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The high prevalence of osteoarthritis (OA), as well as the current lack of disease-modifying drugs for OA, has provided a rationale for regenerative medicine as a possible treatment modality for OA treatment. In this editorial, the current status of regenerative medicine in OA including stem cells, exosomes, and genes is summarized along with the author’s perspectives. Despite a tremendous interest, so far there is very little evidence proving the efficacy of this modality for clinical application. As symptomatic relief is not sufficient to justify the high cost associated with regenerative medicine, definitive structural improvement that would last for years or decades and obviate or delay the need for joint arthroplasty is essential for regenerative medicine to retain a place among OA treatment methods. Cite this article:
The effective capture of outcome measures in
the healthcare setting can be traced back to Florence Nightingale’s
investigation of the in-patient mortality of soldiers wounded in
the Crimean war in the 1850s. Only relatively recently has the formalised collection of outcomes
data into Registries been recognised as valuable in itself. With the advent of surgeon league tables and a move towards value
based health care, individuals are being driven to collect, store
and interpret data. Following the success of the National Joint Registry, the British
Association of Spine Surgeons instituted the British Spine Registry.
Since its launch in 2012, over 650 users representing the whole
surgical team have registered and during this time, more than 27 000
patients have been entered onto the database. There has been significant publicity regarding the collection
of outcome measures after surgery, including patient-reported scores.
Over 12 000 forms have been directly entered by patients themselves,
with many more entered by the surgical teams. Questions abound: who should have access to the data produced
by the Registry and how should they use it? How should the results
be reported and in what forum? Cite this article:
We explore the limitations of complete reliance
on evidence-based medicine which can be diminished by confounding
issues and sampling bias. Other strategies which may be reasonably
invoked are discussed. Cite this article:
The limitations and benefits of patient-reported
outcome measures, in defining the merits of arthroplasty surgery,
are discussed. Cite this article:
In cerebral palsy, the site and severity of the brain lesion are directly linked to gross motor function and the development of musculoskeletal deformities. The relationship between walking ability and orthopaedic surgery in children with cerebral palsy is not fully understood. The development of new tools such as the Functional Assessment Questionnaire and the Functional Mobility Scale can be used to give new insights on the functional impact of multilevel surgery. These scales are most useful as part of systematic, long-term follow-up.
