A5053309459- Orthopaedic implants and arthroplasty
- Total Knee Arthroplasty Outcomes
- Orthopedic Infections and Treatments
- Hip and Femur Fractures
- Hip disorders and treatments
- Pelvic and Acetabular Injuries
- Cardiac, Anesthesia and Surgical Outcomes
- Advanced materials and composites
- Radiology practices and education
- Clinical practice guidelines implementation
- Hospital Admissions and Outcomes
- Innovations in Medical Education
- Health and Medical Research Impacts
- Meta-analysis and systematic reviews
- Trauma and Emergency Care Studies
- Anorectal Disease Treatments and Outcomes
- Academic Publishing and Open Access
- Pain Management and Placebo Effect
- Teratomas and Epidermoid Cysts
- Reflective Practices in Education
- Nursing Roles and Practices
- Advanced X-ray and CT Imaging
- scientometrics and bibliometrics research
- Congenital gastrointestinal and neural anomalies
- Peripheral Artery Disease Management
Royal United Hospital
2010-2024
Royal United Hospital Bath NHS Trust
2018-2022
Southmead Hospital
2012-2019
University of Bristol
2014-2019
National Institute for Health Research
2019
NIHR Bristol Biomedical Research Centre
2019
NIHR Oxford Musculoskeletal Biomedical Research Centre
2018
North Bristol NHS Trust
2017
Hispanics in Philanthropy
2014
Avon Medical Centre
2012
Total hip replacement causes a short-term increase in the risk of mortality. It is important to quantify this and identify modifiable factors so that post-operative mortality can be minimised. We performed systematic review critical evaluation current literature on topic. identified 32 studies published over last 10 years which provide either 30-day or 90-day data. estimate pooled incidence during first 30 90 days following 0.30% (95% CI 0.22 0.38) 0.65% 0.50 0.81), respectively. found...
Recent publications indicate increased mortality in patients admitted to hospital at the weekend, but these findings may be subject inadequate adjustment for case-mix and complexities of resource provision. Hip fractures generally occur a frail comorbid population with consistent diagnosis precipitating admission as an emergency. We therefore aimed examine association between day week milestones care pathway 30-day this population.Using data from prospective national database hip fractures,...
Aims The aim of this study was to investigate the association between type operation used treat a trochanteric fracture hip and 30-day mortality. Patients Methods Data on 82 990 patients from National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical surgical characteristics, socioeconomic factors. Results use short long intramedullary nails associated an increase in mortality (adjusted odds ratio (OR) 1.125,...
The NHS Institute for Innovation and Improvement has determined that a £7 million saving can be achieved per trust by improving theatre efficiency. aim of this quality improvement project was to improve orthopaedic turnaround without compromising the patient safety. We process mapped all stages from application dressing knife skin on next in order identify potential areas improvement. Several suggestions arose which were tested multiple PDSA cycles single theatre. These changes either...
Aims Periprosthetic fractures (PPFs) around the knee are challenging injuries. This study aims to describe characteristics of PPFs and impact patient demographics, fracture types, management modalities on in-hospital mortality. Methods Using a multicentre design, independent registry data, we included adult patients sustaining PPF arthroplasty between 1 January 2010 31 December 2019. Univariate, then multivariable, logistic regression analyses were performed patient, fracture, treatment...
Reinstating elective hip and knee arthroplasty services presents significant challenges. We need to be honest about the scale of obstacles ahead realise that health challenges economic consequences COVID-19 pandemic are potentially devastating. must also prepare make difficult ethical decisions restarting arthroplasty. These should based on existing evidence-base, reliable data, recommendations experts, regional circumstances.
Twenty randomized controlled trials comprising 1893 primary total knee replacements were included in this review.The subvastus approach conferred superior results for mean difference (MD) time to regain an active straight leg raise (1.7 days, 95% confidence interval [CI] 1.0 2.3), visual analogue score pain on day one (0.8 points a scale out of 10, CI 0.2 1.4) and range movement at week (7°, 3.2 10.7). The also resulted fewer lateral releases (odds ratio 0.4, 0.7) less peri-operative blood...
Background Previous research has mainly focused on how factors such as surgical approach might affect implant survivorship and the incidence of complications. Given increasing interest in patient-reported outcomes, purpose this study is to explore whether associated with pain, function, satisfaction at 1–3 years after primary total hip replacement (THR). Methods Details were collated from operation notes for all consecutive patients our centre 2004–2006. All mailed a questionnaire following...
The histological specimens from 29 failed metal-on-metal (MoM) hip arthroplasties treated at our institution were reviewed. Five patients had a MoM total arthroplasty (THA), and 24 resurfacing. Clinical radiographic features of each correlated with the findings. We report three major subtypes. Patients either have macrophage response to metal debris, lymphocytic (ALVAL) or mixed picture both. In addition we observe that ALVAL is located deep within tissue specimens, can occur in environments...
Background and purpose - There is a lack of evidence to support the role hip precautions in preventing dislocation following total arthroplasty (THA). We report an exploratory study which assesses recall, adherence, impact on activities daily living first 6 weeks postoperatively. Patients methods designed new questionnaire based education patients receive refined by professionals within our multidisciplinary team. 129 underwent primary elective THA during period received at Results 97 (75%)...
Surgery for greater trochanteric pain syndrome (GTPS) may be indicated cases refractory to conservative measures. We aim evaluate patient reported outcomes and adverse events following surgery.Postal questionnaires were used a consecutive series of 61 bursectomy gluteal fascia transposition (GFT) procedures. Study Oxford hip score, satisfaction visual analogue lying on the affected side, duration relief after surgery.We received responses regarding 52 procedures at median 34 months...
Surface irregularities of the greater trochanter have been described as a potential radiographic sign trochanteric pain syndrome (GTPS). We report diagnostic accuracy study to evaluate clinical usefulness surface on plain radiographs in diagnosis GTPS.We retrospectively identified anteroposterior pelvic consecutive group 38 patients (representing 27.5% series prevalence) diagnosed with GTPS (mean age 69.5 years ± 16.1 [standard deviation], 27 females, 11 males) based symptoms and positive...
We report a case of fulminating infection tracking from the left ischiorectal fossa to popliteal as consequence rectal perforation 11 days following traditional Milligan–Morgan haemorrhoidectomy. The presented loud squelching noise coming hip on walking. Extensive cellulitis was evident over posterior aspect thigh, with deep fluctuant collection in buttock that communicated compartment thigh. Per examination revealed defect wall, foul-smelling discharge. thigh incision and drainage,...
Cement-in-cement femoral component revision is a useful and commonly practised technique. Onerous hazardous re-shaping of the original cement mantle required if new stem does not seat easily. Furthermore, without removing entirety mantle, freedom to alter anteversion or leg length difficult predict preoperatively. We present data from in vitro experiments testing compatibility top cemented stems according UK registry figures (NJR 2013). This augments preoperative planning by indicating which...
Restoring femoral offset during total hip arthroplasty is important. Femoral and leg lengths are inextricably linked by the caput-collum-diaphysis (CCD) angle of implant being used. We investigate restoration using radiographs a consecutive series patients following implantation with either high CCD angled cementless, or an anatomical cemented component. Although our data suggests that we able to restore device, recommend additional caution when non-anatomical implants.