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Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_16 | Pages 7 - 7
1 Dec 2021
Jamal S Ibrahim Y Akhtar K
Full Access

Abstract

Objective

Open fracture management in the United Kingdom and several other countries is guided by the British Orthopaedic Association's Standards for Trauma Number 4 (BOAST-4). This is updated periodically and is based on the best available evidence at the time. The aim of this study is to evaluate the evidence base forming this guidance and to highlight new developments since the last version in 2017.

Methods

Searches have been performed using the PubMed, Embase and Medline databases for time periods a) before December 31, 2017 and from 01/01/2018–01/02/2021. Results have been summarised and discussed.


The Bone & Joint Journal
Vol. 97-B, Issue 10 | Pages 1309 - 1315
1 Oct 2015
Price AJ Erturan G Akhtar K Judge A Alvand A Rees JL

Despite being one of the most common orthopaedic operations, it is still not known how many arthroscopies of the knee must be performed during training in order to develop the skills required to become a Consultant. A total of 54 subjects were divided into five groups according to clinical experience: Novices (n = 10), Junior trainees (n = 10), Registrars (n = 18), Fellows (n = 10) and Consultants (n = 6). After viewing an instructional presentation, each subject performed a simple diagnostic arthroscopy of the knee on a simulator with visualisation and probing of ten anatomical landmarks. Performance was assessed using a validated global rating scale (GRS). Comparisons were made against clinical experience measured by the number of arthroscopies which had been undertaken, and ROC curve analysis was used to determine the number of procedures needed to perform at the level of the Consultants.

There were marked differences between the groups. There was significant improvement in performance with increasing experience (p < 0.05).

ROC curve analysis identified that approximately 170 procedures were required to achieve the level of skills of a Consultant.

We suggest that this approach to identify what represents the level of surgical skills of a Consultant should be used more widely so that standards of training are maintained through the development of an evidenced-based curriculum.

Cite this article: Bone Joint J 2015;97-B:1309–15.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 74 - 74
1 Jan 2013
Akhtar K Somashekar N Willis-Owen C Houlihan-Burne D
Full Access

Purpose of the study

The aim of this study was to prospectively study the safety, functional outcomes and complications of all patients undergoing bilateral single-stage sequential (BSSS) unicompartmental knee arthroplasty (UKA) in our unit.

Methods and results

394 cemented UKAs were performed in this unit between 2006–2010. A retrospective review identified 38 patients (76 knees) who underwent BSSS UKA, performed by a single surgeon. Patient demographics were recorded as well as pre and post-operative Oxford knee scores, tourniquet times, time to mobilisation, length of in-patient stay and any complications.

There were 22 women and 16 men with a mean age of 64. The mean duration of follow-up was 30 months. The mean total tourniquet time was 83 minutes. The mean time to mobilisation was 18 hours and the average length of stay was 3.5 days. This compares favourably with an institutional average length of stay of two days for a single UKA.

There was a significant improvement in the mean pre- to post-operative Oxford Knee Score (from 14 to 34, p< 0.0001).

One patient required operative fixation of a tibial plateau fracture after sustaining a mechanical fall two months following surgery. There were no other major complications, including thrombo-embolic events or deep infections. Two patients required excision of a superficial suture granuloma.