The importance of accurate identification and reporting of surgical
site infection (SSI) is well recognised but poorly defined. Public
Health England (PHE) mandated collection of orthopaedic SSI data
in 2004. Data submission is required in one of four categories (hip
prosthesis, knee prosthesis, repair of neck of femur, reduction
of long bone fracture) for one quarter per year. Trusts are encouraged
to carry out post-discharge surveillance but this is not mandatory.
Recent papers in the orthopaedic literature have highlighted the
importance of SSI surveillance and the heterogeneity of surveillance
methods. However, details of current orthopaedic SSI surveillance
practice has not been described or quantified. All 147 NHS trusts in England were audited using a structured
questionnaire. Data was collected in the following categories: data
collection; data submission to PHE; definitions used; resource constraints;
post-discharge surveillance and SSI rates in the four PHE categories.
The response rate was 87.7%.Aims
Patients and Methods
We present a case series of five patients who had revision surgery
following magnetic controlled growing rods (MGCR) for early onset
scoliosis. Metallosis was found during revision in four out of five
patients and we postulated a mechanism for rod failure based on
retrieval analysis. Retrieval analysis was performed on the seven explanted rods.
The mean duration of MCGR from implantation to revision was 35 months
(17 to 46). The mean age at revision was 12 years (7 to 15; four
boys, one girl).Aims
Patients and Methods
We have examined the outcome in 19 professional rugby union players who underwent anterior cervical discectomy and fusion between 1998 and 2003. Through a retrospective review of the medical records and telephone interviews of all 19 players, we have attempted to determine the likelihood of improvement, return to professional sport and the long-term consequences. We have also attempted to relate the probability of symptoms in the neck and radicular pain in the arm to the position of play. Neck and radicular pain were improved in 17 patients, with 13 returning to rugby, the majority by six months after operation. Of these, 13 returned to their pre-operative standard of play, one to a lower level and five have not played rugby again. Two of those who returned to the game have subsequently suffered further symptoms in the neck, one of whom was obliged to retire. The majority of the players with problems in the neck were front row forwards. A return to playing rugby union after surgery and fusion of the anterior cervical spine is both likely and safe and need not end a career in the game.
