On 18th January 2018 the London Sports Orthopaedics practice (LSO) held its launch party for the opening of its new state-of-the-art dedicated Research & Outcomes Centre at 31 Old Broad Street, the centre of The City of London (www.sportsortho.co.uk).
LSO is a growing practice of currently 16 consultants, with orthopaedic consultants, neurosurgical spine surgeons, sports physicians, rheumatologists and pain specialists, covering the whole field of musculoskeletal medicine. Founded in 2008 by Mr Ian McDermott, the practice has grown steadily and is now one of the top private group practices in the UK for orthopaedics and sports injuries. LSO’s consultants operate predominantly out of London Bridge Hospital, which is one of the best private hospitals in the whole of the UK.
Most people would tend to associate research with laboratories and with universities. However, research underpins the very essence of modern evidence-based clinical practice. A thorough knowledge and understanding of research is essential for maintaining the most modern and up-to-date patient care with the latest technologies.
Many of the consultants in LSO also hold NHS posts in London’s top teaching hospitals, with several also holding honorary academic positions, linked to a number of different universities, including The University of London, Brunel University and The University of Belgrade, in Serbia. LSO’s consultants have a long track record of undertaking research, with a combined list of hundreds of publications, and national and international presentations.
To-date, it has always been particularly difficult to set up and run clinical research projects within the independent healthcare sector, and even robust clinical audit and outcomes data has proved hard to obtain. Recently, the Competition and Markets Authority (CMA) mandated that patient outcomes data should be gathered, shared and published for the Independent Healthcare Sector, with the Private Healthcare Information Network (PHIN) being the body now responsible for delivering this. This is now forcing people to take outcomes data more seriously; however, the extent of the dataset being gathered by PHIN is, inevitably, somewhat limited.
LSO is taking data collection very seriously indeed, and the PHIN dataset can be considered as just a rudimentary starting point. The new Research & Outcomes Centre is equipped with a brand new top-of-the-range Biodex Isokinometer, for accurately measuring strength, power and speed for multiple movements of multiple different body parts. This is also the first centre in the UK to house the KneeKG 3D video gait analysis system from Emovi. In addition, there is a dedicated Research Office, staffed by a full-time Clinical Nurse Specialist, a dedicated Research Physio and a dedicated Research Nurse, all working with LSO in conjunction with London Bridge Hospital. The Research & Outcomes Centre now allows the collection of extensive datasets of patients’ pre-op and post-op objective and subjective performance and outcomes scores, with PROMs (Patient Reported Outcomes Measures) being taken directly from patients, face to face. They are recorded and stored with dedicated software developed in conjunction with Optimum Contact, who provide outcomes data for several NHS Trusts.
The aim is very specific: to gather detailed, accurate, robust patient data to demonstrate clinical outcomes, with a view to sharing data and publishing the outcomes widely. Managing Partner of LSO, Mr Ian McDermott says “Within our practice we offer first class patient care of the highest possible calibre, and we intend to prove that and quantify that, rather than just relying on ‘soft data’ from patient and referrer feedback. However, the PROMs data is just a basic starting point. The LSO Research & Outcomes Centre has also been set up specifically to support multiple clinical audits and clinical research projects, with several projects already underway, including:
- A retrospective audit of 60 meniscal allograft transplantation cases, evaluating the different potential definitions of success.
- A retrospective comparative cohort audit of 120 patients investigating the effects of Vivostat PRF biological glue in reducing pain, swelling and bleeding after total knee replacement surgery.
- A review of 50 patients following internal bracing of Achilles tendon repairs with FibreTape.
- A prospective study investigating the role of patellar taping in patients with patellar maltracking, using a patellofemoral calliper and 3T MRI at 30 degrees knee flexion.
Since opening the Research & Outcomes Centre we have already received several submissions from local physiotherapy colleagues for further potential collaborative clinical projects”.
LSO’s firm intention is to generate significant volumes of papers and presentations, providing further insight into the latest and best clinical treatments, to ensure that the private sector starts to contribute actively to the world of academia and to published clinical evidence.
To support their endeavours, the consultants at LSO have helped establish the Sports Orthopaedics Research Foundation (SORF). SORF (www.sorf.org.uk) is an independent entity with its own Board of Trustees, and it has been set up as a tool to generate funding to support clinical audit, research, medical training and education.
Mr Ian McDermott says “SORF is currently in what we hope are the final stages of its application to the Charities Commission to be registered as a formal charity, and the foundation has already managed to accrue funds, with a formal grants application policy and a grants committee made up of individuals with proven academic records.
We are determined to persevere with our mission to bring clinical audit and research firmly into the private sector. With each project that we set up, the overall process for designing studies and for going through the formal application processes (with hospital approval and with formal Research & Ethics Committee submissions) becomes that much easier, with a positive feedback loop and a snowball effect. The private healthcare sector offers some of the newest techniques with some of the latest technologies from some of the best consultants in the world in some of the best hospitals in the world. With time and effort, with a bit of commitment and appropriate investment, and with the right manpower and the right tools, we really ought to be able to corroborate statements that currently sound like just simple empty marketing spiel, and back them up with genuine hard facts and figures. Patient care in the private sector in the UK really is truly world class, particularly in the top Central London private hospitals, where investment into quality has been huge. So, let’s all work together properly to actually prove it!”.
LSO would be happy to hear from any allied health professionals who might want to discuss potential research projects. Please contact: