Aims: To determine pre and post-op patient satisfaction and to document complications. Methods: A questionnaire based study of a consecutive series of 71 Birmingham Hip Resurfacings performed by a single surgeon over a two year period. Mean age 54 (range 29 to 70 years). Outcome measures used were the Oxford Hip Score and Short Form 36 Results: There was a signiþcant improvement in outcome scores following surgery. Oxford hip score improved from 41.1 to 16.6 (signiþcant p< 0.05) SF36 score improved from 24.8 to 48.2 (signiþcant p< 0.05) Complications were 2 femoral nerve palsies, 1 lateral popliteal nerve palsy, 1 re-operation for a retained guide pin, 1 post operative fracture, 1 DVT, 1 PE and 8 patients received oral antibiotics for wound erythema or discharge but there were no deep infections. 89% would recommend the operation to a friend, with males rating the operation more highly. Mean visual analogue score of 91% for overall satisfaction, again males rating higher. Conclusions: Birmingham Hip Resurfacing gave signiþcant improvements in patient function, comparable or better than other similar results looking at conventional hip replacement. Patient satisfaction is high despite the younger patient group with active life styles. The group includes one Jiu Jitsu instructor and a triple marathon runner. One patient had previously had a contralateral conventional uncemented total hip replacement which he was pleased with... until he had experienced Òthe ÒfeelÒ of my Birmingham HipÒ

Our audit examined the rates of complication in the surgical wounds of patients having surgery for fractured neck of femur, comparing the use of skin clips and an absorbable subcuticular suture.

The initial part of the audit compared the commonly used methods of skin closure at our institution, as outlined above. One hundred consecutive patients with fractured necks of femur (NOF) were studied. The closure of the wounds was randomly allocated between skin clips and subcuticular suture. The wounds were monitored for signs of complications, including infection, for the duration of hospital stay. It was found that the use of skin clips carried with it a significantly higher rate of complication (11.1% ) when compared with use of subcuticular absorbable suture (0% ). At this stage, we concluded that the latter method be adopted as departmental policy.

A further study was performed one year later to reevaluate the efficacy of the new practice. A further fifty consecutive patients with NOF were studied using the same parameters as before. Our results demonstrated that the rate of complication was clinically and statistically significant.

We closed the loop of the audit cycle and concluded that the use of an absorbable subcuticular suture should be the preferred method of closure of hip wounds in NOF surgery.