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repOrt – Periodico online di SICOOP – 16/09

repOrt – Periodico online di SICOOP – 16/09

The 1999 Institute of Medicine (IOM) report To Err Is Human transformed thinking about patient safety in U.S. health care. On its 15th anniversary, a topic largely missing from that report is finally getting its due. With its new re- port, Improving Diagnosis in Health Care, the IOM has acknowledged the need to address diagnostic error as a “moral, professional, and public health imperative.”1 The new report emphasizes that diagnostic errors may be one of the most common and harmful of patient-safety problems.  Read more…
 
Patient-reported outcome measures (PRoms) are a key parameter for assessing outcome following total hip arthroplasty. PRoms are widely used to power clinical studies and increasingly complement implant survivor- ship in national joint registries, providing a measure of a patient's pain and physical function.
There is a plethora of potential patient outcome tools that can be employed, which, though similar, offer a unique perspective on patient outcome. There is no con- sensus as to which scores ‘should’ be used, and research- ers typically revert to the most commonly reported scores such as (for hip arthroplasty) the oxford hip Score (ohS)3 or harris hip Score. Read more…
 
A 56-year-old gentleman, who had undergone a left total hip arthroplasty (THA) eighteen years ago for failed slipped capital femoral epiphysis (SCFE) pinning, presented with increasing pain in his left hip and thigh over the last three years. He had a significant decline in his function over the last year. He ambulated with crutches and was unable to bear weight on the left leg. He had become essentially immobile from his condition. He denied fevers or chills and had no rest or night pain. He took narcotic analgesics for pain control daily. Read more…
 
I perform a primary Total Hip Replacement (THR) using the posterolateral approach. This is the most commonly used approach for a routine primary THR. Austin Moore first described the currently used posterior approach [1]. He utilised the distal part of the original descriptions by Von Langenbeck and Theodor Kocher [2]. The advantages of the posterior approach include its simplicity, offering an excellent exposure to both the acetabulum and proximal femur with the potential to be extensile while preserving the abductor musculature [1,3]. I perform a mix of cemented, uncemented and hybrid (uncemented acetabular component and cemented femoral component) THRs. The most common bearing I use is a metal on highly cross-linked polyethylene with the occasional use of ceramic bearings. Read more…
 
Treatment of medial meniscus pathology is one of the most commonly performed arthroscopic and often presents difficult access during arthroscopy [1, 2]. There are various anatomical constraints in that the medial meniscus is mobile and the medial femoral condyle obscures the view of a large portion of the meniscus which is more convex and larger posteriorly when compared to lateral counterparts. Access to the posterior horn of the medial meniscus often requires a valgus stress while holding the knee slightly flexed and externally rotated to open medial joint. Read more…