Satisfaction following total knee replacement (TKR) surgery remains suboptimal at around 80%. Prediction of factors influencing satisfaction may help manage expectations and thus improve satisfaction. We investigated preoperative variables that estimate the probability of achieving a successful surgical outcome following TKR in several outcomes important to patients. 9 pre-operative variables (easily obtained on initial consultation) of 591 unilateral TKRs were selected for univariant then multivariant analyses. These variables included Oxford Knee Score (OKS), age, sex, BMI, ASA score, pain score, mobility aids, SF12 PCS & SF12 MCS. Using the relative predictive strengths of these variables we modeled the probabilities a successful result would be achieved for 6 patient reported outcomes at 3 and 12 months following surgery. These were ‘Excellent/good OKS’, ‘Mild/no pain’, ‘Walking without/at first a limp’, ‘No/little interference with normal work’, ‘Kneeling with little/no difficulty’ and ‘Satisfaction with surgery’.Introduction & aims
Method
The risk of hip dislocation after revision total hip arthroplasty is up to 20% following surgery for periprosthetic fractures. A technique was developed by the senior authors, involving a transtrochanteric osteotomy and superior capsulotomy to attempt to minimise this risk(1). This prospective study examines a cohort of 40 patients undergoing this novel technique, which involves extending the fracture proximally to the tip of the greater trochanter. This is then extended into the soft tissues in the mid lateral plane as a split of the glutei and a minimally superior capsulotomy (preserving the anterior and posterior capsule). This allows for revision of the femoral component, and retention of the socket and liner. The outcomes of interest to the authors were dislocation rates, clinical outcome measured using the Oxford hip score. These were assessed along with X-ray imaging at 1, 2 and 5-year intervals to confirm fracture union and measure stem subsidence.Introduction
Methods
The optimal treatment for isolated patello-femoral arthritis is unclear. Patello-femoral arthroplasty (PFA) may offer superior knee function in isolated patello-femoral osteoarthritis compare to TKA. The literature is controversial for patient outcomes in PFA. Some reports showed improved outcomes while others were disappointing. We assessed our outcomes to try to identify causes for poor outcomes. The Trent Arthroplasty was established in 1990 to collect prospective data on knee arthroplasty surgery. Data is entered by surgeons at the time of surgery, with patient consent. PFA constitute less than 1% of the arthroplasties performed in this region. Patients were sent self-administered outcome forms 1 year post-op. Re-operation and revision procedures were reported. 334 PFA have been registered from 17 hospitals. 79% were female patients with 43% of the patients aged 55 years or less, suggesting dysplasia as the cause of their osteoarthritis. Age range 28–94 yrs (SD 11.8 yrs). The implants were Stryker Avon 236, Corin Leicester 47, Link Lubinus 24, Smith & Nephew Journey 10, DePuy LCS 7, Wright FPV 2, other 8.Introduction
Methods
