Endoprosthetic replacement of the pelvis is one of the most challenging types of limb-salvage surgery, with a high rate of complications. In an attempt to reduce this and build greater versatility into the reconstruction process, a new type of pelvic endoprosthesis was developed in 2003, based on the old McKee-Farrar prosthesis. This study reviews the outcomes in 27 patients who had an ice-cream cone pelvic prosthesis inserted at two different specialist bone tumour centres in the United Kingdom over the past six years. The indications for treatment included primary bone tumours in 19 patients and metastatic disease in two, and six implants were inserted following failure of a previous pelvic reconstruction. Most of the patients had a P2+P3 resection as classified by Enneking, and most had resection of the ilium above the sciatic notch. The mean age of the patients at operation was 49 years (13 to 81). Complications occurred in ten patients (37.0%), of which dislocation was the most common, affecting four patients (14.8%). A total of three patients (11.1%) developed a deep infection around the prosthesis but all were successfully controlled by early intervention and two patients (7.4%) developed a local recurrence, at the same time as widespread metastases appeared. In one patient the prosthesis was removed for severe pain. This method of treatment is still associated with high morbidity, but early results are promising. Complications are diminishing with increasing experience.

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Theatre operation notes are a mandatory part of patients' records and are important for the clinician and patient. They may be required for research/audit and also form part of the patients' medicolegal record. The Royal College of Surgeons of England 1 states that medical records are 'fundamental for clinical care and audit of surgical services' and the British Orthopaedic Association (BOA) 2 tell us 'good records are a basic tool of clinical practice', emphasising the importance of record keeping.The BOA in association with the British Association for Surgery of the Knee (BASK) have set out guidelines for operation note keeping in the publication Knee Replacement: A Guide to Good Practice. 2This study audited the quality of operative note keeping for total knee replacements against the standards set by the BOA. The results were presented to the department, practice was changed and the audit cycle completed with a review of subsequent operation notes. We could find no published studies which examined the quality of notes against specific guidelines. Patients and MethodsA prospective review was carried out of the operation note of every patient undergoing total knee replacement at a district general hospital over a total of 8 months. The information required by the BOA guidelines was broken down to individual data points and put onto a checklist. Added to this checklist were several other data points which are not required by the guidelines but which are clinically relevant and may be present in the note. Each operation note was compared against this checklist. Also recorded were the grade of operating surgeon and whether the operating surgeon wrote the note. If the entry on the operation note was illegible, it was not credited as a present data point.The results of this preliminary audit were presented to the department and a change of practice was implemented. Everyone in the department was provided with a copy of the guidelines and lists of the required 20 data points were posted in the department and in the surgeons' room in theatre. The audit was then repeated to complete the cycle. This study audited the quality of operative note keeping for total knee replacements against the standards set by the British Orthopaedic Association (BOA). PATIENTS AND METHODS A prospective review of all patients undergoing total knee replacement at a district general hospital over 8 months. Data recorded were compared with those required by the BOA good-practice guidelines. Change in practice was implemented and the audit cycle completed. Data were statistically analysed. RESULTS A total of 129 operation notes were reviewed. There was a significant improvement in the mean number of data points recorded from 9.6 to 13.1. The least well recorded data were diagnosis, description of findings, alignment and postoperative flexion range. All had a significant improvement except description of findings. The operating surgeon writing the note improved from 56% to 67%. Detailed postoperative instructions also improved in quality. CONCL...

The aim of this study was to assess sporting and physical activities in patients who had undergone hip resurfacing. Our study included 117 patients who underwent hip resurfacing between