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The Bone & Joint Journal
Vol. 101-B, Issue 8 | Pages 951 - 959
1 Aug 2019
Preston N McHugh GA Hensor EMA Grainger AJ O’Connor PJ Conaghan PG Stone MH Kingsbury SR

Aims

This study aimed to develop a virtual clinic for the purpose of reducing face-to-face orthopaedic consultations.

Patients and Methods

Anonymized experts (hip and knee arthroplasty patients, surgeons, physiotherapists, radiologists, and arthroplasty practitioners) gave feedback via a Delphi Consensus Technique. This consisted of an iterative sequence of online surveys, during which virtual documents, made up of a patient-reported questionnaire, standardized radiology report, and decision-guiding algorithm, were modified until consensus was achieved. We tested the patient-reported questionnaire on seven patients in orthopaedic clinics using a ‘think-aloud’ process to capture difficulties with its completion.


The Journal of Bone & Joint Surgery British Volume
Vol. 91-B, Issue 9 | Pages 1217 - 1222
1 Sep 2009
King RJ Makrides P Gill JA Karthikeyan S Krikler SJ Griffin DR

We have developed a novel method of calculating the radiological magnification of the hip using two separate radio-opaque markers. We recruited 74 patients undergoing radiological assessment following total hip replacement. Both the new double marker and a conventional single marker were used by the radiographer at the time of x-ray. The predicted magnification according to each marker was calculated, as was the true radiological magnification of the components. The correlation between true and predicted magnification was good using the double marker (r = 0.90, n = 74, p < 0.001), but only moderate for the single marker (r = 0.50, n = 63, p < 0.001). The median error was significantly less for the double marker than for the single (1.1% vs 4.8%, p < 0.001). The double marker method demonstrated excellent validity (intraclass correlation coefficient = 0.89), in contrast to the single marker (0.32).

The double marker method appears to be superior to the single marker method when used in the clinical environment.