ObjectivesTo determine whether an entirely electronic system can be used to capture both patient-reported outcomes (electronic Patient-Reported Outcome Measures, ePROMs) as well as clinician-validated diagnostic and complexity data in an elective surgical orthopaedic outpatient setting. To examine patients' experience of this system and factors impacting their experience.DesignRetrospective analysis of prospectively collected data.SettingSingle centre series. Outpatient clinics at an elective foot and ankle unit in the UK.ParticipantsAll new adult patients attending elective orthopaedic outpatient clinics over a 32-month period.InterventionsAll patients were invited to complete ePROMs prior to attending their outpatient appointment. At their appointment, those patients who had not completed ePROMs were offered the opportunity to complete it on a tablet device with technical support. Matched diagnostic and complexity data were captured by the treating consultant during the appointment.Outcome measuresCapture rates of patient-reported and clinician-reported data. All information and technology (IT) failures, language and disability barriers were captured. Patients were asked to rate their experience of using ePROMs. The scoring systems used included EQ-5D-5L, the Manchester-Oxford Foot Questionnaire (MOxFQ) and the Visual Analogue Scale (VAS) pain score.ResultsOut of 2534 new patients, 2176 (85.9%) completed ePROMs, of whom 1090 (50.09%) completed ePROMs at home/work prior to their appointment. 31.5% used a mobile (smartphone/tablet) device. Clinician-reported data were captured on 2491 patients (98.3%). The mean patient experience score of using Patient-Reported Outcome Measures (PROMs) was 8.55±1.85 out of 10 and 666 patients (30.61%) left comments. Of patients leaving comments, 214 (32.13%) felt ePROMs did not adequately capture their symptoms and these patients had significantly lower patient experience scores (p<0.001).ConclusionsThis study demonstrates the successful implementation of technology into a service improvement programme. Excellent capture rates of ePROMs and clinician-validated diagnostic data can be achieved within a National Health Service setting.

No abstract

No abstract

No abstract

Category: Basic Sciences/Biologics Introduction/Purpose: The tibiotalar angle(TTA) is an important radiographic tool to determine alignment or malalignment of the ankle and hindfoot.Two methods of measuring the TTA have been described. The midline TTA(MTTA) is when the first line is along the anatomical axis of the tibia, and the second line is along the superior articular surface of the talus. Another method measures a line along the lateral border of the tibia, and a line along the superior articular surface of the talus (the lateral TTA, LTTA). The aims of the study were to compare the two angles as measured on mortise and AP radiographs in normal and pathological cases.We also compared the MTTA and LTTA, to see if they are comparable and if both methods are reliable and reproducible. Methods: A retrospective radiograph review was performed of sequential ankle radiographs taken between 2016 and 2017 across 4 specialist orthopaedic centres in the United Kingdom. Patients were categorised into two distinct groups. In the Normal Group (NG), patients had no evidence of injury and normal radiological appearances. In the Arthritis Group (AG), patients had radiographic changes as per the Kellgren-Lawrence scale 2 to 4. All radiographs were weightbearing and classified as either AP or mortise views based on the position of the talus and overlap of the tibia and fibula. The MTTA and the LTTA were measured on each radiograph. Results: There were 320 radiographs for review;158 normal radiographs and 162 radiographs had arthritis.There were 117 AP and 203 mortise radiographs. The overall mean MTTA was 88.7±5.1 degrees(range 77-104), and the mean LTTA was 87.5±5.2 degrees(range 73-104);p<0.01.There was no significant difference between the MTTA and LTTA in the normal group. There was a significant difference(p<0.01) when comparing the MTTA and LTTA in the arthritis group(Table 1). There was no significant difference when the MTTA was measured between the AP and Mortise radiographs. There was a significant difference in the LTTA between AP and mortise radiographs(p=0.04). There was no significant difference between the MTTA or LTTA when measuring the angles on AP radiographs(p=0.09).However, there was a significant difference when measuring these angles in the mortise radiographs(p=0.02). Conclusion: Understanding the tibiotalar angle is key to planning for deformity correction. It is important that consistency of methods for measurement are used for reporting. In this paper we have shown the MTTA to be a reliable and reproducible tool for measuring the TTA, in both normal ankle radiographs and in patients with ankle arthritis. There is no significant difference when the MTTA is measured using an AP or a mortise radiograph. In contrast, we have shown that the LTTA to be unreliable and statistically different when measured on both AP and mortise radiographs.