Unicompartmental knee replacement is a common procedure for the treatment of osteoarthritis confined to one compartment of the knee. Dislocation of the mobile bearing is a recognised complication. We present a patient with a 6-year asymptomatic bearing dislocation, missed on original presentation.

Increasingly, hospitals are adopting a nurse-led follow-up service (NLFU), aimed at improving post operative community care following total hip/knee arthroplasty. This article hypothesises that it is feasible for NLFU services to replace traditional 6-week consultant-led hospital follow-up. The experience of implementing domiciliary 6-week NLFU, an approach previously unreported by any other UK centre is reported upon. This article presents the NLFU pathway protocol and a retrospective analysis of total hip arthroplasty (n=347) and total knee arthroplasty patients (n=356) the year after its introduction in September 2015. The pathway's utilisation, safety, and patient satisfaction from a postal survey are detailed. During the study period, the 6-week NLFU pathway utilisation rates were 30% for total hip arthroplasty (n=103) and 27% for total knee arthroplasty (n=96). NLFU was deemed safe, with a 10% re-referral to consultant clinic rate and no reported adverse outcomes related to process. Patients reported high levels of satisfaction. This article demonstrates that domiciliary NLFU at 6 weeks provides a feasible follow-up mechanism for primary hip and knee total joint arthroplasty, with high patient satisfaction levels. This offers clear benefits to healthcare Trusts in reducing follow-up appointments, in turn releasing capacity for new referrals and freeing staff for other duties.

No abstract