This study was performed to evaluate the pre-operative concerns of patients undergoing total knee or hip replacement surgery.

A cross-sectional study of 370 patients was performed. The patients completed a postal questionnaire on 29 concerns, each rated on a scale of 1 (not concerned) to 4 (very concerned). SF-12 and Oxford knee or hip scores were also calculated. Analysis was carried out using chi-squared test.

217 questionnaires were returned. The results showed that the greatest concern for patients was cancellation of their operation. This was followed by failure of the operation to reduce pain, loss of a limb and joint infection. Concerns regarding scar problems, nursing care and preoperative tests were the lowest.

Women showed statistically significant greater concerns in 9 areas. Younger patients (age< 65) showed increased concerns in 8 areas. Patients who had previously undergone joint replacement were less concerned than those who had not had previous lower limb joint replacements for 6 responses. They showed increased concern in 2 areas, nursing care and hospital food. Those undergoing total hip replacement were more concerned about dislocation, dressing and returning to work (all p< 0.05). The mean Oxford Knee or Hip Score was 42.96 and 45.12 respectively (scale 12–60, 60 being most severe symptoms). The mean SF-12 scores were 41.14 for the mental component and 28.70 for the physical component score (scale 0–100, 100 representing greatest level of good health).

The mean level of concern is low at 1.9 (scale 1 to 4). It is encouraging that patients who have had a previous joint replacement are generally less concerned. Possible reasons for increased concerns amongst women and younger patients are discussed. SF-12 and Oxford Knee/Hip Scores are comparable with other studies.

In conclusion, this study provides useful information for the preoperative counselling of patients and the production of pre-operative literature.

This study was performed to evaluate the pre-operative concerns of patients undergoing total knee or hip replacement surgery.

A cross-sectional study of 370 patients was performed. The patients completed a postal questionnaire on 29 concerns, each rated on a scale of 1 (not concerned) to 4 (very concerned). SF-12 and Oxford knee or hip scores were also calculated. Analysis was carried out using chi-squared tests on SPSS.

217 questionnaires were returned. The results showed that the greatest concern for patients was cancellation of their operation. This was followed by failure of the operation to reduce pain, loss of a limb and joint infection. Concerns regarding scar problems, nursing care and preoperative tests were the lowest.

Women showed statistically significant greater concerns in 9 areas. Younger patients (age< 65) showed increased concerns in 8 areas. Patients who had previously undergone joint replacement were less concerned than those who had not had previous lower limb joint replacements for 6 responses. They showed increased concern in 2 areas, nursing care and hospital food. Those undergoing total hip replacement were more concerned about dislocation, dressing and returning to work (all p< 0.05). The mean Oxford Knee or Hip Score was 42.96 and 45.12 respectively (scale 12–60, 60 being most severe symptoms). The mean SF-12 scores were 41.14 for the mental component and 28.70 for the physical component score (scale 0–100, 100 representing greatest level of good health).

The mean level of concern is low at 1.9 (scale 1 to 4). It is encouraging that patients who have had a previous joint replacement are generally less concerned. Possible reasons for increased concerns amongst women and younger patients are discussed. SF-12 and Oxford Knee/Hip Scores are comparable with other studies.

In conclusion, this study provides useful information for the preoperative counselling of patients, production of preoperative literature and for improving the service we offer to our patients.

We compared the effects of continuous passive motion with those of intermittent active motion on the results of the resurfacing with autogenous periosteal grafts of full-thickness defects on the articular surface of rabbit patellae. Of 45 rabbits with defects, 30 received grafts. Fifteen of these had continuous passive motion for two weeks and intermittent active motion for four weeks; the other 15 had intermittent active motion for six weeks. In 15 the defects were not grafted (control group) and they had intermittent active motion for six weeks. Ten more rabbits had a sham operation. Six weeks after surgery, the results were assessed by the gross appearance, histology, histochemistry, immunohistochemistry and electron microscopy. By all assessments the quality of neochondrogenesis produced by periosteal grafts was superior to that in ungrafted defects (p less than 0.05) and the results in continuous passive motion treated animals were superior to those in intermittent active motion treated animals (p less than 0.05). The periosteal grafts produced hyaline cartilage containing type II collagen but the organisation of its fibres was irregular.

The survivorship method of analysis has been used to compare the failure rate and overall success of 1,430 cemented primary total knee arthroplasties performed at The Hospital for Special Surgery over a 15-year period. There were 224 total condylar prostheses with a polyethylene tibia, 289 of the posterior stabilised type with an all polyethylene tibia, and 917 posterior stabilised with a metal-backed tibial component. There were 12 failures in the total condylar series, giving an average annual failure rate of 0.65% and a 15-year success rate of 90.56%. The posterior stabilised prosthesis with a polyethylene tibia showed an average annual failure rate of 0.27% and a 10-year success rate of 97.34%, and this prosthesis with a metal-backed tibial component gave an annual failure rate of 0.19% and a seven-year success rate of 98.75%. The overall survival rate was not influenced by sex or age, diagnosis or the percentage of ideal body weight. No metal-backed tibial components have yet needed revision for loosening. It seems that infection will be the major cause of failure.