We aimed to assess individual differences in complaints in patients just before total hip replacement (THR) and the importance attached to the relief of each of them. In a pilot study, using open-ended interviews, we identified 16 main complaints, four of which (night pain, unequal leg length and discomfort during sexual and recreational activities) were not included in any of the six hip-rating scales in general use. Each of the 16 complaints was then assessed in 72 patients and rated for severity and the relative importance of relief. From this we calculated a severity-importance rating for each complaint and a patient-specific score for all complaints. The 72 patients had a mean age of 64 years (17 to 92) and 51% were men. The most important reasons for wanting a THR were day pain and walking difficulty, but the complaints mentioned above and not included in standard hip scores were also important. Greater attention to the individual requirements of patients might improve evaluation of the outcome of orthopaedic treatments.

Long radiographs are used to measure lower limb axial alignment, to assess the progression of deformity, and to plan corrective surgery. The purpose of this study was to test the belief that jigs are necessary in order to control limb position for radiography. Above-knee amputated limbs were fixed in different positions of rotation and of knee flexion and radiographed to study the effect on the apparent alignment of the limb. If the limb was rotated no more than 10 degrees from the neutral the effect on apparent axial alignment was minimal and radiographic measurement was reliable. This suggests that standardised positioning jigs are not needed in routine clinical practice.