To measure for evidence of early subsidence of Accolade tapered uncemented femoral stems. To quantify any subsidence and to identify factors which may predispose to this.

A retrospective audit of patients who have received Accolade stem total hip joint replacement in Hawkes Bay Hospital from October 2003 to October 2004. Post operative and follow up x rays (within one year of surgery) were reviewed and position of femoral component in the femur was measured and adjusted for magnification and angulation.

Thirty-eight patients were identified. Patients age averaged 66 years old (44 – 82yo). Results show an mean subsidence of 2.8mm with a range of 0 – 13mm.

There is evidence of early subsidence of Accolade femoral stems. In cases of large subsidence under sizing of the femoral component was identified as the most significant contributing factor.

An independent audit of Lumbar Spinal surgery performed by a single surgeon over a 4 year period is presented. The three groups evaluated included Lumbar fusion, decompression and discectomy.

Patients were assessed using the Oswestry Disability Questionairre and five other questions related to overall outcome and patient satisfaction. The minimum follow-up was 6 months. Patient response rate was 74%.

The overall outcome was 81% Excellent/Good vs 19% Fair/Poor. The best outcomes were in the discectomy group. The decompression group showed a variable and unpredictable outcome. Complications encountered in the three subgroups are discussed.

Lumbar spinal surgery offers lasting and predictable outcomes to a large majority of well selected patients. Independent surgical audits form an important part of evaluating one’s surgical practice.