Introduction. Patient-reported outcome measures (PROMs) has gained momentum in the orthopaedic literature. The GOAL-LD (Gait Outcomes Assessment List for Limb Deformity) incorporates the framework of The WHO International Classification of Functioning, Disability and Health and correlates highly with the Paediatric Outcomes Data Collection Instrument (PODCI) when applied in a limb reconstruction setting. The Royal Children's Hospital Melbourne, Australia, supported by The University of Melbourne is designing and implementing a Limb Reconstruction Registry, prospectively enrolling patients with a number of key conditions and provide a mechanism for capturing surgical data and PROMs at regular follow-up intervals. LimbDREAM (The Limb Reconstruction Registry of Experience, Aspiration and Measures) has begun recruiting participants, and this paper serves as a narrative review of our design and implementation process. Materials & Methods. After provision of a research grant, audit was conducted to examine local case mix and estimate recruitment based on conditions selected. Literature review was focussed on (i) registries in the paediatric limb reconstruction domain and (ii) use of PROMs across conditions selected. A high-level process-flow chart was constructed in order to inform governance and staffing requirements in addition to REDCap Database structure. Local as well as scalable deployment was considered. Alpha and beta testing was performed by principal and associate investigators prior to participant recruitment. Results. Audit identified 6 condition streams for inclusion: Congenital limb deficiencies, congenital pseudarthrosis of the tibia, bone dysplasias, bone tumours, amputation, and complex deformity of other etiology. Literature review identified 20 PROMs used across these conditions, with limited validation studies and significant implementation heterogeneity. REDCap database design took longer than anticipated (planned 10 months, actual 18 months) before being recruitment ready, due to the complexity of ensuring data collection logic would work across highly diverse patient journeys. Initial recruitment across all streams has been promising. Email and text message reminders have proved helpful in increasing survey return rates. Conclusions. Prospective collection of PROMs as well as surgical data via a standardized dataset will provide the basis for future condition-specific research, with the ability to support nested trials. Implementation requires forethought with regard to time frames and staffing for non-automated steps as well as data integrity review. The next phase of the LimbDREAM project will be to integrate use of the Registry into our weekly Limb Reconstruction Meeting to ensure that operative plans and data are captured close to the point of care

to determine the extent of Orthobullets use by orthopaedic residents in academic and clinical settings. We also wanted to determine whether its widespread use is the same in various training programs around the world and so we chose to survey two distinct programs without any academic or institutional ties. An electronic 9 question survey created using SurveyMonkey was sent to residents in two distinct Orthopaedic residency programs, either via text message or by email. The two programs surveyed were the McGill University Orthopaedic Surgery residency program located in Montreal, Canada, and the Oman Medical Specialty Board (OMSB) Orthopaedic Surgery residency program located in Muscat, Oman. A total of 36 residents, 20 from McGill and 16 from OMSB, responded to the survey request. In both programs, 89% of all the residents surveyed claimed they use Orthobullets at least 4 times per week, and greater than 95% of them use it during call shifts to obtain information rapidly. Regarding the use of Orthobullets in the context of operating theatre case preparation, over 50% of residents claim to use it often while only 25% claim to rarely use it for this purpose. The use of Orthobullets during clinics seemed to be the least popular among residents as 47% claimed they rarely use it. Cumulatively in both programs, more than 80% of residents indicated that they always use Orthobullets in preparation for an exam especially among senior residents. Approximately two thirds of residents have said they completely trust the information provided on Orthobullets, with the remainder indicating that they trust Orthobullets more than 75% of the time. The proportion of residents who indicated that they completely trust Orthobullets was greater in the OMSB group (75%) and among senior trainees. Over 85% of residents discovered Orthobullets through friends and colleagues, and the rest through the program and faculty members. Our survey results demonstrate the widespread use of Orthobullets, a popular online orthopaedic resource, among orthopaedic residents of all levels. The settings in which Orthobullets was most used were exam preparation and during call shifts. In addition, with the high amount of confidence residence have Orthobullets, it is questionable as to how many are actually aware that its information is not validated. For the time being however, we do not discourage the use of Orthobullets for exam preparation, however, we recommend that programs warn their residents to abstain from using it in their clinical decision-making until it has demonstrated peer-reviewed approval

Aims

COVID-19 has compounded a growing waiting list problem, with over 4.5 million patients now waiting for planned elective care in the UK. Views of patients on waiting lists are rarely considered in prioritization. Our primary aim was to understand how to support patients on waiting lists by hearing their experiences, concerns, and expectations. The secondary aim was to capture objective change in disability and coping mechanisms.