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Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_16 | Pages 70 - 70
1 Dec 2021
McCabe-Robinson O Nesbitt P
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Abstract

Introduction

Bipolar hemiarthroplasty(BPHA) for displaced intracapsular neck of femur fractures(DICNOF) is a controversial topic as conflicting evidence exists. The most common reason for revision to total hip arthroplasty(THA) from BPHA is acetabular erosion. In our study, we sought to quantify the direction of migration of the bipolar head within the first 3 years post-operatively.

Methods

A proportional index in the horizontal and vertical planes of the pelvis were used to quantify migration. This method removed the need to account for magnification and rotation of the radiographs.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_8 | Pages 52 - 52
1 Apr 2017
Cundall-Curry D Lawrence J
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Background. Since it's establishment in 2007, the National Hip Fracture Database [NHFD] has been the key driving force in improving care for hip fracture patients across the UK. It has facilitated the setting of standards to which all musculoskeletal units are held, and guides service development to optimise outcomes in this group of patients. As with any audit, the ability to draw conclusions and make recommendations for changes in practise relies on the accuracy of data collection. This project aimed to scrutinise the data submitted to the NHFD from a Major Trauma Centre [MTC], focusing on procedure coding, and discuss the implications of any inaccuracies. Method. The authors performed a retrospective analysis of all procedure coding data entered into the NHFD from July 2009 to July 2014 at Cambridge University Hospitals NHS Foundation Trust. We examined 1978 cases for discrepancies, comparing procedure codes entered into the NHFD with post-procedure imaging and operative notes. Results. The procedure coding data submitted to the NHFD was highly inaccurate, with incorrect procedure codes in 24% of the 1978 cases reviewed. In particular, coding of cemented total arthroplasty and cemented bipolar hemiarthroplasty, with coding errors in registry data of 42% and 39% respectively. Of the 67 THRs performed only 52% were correctly coded for, and only 626 of the 915 hemiarthroplasties (68%). 16% of cannulated hip screws actually underwent primary arthroplasty. Conclusions. This study highlights the inaccuracy of coding data entered into the NHFD from a Major Trauma Centre, with data on arthroplasty being particularly inadequate. The unreliability of procedure data leaves us unable to evaluate surgical treatment strategies using the NHFD. This has worrying implications for standard setting, service development and, consequently, patient care. Level of evidence. 2c