Projects

“Effect of taping on kneecap position and experience of pain in …

Project Overview

This study has been designed by Kevin Campbell-Karn (PhD student at Brunel University and Senior Lecturer at Bucks New University), Dr Thomas Korff (Senior Lecturer at Brunel University and Lead Supervisor) and Mr Ian McDermott (Consultant Orthopaedic Surgeon at London Sports Orthopaedics, Honorary Professor Associate at Brunel University and Second Supervisor).

We are conducting this study into the measurement of the position of the kneecap in people with pain in the front of their knee before and after patellar taping is applied.

Taping has been recognised as a method by which some patients can have pain relief; however, the means by which this happens is still under debate.

 

We will be testing at the London Sports Orthopaedics practice in the MRI scanner at 31 Old Broad Street. This study has been designed as a crossover trial, testing the following:

  1. Measurement of the participant’s knee with a specially designed patellar tracking caliper
  2. Squatting/stepping exercises performed with the patient rating their pain during the movements
  3. An MRI scan of the patient’s knee in a fixed position
  4. Patellar taping will then be applied to the patient’s knee and the above will all be repeated.
Project Credits:

Mr Kevin Campbell-Karn, Senior Lecturer at Bucks New University and PhD student at Brunel University.
Dr Thomas Korff, Senior Lecturer at Brunel University.
Mr Ian McDermott, Consultant Orthopaedic Surgeon at London Sports Orthopaedics, Honorary Professor Associate at Brunel University.

“Cartiva interposition for symptomatic hallux rigidus – A pros …

Project Overview

This project is assessing the clinical and functional outcomes of this consecutive series of 30 patients with a follow-up of at least 12 months following Cartiva implantation for arthritis of the great toe. This spacer device is a biocompatible polymer which addresses the pain of great toe arthritis while preserving motion within the joint.

Project Credits:

Mr Henry Atkinson, Consultant Orthopaedic Surgeon, London Sports Orthopaedics

“The use of bioabsorbable Magnesix screws in Bunion surgery R …

Project Overview

This is a pilot series assessing the clinical and functional outcomes of this consecutive series of 24 patients with a follow-up of at least 12 months following bunion surgery using bioabsorbable Magnesix screws. These screws work as well as metal screws, but are bioabsorbable, and hence don’t require removal.

Project Credits:

Mr Henry Atkinson, Consultant Orthopaedic Surgeon, London Sports Orthopaedics

“Internal bracing for Tendoachilles reconstruction – 50 patien …

Project Overview

This project reviews the clinical and functional outcomes of this consecutive series of 50 patients with a follow-up of at least 24 months following internal bracing for ruptured achilles tendons. This innovative surgical technique promotes earlier post-operative mobilisation and a faster return to sports and normal activities, with no single tendon re-tear, and very low complication rates.

Project Credits:

Mr Henry Atksinon, Consultant Orthopaedic Surgeon, London Sports Orthopaedics

“Internal bracing for augmented quadriceps repairs – A review …

Project Overview

This project is reviewing the clinical and functional outcomes of this consecutive series of patients with ruptured quadriceps tendons with a follow-up of at least 24 months following surgery. This innovative surgical technique promotes earlier post-operative mobilisation and a faster return to sports and normal activities, with no single tendon re-tear and no instances of DVT/PE.

Project Credits:

Mr Henry Atkinson, Consultant Orthopaedic Surgeon, London Sports Orthopaedics

“Speedbridge reconstruction for patellar tendon avulsion injurie …

Project Overview

This study is reviewing the clinical and functional outcomes of this consecutive series of 6 patients with avulsions of their patellar tendons using the Speedbridge technique, with a follow-up of at least 12 months following surgery. This innovative surgical technique promotes earlier post-operative mobilisation and a faster return to sports and normal activities, with no single tendon re-tear and no instances of DVT/PE.

Project Credits:

Mr Henry Atkinson, Consultant Orthopaedic Surgeon, London Sports Orthopaedics

“The effect of Vivostat PRF in Total Knee Replacement outcomes&# …

Project Overview

Aims

This project aims to evaluate the potential effects of the intra-operative use of Vivostat PRF in total knee replacement (TKR) surgery.

Background

Vivostat PRF is an autologous platelet-rich fibrin glue / sealant that has been used for several years in various surgical specialities, in including Vascular Surgery, Cardiac Surgery, Hepatobiliary Surgery and Plastic Surgery. Its use has spread into other surgical specialties, including Orthopaedics, where it is now used as a biological glue for cases such as articular cartilage grafting in knees. There is some evidence from Italy (Fornanciai et al) that Vivostat PRF, when used as a fibrin sealant in knee replacement surgery, can reduce post-operative bleeding in the knee and therefore reduce blood transfusion rates. It is our supposition that this should also help reduce post-operative pain and swelling, and therefore aid in early post-operative recovery and early rehab of the patients.

Mr Ian McDermott, Consultant Knee Surgeon at London Bridge Hospital, has been using Vivostat PRF since October 2014. The aim of this audit is to perform a retrospective review on his knee replacement patients comparing those where Vivostat PRF was used vs those where it was not, to see whether any discernible differences in outcome can actually be detected.

Methods

We intend to include 126 TKR cases that were performed by Mr Ian McDermott at London Bridge Hospital since September 2009. These include:

• A case group of 60 TKRs performed with Vivostat PRF, and
• A control group of 66 TKRs performed without Vivostat PRF

Exclusion criteria include partial knee replacements and a small number of simultaneous bilateral cases. These TKRs are made up of both Conformis and Biomet Vanguard cases in both the Vivostat PRF group and the control group.

Once cases and controls have been identified, their patient records will be drawn from the London Bridge Hospital and London Sports Orthopaedics databases. Intra-operative data, nursing and inpatient physio records, and outpatient clinic notes will be inspected. The proposed variables to be observed in this study are:

1. Pre- vs. post-op Hb
2. Transfusion rates
3. Opioid analgesia usage post-operatively
4. Degree of swelling immediately post-operatively
5. Length of hospital stay
6. Range of movement (ROM) at: a) Day 3 post-op, b) 1st follow-up appointment and c) 6-week follow-up appointment
7. The time post-op until the patient can walk up and down stairs comfortably.

After collecting this data we will run comparative statistical analyses, to determine whether any differences can be observed between the two study groups.

Project Credits:

Mr Ian McDermott, Consultant Orthopaedic Surgeon, London Sports Orthopaedics
Dr Henry Conchie, Junior Doctor at Epsom and St Helier Hospital
Mrs Katy Warrington, Physiotherapy Inpatient Clinical Lead, London Bridge Hospital
Mr Caelen Wilson, Senior Charge Nurse for Orthopaedics, London Bridge Hospital
Mr Alan Rayner, Chief Clinical Perfusion Scientist, London Bridge Hospital

“A retrospective audit of the outcomes of meniscal allograft tra …

Project Overview

Objectives: To explore the definition of success after Meniscal Allograft Transplantation (MAT) using both surgical and patient reported-outcomes, to better inform surgeons, patients and healthcare providers alike.

MAT can be a useful option for treating premature knee degeneration after previous meniscal loss in patients younger than fifty years old, who are too young for traditional arthroplasty.  Many outcome studies have been published showing MAT reduces symptoms and improves function, but different outcome measures and definitions of success are used, making it difficult to compare studies.

Methods: 60 patients who underwent MAT between 2008 and 2014 from one surgeon’s cohort were identified. Fresh-frozen non-irradiated grafts were sized-matched from one provider and fixed arthroscopically using transosseous bone tunnels and peripheral capsular sutures. With no MAT-specific measure to assess patient outcomes, six validated measures for knee pathologies were incorporated into an online self-administered questionnaire (KOOS, IKDC, VAS, SF-12, Lysholm and Tegner Before & After MAT).  Patient satisfaction with the procedure and questions around sport were also included to ascertain their relevance in defining success. Common to other MAT studies, surgical failure was defined as removal of most or all of the graft, revision allograft, or conversion to arthroplasty. Clinical failure was defined as a Lysholm score of <65.  The overall complication rate was also calculated.

Project Credits:

Mr Ian McDermott, London Sports Orthopaedics
Mr Henry Searle, The University of Edinburgh