Introduction/Background (roughly 1700 words) Broad area of subject: Total hip replacements To include history of Total hip replacements and controversies How study relates: To suggest the controversies with small stem uncemented total hip replacements. (Controversies exist on safety of use of uncemented short stem hip replacements mainly due to complications/outcomes associated with procedure. Namely: Risk of periprosthetic fracture, complication of subsidence of stem, poor outcome in patient scoring systems due to post operative thigh pain. Other references of complications to be given from lit search.) Study question: Are uncemented short stem total hip replacements safe and practical to be used in clinical practice. (To include advantages of short stem uncemented hip replacements ie; good post operative bone stock which gives more options for further surgery, quicker operation, good anatomical reconstruction. To include references) Guide to subsequent chapters: This part should mention what is the significance of further chapters to the study /outcomes and not merely mention of whats included. Academic references can be included to show advantages of chapters but not more than 2 or 3. (Further chapters will be on Literature search, methodology , results , discussion and conclusion/recommendations but the proposal requires to be 1700 words on introduction, 2700 words on literature search and 3200 words on methodology roughly) Literature search (Roughly 2700 words) Thorough literature search on uncemented short stem total hip replacements. To include shortcomings in previous studies, strengths of previous studies, problems associated with short stem uncemented hip replacements as suggested by literature, advantages of short stem hip replacements as suggested by literature, upcoming studies which will shed more evidence on short stem uncemented hip replacements (particular reference and details on CASINO trial registered in 2018. Methodology (roughly 3200 words) Underlying philosophy behind research: (short stem replacements are advantageous for use and are safe to use. This should be explained in details with references from literature) What research methods can be used How will data be collected: We will be performing a retrospective study on data that has been collected prospectively since 2012. Data has been collected by team members as a part of record holding for department . Our specialist physiotherapist had in addition kept details of type of prosthesis used, side of operation , complications/problems noted during follow up appointments. Patients were routinely followed up for clinical assessment and xrays for atleast 1 year following the operation. The xrays done during follow ups will be retrospectively studied for signs of loosening of prosthesis, signs of subsidence and any other complications noted (fractures/fixations of fractures). Any complications found during the clinical assessments will be mentioned along with management details of the complications once data collection is completed. The details of these will be obtained from case notes. Further data will be obtained from the national joint registry to look for complications treated elsewhere.(this section will require reference to what data is held by the British national joint registry for hip arthroplasty and what evidence can be extrapolated from there) How will data be analysed: Mention of scoring systems , academic tests/methodology that can be applied to study and analyse data , how will its clinical applicability be judged with various tools. Justification of methods/tools/tests used in the study: also to mention justification of data collected (data collected is over major areas of concern associated with procedure to show the prevalence of those in the study population which will help us assess the safety of use of short stem uncemented hip replacements ) and methods used to collect data.
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