Advertisement for orthosearch.org.uk
Results 1 - 7 of 7
Results per page:
Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_13 | Pages 36 - 36
7 Aug 2023
Matthews S Acton D Tucker A Graham J
Full Access

Abstract

Introduction

The Syn-VAR RCT is the first of its kind comparing hamstrings autograft v synthetic neoligament for MPFL reconstruction.

Our aim is to evaluate short and long term patient related outcomes measures (PROMs) following synthetic / autologous MPFL reconstruction in a heterogenous cohort of patients with recurrent patellar instability.

Method

20 patients meeting inclusion criteria were recruited and randomised. Standardised surgery was performed by a single surgeon in Altnagelvin Hospital with data collected over 3 years from 2016. Kujala score was the primary outcome measure with data captured preoperatively and 12 weeks/2 years postoperatively. Secondary outcomes included four other validated scores and complications including Norwich Patellar Instability, Lysholm, IKDC and Banff


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_1 | Pages 29 - 29
1 Feb 2021
Kolessar D Harding J Rudraraju R Hayes D Graham J
Full Access

Introduction

Robotic-arm assisted knee arthroplasty (rKA) has been associated with improved clinical, radiographic, and patient-reported outcomes. There is a paucity of literature, however, addressing its cost effectiveness. In the context of an integrated health system with an insurance plan and single source comprehensive data warehouse for electronic health records and claims data, we present an evaluation of healthcare costs and utilization associated with manual knee arthroplasty (mKA) versus rKA. We also examine the influence of rKA technology on surgeons’ practice patterns.

Methods

Practice patterns of KA were assessed 18 months before and after introduction of robotic technology in April 2018. For patients also insured through the system's health plan, inpatient costs (actual costs recorded by health system), 90-day postoperative costs (allowed amounts paid by insurance plan), and 90-day postoperative utilization (length of stay, home health care visits, rehabilitation visits) were compared between mKA and rKA patients, stratified by total (TKA) or unicompartmental (UKA) surgery. Linear regression modeling was used to compare outcomes between the two pairs of groups (mKA vs. rKA, for both UKA and TKA). Log-link function and gamma error distribution was used for costs. All analyses were done using SAS statistical software, with p<0.05 considered statistically significant.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_10 | Pages 13 - 13
1 May 2017
Graham J Heywood J
Full Access

Purpose and background

A review of secondary healthcare provision for civilians suffering persistent pain and living in the British Forces Germany (BFG) community was carried out in order to better inform referral from primary care. This population consists mostly of British nationals each with differing linguistic skills and cultural backgrounds. Patients may be referred to Evangelisches Krankenhaus Bielefeld (EvKB) in Germany or to Guys and St Thomas' NHS Foundation Trust (GSTT) in the UK. It was considered important to identify potential language or cultural-related barriers to improve decision making when considering where best to refer for a pain management programme (PMP).

Methods

Clinical visits undertaken at GSTT and EvKB involved observation of clinical activities, collection of documentation and informal staff discussions. Data were organised into common themes and categorised to provide information for written reflective accounts on each visit.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_IV | Pages 440 - 441
1 Apr 2004
Graham J Turner P Johnson D
Full Access

Purpose To compare the patient’s experience of anterior cruciate ligament (ACL) reconstruction with previously validated outcome measures.

Methods Forty-five patients who had previously undergone ACL reconstruction performed by a single surgeon at least one year previously were assessed. A mean time of 33 months had elapsed between surgery and assessment. Each assessment included the Modified Lysholm Score, the Tegner Activity Score and the one-legged hop test (OHT). Patient’s subjective assessment included visual analogue scales (VAS) for pain, knee function, achievement of expectations and satisfaction. Correlation of all these items was performed using SPSS.

Results The mean Lysholm score was 90.3, with mean Tegner scores of 6.9 pre-injury, 5.2 currently and 6.3 desired. The mean OHT index was 0.92. The VAS scores (range 0 to 100) were 25 mm for pain, 79 mm for knee function and 77 mm for satisfaction. The VAS score (range −50 to 50) for expectations was 16 mm. Highly significant correlations were found between the Lysholm scores and all VAS scores; all VAS scores with each other; and the discrepancy between the current/desired Tegner scores and satisfaction. Significant correlations were found between age and achievement of expectations; the current Tegner score and achievement of expectations/satisfaction; and the discrepancy between the current/desired Tegner scores and achievement of expectations/time following surgery. There was a poor correlation between the OHT and the other variables in this post-operative population.

Conclusions Patient assessed measures of symptoms and satisfaction following ACL reconstruction correlate well with accepted outcome measures. A discrepancy between current and desired activity levels influence satisfaction following ACL reconstruction to a greater degree than actual activity levels. Patients should therefore be warned pre-operatively of a potential reduction in activity level post-operatively.


The Journal of Bone & Joint Surgery British Volume
Vol. 55-B, Issue 4 | Pages 786 - 795
1 Nov 1973
Graham J Checketts RG

1. The results of synovectomy of the knee in eighty-five patients with rheumatoid arthritis are presented.

2. When reviewed between five and nine years after operation 55 per cent of 122 knees still had improvement in pain.

3. Only 31 per cent of knees lost movement.

4. Recurrence of symptoms in nearly all cases was related to the recurrence of active rheumatoid synovitis.

5. Recurrence of symptoms was a little less likely when the generalised disease improved, when the Rose-Waaler test was negative, when only one knee was involved and when the operation had been carried out within three years of the onset of disease in that knee.


The Journal of Bone & Joint Surgery British Volume
Vol. 53-B, Issue 4 | Pages 650 - 659
1 Nov 1971
Graham J Harris WH

1. The early signs of Paget's disease of the acetabulum and femur are described.

2. The pattern of arthritis is presented in 199 hips in which Paget's disease of bone occurred in either the femur, the acetabulum or both bones. Distinct patterns of disease occur with different bone involvement.

3. Selective narrowing of the medial segment of the joint is common and is particularly associated with pelvic disease. Why the narrowing occurs here preferentially is unexplained.

4. Protrusio acetabuli occurred in only 25 per cent of hips and usually when both the femur and the acetabulum were involved. This may be due to the presence simultaneously of weakened bone and coxa vara, the latter leading to an alteration in the direction of the resultant force across the hip joint.

5. Degenerative arthritis was present with Paget's disease in 14 per cent of hips but it may be a chance relationship in half of these hips.


The Journal of Bone & Joint Surgery British Volume
Vol. 50-B, Issue 3 | Pages 562 - 569
1 Aug 1968
Graham J

1. A report is presented of the results of a trial to compare the effects of early and late weight-bearing in patients with a transcervical fracture of the femur treated by reduction of the fracture and internal fixation with a sliding nail-plate.

2. One hundred and twelve patients have been assessed clinically and radiologically three years after operation.

3. Retrospective analysis of factors that affect the outcome of treatment suggests that the two groups were fairly evenly balanced.

4. The results show that full weight-bearing two weeks after operation did not increase the incidence of failure of fixation or of non-union.

5. The higher incidence of superior segmental collapse in patients in whom weight-bearing was deferred for twelve weeks can be explained by the greater number of high fractures in this group and the greater number with a poor reduction.