ORCID Profile
0000-0001-8665-693X
Current Organisations
University of Tasmania
,
Launceston General Hospital
,
Tamar Valley Orthopaedics
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Publisher: Wiley
Date: 27-01-2023
DOI: 10.1111/ANS.18287
Abstract: Surgical coaching is a new approach to continuous professional development (CPD). Advocates claim that coaching improves surgical and non‐technical skills, leading to enhanced performance and reduced stress and burnout. Widespread acceptance of coaching in the surgical community is limited due to a paucity of evidence, surgery‐specific obstacles and lack of resources. This narrative review introduces what ‘surgical coaching’ is and describes its origins. Coaching techniques are based on live or video observation of procedures, followed by collaborative analysis, reflection and goal planning in a non‐competitive setting aided by an expert, peer or lay coach. Technical skills improvements have been reported using coaching techniques, yet long‐term influence on non‐technical competencies, overall performance and surgeon wellbeing are largely hypothetical. There are clear potential benefits in the application of surgical coaching to daily surgical practice. However, significant knowledge gaps remain. Dedicated research into the short‐term applicability and the long‐term effects of surgical coaching are required.
Publisher: Wiley
Date: 21-02-2022
DOI: 10.1111/ANS.17547
Abstract: The Anatomique Benoist Girard (ABG) II femoral implant was a commonly used stem for primary total hip replacement (THR) at our institution (Launceston, Tasmania Australia). We identified peri‐prosthetic fracture as the main cause of late failure. The late periprosthetic fracture rate for ABG II implants was reviewed with national statistics, using Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data. National revision rates for periprosthetic fracture were used to compare ABG II with all other cementless femoral stems. ABG II stems accounted for 1% (2719 implants) of all femoral stem implants in Australia during the 12‐year review period, compared to 23% (587 implants) in Launceston Hospitals. Although the Launceston cumulative percent revision rate for the ABG II stem was lower than the National rate at all time points, the reasons for revision were similar. The most common reason for revision of ABG II was fracture (56.8%), followed by loosening (15.3%). This differs from the reasons for revision in other cementless prostheses (loosening 23.9%, fracture 20.8%, dislocation 18.7%). Cumulative percent revision rates from late periprosthetic fracture, were higher for the ABG II stem than other cementless femoral prostheses. This review of the AOANJRR has confirmed a local and national higher revision rate of the ABG II stem due to late periprosthetic fracture compared with other cementless stems. Stem design must be considered to reduce the risk of late periprosthetic fracture.
Publisher: Wiley
Date: 05-04-2023
DOI: 10.1111/ANS.18449
Abstract: The objective is to determine whether body mass index is associated with patient‐reported expectations and well‐being before primary total hip or total knee arthroplasty, and patient‐reported outcomes 6 months after surgery. Data were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. Outcome measures included pre‐operative expectations for post‐operative mobility, joint pain and health, pre‐ and post‐operative EQ‐5D‐5L, EQ‐VAS, Oxford Hip/Knee Scores and joint pain scales, and post‐operative perceived change and perceived satisfaction. Associations with BMI were assessed using chi‐square tests, analysis of variance and Linear Mixed Models equations. Data were available for 12 816 primary THA patients and 20 253 primary TKA patients. Pre‐operatively, patients in higher BMI categories were significantly more likely to expect ongoing problems with mobility, more joint pain and poorer health following surgery ( P .01 for all analyses). For arthroplasty patients, higher BMI was associated with poorer pre‐operative and post‐operative scores for all measures. BMI was positively associated with improvements in EQ‐5D, OHS/KS and joint pain. While between‐group differences were statistically significant, many were small in magnitude. There was no association between BMI and patient‐perceived change or satisfaction after arthroplasty. Patients undergoing THA/TKA, higher BMI was associated with lower pre‐operative expectations, poorer well‐being before surgery, and worse scores after surgery. Patients who were obese demonstrated comparable satisfaction with their operated joint, compared with non‐obese patients. BMI was associated with greater pre‐ to post‐operative improvements in outcome scores for EQ‐5D, VAS knee, OHS/OKS and joint pain but these differences may not be clinically important.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Jonathan Seymour Mulford.