With the rising demand for primary total hip arthroplasty (THA), there has been an emphasis on reducing the revision burden and improving patient outcomes. Although studies have shown that primary THA effectively minimizes pain and restores normal hip function for activities of daily living, many younger patients want to participate in more demanding activities after their operation. With IRB approval, 2 groups of subjects were enrolled in this study: (i) 143 patients at an average of 25 months (range 10–69 months) post-primary THA, and (ii) 165 control subjects with no history of hip surgery or hip pathology. All subjects were assigned to one of four categories according to their age and gender: Group A: 40–60 year old males (31 THA; 42 Controls), Group B: 40–60 year old females (25 THA; 53 Controls), Group C: 60–80 year old males (35 THA; 25 Controls), and Group D: 60–80 year old females (36 THA; 23 Controls). Each patient completed a self-administered Hip Function Questionnaire (HFQ) which assessed each subject's satisfaction, expectations, symptoms and ability to perform a series of 94 exercise, recreational and daily living activities. These included participation in work-out activities, adventure and water sports, running and biking, and contact and team sports. Each participant was also asked their activity frequency, symptom prevalence and satisfaction with their hip in performing each activity.Background
Methods
With the growing emphasis on the cost of medical care, there is renewed interest in the productivity and efficiency of surgical procedures. We have developed a method to systematically examine the efficiency of the surgical team during primary total knee replacement (TKR). In this report, we present data derived from a series of procedures performed by different joint surgeons. This data demonstrates a variation between the duration and efficiency of each step in this procedure and its relationship to the experience and coordination of the surgeon working with the scrub team. After consent was achieved, videotaped recordings were prepared of ten primary TKR procedures performed by five highly experienced joint surgeons. For quantitative analysis, each procedure was divided into 7 principal tasks from initial incision to wound closure. In order to quantify efficiency, we recorded the occurrence of events leading to delays in each step of the procedure. Starting with a total score of 100 points, deductions were made, based on the number of delaying events and its impact on the efficiency of the procedure. A final score for the surgery was then determined using the individual scores from each principal task. The experience of each member of the surgical team in participating in TKR, and in working with the surgeon, were recorded and correlated with the total efficiency score for the entire procedure.Introduction
Methods
