The accurate and detailed documentation of surgical procedures is essential, forming part of good clinical practice set out by the General Medical Council (GMC). In the case of knee arthroscopy, it is vital for planning further management when referring to a soft tissue knee specialist. This study assesses the quality of documentation of knee arthroscopy and evaluates the implementation of a novel operative template. A retrospective study of 50 operative-notes of patients undergoing knee arthroscopy was completed. A 41-point assessment was made based on guidelines from the GMC, Royal College of Surgeons of England (RCSE), British Orthopaedic Association (BOA) and British Association for Surgery of the Knee (BASK). An operative-note template was devised to address the criteria important for further interventions and then assessed for its efficacy in providing appropriately detailed findings. Detailed documentation deemed essential by current guidelines were lacking the minimum standards expected. Criteria that were considered necessary for an arthroscopic procedure were as low as 4%. After instigating the new operative template, there was a statistically significant increase (p < 0.001) in documentation accuracy throughout the necessary criteria set out by the GMC, RCSE, BOA and BASK. We have devised an operative template for knee arthroscopy that improves the quality of documentation and allows for optimal further surgical planning. Clear documentation is important for patient safety, adequate referral to a specialist, research and coding purposes. This will ideally reduce the number of repeat knee arthroscopies performed and optimise patient care from the outset.
To demonstrate the effect of location of the split of the plaster on the raised intercompartmental pressure in the volar and dorsal compartments. Artificial forearm skeleton was used along with two half litre saline bags on ether side representing volar and dorsal forearm compartment. A single layer of cotton wool with half width overlap was applied followed by three rolls of 10cm x 2.5 m plaster of paris. This was then left to dry for four hours. Both the saline bags had an eighteen gauge catheter inserted that was connected to the central venous pressure monitoring line on the anaesthetic machine. Baseline pressure in mmHg was recorded. Normal saline was then injected in both the bags so as to raise the pressure to 50 mmHg in each compartment. POP cast was then split, spread and then the wool was cut down to the saline bags while continually monitoring the pressures. The respective change in the pressure at the end of each step was recorded. Six simulated forearm models had dorsal splits and an equal number had volar splits. The effect of the site and various steps of splitting on the drop in respective compartment pressures was compared.Aim
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