An evaluation of the clinical efficacy and risk profile of routine spinal operations performed in the National Health Service
Back pain affects the majority of people at some point in their life, costing the United Kingdom approximately £12 billion per year. It worsens quality of life through loss of function, pain and its psychological effects. We do not currently know the outcomes of routine spinal surgery performed in the National Health Service to help relieve back pain. Most research has been poor with not enough patients to draw conclusions from.
Adhesive Capsulitis Corticosteroid and Dilation Randomised Controlled Trial: A Feasibility Study in Primary Care
Shoulder pain accounts for 3% of all visits to a GP, with frozen shoulder being the most common cause of pain. Prevalence of frozen shoulder is estimated to be 10% of working age adults, having a significant impact on function and the ability to work.
DUALITY: Dual mobility (DM) versus standard articulation total hip replacement (THR) in the treatment of older adults with a hip fracture
Worldwide there are 1.3 million hip fractures with more than 70,000 hip fractures in the UK every year; projected to rise to more than 100,000 by 2020 in the UK.
Hip fracture is one of the biggest challenges facing patients and healthcare systems. Worldwide there are 1.3 million hip fractures with more than 70,000 hip fractures in the UK every year. These figures are projected to rise to more than 100,000 by 2020 in the UK and more than 6 million by 2050 worldwide. The global cost of this clinical problem is estimated at 1.75 million disability adjusted life years lost and represents 1.4% of the total healthcare burden in established market economies.
NIHR has several streams from which commissioning inputs can be generated – NICE research recommendations, researcher inputs and priority setting exercises. The flagship amongst these is the James Lind Alliance. This has been enormously successful in generating commissioned trial calls and is one of the ways that the community have together driven a transformation in the culture of bone and joint health research. We are delivering a prioritisation partnership with multiply injured patients, those sustaining major trauma.
The Tendon Seed Network will spatially define the transcriptome of extracellular matrix-rich tissues such as tendon across multiple anatomic and micro-anatomic sites. To enable this, the project will develop clinical, laboratory, bioinformatics, and mathematical modelling tools and platforms. This group will also pilot a patient engagement strategy in order to increase recruitment of ethnically underrepresented donors by developing and growing partnerships with clinical research teams in London and Birmingham.
Worldwide there are 1.3 million hip fractures with more than 70,000 hip fractures in the UK every year; projected to rise to more than 100,000 by 2020 in the UK. The global cost of this clinical problem is estimated at 1.75 million disability adjusted life years lost and represents 1.4% of the total healthcare burden in established market economies. People suffering hip fracture have a 30 day mortality of 7% and experience a persistent reduction in their health-related quality-of-life similar to that of a major stroke.
There is evidence from many countries that patients with severe injuries should be treated in specialist hospitals. In 2012, trauma services across England underwent a major re-organisation; 22 hospitals were designated as ‘Major Trauma Centres’ (MTCs) that would treat the most severely injured adult patients, even if this meant ambulances by passing other hospitals. Although this restructuring required considerable financial investment, it is unknown whether it has improved care for these severely injured patients.
Ankle fracture is one of the most common musculoskeletal injuries sustained in the UK. Many of these patients experience ongoing pain and physical impairment with the consequences of the fracture and its management lasting for several months or even years. The broad aim of ankle fracture treatment is to maintain the alignment of the joint whilst the fracture heals. More severe injuries to the ankle, those which require realignment or are expected to be unstable, are routinely treated surgically.
There are around 170 ankle fractures each day in the UK. Many of these injuries heal with support in a plaster cast or splint, but some require surgery to restore the natural alignment of the bones and fix them in place with screws and plates. This promotes good ankle function once the fracture has healed. Following surgery for an ankle fracture, patients are commonly told not to walk on the affected leg for six weeks in order to allow the bones to heal.
Every year 65,000 people in England, Wales and Northern Ireland break their hip and undergo surgery. This is a devastating injury for these typically elderly, frail and anaemic patients. As a result of the break and the surgery, 30% of patients require a transfusion of someone else’s donated blood. This can lead to complications, increase the risk of infections (e.g. pneumonia or a wound infection) and increases the length of the hospital stay.
Fractures of the proximal femur (hip fractures) are one of the greatest challenges facing the medical community. In 1990, a global incidence of 1.31 million was reported and was associated with 740,000 deaths. Hip fractures constitute a heavy socioeconomic burden worldwide. The cost of this clinical problem is estimated at 1.75 million disability adjusted life years lost, 1.4% of the total healthcare burden in established market economies.