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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
There is continued debate as to whether cemented or cementless implants should be utilized in particular cases based upon chronological age. This debate has been rekindled in the UK and other countries by directives mandating certain forms of acetabular and femoral component fixation based exclusively on the chronological age of the patient. This editorial focuses on the literature-based arguments to support the use of cementless total hip arthroplasty (THA), while addressing potential concerns surrounding safety and cost-effectiveness. Cite this article:
Many hospitals do not have a structured process
of consent, the attainment of which can often be rather ‘last-minute’
and somewhat chaotic. This is a surprising state of affairs as spinal
surgery is a high-risk surgical specialty with potential for expensive
litigation claims. More recently, the Montgomery ruling by the United
Kingdom Supreme Court has placed the subject of informed consent
into the spotlight. There is a paucity of practical guidance on how a consent process
can be achieved in a busy clinical setting. The British Association
of Spinal Surgeons (BASS) has convened a working party to address
this need. To our knowledge this is the first example of a national
professional body, representing a single surgical specialty, taking such
a fundamental initiative. In a hard-pressed clinical environment, the ability to achieve
admission reliably on the day of surgery, in patients at ease with
their situation and with little likelihood of late cancellation,
will be of great benefit. It will reduce litigation and improve
the patient experience. Cite this article:
The extent and depth of routine health care data
are growing at an ever-increasing rate, forming huge repositories
of information. These repositories can answer a vast array of questions.
However, an understanding of the purpose of the dataset used and
the quality of the data collected are paramount to determine the
reliability of the result obtained. This Editorial describes the importance of adherence to sound
methodological principles in the reporting and publication of research
using ‘big’ data, with a suggested reporting framework for future 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.
