Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.

AIM: In the years 1990-1993, in an effort to reduce waiting-list time, a small number of patients were sent from Exeter to hospitals in London to undergo elective total hip replacement. No medium- or long-term follow-up was arranged. Our aim was to audit the outcome of these hip replacements. PATIEN...

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Main Authors: Ciampolini, Jac, Hubble, Matthew J. W.
Formato: Artigo
Idioma:English
Publicado em: Royal College of Surgeons of England 2005
Assuntos:
Research Article
Acesso em linha:https://ncbi.nlm.nih.gov/pmc/articles/PMC1963843/
https://ncbi.nlm.nih.gov/pubmed/15720905
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1308/1478708051450
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spelling pubmed-19638432007-12-04 Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists. Ciampolini, Jac Hubble, Matthew J. W. Ann R Coll Surg Engl Research Article AIM: In the years 1990-1993, in an effort to reduce waiting-list time, a small number of patients were sent from Exeter to hospitals in London to undergo elective total hip replacement. No medium- or long-term follow-up was arranged. Our aim was to audit the outcome of these hip replacements. PATIENTS AND METHODS: Review of the records of the referring medical practices, Regional Health Authority, local orthopaedic hospital and the distant centres at which the surgery was performed identified 31 cases. A total of 27 hip replacements in 24 patients were available for clinical and radiological review. RESULTS: 12 (44%) hips have so far required revision surgery, at a mean of 6.5 years. Of these, three (11%) have been for deep infection. A further three hips (11%) are radiologically loose and are being closely monitored. Two patients (7%) suffered permanent sciatic nerve palsy. CONCLUSIONS: Patients whose surgery was performed locally over a similar time period have a published failure rate of only 4.9%. This difference is highly statistically significant (P < 0.001). The causes for such a difference in outcome were analysed and include surgical technique, implant selection and absence of follow-up. In the light of this evidence, we would like to urge the government to address waiting list problems by investing in the local infrastructure. Expanding those facilities where properly audited and fully accountable surgeons operate must be the way forward. Royal College of Surgeons of England 2005-01 /pmc/articles/PMC1963843/ /pubmed/15720905 http://dx.doi.org/10.1308/1478708051450 Text en
institution US National Library of Medicine
collection PubMed Central
language English
format Article
topic Research Article
spellingShingle Research Article
Ciampolini, Jac
Hubble, Matthew J. W.
Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.
description AIM: In the years 1990-1993, in an effort to reduce waiting-list time, a small number of patients were sent from Exeter to hospitals in London to undergo elective total hip replacement. No medium- or long-term follow-up was arranged. Our aim was to audit the outcome of these hip replacements. PATIENTS AND METHODS: Review of the records of the referring medical practices, Regional Health Authority, local orthopaedic hospital and the distant centres at which the surgery was performed identified 31 cases. A total of 27 hip replacements in 24 patients were available for clinical and radiological review. RESULTS: 12 (44%) hips have so far required revision surgery, at a mean of 6.5 years. Of these, three (11%) have been for deep infection. A further three hips (11%) are radiologically loose and are being closely monitored. Two patients (7%) suffered permanent sciatic nerve palsy. CONCLUSIONS: Patients whose surgery was performed locally over a similar time period have a published failure rate of only 4.9%. This difference is highly statistically significant (P < 0.001). The causes for such a difference in outcome were analysed and include surgical technique, implant selection and absence of follow-up. In the light of this evidence, we would like to urge the government to address waiting list problems by investing in the local infrastructure. Expanding those facilities where properly audited and fully accountable surgeons operate must be the way forward.
author Ciampolini, Jac
Hubble, Matthew J. W.
author_facet Ciampolini, Jac
Hubble, Matthew J. W.
author_sort Ciampolini, Jac
title Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.
title_short Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.
title_full Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.
title_fullStr Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.
title_full_unstemmed Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.
title_sort early failure of total hip replacements implanted at distant hospitals to reduce waiting lists.
publisher Royal College of Surgeons of England
publisher_facet Royal College of Surgeons of England
publishDate 2005
url https://ncbi.nlm.nih.gov/pmc/articles/PMC1963843/
https://ncbi.nlm.nih.gov/pubmed/15720905
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1308/1478708051450
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