The management of patients with massive irreparable rotator cuff tears (RCT) has traditionally proved challenging. This prospective study was undertaken with the aim to assess the overall functional outcome following the use of human dermal allograft in the reconstruction of massive irreparable RCT.

15 patients were included in the study, having a median age of 63 years. All patients underwent open reconstruction of massive irreparable RCT. None of the selected patients had evidence of significant gleno-humeral arthritis. All patients were evaluated pre- and post- operatively by the treating surgeon, and followed up for 12 months. The same physiotherapy protocol was prescribed for all patients. Initial and follow-up assessments were done at regular intervals using the Oxford and quick-DASH scoring systems.

A very high patient satisfaction rate, with substantial improvement in pain and function was noted. There was substantial improvement in Oxford shoulder score from a mean of 23.3 to 8.7 (p<0.01), and a similar improvement in mean quick-DASH score from 50.3 to 23.0 (p<0.01)

Of the 15 patients, 11 had an improvement of >10 in Oxford score, with these reporting a score of <10 after 12 months. None of the patients had any significant complications because of the surgery, and none had a deterioration in Oxford score from their pre-operative status.

We found that Human dermal allograft is a very effective tool in the repair of massive irreparable RCT, with excellent follow-up results after one year.

This aim of this study was to identify common factors in patients with the shortest length of hospital stay following total hip arthroplasty (THA). This would then allow a means of targeting suitable patients to reduce their length of stay.

This was a retrospective cohort study of all patients undergoing primary THA at our institution between September 2013 and August 2014. Demographic data were collected from the patient record. The cohort was divided into those discharged to home within two days of operation and the rest of the THA population. The demographics (age, gender, ASA grade, body mass index (BMI), primary diagnosis, socioeconomic status (Scottish Index of Multiple Deprivation, SIMD and SIMD health domain) were compared between groups. In addition for the early discharge group information on comorbidities, family support at home and independent transport were collected.

The study cohort was 1292 patients. 119 patients were discharged home on the first post-operative day. Those discharged earlier were on average younger (p<0.0001), more likely to be male (p<0.0001) and had a lower ASA grade (p<0.00001). Other demographics did not differ between groups. Patients who were discharged early also appeared to have few comorbidities (Diabetes 5.9%, Cardiac disease 7.6%, Respiratory disease 9%), high levels of family support at home (95%) and high levels of independent transport arrangements (97%).

Factors associated with those patients with the shortest lengths of stay were identified. Such factors could be used to target patients who are suitable for streamlined recovery programmes aimed at early discharge after THA and assist with service planning.