Restarting planned surgery during the COVID-19 pandemic is a clinical and societal priority, but it is unknown whether it can be done safely and include high-risk or complex cases. We developed a Surgical Prioritization and Allocation Guide (SPAG). Here, we validate its effectiveness and safety in COVID-free sites. A multidisciplinary surgical prioritization committee developed the SPAG, incorporating procedural urgency, shared decision-making, patient safety, and biopsychosocial factors; and applied it to 1,142 adult patients awaiting orthopaedic surgery. Patients were stratified into four priority groups and underwent surgery at three COVID-free sites, including one with access to a high dependency unit (HDU) or intensive care unit (ICU) and specialist resources. Safety was assessed by the number of patients requiring inpatient postoperative HDU/ICU admission, contracting COVID-19 within 14 days postoperatively, and mortality within 30 days postoperatively.Aims
Methods
A flexed knee gait is common in patients with bilateral spastic
cerebral palsy and occurs with increased age. There is a risk for
the recurrence of a flexed knee gait when treated in childhood,
and the aim of this study was to investigate whether multilevel
procedures might also be undertaken in adulthood. At a mean of 22.9 months (standard deviation 12.9), after single
event multi level surgery, 3D gait analysis was undertaken pre-
and post-operatively for 37 adult patients with bilateral cerebral
palsy and a fixed knee gait.Aims
Patients and Methods