Objective: Elderly patients with femoral neck fracture have varying degrees of cognitive capabilities when admitted to hospital. Following hemiarthroplasty, these patients are given standard precautionary advice in order to prevent dislocation of their prostheses. We aim to determine the relationship between mental state on admission and the ability to recollect these precautions postoperatively. Design: Over a one-month period, 26 patients, aged 70 years and above admitted with hip fracture, were recruited prospectively for this audit study. Mini-mental test score on admission was used to classify non aphasic subjects into three groups: normal, mildly impaired and severely impaired. On the 2. nd. post-operative day (POD) the patients were given verbal instructions aimed at preventing dislocation of their hemiarthroplasty. Recollection of these precautions was then tested using a specially designed questionnaire (score: 1–10) on POD-6 and at 6 weeks. Results: One patient died (3.8%). Of the remainder, 21 (84%) were female and 4 (16%) were male. The mean age was 80.4. There were 10 patients in Group-I (normal; 40%), 7 in Group-II (mildly impaired; 28%) and 8 in Group-III (severely impaired; 32%). The resulting score to the questionnaire in Group-I was 6.2 and 3.2; Group-II was 3.3 and 1.2; and Group-III was 0.3 and 0.3 on POD-6 and 6 weeks respectively. Conclusion: 6 days following surgery, the best recollection of advice is only 2 thirds of what the patient had been told and 6 weeks following surgery, the best recollection of advice is only 1 third of the advice given. The recollection of advice in both mentally impaired groups was very poor throughout the study period. We recommend either not giving hip precautions advice to these patients or changing the way the advice is given to try to improve their recollection

Introduction: Elderly patients with neck of femur fracture have a wide range of cognition when admitted to hospital. Following hemiarthroplasty, these patients are usually given a standard set of precautionary advice in order to prevent dislocation of their prostheses. This may constitute a loss of time and resources as patients may not recall all the advice given. Aim: We aim to determine the relationship between mental state on admission and the ability to recollect these precautions postoperatively. Setting: Leicester Royal Infirmary, a busy teaching hospital. Method: Over a one-month period, 26 patients, aged 70 years and above admitted with hip fracture, were recruited prospectively for this audit study. The patients’ mini-mental test score on admission was used to classify nonaphasic subjects into three groups: normal, mildly impaired and severely impaired cognition. On the 2. nd. post-operative day (POD) the patients were given verbal instructions aimed at preventing dislocation of their hemiarthroplasty. Recollection of these precautions was then tested using a specially designed questionnaire (score: 1–10) on POD-6 and at 6 weeks. Results: One patient died (3.8%). Of the remainder, 21 (84%) were female and 4 (16%) were male. The mean age was 80.4. There were 10 patients in Group-I (normal; 40%), 7 in Group-II (mildly impaired; 28%) and 8 in Group-III (severely impaired; 32%). The resulting score to the questionnaire in Group-I was 6.2 and 3.2; Group-II was 3.3 and 1.2; and Group-III was 0.3 and 0.3 on POD-6 and 6 weeks respectively. Conclusion: 6 days following surgery, the best recollection of advice is only 2 thirds of what the patient had been told. 6 weeks following surgery, the best recollection of advice is only 1 third of the advice given. The recollection of advice in both mentally impaired groups was very poor throughout the study period. We recommend either not giving hip precautions advice to these patients or changing the way the advice is given to try to improve their recollection

Objectives. The primary aim of this study was to assess the reproducibility of the recalled preoperative Oxford Hip Score (OHS) and Oxford Knee Score (OKS) one year following arthroplasty for a cohort of patients. The secondary aim was to assess the reliability of a patient’s recollection of their own preoperative OHS and OKS one year following surgery. Methods. A total of 335 patients (mean age 72.5; 22 to 92; 53.7% female) undergoing total hip arthroplasty (n = 178) and total knee arthroplasty (n = 157) were prospectively assessed. Patients undergoing hip and knee arthroplasty completed an OHS or OKS, respectively, preoperatively and were asked to recall their preoperative condition while completing the same score one year after surgery. Results. A mean difference of 0.04 points (95% confidence intervals (CI) -15.64 to 15.72, p = 0.97) between the actual and the recalled OHS was observed. The mean difference in the OKS was 1.59 points (95% CI -11.57 to 14.75, p = 0.10). There was excellent reliability for the ‘average measures’ intra-class correlation for both the OHS (r = 0.802) and the OKS (r = 0.772). However, this reliability was diminished for the individuals OHS (r = 0.670) and OKS (r = 0.629) using single measures intra-class correlation. Bland–Altman plots demonstrated wide variation in the individual patient’s ability to recall their preoperative score (95% CI ± 16 for OHS, 95% CI ± 13 for OKS). Conclusion. Prospective preoperative collection of OHS and OKS remains the benchmark. Using recalled scores one year following hip and knee arthroplasty is an alternative when used to assess a cohort of patients. However, the recall of an individual patient’s preoperative score should not be relied upon due to the diminished reliability and wide CI. Cite this article: T. F. M. Yeoman, N. D. Clement, D. Macdonald, M. Moran. Recall of preoperative Oxford Hip and Knee Scores one year after arthroplasty is an alternative and reliable technique when used for a cohort of patients. Bone Joint Res 2018;7:351–356. DOI: 10.1302/2046-3758.75.BJR-2017-0259.R1

Do patients’ recollections of disease severity following joint replacement surgery accurately reflect their pre-operative disability? Oxford Knee score questionnaires were sent to 100 patients who had undergone primary knee replacement surgery between January 1998 and July 2000.They were asked to complete these in a manner reflecting their pre-operative disability. The results were then compared with actual scores completed by the same group of patients prior to their surgery. The response rate was 78%.The mean pre-operative score was 45 compared to the recall score of 46.9. The difference was not significant (p=0.77).We believe that recall of disability using a simple knee score is a reliable method of assessing pre-operative disability

The purpose of this study was to establish whether retransfusion of blood collected in drains following total joint replacement was a safe and effective procedure. All patients undergoing a total joint arthroplasty, with no history of infection, between March and October 2001, were entered into the study. A single surgeon operated on all patients and no patient was excluded from the study. Informed consent was obtained and all blood drained into a recollection system within 6 hours of surgery was retransfused .A prospective protocol was filled out in all cases documenting the pre and postoperative haemoglobin, amount transfused and any extra transfusion requirements. A special note was made of any complications encountered during retransfusion. The results were then compared to previously known transfusion rates within the same hospitals. There were 141 Total Joint Arthroplasties performed within the study period -12 were bilateral and 12 were revisions procedures. The average drainage was 655ml (60–3280ml) and the average amount of retransfused blood from the drains was 225ml (100–1822ml). There were a total of 9 (6.3%) subsequent blood transfusions. Four (3.8%) in primary and 5 (20.8%) in bilateral or revision procedures. Transfusing patients with salvaged blood from the drains in total joint arthroplasty is a safe, reliable and cost effective practice, which significantly reduces the requirement for a subsequent blood transfusion. As a result of this study the Christchurch Orthopaedic Group has adopted a routine practise of retransfusing drained blood in all total joint arthroplasties

Aims

Patient decision aids have previously demonstrated an improvement in the quality of the informed consent process. This study assessed the effectiveness of detailed written patient information, compared to standard verbal consent, in improving postoperative recall in adult orthopaedic trauma patients.

Aims

The aim of this study was to identify the information topics that should be addressed according to the parents of children with developmental dysplasia of the hip (DDH) in the diagnostic and treatment phase during the first year of life. Second, we explored parental recommendations to further optimize the information provision in DDH care.

Aims

Perthes’ disease is an uncommon hip disorder with limited data on the long-term outcomes in adulthood. We partnered with community-based foundations and utilized web-based survey methodology to develop the Adult Perthes Survey, which includes demographics, childhood and adult Perthes’ disease history, the University of California Los Angeles (UCLA) Activity Scale item, Short Form-36, the Hip disability and Osteoarthritis Outcome Score, and a body pain diagram. Here we investigate the following questions: 1) what is the feasibility of obtaining > 1,000 survey responses from adults who had Perthes’ disease using a web-based platform?; and 2) what are the baseline characteristics and demographic composition of our sample?