ABSTRACT
Seventy-one Geomedic total knee replacements were reviewed retrospectively at a maximum of eight and a half years. The prosthesis was found to be successful in its primary aim of relieving pain. However, there was an overall failure rate of 18.3%. Analysis of the results by an actuarial method allowed comparison with other prostheses. The factors involved in failure are discussed.
Subject(s)
Arthritis, Rheumatoid/surgery , Knee Prosthesis , Osteoarthritis/surgery , Adult , Aged , Equipment Failure , Evaluation Studies as Topic , Female , Follow-Up Studies , Humans , Knee Joint/physiology , Locomotion , Male , Middle Aged , Movement , Postoperative Complications/etiologyABSTRACT
Psychiatric syndromes following compensable injury are not unusual in surgical practice. All such patients show exaggeration of their symptoms; compensation neurosis and malingering in particular are difficult to separate clinically. The signs and symptoms are reviewed. The prognosis has been assessed in 52 cases of compensation neurosis/malingering; remission of symptoms was usual except for spinal injuries, but return to previous occupation was not common and, despite the triviality of 70% of the injuries, 73% of the patients were off work for more than 6 months. The factors affecting prognosis are discussed, but the effect of legal settlement of claims could not be assessed accurately.
Subject(s)
Disability Evaluation , Wounds and Injuries/psychology , Humans , Malingering/diagnosis , Neurotic Disorders/diagnosis , Prognosis , Workers' CompensationABSTRACT
Increasing litigation in recent years makes it more and more necessary for the surgeon to be on his guard against actions or omissions that might be construed as professional negligence. Some of the more common causes of such negligence and their avoidance are discussed. If the current tendency of the courts to interpret mistakes and errors of judgment as negligence continues some change in the law will be essential if the practice of defensive medicine is to be avoided.
