To evaluate safety outcomes and patient satisfaction of the re-introduction of elective orthopaedic surgery on ‘green’ (non-COVID-19) sites during the COVID-19 pandemic. A strategy consisting of phased relaxation of clinical comorbidity criteria was developed. Patients from the orthopaedic waiting list were selected according to these criteria and observed recommended preoperative isolation protocols. Surgery was performed at green sites (two local private hospitals) under the COVID-19 NHS contract. The first 100 consecutive patients that met the Phase 1 criteria and underwent surgery were included. In hospital and postoperative complications with specific enquiry as to development of COVID-19 symptoms or need and outcome for COVID-19 testing at 14 days and six weeks was recorded. Patient satisfaction was surveyed at 14 days postoperatively.Aims
Methods
The aim of this study was to identify risk factors for prosthetic
joint infection (PJI) following total knee arthroplasty (TKA). The New Zealand Joint Registry database was analysed, using revision
surgery for PJI at six and 12 months after surgery as primary outcome
measures. Statistical associations between revision for infection,
with common and definable surgical and patient factors were tested.Aims
Patients and Methods
When transferring tissue regenerative strategies
involving skeletal stem cells to human application, consideration needs
to be given to factors that may affect the function of the cells
that are transferred. Local anaesthetics are frequently used during
surgical procedures, either administered directly into the operative
site or infiltrated subcutaneously around the wound. The aim of
this study was to investigate the effects of commonly used local anaesthetics
on the morphology, function and survival of human adult skeletal
stem cells. Cells from three patients who were undergoing elective hip replacement
were harvested and incubated for two hours with 1% lidocaine, 0.5%
levobupivacaine or 0.5% bupivacaine hydrochloride solutions. Viability
was quantified using WST-1 and DNA assays. Viability and morphology
were further characterised using CellTracker Green/Ethidium Homodimer-1
immunocytochemistry and function was assessed by an alkaline phosphatase
assay. An additional group was cultured for a further seven days
to allow potential recovery of the cells after removal of the local
anaesthetic. A statistically significant and dose dependent reduction in cell
viability and number was observed in the cell cultures exposed to
all three local anaesthetics at concentrations of 25% and 50%, and
this was maintained even following culture for a further seven days. This study indicates that certain local anaesthetic agents in
widespread clinical use are deleterious to skeletal progenitor cells
when studied
