Amjad N Bhatti
Betsi Cadwaladr University Health Board (Glan Clwyd Hospital), UK
Amjad Bhatti is a Consultant Orthopaedic Surgeons provide a wide range of emergency and elective treatment to patients throughout North Wales. He is currently in the Department of Orthopaedics working at Betsi Cadwaladr University Health Board (Glan Clwyd Hospital).
Patient reported outcome measures (PROMs) were introduced in orthopaedic practice in UK, since 2009, the National Joint Registry emphasized its use by NHS trusts in order to improve quality of care, in this study we looked into the potential role of PROMs combined with radiological imaging in follow up after elective joint replacement surgery.
50 patients who underwent primary elective joint replacement surgery from Jan 2013 till Jun 2013 under care of senior author, were randomly identified, pen and paper Oxford hip and knee score questionnaires, with radiological imaging request forms were sent by post, a covering letter explaining the rationale of study to patients in simple language was added, for the radiology request form patients were advised to go to their nearest hospital at their convenience, a business reply pre paid envelope was included with the letter for returning the Oxford scoring questionnaires.
38 out of 50 patients responded to the postal request, giving a response rate of 76 %, an overall improvement of 12 % from the agreed standards for postal surveys with pre-paid envelopes. The X-rays were reviewed by the radiologist and senior author for any radiological evidence of aseptic loosening, none out of 38 X-rays which were reviewed, showed any evidence of aseptic loosening. Oxford hip or knee score for each individual patient was calculated using a 0-48 method.
Response rate of 76 % indicates that PROMs though not validated for follow-up, may have a potential role if combined with appropriate use of Radiological imaging in medium to long term follow-up after elective joint replacement surgery, which might prove beneficial in reducing work load on routine Arthroplasty follow-up clinics.