Amir Abdelmalek1, Oliver Donaldson2. 1. ST5 Trauma and Orthopaedics (Severn Deanery), Yeovil District Hospital, Higher Kingston, Yeovil, UK. 2. Consultant Trauma and Orthopaedics, Yeovil District Hospital, Higher Kingston, Yeovil, UK.
Abstract
BACKGROUND: The number of total elbow replacement (TER) procedures conducted is relatively low compared to other joint arthroplasties. We have established a survey about current service provision and possible future improvements in the UK. METHODS: A British Elbow and Shoulder Society (BESS) approved online survey was circulated to its surgical members. RESULTS: In total, 153 members of BESS responded. Almost 31% of respondents performed two to five TER in 2014; 28% performed none and 22.7% performed five to ten. Two-thirds of respondents did not perform any revision surgery. The main indication for TER was rheumatoid arthritis (33%), followed by acute trauma (28.5%). In addition, 67% of surgeons have an available 'network' for advice, either locally or regionally. Most primary procedures (93%) were carried out within the local units. However, 34% of complex primary or revision procedures were referred to another centre. Furthermore, 52% of respondents agree that, to be proficient in TER, a minimum number of procedures per annum should be performed: 62% stated that five procedures per annum should be considered as the minimum required. Suggestions for improvement included a hub and spoke model (48%) and a dedicated TER surgeon within the unit (45%). CONCLUSIONS: The survey highlights the interest in exploring options for improving TER provision in the UK.
BACKGROUND: The number of total elbow replacement (TER) procedures conducted is relatively low compared to other joint arthroplasties. We have established a survey about current service provision and possible future improvements in the UK. METHODS: A British Elbow and Shoulder Society (BESS) approved online survey was circulated to its surgical members. RESULTS: In total, 153 members of BESS responded. Almost 31% of respondents performed two to five TER in 2014; 28% performed none and 22.7% performed five to ten. Two-thirds of respondents did not perform any revision surgery. The main indication for TER was rheumatoid arthritis (33%), followed by acute trauma (28.5%). In addition, 67% of surgeons have an available 'network' for advice, either locally or regionally. Most primary procedures (93%) were carried out within the local units. However, 34% of complex primary or revision procedures were referred to another centre. Furthermore, 52% of respondents agree that, to be proficient in TER, a minimum number of procedures per annum should be performed: 62% stated that five procedures per annum should be considered as the minimum required. Suggestions for improvement included a hub and spoke model (48%) and a dedicated TER surgeon within the unit (45%). CONCLUSIONS: The survey highlights the interest in exploring options for improving TER provision in the UK.
Entities:
Keywords:
TER; elbow arthroplasty; getting it right first time; hub and spoke; national survey; surgeon volume
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