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Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_11 | Pages 18 - 18
1 Nov 2022
STANDARDIZING VENOUS THROMBOEMBOLISM PROPHYLAXIS REGIME FOR NECK OF FEMUR FRACTURES
Dhaliwal S Yap R Gabr H Marson B Bidwai A Desai V
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Abstract

Introduction

Neck of femur (NOF) fracture patients are at risk of developing venous thromboembolisms (VTE). VTE risks could be reduced by adhering to the National Institute for Health and Care Excellence (NICE) recommendation for 1 month of prophylaxis with low molecular weight heparin. This audit aimed to assess and improve local compliance to national guidelines on VTE prophylaxis in NOF fracture patients following discharge.

Methods

A retrospective consecutive case series of all NOF fractures treated at our institution from May – July 2021 was conducted. Those not eligible for outpatient VTE prophylaxis were excluded (anticoagulated for other indications, completed prophylactic course in hospital, inpatient death, pharmacological prophylaxis contraindicated). The agent and duration of VTE prophylaxis, and the occurrence of clinically significant VTE or bleeds were recorded. A re-audit was conducted in March 2022.

Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_11 | Pages 22 - 22
1 Nov 2022
VITAMIN D DEFICIENCY IN PAEDIATRIC AND YOUNG ADULT PATIENTS (AGED 0 −50) WITH FRACTURES UNDERGOING OPERATIVE MANAGEMENT
Tolat A Salam NA Gavai P Desai V
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Abstract

Introduction

Vitamin D deficiency in the UK is well documented − 30–40% of the population. It is an essential component of calcium metabolism and adequate levels are important for bone healing. Studies have demonstrated an overall prevalence of vitamin D deficiency/insufficiency at 77% in trauma patients aged >18, deficiency alone was 39%. Adequate vitamin D levels have a positive effect on bone mineral density and callus formation at fracture sites.

Methods

We conducted a retrospective consecutive case series of all patients aged 0–50 undergoing surgical management for any fracture in October 2021 to March 2022. We assessed if vitamin D levels were checked and if patients were prescribed replacement as per local guidelines.

Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_11 | Pages 2 - 2
1 Nov 2022
FACTORS AFFECTING MOBILIZATION AFTER LOWER LIMB ARTHROPLASTY
Hafeez K Umar M Desai V
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Abstract

Aim

This study was aimed to look into factors responsible for delayed mobilization after lower limb arthroplasty and effect on length of stay.

Methods

It is an observational study conducted at Kings Mill Hospital from August to October 2021. All patients undergoing primary knee or hip arthroplasty were included in the study, while patients with revision surgeries were excluded. A proforma was designed to record demographics and different variables including medications, type of anaesthesia, orthostatic hypotension, dizziness, preop and post op pain score, fall in haemoglobin, analgesia and length of stay. Patients were assessed on day one and data was recorded in the proforma. Data was analysed using SPSS.

Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_III | Pages 412 - 413
1 Sep 2009
THE USE OF A TANTALUM-BASED AUGMENTATION PATELLA IN PATIENTS WITH A PREVIOUS PATELLECTOMY
Kwong Y Desai V
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Introduction: The indications for patellectomy have been considerably narrowed in recent years, but there remains a cohort of patients with previous patellectomies that remain symptomatic. In addition, these patients can develop osteoarthrosis or instability, and their treatment is challenging. We report our experience of the use of a novel implant to substitute for the absent native patella.

Materials and Methods: Six patients were treated with the Augmentation Patella (Zimmer, Allendale, USA), which was sutured to the patellar tendon. All 6 patients had previously had a patellectomy for anterior knee pain syndrome or chondromalacia patellae, between 5 and 22 years previously. They all had an arthroscopy to document the extent of degenerative changes. Patients with trochlear changes only had the trochlea resurfaced (4 cases) and those with tibio-femoral changes as well had a total knee replacement (2 cases).

Results: One patient reported excellent relief of pain, with no evidence of radiological loosening. Two patients continued to complain of pain despite the implant being solidly fixed. One patient developed wound complications secondary to difficult closure due to the bulk of the implant. In two patients, the implant loosened within 15 months necessitating further surgery to retrieve the Augmentation Patella.

Discussion: The results of the Augmentation Patella in our series of patients with previous patellectomies have been disappointing. Previous studies, where this implant has been used with a remaining shell of patella, has yielded better results. This suggests that bony ingrowth is important for a successful outcome. We recommend that this device should only be implanted if bony contact is possible.