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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_11 | Pages 51 - 51
1 Dec 2020
Khan MM Pincher B Pacheco R
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Aims and objectives. Our aim was to evaluate the indications for patients undergoing magnetic resonance imaging (MRI) of the knee prior to referral to an orthopaedic specialist, and ascertain whether these scans altered initial management. Materials and Method. We retrospectively reviewed all referrals received by a single specialist knee surgeon over a 1-year period. Patient demographics, relevant history, examination findings and past surgical procedures were documented. Patients having undergone MRI prior to referral were identified and indications for the scans recorded. These were reviewed against The NHS guidelines for Primary Care Physicians to identify if the imaging performed was appropriate in each case. Results. A total of 261 patients were referred between 1. st. July 2018 and 30. th. June 2019. 87/261 patients underwent MRI of the knee joint prior to referral. The mean patient age was 53 years with predominance of male patients (52 verses 35 females). 21/87 patients (24%) underwent the appropriate imaging prior to referral with only 13% of patients undergoing x-ray imaging before their MRI. In cases where MRI was not indicated, patients waited an average of 12 weeks between their scan and a referral being sent to the specialist knee surgeon. Conclusion. 76% of patients referred to orthopaedics had inappropriate MRI imaging arranged by their primary care physician. For a single consultant's referrals over 1 year these unnecessary MRI scans cost the NHS £13,200. Closer adherence to the guidelines by primary care physicians would result in a financial saving for the NHS, faster referral times and a more effective use of NHS resources


Bone & Joint Research
Vol. 5, Issue 2 | Pages 37 - 45
1 Feb 2016
Roh YH Kim W Park KU Oh JH

Objectives

This study was conducted to evaluate the cytokine-release kinetics of platelet-rich plasma (PRP) according to different activation protocols.

Methods

Two manual preparation procedures (single-spin (SS) at 900 g for five minutes; double-spin (DS) at 900 g for five minutes and then 1500 g for 15 minutes) were performed for each of 14 healthy subjects. Both preparations were tested for platelet activation by one of three activation protocols: no activation, activation with calcium (Ca) only, or calcium with a low dose (50 IU per 1 ml PRP) of thrombin. Each preparation was divided into four aliquots and incubated for one hour, 24 hours, 72 hours, and seven days. The cytokine-release kinetics were evaluated by assessing PDGF, TGF, VEGF, FGF, IL-1, and MMP-9 concentrations with bead-based sandwich immunoassay.


Bone & Joint 360
Vol. 3, Issue 1 | Pages 37 - 38
1 Feb 2014
Hak DJ