The Elective Orthopaedic Centre Research & Education Department

The South West London Elective Orthopaedic Centre (The EOC) is an NHS Treatment Centre. It serves a population of 1.5 million and performs over 4,000 elective operations per year, making it one of the largest orthopaedic centres in the world.

The majority (approximately 3,000) of these operations are major replacements, hip or knee, which were the centre’s focus when it opened 6 years ago. The centre is diversifying its services to include shoulder, elbow, spinal and soft tissue surgery.

A world-leading centre in Orthopaedics, the EOC gives research a high priority. This ensures the best possible care for patients who are offered surgical techniques, implants and medicines that are most technologically advanced, and are cared for by a high calibre of staff.

In addition to monitoring the clinical outcomes and standards of care delivered to all EOC patients, the research unit is actively involved in three main streams of research:

• The development of new implants and surgical techniques

• The long term evaluation of new implants: many through the Orthopaedic Data Panel (ODEP)

• Research trials on new medicines (e.g. Factor Xa inhibitors)

The EOC has the infrastructure in place to deliver research on a significant scale.

Working in collaboration with us enables access to:

• 4,000 patients per annum undergoing elective surgery

• High recruitment rates of patients to studies

• Experience in regulatory submissions

• Knowledge of approvals within the NHS

• Project management (including multi-national studies), from start-up to the analysis and reporting of results

• Data entry, data management and effective systems for long-term follow-up of patients

• Protocol  and CRF design

• Highly experienced research staff

• Director – Mr Richard E Field

• Management, administration & IT support

• Clinical research staff (nurses, surgeons and physicians) 

A research-promoting culture ensures that staff remain interested in their work and are motivated to improve the care provided to patients. Research presentations and publications enable communication of work to the broader healthcare community and strengthen the reputation of the Centre as a national and international leader in orthopaedic practice.

A part time Director of Research is in post and a limited company, The Orthopaedic Research and Education Foundation Ltd, has been established to enable contacts with industry. A charitable trust has also been established.

Regular repeats of the fundraising charity walk for EOC research, which rose over £80,000 in June 2009.

The Research Unit has undergone a rapid expansion since it’s opening in 2006 and currently consists of Research Director, Senior Orthopaedic Fellow, Business Manager, 2 Clinical Research Fellows, 2 Surgical Research Fellows, 1 Teaching Fellow, 2 Research Nurses, ODEP Co-ordinator, Outcomes Administrator, Administration Assistants and Work Experience Students.

Outcomes

The EOC’s goal is to gather accurate data on every step of the patient pathway. The acquisition of accurate outcome data is essential to provide the highest standard of patient care. It is the basis for staff awareness of performance, the driver for the improvement programme and the source of information that enables The EOC to share its experiences with the broader healthcare community.

EOC outcome data has been used to prepare presentations at numerous healthcare meetings and is providing data that allows the submission of research papers. The presentation of this data will continue to be developed and will be increasingly powerful as the number of patients increases.

EOC aims to develop its data acquisition infrastructure into a web based service that will allow the Centre to host multi-centre research and outcome studies for the pharmaceutical industry and orthopaedic implant manufacturers.

Current Projects

Below is a table of some research studies that are being undertaken at the EOC at present. We also have a number of new projects in the pipeline which can also be identified below.

EOC Studies Actively Recruiting as of June 2010

Study

Anthology ODEP

Medacta Amistem Anterior vs posterior surgical technique RCT

Medacta Amistem ODEP

Wound infiltration, RCT

RA Tissue Donation (Kennedy Institute)

Studies in the pipeline

Smith & Nephew Deuce Knee

JRI/Active Implants, Tribofit Buffer -ODEP

Corin, Minihip ODEP

VTE Prophylaxsis

PER Surveillance study

PER DEXA study

EOC Biobank

Effects of Yakult on preventing antibiotic-associated diarrhoea and C. difficile infection in healthy patients undergoing elective orthopaedic surgery

Recruitment recently completed

VTE prevention – YM150

MRK ODEP

Publications

We have a research programme that is generating a steady stream of publications, higher degrees, inclusion in NIHR sponsored research grants and income from commercial trials.  The EOC aims to maximise the number of publications that are generated by the centre and its staff.  We are increasingly aware of the value of publications and the importance that leading medical institutions place on this measure of performance.  Below is a list of publications that have been published in peer review journals