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Biomedical subjects

B Bewley

Publications and source records attributed to B Bewley.

8 recordsLinked to original sources
PubMed2003

The St. Leger total knee replacement--a 7-year clinical assessment and survivorship analysis.

The St. Leger total knee replacement was developed with the aim of producing an affordable prosthesis which contained the best known features of current designs and also allowed ease of instrumentation. We present the medium term clinical and radiographic outcome and survivorship of the prosthesis. From 1992 to August 1994, 150 St. Leger total knee replacements were performed on 53 male and 72 female patients. Mean age was 67 (Range: 40-86). Sixty-nine percent of operations were for osteoarthritis and 30% for rheumatoid arthritis. Patients were reviewed at 1, 4 and 7 years postoperatively by an independent assessor. One hundred and twenty-three patients were assessed at 4 years and 83 patients at 7 years. The American Knee Association Scores revealed 84% excellent or good, 9% fair, and 7% poor results at 7 years. No patients complained of severe pain, 90% had mild or no pain, 10% had moderate pain. Eighty nine percent of patients were satisfied with their outcome. There were five complications requiring revision: infection (2), loosening (1), valgus instability (1) and knee stiffness (1). Survivorship analysis revealed 95% (95% CI +/-7.2%) survival at 7 years. Total knee replacement using the St. Leger knee prosthesis has comparable results to other condylar knee systems that cost almost twice the price.

Adult↗
PubMed1994

A ten-year prospective study of vertebral canal size as a predictor of back pain.

This prospective study compared ultrasound measurement of the lumbar vertebral canal with subsequent back pain; 669 mining and nursing recruits had been measured before 1980, and 450 replied to a postal questionnaire in 1990. There was no significant difference in the prevalence of back pain or the need to be off work with back pain, in those whose canals were above and below the mean. However, going to bed with back pain was more frequent in those with small canals and approached significance (P = 0.068). Those with small canals were more likely to visit doctors and have treatment for back pain. Canal measurement is not a predictor for back pain, but as a risk factor for severe back pain in early working life, it approaches significance.

Adult↗
PubMed1992

Boneline: evaluation of an initiative to improve communication between specialists and general practitioners.

In response to a previous study of GPs' and consultants' satisfaction with orthopaedic outpatient referrals, orthopaedic surgeons at Doncaster Royal Infirmary made themselves available for telephone consultations with general practitioners (GPs) at advertised times. This service, called 'Boneline', was used infrequently, though the GPs who did use it found it valuable, and reported that a number of referrals had been avoided by speaking to the consultant. There was, however, no significant change in the rate at which requests for out-patient appointments were received during the six months of Boneline's operation. Opportunities for improving telephone communication between GPs and consultants are discussed.

Communication↗
PubMed1991

Improving care: a study of orthopaedic outpatient referrals.

OBJECTIVE: To identify aspects of outpatient referral in which general practitioners', consultants', and patients' satisfaction could be improved. DESIGN: Questionnaire survey of general practitioners, consultant orthopaedic surgeons, and patients referred to an orthopaedic clinic. SETTING: Orthopaedic clinic, Doncaster Royal Infirmary. SUBJECTS: 628 consecutive patients booked into the orthopaedic clinic. MAIN OUTCOME MEASURES: Views of the general practitioners as recorded both when the referral letter was received and again after the patient had been seen, views of the consultants as recorded at the time of the clinic attendance, and views of the patients as recorded immediately after the clinic visit and some time later. RESULTS: Consultants rated 213 of 449 referrals (42.7%) as possibly or definitely inappropriate, though 373 of 451 patients (82.7%) reported that they were helped by seeing the consultant. Targets for possible improvement included information to general practitioners about available services, communication between general practitioners and consultants, and administrative arrangements in clinics. Long waiting times were a problem, and it seemed that these might be reduced if general practitioners could provide more advice on non-surgical management. Some general practitioners stated that they would value easier telephone access to consultants for management advice. It was considered that an alternative source of management advice on musculoskeletal problems might enable more effective use to be made of specialist orthopaedic resources. Conclusion--A survey of patients' and doctors' views of referrals may be used to identify aspects in which the delivery of care could be made more efficient. Developing agreed referral guidelines might help general practitioners to make more effective use of hospital services.

Attitude of Health Personnel↗