We introduced a self-care pathway for minimally displaced distal radius fractures, which involved the patient being discharged from a Virtual Fracture Clinic (VFC) without a physical review and being provided with written instructions on how to remove their own cast or splint at home, plus advice on exercises and return to function. All patients managed via this protocol between March and October 2020 were contacted by a medical secretary at a minimum of six months post-injury. The patients were asked to complete the Patient-Rated Wrist Evaluation (PRWE), a satisfaction questionnaire, advise if they had required surgery and/or contacted any health professional, and were also asked for any recommendations on how to improve the service. A review with a hand surgeon was organized if required, and a cost analysis was also conducted.Aims
Methods
Arthroscopic lavage is commonly used in the management of mild to moderate arthritis of the knee. In the last few years the use of Hyaluronic Acid and its derivatives has become popular in the management of this same group of patients. The study was set up to establish whether Synvisc (HylanGF-20) produced equivalent or improved symptomatic relief when compared to arthroscopic lavage. A prospective randomised trial. Fifty patients with knee OA were randomly allocated to either the arthroscopic lavage or Synvisc group. All patients were assessed prior to treatment using the WOMAC knee evaluation questionnaire, and further assessments were made at 6 weeks, 3 months, 6 months and one year post treatment. The Synvisc group showed greater and more consistent improvement in WOMAC scores than the lavage group at all assessments post treatment. The difference between the treatment groups was statistically significant at 6 months (p<
0. 05) and at 1 Year (p=0. 0018). We conclude that a course of Synvisc injections can be administered on an out-patient basis and is a safer, more cost-effective and more reliable treatment for Knee OA compared to arthroscopic lavage.
