At the Peninsula NHS Treatment Centre in Plymouth some of the surgeons are UK trained and some trained elsewhere in Europe.

This paper examines the outcomes of a large series of joint replacements from 2006 to 2008 at a minimum of one year follow up to determine whether the place of orthopaedic specialist training makes any difference to the outcome. The same implants were used by all surgeons and the anaesthetic technique and post-operative management was identical.

1700 patients were interviewed by a structured telephone questionnaire with over 92% follow-up and the results entered into a joint replacement database. Additional data about length of stay and blood transfusion was added.

Results will be presented about length of stay, transfusion requirements, any further treatment or hospital attendance relating to the new joint, reoperation, deep or superficial infection, hip dislocation, VTE and patient satisfaction.

The surgeon's place of orthopaedic training was found to make no difference to the surgical outcome.

Background: Independent Sector Treatment Centres (ISTC) are now providing significant volumes of elective orthopaedic care in the UK. They have been the subject of considerable publicity. The ISTC in Plymouth was the first newly built orthopaedic centre to open.

This paper describes the methods of working and analyses the early results of nearly a thousand joint replacements implanted between May 2005 and April 2006. It is the first set of such results to be become available.

Methods: Data on each case was collected prospectively and entered into a database. This included demographic information, surgical and implant data, blood loss and transfusion requirements, length of stay, patient satisfaction, readmission rate, complications and mortality. One hundred consecutive postoperative hip replacement x-rays were scored by an independent orthopaedic surgeon. The alignment of one hundred consecutive postoperative knee x-rays was evaluated by long leg views. Comparison is made to published UK and international data.

Results: Ongoing

Conclusion: Ongoing

In the years 1990–1993, in an effort to reduce waiting list time, a small number of patients were sent from Exeter to hospitals in London to undergo elective total hip replacement. No medium- or long-term follow-up was arranged. Our aim was to audit the outcome of these hip replacements.

Review of the records of the referring medical practices, Regional Health Authority, local Orthopaedic Hospital and the distant centres at which the surgery was performed has identified 31 cases. A total of 27 hip replacements in 24 patients were available for clinical and radiological review.

12 (44%) hips have so far required revision surgery, at a mean of 6.5 years. Of these, three (11%) have been for deep infection. A further three hips (11%) are radiologically loose and are being closely monitored. Two patients (7%) suffered permanent sciatic nerve palsy.

Patients whose surgery was performed locally over a similar time period have a published failure rate of only 4.6%. The causes for such a difference in outcome were analysed and include surgical technique, implant selection and absence of follow-up. In the light of this evidence, we would like to urge the government to address waiting list problems by investing in the local infrastructure. Expanding those facilities where properly audited and fully accountable surgeons operate must be the way forward.

Introduction and Aims: In the years 1990–1993, in an effort to reduce waiting list time, a small number of patients were sent from Exeter to hospitals in London to undergo elective total hip replacement. No medium- or long-term follow-up was arranged. Our aim was to audit the outcome of these hip replacements.

Method: Review of the records of the referring medical practices, Regional Health Authority, local Orthopaedic Hospital and the distant centres at which the surgery was performed has identified 31 cases. A total of 27 hip replacements in 24 patients were available for clinical and radiological review.

Results: Twelve (44%) hips have so far required revision surgery, at a mean of 6.5 years. Of these, three (11%) have been for deep infection. A further three hips (11%) are radiologically loose and are being closely monitored. Two patients (7%) suffered permanent sciatic nerve palsy.

Conclusion: Patients whose surgery was performed locally over a similar time period have a published failure rate of only 4.6%. The causes for such a difference in outcome were analysed and include surgical technique, implant selection and absence of follow-up. In the light of this evidence, we would like to urge the government to address waiting list problems by investing in the local infrastructure. Expanding those facilities where properly audited and fully accountable surgeons operate must be the way forward.