Background and purpose of the study

Effective communication between healthcare professionals and patients is key to a successful consultation and is reported to affect both adherence to treatment and outcome. Despite this evidence, research on how best to open consultations is limited and the optimal way, unknown.

This study seeks the opinions of physiotherapists on how to open a clinical encounter in an adult musculoskeletal outpatient setting – a topic which has relevance to all clinicians aiming to build rapport with their patients.

Background: A common question asked by patients who have undergone knee arthroplasty is whether they will activate the security scanners at airports. This has become a greater issue for the patient in the post 9/11 era.

This study surveys our patients to determine their experiences at airport security, establishes the detectability of common orthopaedic implants in an airport security scanner

Materials and Methods: A survey of a single surgeon series of knee arthroplasty patients was conducted to ascertain the frequency with which they activated airport security scanners. Their experiences were documented and their preferences for identification were ascertained.

A volunteer with metal implants strapped on and patients with implants in-situ walked through a gate scanner at a UK airport. Also, standard operating procedures at UK airports were ascertained.

Results: 150 patients were surveyed. 61 male, 89 female with an average age of 71 years.

There were 111 total knee replacements (TKR), 20 unicompartmental knee replacements (UKR), 2 bilateral UKR replacements, 17 bilateral TKR.

Unlike previous studies from the U.K., virtually all patients with a TKR activated the gate scanner. Conversely, those with unicompartmental replacements did not.

Patients are concerned about this possibility but are not informed at time of surgery and do not know what the procedures are if their implant is detected.

The patient with the bilateral UKR did not set off the scanners where as the patient with the TKR did.

A variety of surprisingly large trauma implants escaped detection.

Conclusion: In contrast to previous work this study demonstrates that patients with TKR do activate the scanner, possibly due to heightened security. Other implants do to a variable extent. Patients are concerned about this possibility and should be made aware both of this and the further checks to which they will be exposed. Our survey demonstrated differences in how passengers with metal implants are screened by airport security around the World and particularly in the United States. In line with the International Air Transport Association (IATA) we propose the development of a more harmonised approach to screen international travellers.