ABSTRACT
During the response to the COVID-19 pandemic, doctors will be redeployed into roles with which they are unfamiliar. Adequate training must be provided to reacquaint doctors with medical ward practice, supporting psychological wellbeing and patient safety. Here we describe a cross-skilling programme in North Bristol NHS Trust designed to address colleague anxiety and support wellbeing during redeployment.
ABSTRACT
AIMS: Despite kneeling being an important and valued function of the knee, a proportion of patients are unable to kneel following arthroplasty. We explore the reasons for this, and assess whether neuropathic pain is a contributing factor. METHODS: In this observational study, data was collected prospectively for 134 knees. At one year follow-up, patients completed a semi-structured questionnaire, the Oxford Knee Score (OKS), and the painDETECT score. Ability to kneel was assessed by question 7 of the OKS. Change in kneeling ability was assessed using Wilcoxon signed-rank test, normal data with independent t-test, and a regression and ANOVA analysis performed to assess predictors of kneeling ability. RESULTS: 88% of patients had tried kneeling post-operatively. There was no change in kneeling ability for the whole cohort from pre- to post-operatively (pâ¯=â¯0.313). Patient reasons for not kneeling varied. Male gender, younger age and a reduced pain score were all significantly associated with a greater ability to kneel postoperatively. There was a trend towards an improved ability with increased flexion. Mean pain scores for all kneeling abilities lay within the nociceptive rather than neuropathic range. CONCLUSION: Kneeling ability varies greatly post-knee replacement, and is multifactorial. Greater pain is a contributing factor to the inability to kneel postoperatively, but this appears to be nociceptive rather than neuropathic in nature.
