Methods

We present a case-series of consecutive patients treated at our institution due to a severe fungal osteomyelitis after an arthroscopic ACL-R from November 2005 to March 2015. Patients were referred to our institution from different areas of our country. We evaluated the amount of bone resection required, type of final reconstructive procedure performed, and Musculoskeletal Tumor Society (MSTS) functional score.

Methods and Results

In 2006, the lower limb arthroplasty surgeons at UHCW NHS Trust decided to set up a ‘virtual’ arthroplasty surveillance plan to provide long-term radiographic and patient reported clinical outcomes for all patients undergoing hip and knee arthroplasty. In the face of increasing pressure upon outpatient waiting time and funding issues, this system was designed to replace the routine clinical review of patients in the outpatient department.

While simple in principle, the virtual arthroplasty surveillance plan required input from surgeons and allied health professionals, hospital management, PCT clinicians, PCT finance, hospital finance, IT services and of course patients. However, in 2009 we were able to provide an electronic record of functional outcome scores and associated radiographs for over 1000 patients who had primary hip and knee arthroplasty surgery in our unit. Response rates for the first 6 months of 2009 for hip arthroplasty were 85.2% for functional outcomes and 84.2% for radiographic review. The subsequent clinical input is managed through ‘virtual’ clinics which provide a means to track patient outcomes and also an automated mechanism for financing the system. There are several areas which can still be improved, but early qualitative feedback suggests that this system provides high levels of satisfaction for both patients and surgeons.