With resumption of elective spine surgery services following the first wave of COVID-19 pandemic, we conducted a multi-centre BASS collaborative study to examine the clinical outcomes of surgeries. Prospective data was collected from eight spinal centres in the first month of operating following restoration of elective spine surgery following the first wave. Primary outcomes measures were the 30-day mortality rate and postoperative Covid-19 infection rate. Secondary outcomes analysed were the surgical, medical adverse events and length of inpatient stay.Abstract
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Difficulties arise when counselling younger patients on the long-term sequelae of a minor knee chondral defect. This study assesses the natural history of patients with grade 2 Outerbridge chondral injuries of the medial femoral condyle at arthroscopy. We reviewed all arthroscopies performed by one surgeon over 12 years with Outerbridge grade 2 chondral defects. Patients aged 30 to 59 were included. Meniscal injuries found were treated with partial menisectomy. All patients had five-year follow up minimum. Primary outcome measure was further interventions of total or unicondylar arthroplasty or high tibial osteotomy. We analysed 3,344 arthroscopies. Average follow up was 10 years (Range 5–17 years). A total of 357 patients met inclusion criteria of which 86 had isolated medial femoral condyle disease. Average age was 50 at the time of arthroscopy. Average BMI at surgery was 31.7 and average chondral defect area was 450 mm2. Isolated MFC chondral disease had a 10.5% intervention rate. Intervention occurred at a mean of 8.5 years post primary arthroscopy. In young patients Outerbridge II chondral injuries affecting ≥2 compartments have a high rate of further intervention within a decade. This information is crucial in counselling young patients on long-term sequelae of benign chondral lesions.
Lisfranc joint injuries account for only 0.2% of all fractures but early diagnosis improves the chances of a better outcom]. Radiographic signs, such as diastasis (>2mm) of the 1–2 interspace, are subtle and. often missed, leading to a poorer outcome. We present a new radiographic sign, less likely to result in missed diagnoses. Null nypothesis: The intermetarsal angle remains unchanged in Lisfranc injuries. A series of radiographs demonstrating Lisfranc injury were interspersed with normal and postoperative cases. Evidence of fixation was obscured. A selection of Foundation and Core Trainee medical staff measured the intermetatarsal angle (IMA) on two separate occasions. The measuring technique was demonstrated with no explanation for the reason behind the measurement.Introduction
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The Dawn Hip - An Effective Strategy to Improve the Management of Traumatic Hip Fractures Traumatic hip fractures are managed with nationwide standards, and are regularly audited and published. A previous audit last year at the William Harvey revealed 66% of hip fractures were operated within 48 hours, compared to the national average of 75%. We implemented a strategy to improve this target by introducing the ‘Dawn Hip’ - a hip fracture operation which is prepared for surgery at 8am on the Emergency (CEPOD) list. Over a two month period after the introduction of the ‘Dawn hip’, the number of hip operations and start time on the CEPOD list were audited. Performance data were extrapolated from the National Hip Fracture Database (NHFD) and compared nationally.Introduction
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