Tom Wainwright

Tom Wainwright
Bournemouth University | BU · Orthopaedic Research Institute

26.7
 · 
PgDip PgCert BSc (Hons) MCSP
About
68
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Introduction
Tom Wainwright is a physiotherapist, clinical academic and quality improvement specialist. He is Associate Professor in Orthopaedics and Deputy Head of the Orthopaedic Research Institute at Bournemouth University. He has a broad range of orthopaedic and musculoskeletal related research interests, and is internationally recognised for his work on Enhanced Recovery after Surgery (ERAS) protocols within orthopaedics. Tom is passionate about improving the quality of healthcare systems and works to help other healthcare providers improve the quality of their services. The Institute of Consulting named him as the 2010 Young Consultant of the Year for his work on a portfolio if quality improvement projects.
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Research items (68)
Article
Purpose: The aim of this study was to critically examine the content of smartphone apps produced for patients undergoing total hip replacement and total knee replacement surgery. Materials and methods: A systematic search was conducted across the five most popular smartphone app stores: iTunes; Google Play; Windows Mobile; Blackberry App World; and...
Article
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Exercise-based interventions applied before and after total hip and knee arthroplasty (THA and TKA, respectively) have been investigated for a number of years, based on the assumption that they will enhance post-operative recovery. Although recent studies suggest that high-volume, pre-operative exercise may enhance post-operative recovery after TKA...
Article
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Aim The aim of this feasibility study was to investigate the potential role of a novel neuromuscular electrical stimulation (NMES) device in preventing the formation of oedema following total hip replacement (THR). Methods Successive primary THR patients were recruited into a randomised controlled trial. Participants were randomised to wear either...
Article
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Nutritional supplements can influence outcomes for individuals undergoing major surgery, particularly in older persons whose functional reserve is limited. Accelerating recovery from total hip replacement (THR) and total knee replacement (TKR) may offer significant benefits. Therefore, we explored the role of nutritional supplements in improving re...
Article
Purpose: Enhanced Recovery after Surgery (ERAS®) has improved outcomes following elective surgery. This narrative review aimed to assess current evidence for post-operative physiotherapy interventions in general surgical procedures which adopt ERAS® principles. Materials and methods: A systematic review of the literature between 2000 and 2017 was...
Article
Objectives: Total hip replacement (THR) and total knee replacement (TKR) are two of the most common orthopaedic surgeries that occur in the United Kingdom (UK) annually. Enhanced recovery after surgery (ERAS) programmes aim to decrease convalescence across procedures. It has been highlighted that post operative physiotherapy routines may not conta...
Article
The increasing use of anticoagulant and antiplatelet therapy for the prevention of thromboembolic disease poses a significant challenge to orthopaedic surgeons treating elderly patients presenting with proximal femoral fractures. Early surgical intervention is known to be beneficial from a clinical perspective and has been encouraged in the UK thro...
Article
Introduction: Oxford Hip Scores (OHS) and Oxford Knee Scores (OKS) are being collected as part of the Patient Reported Outcome Measures (PROMs) evaluation programme on total hip and knee replacement. This study compares the PROMs outcomes from best and poorest performing English hospitals, as defined by NHS England’s data of elective hip and knee s...
Article
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Clinical teams are under increasing pressure to facilitate early hospital discharge for total hip replacement and total knee replacement patients following surgery. A wide variety of wearable devices are being marketed to assist with rehabilitation following surgery. A review of wearable devices was undertaken to assess the evidence supporting thei...
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Electrostimulation devices stimulate the common peroneal nerve, producing a calf muscle-pump action to promote venous circulation. Whether knee joint angle influences calf neuromuscular activity remains unclear. Our aim was to determine the effects of knee joint angle on lower limb neuromuscular activity during electrostimulation.
Article
Background: Enhanced Recovery After Surgery (ERAS) has been successfully adopted across a range of procedures. This study explores whether there is scope to improve length of stay (LOS) for total ankle replacement surgery (TAR) in the UK by implementing ERAS pathways. Methods: Hospital Episode Statistics (HES) data (April 2015/March 2016) on LOS...
Article
This article describes the concept of Enhanced Recovery after Surgery (ERAS) and its application to spine surgery. ERAS is a multimodal approach designed to reduce the surgical stress response and accelerate recovery following surgery. It is a multi-disciplinary, patient-centred approach that employs an evidenced-based pathway of standardised care....
Article
Purpose: Hip osteoarthritis (OA) is a chronic musculoskeletal condition affecting 2.5 million people in England. There is limited evidence on practice in the United Kingdom (UK) by physiotherapists in the public sector. A snapshot survey was conducted in a limited time period to inform standard care in a trial funding application. Methods: An onlin...
Article
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Enhanced recovery after surgery (ERAS) is an evidence-based, multimodal approach to optimising patient outcomes following surgery. The role of physiotherapy within ERAS and intensive care units (ICU) is important. Patients admitted to an ICU following elective major surgery may suffer from physical, psychological and cognitive problems, which can i...
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The laser speckle contrast imager (LSCI) provides a powerful yet simple technique for measuring microcirculatory blood flow. Ideal for blood dynamic responses, the LSCI is used in the same way as a conventional Laser Doppler Imager (LDI). However, with a maximum skin depth of approximately 1 mm, the LSCI is designed to focus on mainly superficial b...
Project - Enhanced Recovery after Surgery (ERAS)
Update
Project goal
Enhanced Recovery after Surgery (ERAS)
Background and motivation
Enhanced Recovery after Surgery (ERAS)
Article
Purpose: Rehabilitation following hip-replacement surgery routinely includes bed exercises. However, bed exercises appear to have little impact on pain, hip motion, strength and functional mobility. Sit-standing is a prerequisite for mobilisation and discharge, involving: asymmetrical weight-bearing, stability and concentric-eccentric contractions...
Article
Objective: This study compares the effectiveness of a neuromuscular electrical stimulation (NMES) device and an intermittent pneumatic compression (IPC) device on enhancing microcirculatory blood flow in the thigh of healthy individuals, when stimulation is carried out peripherally at the calf. Materials and methods: Blood microcirculation of te...
Article
Background: Total hip replacement (THR) and total knee replacement (TKR) are common orthopaedic procedures. However, an optimal programme for post-operative rehabilitation has yet to be established. Stair negotiation is a challenging, habitual task, regularly used as a post-operative functional outcome measure; yet as a physical rehabilitation int...
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Acute or chronic abdominal pain can be mimicked by thoracic spine dysfunction. However, it is comparatively rare and there is frequently a delay in its diagnosis that may lead to unnecessary surgery, or the patient's symptoms being undiagnosed or labelled psychosomatic. The failure to associate thoracic spine dysfunction with abdominal pain persist...
Article
Introduction This study examines patients' perceptions of the usefulness of occupational therapy and assistive devices provided, in achieving discharge criteria and assisting with activities of daily living once home, following an Enhanced Recovery After Surgery protocol for total hip and total knee replacement patients. Methods Two weeks following...
Article
Introduction Approximately 67,000 hip fractures occurred in England, Wales and Northern Ireland in 2014, and annual hospital costs for fracture are around £1.1 billion. We review the potential scope for improving length of stay (LOS). Methods Hospital Episode Statistics data on non-elective admissions to 137 hospital trusts between November 2013 an...
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Osteoarthritis of the hip is associated with pain, stiffness and limitations to activities of daily living. The aims of this quality improvement project were to introduce a service developed to promote the self-management of hip osteoarthritis through exercise and education, and to assess the impact of the programme on pain, function and quality of...
Article
This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is requi...
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Plain English summary Involving patients and the public in research helps to ensure that research remains relevant, and has an impact on the people it aims to benefit. Funding bodies now require patients and the public to be involved at all stages of research. Patients and members of the public were involved from the outset in research into a cycli...
Article
This article examines the relevance of applying the Enhanced Recovery after Surgery (ERAS) approach to patients undergoing major spinal surgery. The history of ERAS, details of the components of the approach, and the underlying rationale are explained. Evidence on outcomes achieved by using the ERAS approach in other orthopaedic and complex surgica...
Conference Paper
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A summary of 16 recent construct validity studies is provided by this research which assesses evidence demonstrating whether virtual reality (VR) simulators can be used to assess and score the skill levels of orthopaedic surgeons. The findings of this study are that there is overwhelming evidence that VR simulators can reliably assess the skill lev...
Article
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A 71-year-old man presenting with hip osteoarthritis, with a complex range of comorbidities was referred by his general practitioner to CHAIN (Cycling against Hip PAIN), a 6 week programme developed to aid self-management of hip osteoarthritis through exercise, education and advice, as defined by the National Institute for Health and Care Excellenc...
Conference Paper
Full-text available
This paper summarises recent validation studies and evidence demonstrating whether training on virtual reality (VR) simulators directly relates to improved performance in-vivo for orthopaedic surgical procedures. This research provides a summary of transfer validity on virtual reality orthopaedic simulators. This covers studies which have shown val...
Article
BACKGROUND: The use of larger femoral heads has been proposed to reduce the risk of dislocation after total hip arthroplasty, but there is a lack of evidence to support this proposal. The aim of this multicenter randomized controlled trial was to determine whether the incidence of dislocation one year after total hip arthroplasty is significantly l...
Article
Between August 2007 and May 2009, 2128 consecutive patients underwent either primary hip or knee joint replacement surgery at our institute on an enhanced recovery pathway. We aimed to investigate the potential benefits of this pathway in patients over the age of 85 years. Data extracted from Hospital Episode Statistics were analysed. This data are...
Article
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Abstract: Introduction: Orthopaedic enhanced recovery after surgery (ERAS) providers are encouraged to estimate the actual benefit of ERAS according to the patient’s opinion by using patient generated data alongside traditional measures such as length of stay. The aim of this paper was to systemically review the literature on the use of patient gen...
Chapter
Introduction: Metal-on-metal hip resurfacings (HR) have been widely used over the last 10 years due to their perceived advantages in younger active individuals. However, concerns over the use of metal-on-metal articulations, following the withdrawal of the ASR (DePuy Orthopaedics Inc., Warsaw, Indiana), have led the British Orthopaedic Association...
Article
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Metal-on-metal (MoM) hip resurfacings (HRs) and large head total hip replacements (LHTHRs) were perceived by many as a surgical revolution, with clear advantages over the traditional metal-on-polyethylene total hip replacement (THR). This is especially the case for younger, active individuals in whom conventional THR has been associated with higher...
Article
Minimally invasive hip and knee replacement surgery (MIS) continues to receive coverage in both the popular press and scientific literature. The cited benefits include a smaller scar, less soft tissue trauma, faster recovery, reduced hospital stay, decreased blood loss and reduced post-operative pain. These outcomes are highly desirable and consist...
Article
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The last 10 years has seen the increased use of enhanced recovery pathways across several surgical specialities. A prerequisite of enhanced recovery is the ability to mobilise patients early. This is dependent upon good postoperative pain control. A number of different techniques have been employed in joint replacement surgery to address this issue...
Article
The use of enhanced recovery pathways within elective surgery has increased in recent years but uptake outside of specialist centres is still slow, despite the growing evidence base to support their introduction. This article will briefly outline what is meant by an enhanced recovery pathway (ERP) and outline the central characteristics and feature...
Article
Removing well-fixed cementless acetabular components can be a challenge for every orthopedic surgeon involved in revision hip arthroplasty. Forceful removal of such components often leads to acetabular bone loss and compromises reimplantation of a new socket. Instruments like the Explant Acetabular Cup Removal System (Zimmer, Warsaw, Ind) are devel...
Chapter
The design and manufacture of ceramic implants has improved significantly over the last decade. Consequently the use of ceramic-on-ceramic bearings in total hip replacement has become increasingly popular with over 150,000 components having been implanted in Europe [1]. This increased use and uptake of the ceramic-on-ceramic combination can be thou...