Objective: To study the effect in health status of telephone contact 2+10 weeks after total hip replacement (THR) during the first nine months after surgery. Not all of patient have improvement in their health status and quality of life, that the surgery benefits them.

Method: A randomised clinical trial enrolled 180 patients aged 65+ focusing on patients’ health status using SF-36, 4 weeks pre–to 3 and 9 months postoperative were carried out. Patients were randomised 4 weeks preoperative either to control or intervention group. Both groups received the conventional treatment. Furthermore the intervention group had postoperative telephone monitoring two and ten weeks after surgery Patients were given counselling by using an interview-guide within eight main themes referring to patients’ actual situation after THR.

Results: All patients experienced increase in their health status after THA. The intervention significantly reduced the time for patients to reach their habitual level as patients in the intervention group reached their habitual level at three months whereas patients in the control group reached this level after nine months.

Conclusion: Support by phone contact after THR seems to benefit patients’ outcome.

The presentation is based on the results of the nursing intervention program by using telephone contact to elderly patients with hip replacement after discharge.

Background Hip fractures are one of the leading causes of hospital admissions. Surgical treatment is often associated with significant blood loss, requiring post-operative erythrocyte transfusion. Aim To assess post-operative erythrocyte transfusion rates for hip fractures and evaluate the effect of tranexamic acid (TXA). Method. All patients undergoing surgical repair of a hip fracture at RLBUHT between 1st April 2013 – 30th April 2014 were selected. Data regarding transfusion status and peri-operative TXA use was collected from electronic databases and case notes. Results. 450 patients were admitted with a hip fracture, of whom 441 underwent surgery. Modalities of hip fixation included total hip replacement (THR, n=39), hemiarthroplasty (n=145), dynamic hip screw (DHS, n=116), cannulated hip screw (CHS, n=17) and long (n=71) and short (n=53) intramedullary hip screw (IMHS). 44.2% received a post-operative erythrocyte transfusion, with an average of 2.5 units per patient (range 1–9 units). With all study subjects included, the average transfusion rates for THR, hemiarthroplasty, DHS, CHS, long IMHS and short IMHS were 0.44 units, 0.78 units, 0.97 units, 0.47 units, 1.55 units and 1.19 units respectively. Data regarding intra-operative TXA administration was available for 318 (72.1%) patients, sixty-one of whom received TXA. 27.9% given TXA required a post-operative transfusion (range 0–6 units), compared to 35.4% of patient with no intra-operative TXA (range 0–11 units), p=0.142. Conclusion. 44.2% of patients required an erythrocyte transfusion, with an average of 2.5 units per patient of those transfused. This is higher than rates quoted by other studies including Shokoohi et al who had a transfusion rate of 32.6%. Adherence to local transfusion protocols must be reviewed. There is a tendency for TXA to reduce post-operative transfusion requirements, however in this study, this did not reach statistical significance (p=0.142). A larger, randomised controlled trial is required to assess the role TXA in hip fracture surgery

Introduction. Concerns regarding UHMWPE wear particle induced osteolysis in total hip replacement (THR, [1]) have led to alternative materials to be sought. Carbon-fibre reinforced poly-ether-ether-ketone (CFR-PEEK) has shown reduced wear in hip and knee configurations compared with conventional polyethylene [2-4]. The aim of this study was to investigate the wear performance of a ceramic-on-CFR PEEK THR through a simulator study. Methodology. Five 36mm diameter Biolox Delta heads were paired with extruded CFR-PEEK cups and tested in a hip wear simulator (Simulator Solutions, UK) for 10 million cycles (Mc). Tests were performed in a Prosim hip simulator, which applied a twin peak loading cycle, with a peak load of 3kN. Flexion-extension of −15 to +30 degrees was applied to the head and internal-external rotation of +/− 10 degrees was applied to the cup, components were mounted anatomically. The lubricant was 25% (v/v) calf serum supplemented with 0.03% (w/v) sodium azide. Wear was assessed gravimetrically at several intervals adjusted for moisture uptake using loaded and unloaded soak controls. Results. The volumetric wear of the CFR-PEEK cups was calculated from weight loss, corrected for fluid uptake by a mean value of the loaded and unloaded soak controls. The CFR-PEEK bearings exhibited step-like wear behaviour throughout the study (Figure 1), with periods of ‘higher’ wear rate (between 0.4mm–1.4mm. 3. /Mc) and periods of a ‘lower’ wear rate (less than 0.4mm. 3. /Mc), a phenomenon that has previously been observed with this material [3]]). Discussion. The wear of a novel ram-extruded CFR-PEEK cup, articulating with a Biolox Delta ceramic head was assessed through a 10Mc experimental wear study. The mean wear rate over the period of the study was very low, with less than 1mm. 3. /Mc measured. The wear rates observed in this study are comparable with reported wear rates for 36mm diameter hard-on-hard bearings [5], and lower than wear rates measured for a highly cross-linked polyethylene bearing [6]. The wear rates reported in this study are lower than those previously reported [3], however, as CFR-PEEK operates within a boundary lubrication regime, the reduced head diameter in the present study would result in reduced sliding distance and lower surface wear