Publications by authors named "Toby Smith"

Background: The foot and ankle are frequently affected in rheumatic and musculoskeletal diseases (RMDs), yet there is a lack of high-quality evidence to determine the effectiveness of treatments. Outcomes in research are often inconsistently measured, impeding evidence synthesis. Additionally, clinical decisions are based on research outcomes, but these are not always regarded as important by people with RMDs.

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Background: This systematic review aims to evaluate the effectiveness and safety of custom femoral stems in primary total hip arthroplasty (THA) for patients with secondary osteoarthritis with abnormal hip anatomy.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, databases were systematically searched for studies published on primary THA utilizing custom femoral stems. Inclusion criteria were studies on patients with secondary osteoarthritis receiving custom stems, with outcomes including implant survival, revision rates, and functional scores.

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Periprosthetic joint infection (PJI) is a major challenge for surgical teams and patients following an orthopedic surgical procedure. There is limited understanding on patient and health professional's perception of PJI. The aim of this study was to examine the literature to better understand the perspectives of patients, and those who manage PJI.

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Introduction: medial patellofemoral ligament reconstruction (MPFLr) is a common surgical procedure for treating patellar instability. Grafts can be fixed to the femur using a bone-tunnel technique with an interference screw. However, this may lead to femoral tunnel enlargement (FTE) post-operatively.

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Background: Shoulder osteoarthritis is a common cause of pain, disability and difficulty sleeping. Patient information leaflets are produced by NHS Trusts with the aim of informing patients about their diagnosis and available treatment options.

Objectives: The aim of this study was to identify and describe the non-surgical management of people with shoulder osteoarthritis according to publicly available information leaflets produced by NHS Trusts.

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Objectives: This systematic review aims to determine the effectiveness of ambulance transportation versus helicopter transportation on mortality for trauma patients.

Methods: A systematic review of published and unpublished databases (to August 2023) was performed. Studies, reporting mortality, for people who experienced trauma and were transported to a trauma unit by ambulance or helicopter were eligible.

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Background And Objective: Post-operative periprosthetic femoral fractures (POPFF) present a growing challenge for healthcare services, but there are limited national data on patient profiles, short-term outcomes, and post-discharge follow-up. We aimed to fill these gaps.

Methods: Using Hospital Episode Statistics (HES), we identified POPFF discharges from hospitals in England for patients aged 18 and above between April 2016 and December 2022.

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To determine the efficacy of transdermal anti-inflammatory patches in the treatment of acute and chronic musculoskeletal pain. A comprehensive search of: Cochrane Central register of controlled trials, EMBASE, MEDLINE, CINAHL and PubMed, for studies using transdermal anti-inflammatory patches vs placebo for management of musculoskeletal pain, e.g.

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Background: In the UK, one in four patients are in work at the time of their hip or knee replacement surgery. These patients receive little support about their return to work (RTW). There is a need for an occupational support intervention that encourages safe and sustained RTW which can be integrated into National Health Service practice.

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Article Synopsis
  • * The REPPORT trial is a multicenter study comparing personalized rehabilitation to surgery for managing this condition, targeting 276 participants across the UK and using random assignment to treatment groups.
  • * The trial will evaluate effectiveness based on participant-reported outcomes over 18 months and gather additional data on health impacts and resource use, with results set to be shared in peer-reviewed publications.
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  • Tibial plateau fractures are complex knee injuries that are challenging to treat, often requiring surgical fixation and sometimes bone defect fillers, but there is no established best practice for either approach.
  • The study aimed to evaluate the effectiveness and potential risks of various surgical methods and filler materials for these fractures by analyzing data from randomized controlled trials and quasi-RCTs.
  • Ultimately, 15 trials with 948 adult participants were included, focusing on outcomes like quality of life, limb function, and the rate of complications such as reoperations.
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Background: A high proportion of patients do not regain outdoor mobility after hip fracture. Rehabilitation explicitly targeting outdoor mobility is needed to enable these older adults to recover activities which they value most. The overarching aim of this study is to determine the feasibility of a randomised controlled trial which aims to assess the clinical- and cost-effectiveness of an intervention designed to enable recovery of outdoor mobility among older adults after hip fracture (the OUTDOOR intervention).

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Article Synopsis
  • Chronic spinal pain negatively impacts both physical and mental health, and the relationship between psychological factors and pain modulation mechanisms is not well understood.* -
  • A systematic review analyzed studies on the relationship between conditioned pain modulation (CPM) and psychological factors in chronic spinal pain, identifying seven eligible studies with moderate quality.* -
  • Results suggest there is very low evidence that depression, anxiety, and fear avoidance do not significantly affect CPM responder status, while higher pain catastrophizing correlates with CPM non-responder status.*
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Objective: To investigate whether a combined hip and knee muscle strengthening program is superior to a knee strengthening program for people after lateral patellar dislocation (LPD).

Design: Single-blind, superiority, randomized controlled trial with 48 weeks follow-up.

Setting: Physiotherapy out-patient clinic.

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Background: Posterior Tibial Tendon Dysfunction (PTTD) is commonly seen within musculoskeletal care. The condition's prevalence and management is poorly understood. This study aims to demonstrate current practice by multi-professional clinicians across the United Kingdom within the National Health Service.

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Background: Diabetes inpatient specialist services vary across the country, with limited evidence to guide service delivery. Currently, referrals to diabetes inpatient specialists are usually 'reactive' after diabetes-related events have taken place, which are associated with an increased risk of morbidity/mortality and increased length of hospital stay. We propose that a proactive diabetes review model of care, delivered by diabetes inpatient specialist nurses, may contribute to the prevention of such diabetes-related events and result in a reduction in the risk of harm.

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Introduction: Pain and disability after meniscectomy can be a substantial lifelong problem. There are few treatment options, especially for young people. Non-surgical management (rehabilitation) is an option but increasingly surgeons are performing meniscal allograft transplants (MATs) for these individuals.

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Background: International research suggests that triage nurses' decision-making practices and training experiences vary significantly across emergency departments (EDs). However, there does not appear to be similar research published in the UK. Understanding factors, such as demographics, training and decision-making could provide a picture of triage nurses working in UK EDs, identify the interventions required to improve practice and inform further research.

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Background: Children and adolescents have the highest incidence of patellar instability among the population. We aimed to identify patho-morphological and epidemiological factors associated with patellar instability, and to identify factors predisposing to recurrence in children and adolescents.

Methods: Published and unpublished literature databases, conference proceedings and the reference lists of included studies were searched to the 14th of March 2024.

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Purpose: This systematic review aimed to understand older people's perspectives of associated fear-avoidant beliefs following upper limb fracture.

Methods: Published and unpublished literature databases were systematically searched from inception to 1st April 2023. Qualitative studies reporting the perspectives of fear-avoidant beliefs or behaviours in people who had sustained an upper limb fracture were eligible.

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Objectives: Identify and evaluate factors affecting early mobilisation on the day following hip fracture surgery.

Design: Mixed methods, scoping review.

Data Sources: MEDLINE, AMED, CINAHL, APA PsycINFO, APA PsycArticles, ISRCTN, Clinical Trials registry and grey literature accessed in November 2022 with publication dates between 2001 and November 2022.

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Objectives: To assess the feasibility of conducting a pragmatic, multicentre randomised controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery.

Design: Two-arm, multicentre, pragmatic, open, feasibility RCT with embedded qualitative study.

Setting: National Health Service (NHS) providers in five English hospitals.

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