Functional rehabilitation has become an increasingly popular treatment for Achilles tendon rupture (ATR), providing comparably low re-rupture rates to surgery, while avoiding risks of surgical complications. Limited evidence exists on whether gap size should affect patient selection for this treatment option. The aim of this study was to assess if size of gap between ruptured tendon ends affects patient-reported outcome following ATR treated with functional rehabilitation. Analysis of prospectively collected data on all 131 patients diagnosed with ATR at Royal Berkshire Hospital, UK, from August 2016 to January 2019 and managed non-operatively was performed. Diagnosis was confirmed on all patients by dynamic ultrasound scanning and gap size measured with ankle in full plantarflexion. Functional rehabilitation using an established protocol was the preferred treatment. All non-operatively treated patients with completed Achilles Tendon Rupture Scores (ATRS) at a minimum of 12 months following injury were included.Aims
Methods
The objective of this double-blind randomised controlled trial
was to assess whether ultrasound guidance improved the efficacy
of corticosteroid injections for Morton’s neuroma (MN). In all, 50 feet (40 patients) were recruited for this study but
five feet were excluded due to the patients declining further participation.
The mean age of the remaining 36 patients (45 feet) was 57.8 years
(standard deviation (Aims
Patients and Methods
Effective utilisation of blood products is fundamental. The introduction of Maximum Surgical Blood Ordering Schedules (MSBOS) for operations provides guidance for effective cross-matching. A retrospective analysis of blood ordering practices was undertaken to establish an evidence-based MSBOS for revision THR and TKR. The impact of the use of intraoperative cell-salvage devices was also assessed.
The gold standard for the CTR is 2:1 or less. The TI establishes the likelihood of blood being transfused for a certain procedure. If the TI is less than 0.5, then cross-matching blood is considered unnecessary.
In revisions of non-infected TKR (n=95), the CTR=4.33 and TI=0.48. In infected cases (n=54) the CTR=2.16 and TI=1.35. There was considerable change in the practice of ordering cross-matched blood following the introduction of intraoperative cell-salvage devices (Revision THR: CTR=1.93, TI=0.84; Revision TKR: CTR=1.20, TI=0.16)
The introduction of this MSBOS in conjunction with intraoperative cell-salvage, could promote blood conservation and financial savings.
The gold standard for the CTR is 2:1 or less. Procedures with ratios greater than 3:1 should substitute for a ‘group and save’. The TI establishes the likelihood of blood being transfused for a certain procedure, i.e., the number of units transfused divided by the number of patients having the procedure. If the TI is less than 0.5, then cross-matching blood is considered unnecessary.
In revisions of non-infected TKR (n=95), the CTR=4.33 and TI=0.48. In infected cases (n=54) the CTR=2.16 and TI=1.35. There was considerable change in the practice of ordering cross-matched blood following the introduction of intraoperative cell-salvage devices (Revision THR: CTR=1.93, TI=0.84; Revision TKR: CTR=1.20, TI=0.16)
The introduction of this MSBOS in conjunction with intraoperative cell-salvage, could promote blood conservation and financial savings.
