改进髋关节或膝关节翻修关节置换术的网络流程:COVID-19 大流行的一线希望。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-03-01 Epub Date: 2023-09-13 DOI:10.1177/11207000231200824
Urjit Chatterji, Darren Puttock, Amin Kheiran, Darren Sandean, Gary Mundy, Dipen Menon, Andrew Brown
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引用次数: 0

摘要

背景:以 "中心辐射 "网络模式引入专业矫形服务后,髋关节和膝关节翻修假体植入术后的疗效得到了改善。鉴于 COVID-19 的流行,这些网络进行了一些不可避免的调整。我们调查了最近的调整对我们地区翻修关节成形术网络绩效的影响:我们分两个阶段对在地区翻修关节成形术会议上讨论过的所有转诊病例进行了回顾性审查。第一阶段包括 2018 年 3 月至 2019 年 4 月期间的数据,即 COVID-19 大流行之前的间隔期。第二阶段包括 2020 年 9 月至 2021 年 3 月(COVID-19 大流行期间)的数据。数据收集自东米德兰南部骨科网络(EMSSON)数据库,包括与翻修手术适应症和时间、外科医生建议计划、网络建议计划和已执行的最终计划相关的数据。我们对两个阶段的网络绩效进行了比较和分析:根据国家关节登记处(NJR)的记录,在第一阶段,EMSSON会议讨论了99个病例,相当于该地区翻修关节置换术量的35.7%。每99例病例中有48例(48.5%)被建议修改计划,其中41/48例(85.4%)被采纳。第二阶段包括98例讨论病例,相当于该地区翻修关节置换术量的81.6%。有 20/98 例病例(20.4%)被建议修改计划,所有病例(100%)均遵照执行。对建议调整的坚持率有了显著提高(P根据我们的观察,目前讨论的翻修关节置换术病例的数量和比例都在增加。在进行了上述调整后,对 MDT 建议的遵守情况有了明显改善。总体而言,这些研究结果表明,英国国家医疗服务体系(NHS England)的目标是 100%的翻修关节成形术病例接受 MDT 讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improvements in networking processes for hip or knee revision arthroplasty: a silver lining of the COVID-19 pandemic.

Background: Improvements in outcomes following hip and knee revision arthroplasties have been demonstrated following the introduction of specialised orthopaedic services in the form of 'hub and spoke' networking models. In light of the COVID-19 pandemic, these networks have undergone some inevitable adaptations. We investigated the impact of recent adaptations on the performance of our regional revision arthroplasty network.

Methods: A retrospective review of all referrals that were discussed at our regional revision arthroplasty meeting, over 2 separate phases, was undertaken. Phase 1 included data between March 2018 and April 2019, representing an interval prior to COVID-19 pandemic. Phase-2 included data between September 2020 and March 2021 (during COVID-19 pandemic). Data were collected from East Midland South Orthopaedic Network (EMSSON) database and included data relating to indication and time to revision surgery, surgeon's proposal plan, network proposal plan, and executed definitive plan. We compared and analysed network performance between 2 phases.

Results: In phase 1, 99 cases were discussed in EMSSON meetings, equating to 35.7% of the region's revision arthroplasty volume, according to the National Joint Registry (NJR) records. Plan alterations were recommended in 48/99 cases (48.5%), of which 41/48 (85.4%) were adhered to. Phase 2 included 98 discussed cases, equating to 81.6% of the region's revision arthroplasty volume. Plan alterations were recommended in 20/98 cases (20.4%), all of which were adhered to (100%). Adherence to recommended adaptations showed significant improvement (p < 0.03).

Conclusions: Based upon our observations, a greater volume and proportion of revision arthroplasty cases are now being discussed. Adherence to MDT recommendations has significantly improved following the described adaptations. The number of recommended adaptations to management plans have decreased, indicating an educational value of the network.Overall, these findings demonstrate a trend towards NHS England's target of 100% of revision arthroplasty cases undergoing MDT discussion.

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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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