Supporting Regional Upper Limb Arthroplasty: The Impact of Establishing an Upper Limb Orthopaedic Network.

Journal of shoulder and elbow arthroplasty Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI:10.1177/24715492241258623
Ben Oakley, Ben Marson, Malin Wijeratna, Paul Manning, John Geoghegan, Ben Gooding
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Abstract

Background and objectives: The management of complex upper limb arthroplasty has received national guidelines supporting the use of a regional network. An upper limb network was established for both elbow and shoulder arthroplasty. This study evaluates the impact of establishing this network over a 5-year period.

Methods: Data were collected from network meetings from June 2017 to December 2022. Hospital-level National Joint Registry data were obtained for analysis of case volume.

Results: A total of 243 cases were discussed. Network discussion changed the management plan in 53% of cases. Only 8% of cases required transfer to the tertiary center. The proportional caseload at either hub or spoke hospitals did not change after creation of the network.

Discussion: Regional network discussion aids decision-making for complex cases, with further management options realized in over half of the cases presented. The discussion allowed every patient to gain the advantage of regional expertise while being managed conveniently at their local hospital.

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支持地区性上肢关节成形术:建立上肢矫形网络的影响。
背景和目的:复杂上肢关节置换术的管理已获得国家指导方针的支持,支持使用区域网络。针对肘关节和肩关节置换术建立了上肢网络。本研究评估了建立该网络 5 年来所产生的影响:方法:从2017年6月至2022年12月的网络会议中收集数据。结果:共讨论了 243 个病例:共讨论了 243 个病例。网络讨论改变了53%病例的管理计划。只有8%的病例需要转至三级中心。网络建立后,中心医院或辐射医院的病例量比例均未发生变化:讨论:区域网络讨论有助于复杂病例的决策,在超过一半的病例中实现了进一步的管理方案。讨论使每位患者都能获得区域专家的优势,同时又能在当地医院得到方便的管理。
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