The aim of this study was to prospectively study the safety, functional outcomes and complications of all patients undergoing bilateral single-stage sequential (BSSS) unicompartmental knee arthroplasty (UKA) in our unit. 394 cemented UKAs were performed in this unit between 2006–2010. A retrospective review identified 38 patients (76 knees) who underwent BSSS UKA, performed by a single surgeon. Patient demographics were recorded as well as pre and post-operative Oxford knee scores, tourniquet times, time to mobilisation, length of in-patient stay and any complications. There were 22 women and 16 men with a mean age of 64. The mean duration of follow-up was 30 months. The mean total tourniquet time was 83 minutes. The mean time to mobilisation was 18 hours and the average length of stay was 3.5 days. This compares favourably with an institutional average length of stay of two days for a single UKA. There was a significant improvement in the mean pre- to post-operative Oxford Knee Score (from 14 to 34, p< 0.0001). One patient required operative fixation of a tibial plateau fracture after sustaining a mechanical fall two months following surgery. There were no other major complications, including thrombo-embolic events or deep infections. Two patients required excision of a superficial suture granuloma.Purpose of the study
Methods and results
An anaesthetist recently remarked that orthopaedic surgeons are ‘twice as strong as an ox but half as smart’. We set out to ascertain if this had any evidence basis by conducting an observational study. We compared 36 male orthopaedic surgeons to 40 male anaesthetists across 3 hospitals to ascertain if there was a significant difference between the two groups in terms of Intelligence Quotient (IQ) and strength. We tested the IQ of each doctor using an official MENSA IQ test. We assessed the strength as reflected by the grip strength using a hand-grip dynamometer. Un-paired t-tests were used to assess statistical significance. Orthopaedic surgeons had a significantly greater mean grip strength 47.25Kg (SD=6.95) compared to anaesthetists 43.83Kg (SD=7.57) (p=0.04). The mean IQ of orthopaedic surgeons was also significantly greater at 105.19 (SD=10.85) than anaesthetists at 98.38 (SD=14.45) (p=0.02). Furthermore, the IQ of orthopaedic surgeons seems to increase with increasing age and seniority (an IQ jump of 5 IQ points from Registrar to Consultant). We have concluded that this proverb should be revised to orthopaedic surgeons are as strong as an ox and twice as smart, although further studies are advocated to ascertain the IQ of Ox.
Despite a lack of evidence, the UK's Department of Health introduced a policy of ‘Bare below the elbows’ attire to try to reduce the incidence of nosocomial infection. This study investigates the link between attire and hand contamination. A prospective observational study of doctors working in a District General Hospital was performed. The fingertips were imprinted on culture medium, and the resulting growth assessed for number of colony forming units, presence of clinically significant pathogens and multiply resistant organisms. These findings were correlated with attire, grade, gender and specialty. 92 doctors were recruited of which 49 were ‘Bare below the elbows’ compliant and 43 were not. There was no statistically significant difference between those doctors who were ‘bare below the elbows’ and those that were not for either the number of colony forming units (p=1.0), or the presence of significant organisms (p=0.77). No multiply resistant organisms were cultured from doctors' hands. ‘Bare below the elbows’ attire is not related to the degree of contamination on doctors' fingertips or the presence of clinically significant pathogens. Further studies are required to establish whether investment in doctor's uniforms and patient education campaigns are worthwhile.
