To investigate the feasibility of undertaking a definitive Randomised Controlled Trial (RCT) to determine the effectiveness of early physiotherapy for sciatica. Patients over 18 presenting to their G.P with sciatica were eligible to participate in the study, those without a clear understanding of English or had co-morbidities preventing rehabilitation were ineligible. Process and patient reported outcomes including self-rated disability, pain and general health, were collected at baseline, 6,12 and 26 weeks post randomisation. Participants were randomised into either early physiotherapy, receiving treatment within 2 weeks after randomisation or usual care with physiotherapy commencing 6 weeks post randomisation. Both groups received up to 6 treatment sessions of a patient-centred, goal orientated physiotherapy programme specific to their needs.Purpose of the study
Methods
The aims of the study were to explore the experiences of sciatica sufferers, their perceptions of physiotherapy and healthcare service provision. This was the qualitative element of a mixed methods study investigating the feasibility of early physiotherapy for sciatica. Participants in the pilot trial consented to take part in semi-structured interviews before and after they had undertaken an individualised physiotherapy programme. Data from the interviews was examined line by line using a thematic analysis approach with key themes and sub-themes emerging.Purpose of the study
Methods
Management of the patellofemoral surface in total knee arthroplasty (TKA) remains a topic of debate. Incidence of anterior knee pain and incidence of repeat operation have been the focus of several recent meta-analyses, however there is little recent data regarding patients” subjective ability to kneel effectively after TKA. The purpose of this study was to compare patient reported outcomes, including reported ability to kneel, after total knee arthroplasty with and without patellar resurfacing. Retrospective chart review of 84 consecutive patients who underwent primary TKA with patella resurfacing (56 knees) or without patella resurfacing (28 knees) having a minimum of 2.5 year follow up was performed. Oxford knee scores (OKS), visual analog pain scores (VAS), and questionnaires regarding ability to kneel were evaluated from both groups. Inability to kneel was defined as patients reporting inability or extreme difficulty with kneeling. Shapiro-Wilk test was used to determine normality of data. Mann Whitney U test was used to compare the OKS and VAS between groups. Chi square test was used to compare kneeling ability between groups. Statistical analysis was performed with SPSS version 23 (IBM, Aramonk, NY).Introduction
Methods
Infections in total joint arthroplasty (TJA) are a burden to the healthcare system. An infection in total joint arthroplasty costs nearly $60,000–80,000 to the system. 3 major tenets to decrease surgical site infections, focus on patient preoperative optimization, intraoperative techniques, and postoperative care. Intraoperative vancomycin powder been successful in lowering infection rates in other areas of orthopaedics. The purpose of our study was to investigate whether topical intraoperative vancomycin powder had any effect on surgical site infection, complication rate, or reoperation rate. Our hypothesis was vancomycin powder may decrease the rate of surgical site infections without any effect on wound complications. 208 consecutive patients undergoing either total hip or total knee arthroplasty (THA or TKA) were given intraoperative vancomycin powder or none. 64 patients received vancomycin poweder compared to 164 patients who did not. All preoperative, intraoperative and postoperative management was similar. Preoperative data including age, sex, BMI, diabetes status and comorbidities were recorded. Surgical techniques included medial parapatellar or subvastus for TKA, posterolateral for THA. 90-day culture positive infection and reoperation rates were recorded.Introduction
Materials & Methods
