. Five patients died of unrelated causes and without problems relating to their fracture. We conclude that the Less Invasive Stabilisation System is a satisfactory method of treating these complex and difficult fractures about the knee with a high rate of union and good functional outcome.