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Royal College
British Orthopaedic
AO Trauma
Churchill
Limb Recon
Specialist Reg.
Graham SM; British Limb Reconstruction Society Research Collaborative (Heidari N).
INTRODUCTION: Limb reconstruction surgery (LRS) has a wide range of clinical applications within orthopaedic and trauma surgery. We sought a consensus view from limb reconstruction healthcare practitioners across the United Kingdom to help guide research priorities within LRS. Our aim is to guide future clinical research in LRS, and assist healthcare practitioners, clinical academics, and funding bodies in identifying key research priorities to improve patient care. MATERIALS AND METHODS: A modified Delphi approach was used; it involved an initial scoping survey and a 2-round Delphi process to identify the consensus research priorities in both adult and paediatric LRS. Participants were asked to rank approved submitted questions according to perceived importance on a 5-point Likert scale, where 1 represented lowest importance and 5 indicated highest importance. Mean scores were calculated to identify a consensus of the top ten research priorities for adult and paediatric LRS. RESULTS: One hundred and fifteen participants primarily from across the United Kingdom working in LRS contributed to the modified Delphi process. Participants ranked and then re-ranked the presented research topics in terms of perceived importance. This led to the identification of a top ten research priorities in both adult and paediatric LRS, respectively, based on the collective responses of LRS practitioners. The highest-ranked questions in both adult and paediatric practice related to how to best assess and record patient-reported outcome measures (PROMs) in LRS patients. Other priorities included the effectiveness of specialist physiotherapy, the use of patient-focused psychological support, and the use of various operative management strategies for infection and limb length discrepancies. CONCLUSION: We present a consensus-driven research priority study that outlines the key research topics and themes determined by healthcare professionals within LRS in the United Kingdom. CLINICAL SIGNIFICANCE: These questions will assist funding bodies in prioritising where research funding may be best utilised and help drive future improvement in patient care. HOW TO CITE THIS ARTICLE: British Limb Reconstruction Society Research Collaborative. Identifying Research Priorities in Limb Reconstruction Surgery in the United Kingdom. Strategies Trauma Limb Reconstr 2024;19(1):1-8.
What did we look at?
What 115 UK limb-reconstruction surgeons think are the most important unanswered questions in our field — the ones that, if research solved them next, would help patients most.
Why did we look at it?
Research funding is finite. Without a clear sense of what surgeons actually need to know, money gets spent on questions that don’t change practice. A formal consensus process — here a modified Delphi — produces a ranked, agreed shortlist.
What did we find?
The single highest-ranked priority, both for adult and paediatric limb reconstruction, was how to measure patient-reported outcomes well. Patients should be the ones telling us whether the operation worked. Other priorities: how effective specialist physiotherapy is, how to provide psychological support during long recoveries, and how to choose between operative strategies for infection and length discrepancy.
What does this mean for patients?
The next decade of UK limb-reconstruction research is being directed by what surgeons think will most help patients. Better patient-reported outcomes are at the top of that list.
Strategies in Trauma and Limb Reconstruction 2024. PMID: 38752185.