An opportunity to sleep well in hospital: development of a multi-level intervention to improve inpatient sleep (ASLEEP) using behaviour change theories.

Background: Sleep is substantial issue for hospital inpatients and can negatively affect healing and recovery. There is a good evidence-base for interventions which can improve sleep, however currently they are not being implemented into NHS practice. To address the evidence-practice gap, we have conducted early-phase development for an inpatient sleep intervention (ASLEEP); a multi-level intervention to improve inpatient sleep in UK hospital wards.

Prehabilitation for frail patients undergoing hip and knee replacement in the UK: Joint PREP feasibility study for a randomised controlled trial.

Objective: To determine the feasibility of conducting a randomised controlled trial (RCT) to evaluate a prehabilitation programme for frail patients undergoing total hip replacement (THR) or total knee replacement (TKR).

Design: Randomised feasibility study with embedded qualitative work.

Setting: Three National Health Service hospitals.

Prevalence and patterns of neuropathic pain in people with chronic post-surgical pain after total knee arthroplasty.

Aims: The aim of this study was to describe the prevalence and patterns of neuropathic pain over one year in a cohort of patients with chronic post-surgical pain at three months following total knee arthroplasty (TKA).

Methods: Between 2016 and 2019, 363 patients with troublesome pain, defined as a score of ≤ 14 on the Oxford Knee Score pain subscale, three months after TKA from eight UK NHS hospitals, were recruited into the Support and Treatment After Replacement (STAR) clinical trial. Self-reported neuropathic pain and postoperative pain was assessed at three, nine, and 15 months after surgery using the painDETECT and Douleur Neuropathique 4 (DN4) questionnaires collected by postal survey.

REST: a preoperative tailored sleep intervention for patients undergoing total knee replacement - feasibility study for a randomised controlled trial.

Objectives: To test the feasibility of a randomised controlled trial (RCT) of a novel preoperative tailored sleep intervention for patients undergoing total knee replacement.

Design: Feasibility two-arm two-centre RCT using 1:1 randomisation with an embedded qualitative study.

Setting: Two National Health Service (NHS) secondary care hospitals in England and Wales.

The STAR care pathway for patients with chronic pain after total knee replacement: four-year follow-up of a randomised controlled trial.

Background: The Support and Treatment After Replacement (STAR) care pathway is a clinically important and cost-effective intervention found to improve pain outcomes over one year for people with chronic pain three months after total knee replacement (TKR). We followed up STAR trial participants to evaluate the longer-term clinical- and cost-effectiveness of this care pathway.

Methods: Participants who remained enrolled on the trial at one year were contacted by post at a median of four years after randomisation and invited to complete a questionnaire comprising the same outcomes collected during the trial.

Healthcare professionals' views on implementing the STAR care pathway for people with chronic pain after total knee replacement: A qualitative study.

For many people with advanced osteoarthritis, total knee replacement is an effective treatment to relieve pain and improve function. However, 10-34% of people experience chronic postsurgical pain in the months and years after total knee replacement. The Support and Treatment After Replacement (STAR) randomised controlled trial (ISCRTN92545361) evaluated the clinical- and cost-effectiveness of a new multifaceted and personalised care pathway, compared with usual care, for people with pain at three months after total knee replacement.

Rehabilitation for revision total knee replacement: survey of current service provision and systematic review.

Background: Revision total knee replacement (TKR) is a major operation with a long recovery period and many patients report suboptimal outcomes. Rehabilitation has the potential to improve outcomes. The aim of this study was to understand current provision of rehabilitation for revision TKR in England and evaluate the existing evidence.

Scoping review and characteristics of publicly available checklists for assessing clinical trial feasibility.

Background: Whether there is sufficient capacity and capability for the successful conduct and delivery of a clinical trial should be assessed by several stakeholders according to transparent and evidence-based criteria during trial planning. For this openly shared, user-tested, and validated tools are necessary. Therefore, we systematically examined the public availability and content of checklists which assess the study-level feasibility in the planning phase of clinical trials.

The STAR care pathway for patients with pain at 3 months after total knee replacement: a multicentre, pragmatic, randomised, controlled trial.

Background: Approximately 20% of people experience chronic pain after total knee replacement, but effective treatments are not available. We aimed to evaluate the clinical effectiveness and cost-effectiveness of a new care pathway for chronic pain after total knee replacement.

Methods: We did an unmasked, parallel group, pragmatic, superiority, randomised, controlled trial at eight UK National Health Service (NHS) hospitals.

Screening to Identify Postoperative Pain and Cross-Sectional Associations Between Factors Identified in This Process With Pain and Function, Three Months After Total Knee Replacement.

Objective: To describe the screening and recruitment process of a randomized trial and evaluate associations with knee pain and function 3 months after total knee replacement (TKR).

Methods: In order to screen for a multicenter trial, a total of 5,036 patients were sent the Oxford Knee Score (OKS) questionnaire 10 weeks post-TKR. Patients who reported pain in their replaced knee (score of ≤14 on the OKS pain component) completed a second OKS questionnaire 12 weeks post-TKR.

Effect of Group-Based Outpatient Physical Therapy on Function After Total Knee Replacement: Results From a Multicenter Randomized Controlled Trial.

Objective: To evaluate the long-term clinical effectiveness of a novel group-based outpatient physical therapy (PT) following total knee replacement (TKR).

Methods: In this 2-center, unblinded, superiority, randomized controlled trial, 180 patients on a waiting list for primary TKR due to osteoarthritis were randomized to a 6 session group-based outpatient PT intervention and usual care (n = 89) or usual care alone (n = 91). The primary outcome was patient-reported functional ability measured by the Lower Extremity Functional Scale at 12 months postoperative.

The Relationship between Sacral Kyphosis and Pelvic Incidence.

Study Design: Retrospective cohort study.

Purpose: Evaluate the fixed anatomical parameter of sacral kyphosis (SK) and its relationship with pelvic incidence (PI).

Overview Of Literature: Pelvic parameters determine pelvic and lumbar spinal position.

Clinical- and cost-effectiveness of the STAR care pathway compared to usual care for patients with chronic pain after total knee replacement: study protocol for a UK randomised controlled trial.

Background: Approximately 20% of patients experience chronic pain after total knee replacement. There is little evidence for effective interventions for the management of this pain, and current healthcare provision is patchy and inconsistent. Given the complexity of this condition, multimodal and individualised interventions matched to pain characteristics are needed.

Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway.

Background: Approximately 20% of people who have total knee replacement experience chronic pain afterwards, but there is little evidence about effective interventions for managing this type of pain. This article describes the systematic development and refinement of a complex intervention for people with chronic pain after knee replacement. The intervention is a care pathway involving an assessment clinic and onward referral, with telephone follow-up as required.

Myelography in the Assessment of Degenerative Lumbar Scoliosis and Its Influence on Surgical Management.

Objective: Myelography has been shown to highlight foraminal and lateral recess stenosis more readily than computed tomography (CT) or magnetic resonance imaging (MRI). It also has the advantage of providing dynamic assessment of stenosis in the loaded spine. The advent of weight-bearing MRI may go some way towards improving assessment of the loaded spine and is less invasive, however availability remains limited.

A Radiological Evaluation of Lateral Vertebral Subluxation Associated With Spinal Stenosis in the Lumbar Spine in Degenerative Scoliosis.

Study Design: Retrospective longitudinal cohort.

Objective: To evaluate the different patterns of stenosis with lateral subluxation in degenerative lumbar scoliosis (DLS).

Summary Of Background Data: Lateral subluxation of the vertebra is commonly seen in DLS.

Is kyphoplasty better than vertebroplasty in restoring normal mechanical function to an injured spine?

Introduction: Kyphoplasty is gaining in popularity as a treatment for painful osteoporotic vertebral body fracture. It has the potential to restore vertebral shape and reduce spinal deformity, but the actual clinical and mechanical benefits of kyphoplasty remain unclear. In a cadaveric study, we compare the ability of vertebroplasty and kyphoplasty to restore spine mechanical function, and vertebral body shape, following vertebral fracture.