Effect of music on patients’ anxiety during lower limb arthroplasty procedures under spinal anaesthesia: a prospective randomised controlled study
The increase in the ageing population has resulted in a greater prevalence of age-related diseases such as osteoarthritis and osteoporosis.1 Developments in the field of arthroplasty have resulted in more favourable outcomes and the demand for these procedures is expected to rise exponentially over the next ten years. These projections are likely to burden existing hospital resources. The elderly population have significant medical comorbidities and unique requirements which increase both the surgical and anaesthetic risk, and place further strain on resources. Perioperative assessment and management of these factors is imperative in order to reduce complications and improve patient outcomes.
Epidemiology and antibiotic choice in hand infections requiring surgical drainage: a retrospective study of 414 cases
Infections of the hand and fingers are common conditions and require intricate anatomical and microbiological knowledge to effectively treat these potentially devastating conditions. They are associated with significant morbidity such as stiffness, loss of function, deformity and amputation. Prompt recognition and expeditious treatment is of paramount importance to mitigate the risk of permanent disability. A high index of suspicion with aggressive medical and surgical therapy is recommended to establish early control of the infection. It has been well established that the cornerstones of effective management include surgical incision and drainage of collections, appropriate antibiotic therapy and rehabilitation therapy. Additionally, the importance of initial immobilisation and oedema control followed by early mobilisation cannot be overemphasised. However, the diagnosis may be challenging, as some hand infections may mimic other common conditions such as crystal deposit disease (gout and pseudogout), and viral infections such as herpetic whitlow, due to similar clinical presentations.
Orthopaedic-related trauma in e-hailing motorcycle drivers at a single centre in South Africa
Since the COVID-19 pandemic, the use of technologically based platforms has increased throughout society. An example can be seen in the food and goods delivery industry, whereby e-hailing companies have shown a surge in both revenue and workforce, as seen in the United States of America. South African society is not immune to this progression, with e-hailing services such as Uber Eats, Checkers Sixty60, Mr D, takealot, as well as others, showing a rise in the number of motorcycle drivers on our roads. In accordance with the South African National Land Transport Amendment Bill, e-hailing services pertain to ‘vehicles ... hailed or pre-booked using an e-hailing or technologically enabled application’. This is a loose term which traditionally referred to the transportation of people, but can be used to refer to the transportation of food and goods, as these companies have diversified their scope of service.
Scoops of success: outcomes in a series of 13 patients using a cone cup prosthesis for acetabular reconstruction
Reconstruction of the acetabulum and proximal femur is often required after resection of pelvic tumours and for significant bone loss following fractures and revision arthroplasty. Surgical reconstruction of these defects remains challenging due to the complex anatomy of the pelvis, the biomechanical forces at play and limited remaining bone stock. Although the indications may differ, the problems of implant fixation, joint stability and infection remain.
Management of osteoarticular tuberculosis of the foot and ankle: a scoping review
Extrapulmonary tuberculosis (TB) made up 10–16% of cases notified in 2019, with musculoskeletal TB accounting for 10–25% of these. Osteoarticular TB generally favours, in sequence, the spine, hip, knee, foot and ankle, with spinal TB making up more than half of cases. Foot and ankle TB comprises approximately 0.1–0.3% of all cases of TB. While typically localised, multifocality has been observed in approximately 10% of cases. Delayed treatment of juxta-articular foci allows for spread into adjacent joints and further. The natural progression typically involves worsening stiffness and deformity. According to Tuli, early detection and treatment may result in up to 90% of patients achieving healing with near-normal function.
The implementation of the South African Orthopaedic Registry (SAOR): factors that improve usage
The terms ‘patient registry’, ‘clinical registry’, ‘clinical data registry’,disease registry’ and ‘outcomes registry’ are used interchangeably to denote the collection of data within the healthcare setting, herein referred to as ‘registry’. The Agency for Healthcare Research and Quality (AHRQ) defines a registry as ‘an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes’. Registries are distinct from other forms of medical data collection on account of the focused collection of predetermined data variables for individuals with a defined common feature of interest, taking place across multiple sites. Registries have been created to accrue comprehensive clinical data for evaluation, with purported benefits for the clinical governance of patient care, public health and scientific investigation. Traditionally, registries were developed by organisations or researchers who were responsible for the collection of data and analysis for various utilities. As registries have evolved, patients have become more involved in the establishment of registries and capturing their own data, in what are termed ‘patient-powered registries’. Gliklich et al. summarised the types of registries into three variants according to the purpose of data collection: 1) those related to monitoring patients with a specific disease or condition, 2) registries concerned with administered patient care that monitor the investigation, management and outcomes of treatment, and 3) those where a healthcare product is the focus of interest.