Cappagh National Orthopaedic Hospital
http://hdl.handle.net/10147/129735
2024-03-23T21:36:06ZPrognostic Importance of Pathological Fractures in Osteosarcomas.
http://hdl.handle.net/10147/635880
Prognostic Importance of Pathological Fractures in Osteosarcomas.
Sheridan, G A; Mellon, L; Thompson, E M; O'Kane, G M; O'Toole, G C
Aims To investigate whether pathological fractures impact on osteosarcoma patient prognosis in Ireland. Methods This was a retrospective study over 22 years in a National Orthopaedic Oncology Centre. There were 117 nonfracture cases and 15 fracture cases. Outcome measures included 5 and 10 year event-free (EFS) and overall survival (OS). Kaplan-Meier curves assessed length of survival and time to death. Results Pathological fracture has no significant effect on 10 year EFS or 10 year OS. 3 factors strongly associate with 10 year OS rates: American Joint Committee on Cancer (AJCC) classification (p<0.001), Metastases site (p<0.001) and Distant recurrence (p<0.001). Fractures had poorer post-chemotherapeutic necrosis rates (p=0.005). Conclusion Pathological fractures have no significant effect on survival rates or length of survival in an Irish population. The effect of pathological fractures on necrosis rates must be explored in future research.
2020-12-16T00:00:00ZThe Role of a Seven-Day Physiotherapy Service in Reducing Length of Stay and Improving Cost-Effectiveness in Arthroplasty Surgery.
http://hdl.handle.net/10147/635193
The Role of a Seven-Day Physiotherapy Service in Reducing Length of Stay and Improving Cost-Effectiveness in Arthroplasty Surgery.
Cashman, James; Staunton, Peter; Grant-Freemantle, Marc; Pomeroy, Eoghan
Background Length of hospital stay post hip and knee arthroplasty is influenced by several factors, including gender, home circumstances and underlying diagnosis. Due to increasing demand for hip and knee arthroplasty, elective units, operating within already stressed healthcare systems, must identify methods of increasing efficiency and capacity. We sought to establish whether the lack of a seven-day inpatient physiotherapy service resulted in an increased hospital length of stay post primary hip and knee arthroplasty. Methods One hundred consecutive joint replacements (50 total hip replacements and 50 total knee replacements (TKRs)), performed in our institution from January to February 2020, were assessed. The length of stay for the cohort was analysed, and delays to discharge were identified. T-test was used to analyse the difference in length of stay based on the day of the week the surgery was performed. Results The mean length of stay for all primary hip and knee arthroplasties was 3.42 (standard deviation (SD): 1.62) days. Hip and knee arthroplasties performed on a Thursday or Friday had a significantly higher average length of stay than those performed on Monday, Tuesday or Wednesday (3.89 versus 3.02, p=0.006). We calculated that operating a six-day versus seven-day physiotherapy service in our unit cost 318 bed days per year equating to €986,535. Conclusion Length of stay post total hip and knee arthroplasty in our unit is significantly affected by the day of the week that surgery is performed. Elective orthopaedic units should consider all means of maximising efficiency and lowering costs given the future challenges in service provision.
2023-01-18T00:00:00ZCurrent concepts and outcomes in cemented femoral stem design and cementation techniques: the argument for a new classification system.
http://hdl.handle.net/10147/631888
Current concepts and outcomes in cemented femoral stem design and cementation techniques: the argument for a new classification system.
Cassar-Gheiti, Adrian J; McColgan, Rosie; Kelly, Martin; Cassar-Gheiti, Theresa M; Kenny, Paddy; Murphy, Colin G
Cemented implant fixation design principles have evolved since the 1950s, and various femoral stem designs are currently in use to provide a stable construct between the implant-cement and cement-bone interfaces. Cemented stems have classically been classified into two broad categories: taper slip or force closed, and composite beams or shaped closed designs. While these simplifications are acceptable general categories, there are other important surgical details that need to be taken into consideration such as different broaching techniques, cementing techniques and mantle thickness. With the evolution of cemented implants, the introduction of newer implants which have hybrid properties, and the use of different broaching techniques, the classification of a very heterogenous group of implants into simple binary categories becomes increasingly difficult. A more comprehensive classification system would aid in comparison of results and better understanding of the implants' biomechanics. We review these differing stem designs, their respective cementing techniques and geometries. We then propose a simple four-part classification system and summarize the long-term outcomes and international registry data for each respective type of cemented prosthesis. Cite this article: EFORT Open Rev 2020;5:241-252. DOI: 10.1302/2058-5241.5.190034.
2020-04-02T00:00:00ZExpectations of general practitioners for patients undergoing elective total knee arthroplasty
http://hdl.handle.net/10147/578173
Expectations of general practitioners for patients undergoing elective total knee arthroplasty
Nugent, M; Carmody, O; Kenny, PJ
Most patients undergoing total knee arthroplasty (TKA) in Ireland are referred to orthopaedic services by their general practitioners (GPs). We aimed to evaluate Irish GPs’ expectations for their patients’ perioperative experience and post-operative return to function. A questionnaire was mailed to 350 GPs in all provinces. This included questions relating to GPs’ expectations for their patients and their knowledge and sources of information on TKA. 111 completed questionnaires were returned (response rate 31.7%). Overall expectations for functional and psychological outcomes were high, especially regarding pain relief (108 (97.3%)) expected relief from most or all pre-operative pain), mobility (108 (97.3%)) expected patients to walk medium or long distances) and psychological wellbeing (95 (85.5%) considered this somewhat or very important). Only 22 (20.2%) reported receiving any relevant information or training within the previous year. Overall expectations for functional outcomes were high, however greater communication between surgeons and GPs may improve GP information.
2015-09-01T00:00:00ZCappagh National Orthopaedic Hospital annual report , 2000
http://hdl.handle.net/10147/572450
Cappagh National Orthopaedic Hospital annual report , 2000
Cappagh National Orthopaedic Hospital
Text not transferable.
2001-01-01T00:00:00ZCappagh National Orthopaedic Hospital annual report 2004.
http://hdl.handle.net/10147/572426
Cappagh National Orthopaedic Hospital annual report 2004.
Cappagh National Orthopaedic Hospital
2005-01-01T00:00:00ZPost operative complications in a dedicated elective orthopaedic hospital: transfers requiring specialist critical care support
http://hdl.handle.net/10147/559031
Post operative complications in a dedicated elective orthopaedic hospital: transfers requiring specialist critical care support
Dawson, P; Daly, A; Lui, D; Butler, JS; Cashman, J
We aim to report our experience with out of hospital transfers for postoperative complications in a stand-alone elective orthopaedic hospital. We aim to describe the cohort of patients transferred, the rate of transfer and assess the risk factors for transfer. Patients were identified who were transferred out of the hospital to another acute hospital for management of non-routine medical problems. Patient data was collected relating to age, BMI, ASA, type of surgery, nature of the complication, timing and the outcome of transfer. In 2012, 2,853 inpatient surgical procedures were carried out, 51 patients (1.8%) developed a postoperative complication that required out of hospital transfer. Mean age of patients transferred was 67 (12-86) years, mean age of the overall case mix 58 years (0-96) (p=0.01). 37.7% of the overall case mix of surgeries was made up of primary hip and knee arthroplasty procedures, these patients made up 63.7% of patients transferred out (p=0.001). Mean BMI recorded was 31.7 (22-48) compared to the mean BMI of the total arthroplasty case mix of 28.8 (20-44) (p=0.02). 59% of all patients at our institution were ASA category II or III. 76% of patients transferred were ASA category II or III (p=0.005). We can conclude that patients requiring transfer are typically older. Arthroplasty patients are more likely to require transfer than patients undergoing other orthopaedic procedures. Among the arthroplasty cohort transferred patients will typically have a higher BMI than average. Patients with ASA category II or III make up nearly three quarters of those patients transferred. The mean age of patients transferred is typically older by 9 years.
2015-05-01T00:00:00ZLocal anaesthetics and chondrotoxicty: What is the evidence?
http://hdl.handle.net/10147/324629
Local anaesthetics and chondrotoxicty: What is the evidence?
Baker, Joseph F; Mulhall, Kevin J
Recent reports have suggested that local anaesthetic agents have a toxic effect on articular chondrocytes. This is despite the widespread intra-articular use of local anaesthetic agents following arthroscopic procedures for a number of years.
2012-11-01T00:00:00Z"Superior cleft sign" as a marker of rectus abdominus/adductor longus tear in patients with suspected sportsman's hernia.
http://hdl.handle.net/10147/324619
"Superior cleft sign" as a marker of rectus abdominus/adductor longus tear in patients with suspected sportsman's hernia.
Murphy, Grainne; Foran, Paul; Murphy, Darra; Tobin, Oliver; Moynagh, Michael; Eustace, Stephen
We describe a new imaging sign, the "superior cleft sign", identified at both symphysography and MRI, which should be used as a marker of rectus abdominis/adductor longus attachment tearing.
2013-06-01T00:00:00ZLumbar Morel-Lavallée effusion.
http://hdl.handle.net/10147/324622
Lumbar Morel-Lavallée effusion.
Moran, Deirdre E; Napier, Nicholas A; Kavanagh, Eoin C
2012-12-01T00:00:00Z