Staff Publication

Multidisciplinary team stakeholder event driving development of a novel Haemolytic Disease of the Fetus and Newborn (HDFN) national database for improving clinical outcomes of pregnancy affected by alloimmunisation (2024)

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Type of publication:

Conference abstract

Author(s):

Wilkes N.; Jeffs B.; Morton S.; Rogers L.; *Shields J.; Graham S.; Young B.; Asquith B.; O'Shea M.; McBride C.; Wilkes C.; Hazell M.

Citation:

Transfusion Medicine. Conference: 41st Annual Scientific Meeting of the British Blood Transfusion Society. Glasgow United Kingdom. 34(Supplement) (pp 37-38), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Introduction: HDFN is caused by incompatibility between maternal and fetal red cells, stimulating maternal antibody formation and attacking antigen positive fetal red cells, causing haemolysis (Poole and Daniels, 2007). Severity ranges from mild symptoms of jaundice & anaemia to fatal haemolysis (RCOG, 2014). Scientific advances including anti-D prophylaxis and fetal genotyping have improved clinical care and reduced the occurrence of HDFN (BSH, 2016). Guidelines recommend regularly monitoring maternal blood samples during pregnancy to determine antibody formation and titration, identifying any potential risk to the fetus, thus informing clinical decisions and intervention (BSH, 2016). Reviewing guidelines through evidence base analysis is best for patients, ensuring appropriate management plans. NHSBT historically collected data on outcomes of pregnancies with clinically significant alloantibodies. This project aims to launch a novel data collection platform populating a national pregnancy outcomes database ensuring best practice, prevention and treatment in HDFN. Stakeholder engagement and collaboration is essential, here we present the insights gained and the next steps. Method(s): Stakeholders were surveyed prior to the event to inform current practice and guide the face-to-face event agenda. Continuous improvement tools (including Kano analysis) were employed to facilitate guided evaluation and re-design of the current questionnaire & novel digital platform needs. Stakeholders were split into groups with various professional backgrounds allowing different perspectives to be sought. Following the event attendees had access to the collaborative whiteboard tool, Miro, to further understand challenges and requirements. Results and Discussion: Stakeholder output was key to redesigning a user-friendly questionnaire and drive development of a novel digital platform to promote national uptake. Multidisciplinary team collaboration of clinical, laboratory and operational colleagues across organisations gained helpful intel enabling patient focussed outcomes. This approach enabled open discussions capturing ideas to frame service development. Utilisation of the Kano model was an insightful way of understanding user requirements. Conclusion(s): The expanding dataset will be used to inform future guidelines by questioning which pregnancies are at higher risk of HDFN. Increased information aids in providing optimal care to mothers and their babies. Usage of large datasets to benefit patient outcomes are key strategic priorities within Transfusion 2024 (Stanworth et al, 2023).

DOI: 10.1111/tme.13084

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Tumour immune microenvironment prognostic factors in locally advanced rectal cancer, a systematic review (2025)

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Type of publication:

Journal article

Author(s):

Ball, Alasdair; *Lefroy, Rebecca; Price, Malcolm; McArthur, David; Beggs, Andrew.

Citation:

Frontiers in Oncology. 15:1688696, 2025.

Abstract:

Introduction: Understanding factors influencing individual survival outcomes following surgical resection of locally advanced (LARC) rectal cancer remains challenging. Novel biomarkers could show emerging promise in this setting. This study aimed to systematically review the literature on immune prognostic factors in LARC.

Methods: The review protocol was preregistered on the PROSPERO database (CRD42023460541). Included studies were required to report overall survival and at least one immune prognostic factor for at least ten patients with LARC. Final searches of MEDLINE, EMBASE and Central were concluded on 8th September 2023. The risk of bias was assessed using the QUIPS tool.

Results: 22 retrospective cohort studies involving 2,622 LARC patients were included in the review. We did not find any published data on immune prognostic factors in locally recurrent rectal cancer. Due to inconsistency of immune prognostic factor definitions and measurement methods, meta-analysis would not be meaningful. Instead, the results are presented descriptively. Risk of bias was concentrated in the participation, attrition, and confounding domains. Greater cytotoxic cell infiltration was associated with improved overall survival. There was inconsistent evidence of an association of PD-L1 expression and survival. M2 macrophage infiltration and homozygous germline FPR1 loss-of-function were associated with worse survival.

Discussion: These findings support a role for both innate and acquired immune systems in mediating outcomes following surgery for LARC and suggest that further work into immunomodulation may show promise in improving LARC treatment.

DOI: 10.3389/fonc.2025.1688696

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Artificial Intelligence in Colonoscopy: A Systematic Review of Adenoma Versus Polyp Detection Rates (2025)

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Type of publication:

Systematic Review

Author(s):

Rabba, Waseem; *Asif, Fatima; Younis, Muhammad Y; Nasrullah, Haris; Fatima, Laraib; Arif, Muhammad A.

Citation:

Cureus. 17(12):e98528, 2025 Dec.

Abstract:

Colonoscopy is the gold standard in the prevention of colorectal cancer, but the miss rates of adenoma are high, which restricts its efficacy. To improve lesion recognition, artificial intelligence (AI), especially computer-aided detection (CADe) systems, has been introduced. The aim of this systematic review was to compare AI-assisted colonoscopy in terms of its ability to improve adenoma detection rate (ADR) and polyp detection rate (PDR). An extensive search was performed on PubMed, Embase, and Cochrane Library from 2015 to 2025. There were 17 randomized controlled trials (RCTs) comparing the use of AI-assisted colonoscopy with normal colonoscopy. The methodological quality measure of the included RCTs was Cochrane Risk of Bias 2.0 (RoB 2.0), which subdivided the studies based on low risk, some concerns, or high risk of bias based on whether they were biased in this or that domain. The robVis tool was used to produce the visual summaries. AI-aided colonoscopy effectively enhanced both adenoma detection rate (ADR) and polyp detection rate (PDR) in all of the included studies over conventional colonoscopy. In adenoma detection, accuracy was more than 85%, and in polyp detection, more than 90%. The advantage was also found especially in the detection of small and flat adenomas, which are very often missed in routine practice. The use of AI in colonoscopy is strongly associated with an increase in the detection rate of adenoma and polyps, minimizing the risk of underdiagnosis. The results highlight the clinical promise of AI in the form of a decision-support tool across gastroenterologists and suggest that AI can be applied to enhance the outcomes of preventive and screening colorectal cancer. Future research should be cost-efficient and practical, and combined with some clinical activities.

DOI: 10.7759/cureus.98528

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Functional and Radiological Outcomes Following Volar Locking Plate Fixation for Distal Radius Fractures: A Prospective Analytical Study (2025)

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Type of publication:

Journal article

Author(s):

Mohankumar, Mahesh; *Murugesan, Thivagar; Balamurugan, P; Venkadesh, A; Vishal, M; Muralikrishnan, R.

Citation:

Journal of Orthopaedic Case Reports. 15(12):421-429, 2025 Dec.

Abstract:

Introduction: Most frequent injuries of the Upper limb are a distal radius fracture (DRF). If they aren't handled well, they might cause problems for a long time. There are several techniques to treat this issue, but volar locking plate fixation has become increasingly prevalent since it may restore anatomical alignment, provide stable fixation, and allow for early movement. This study aimed to evaluate the functional and radiological results of distal end radius fractures treated with volar locking plate
fixation.

Materials and Methods: In this prospective analytical investigation, 60 patients with DRFs, ranging in age from 18 to 80 years, were enrolled. Patients were treated with open reduction and internal fixation using volar locking devices. Functional results are evaluated using the Gartland and Werley Demerit Point System and goniometry. Radial length, radial inclination, palmar tilt, and articular step-off were employed to quantify radiological outcomes. Follow-up evaluations were conducted at 2, 4, and 6 weeks, in addition to 6 months. We used the Statistical Package for the Social Sciences version 20 to analyze the data and discovered that P < 0.05 was significant.

Results: Patients exhibited substantial improvement in wrist function across all planes of motion, with plantar flexion rising from 31.6degree at 2 weeks to 67.8degree at 6 months, and dorsiflexion from 31.7degree to 66.4degree. Supination and pronation also became a lot better, becoming close to normal levels after 6 months. The radiographic restoration was good, with a mean radial length of 8.8 mm, an inclination of 17.6degree, and a palmar tilt of 8.9degree. There were very few complications (6.7% arthritis, 6.7% malunion).

Discussion: Our results support previous research showing volar plating offers robust fixation, restores anatomical alignment, and facilitates early mobility. Correlation study revealed that palmar tilt and articular congruity substantially impacted functional recovery, emphasizing the need of meticulous surgical reduction.

Conclusion: Volar locking plate fixation is an effective treatment for DRFs, characterized by low complication rates and excellent functional and radiological outcomes.

DOI: 10.13107/jocr.2025.v15.i12.6578

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Root causes of surgical never-events: a systematic review (2026)

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Type of publication:

Systematic Review

Author(s):

Parmar, Dilen; *Patel, Neil; Kenneth-Ogah, Catherine; Yazdouni, Sadat; Desai, Chaitya; Raveshia, Dimit; Patel, Ravi.

Citation:

Patient Safety in Surgery [Electronic Resource]. 2026 Jan 08.

Abstract:

Background
Never-events represent serious and preventable patient safety incidents within surgical practice, despite increasing national and international efforts to reduce them. Persistent concerns regarding wrong site surgery, retained surgical items, and incorrect implants highlight the need to understand contributory human factors and system-level weaknesses.

Methods
A systematic search of PubMed/Medline, Google Scholar, and the Cochrane Library was conducted. Evidence published between 2014 and 2024 was screened according to predefined eligibility criteria to identify contemporary data relating to surgical never-events. Studies were assessed using standardised selection methods and relevant findings were extracted and synthesised.

Results
Thirty-seven studies met inclusion criteria. Across international literature, recurring contributory factors included communication breakdowns, reduced situational awareness, fatigue, inadequate staffing, inconsistent team composition, and increasing surgical caseloads. Despite advances in safety practices, these factors continued to contribute to adverse surgical outcomes.

Conclusion
Never-events remain a persistent challenge in surgical care. Strengthening safety management systems, improving awareness of human factors, and prioritising non-technical skills training may help reduce the risk of these events. Ongoing evaluation of interventions and further UK-based research are required to support improvement in patient safety outcomes.

Data availability
All data generated or analysed in this study are derived from published articles and are included within this manuscript and its supplementary materials.

DOI: 10.1186/s13037-025-00474-8

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Streamlining administrative processes by analysing how delayed benign histology results letters were done for 2-Weeks- Wait (2WW) gynaecology oncology patients (2024)

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Type of publication:

Conference abstract

Author(s):

*Khanh Kieu X.M.; *Sahu B.; *Ghumaann M.K.

Citation:

BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BGCS ASM 2024. Liverpool United Kingdom. 131(Supplement 4) (pp 34), 2024. Date of Publication: 01 Oct 2024.

Abstract:

Aims: A quality improvement project to identify bottlenecks to the delayed result letters to patients on the 2WW pathway and evaluate the use of a template letter that can be beneficial to both staff and patients. Background(s): The aim of the 2-week- wait pathway is to expedite the diagnosis and treatment of potential cancer cases. From the patient's point of view, the 2WW pathway would not officially end until the final histology result reached the patient. Method(s): We conducted two retrospective audits before and after the implementation of the benign histology template in a span of one month. The date of the primary care referral is day 0. The date and time for the 2WW patients' histology final report can be obtained from SATH's medical electronic platform called Portal. We can then calculate how many days it will take for the result letter to be ready from day 0 of the initial referral. Result(s): Roughly 80% of these patients have benign histology results. Yet, the average time for a 2WW benign histology result letter to be issued is 51 days, counting from their initial 2WW referral. After implementation of template letter, the average waiting time for result has decreased to 37 days. Conclusion(s): The implementation proposal depends greatly on the Trust budget, and further consideration for speech recognition technology training will need a thorough discussion. A benign histology result template would be a cost-effective solution to reduce the unnecessary typing delay.

DOI: 10.1111/1471-0528.17941

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Triple line stapled jejunojejunal anastomosis does not completely prevent post-operative bowel obstruction following laparoscopic Rouxen- Y gastric bypass (2025)

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Type of publication:

Conference abstract

Author(s):

*Gungadin P.; *Bhandari M.; *Riera M.;

Citation:

Obesity Surgery. Conference: BOMSS 2024 Congress. Harrogate . 34(Supplement 1) (pp S26), 2024. Date of Publication: 01 Jun 2024.

Abstract:

Introduction: Small bowel obstruction following jejunojejunal anastomosis (JJ) during a gastric bypass is a recognised complication. Common causes include strictures, intussusception, internal herniae and bowel kinking, thus preventing passage of bowel contents into the common limb (CL). Bidirectional jejunal stapled anastomosis, or triple line anastomosis is meant to decrease the risk of obstruction. However, this risk may not completely be avoided. Case presentation: A patient with history of gastroesophageal reflux, after a sleeve gastrectomy, underwent a conversion to laparoscopic Roux-en-Y gastric bypass. The JJ anastomosis was successfully tested intraoperatively for leak and patency with methylene blue. The patient still developed post-operative bilious vomiting after 24 hours. Abdominal CT confirmed obstruction at the JJ anastomosis. Subsequent laparoscopy demonstrated collapsed CL and dilated both alimentary (AL) and biliopancreatic (BP) limbs. There was no stricture or narrowing. Upon straightening the limbs, bowel contents successfully emptied into the common limb. However, the common limb would appear kinked again when the anastomosis was released, thus causing obstruction. A further stapled anastomosis was performed between CL and BP which straightened the kinked CL. This solved the obstruction. The patient was discharged home three days later. Discussion(s): Small bowel obstruction secondary to kinking despite a triple stapler approach is uncommon. Unfortunately, anastomotic leak and patency test may not completely preclude this complication. Awareness and careful intraoperative inspection of the anastomosis may help to detect probable obstruction.

DOI: 10.1007/s11695-024-07287-1

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RESECT: A Randomised Controlled Trial of Audit and Feedback in Non-muscle-invasive Bladder Cancer Surgery (2025)

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Type of publication:

Randomised controlled trial

Author(s):

Gallagher K.; MacLennan S.; Bhatt N.; Clement K.; Zimmermann E.; Khadhouri S.; Kulkarni M.; Gaba MPhil F.; Anbarasan T.; Asif A.; Light A.; Ng A.; Chan V.W.-S.; Nathan A.; Cooper D.; Aucott L.; Sakthivel D.; Akand M.; Piazza P.; Marcq G.; O'Brien T.; Nielsen M.; Giudice F.D.; Simpson K.; Orecchia L.; Teixeira B.; Geisenhoff A.; Hill G.; Fukuokaya W.; Hidalgo B.G.; El-Hajj A.; Elgamal M.; Fanshawe J.; Wang B.; Lee T.; Manecksha R.; Rivas J.G.; Arda E.; Elhadi M.; Rossi S.; Teoh J.Y.-C.; Kasivisvanathan V.; Hussein I.; Longshaw A.; Kostakopoulos N.; Khadhouri S.A.S.; Kruczynska A.E.; Dimitropoulos K.K.D.; McPhee A.; Gilanliogullari K.P.; Natalie S.; Rutigliani L.; Shallcross O.R.; Dokubo I.I.; Lamb B.W.; Jimie J.H.; Hussein B.; O'Neill C.; Nelson A.R.; MacLeod A.; Arumainayagam N.; Maqboul F.; Agrawal S.; Burns H.; Bekarma H.J.; Mohammad S.; Misurati M.O.; Raslan M.Y.; Anwar A.; Gkikas C.; Alexander C.; Warren H.; Byrnes K.; Edison M.; Croghan S.; Oo E.; Beder D.; Thurtle D.R.; Janebdar H.; Reeves F.; Chua C.U.; Mcalindon J.; Hasan H.; Ng P.Y.; Mayor N.; Attar H.A.; Delacave H.S.T.; Atiyah A.; Atiyah Z.; Jelski J.E.R.; Peacock J.; Davenport K.; Shipstone D.; Malla R.A.; Krishna K.K.I.; Nizov A.; Somov P.; Ahmed Z.; McCann C.; Glackin A.J.; Asaad W.; Bain A.J.; Bordenave M.G.; Ray E.R.; Ghonaimy A.S.; Madaan S.; Fontaine C.L.L.; Daggamseh A.M.K.; Pascoe J.J.; Horn C.; Fuge O.; Laoye A.; Deytrikh A.; Thomas A.G.; Ravishankar K.; Clark M.C.; Panayi Z.; Shillito S.H.; Srirangam S.J.; Bradley C.; Lee X.W.J.W.J.; Mcilhenny C.; Leask J.; sarkar S.; chetwood A.S.A.; Paramore L.; Ali A.S.A.; Odey J.; Sheweita M.S.S.; Ekwueme K.C.; Yogeswaran C.; Mohamed Y.; Trimboli M.; Shafii M.; Duffy S.A.; Morton S.; Bandeira de Mello K.L.; Harris A.; Bruce A.; Fanshawe J.R.; Tan N.J.; Mensah E.; Walters U.; Lami M.; Omar M.A.; Kadhim H.; Gami M.N.; Hawizy A.A.M.H.; Devadoss B.J.; Breish M.; Pina I.; Cresswell J.; Simoes A.; Papadopolous G.G.; Thomas M.M.T.; Ahmed I.I.A.; Sekhon N.C.; Alleemudder A.; Okwuchi D.D.; Willmott S.V.; Majumdar P.; Coyle M.; Simson N.; Egbe A.; Nair A.; Nair M.A.N.; Kailavasan M.; Douglas-Moore J.L.; Elajnaf M.R.; Jackson B.L.; Hamami H.; Hemmant J.; Siraj M.; Craciun M.E.; Lyttle M.; Shendy M.S.; Abdalla A.; Mukherjee R.; Mihuna A.; Kantartzi A.; Atkins C.R.M.; Uddin J.; Motiwala F.; Fanshawe J.B.; Mxxxensah E.; Chan K.H.Y.; Vasdev N.N.V.; Hassan M.M.; Pushkaran A.K.; Salik M.; Barrass B.J.R.; Jones A.; Shakir J.; Waterhouse R.H.; Tan S.; Shah S.; Simpson R.G.; Mohee A.R.; Smith P.M.; Middela S.G.; Gunendran T.; Bhat T.; Mehmood S.M.; Masood S.; Karna S.; Ibiok I.A.; Ollandini G.; Yarwood A.; Hill G.T.; Kanda Swamy G.V.; Healy R.; Faek Halaseh S.A.; Lee S.-M.; Hughes C.M.; Ali O.H.; Boaz R.J.; Gabriel M.M.; Finch W.; Hammad O.O.; Heba S.T.; Yun J.W.; Pandian S.K.; Oliver R.L.; Almpanis S.S.A.; Boxall N.E.; Adamu-Biu F.I.; Pushpa-Rajah J.A.; Miakhil I.; Mera Z.; Sultana A.; Potter J.J.; Coombs L.; Laghari S.; Khan I.A.; Warner R.M.; Olaitan O.; Akman J.; Green W.J.F.; Dooldeniya M.D.; Turo R.K.; Kabia A.A.; Onowa V.E.; Anand C.V.; Tanasescu G.G.T.; Sells L.A.; Acyatan M.G.; Smith T.G.; Lokman U.U.L.; Ramachandra M.; Hodgson D.J.; *Sid Ahmed M.A.M.B.; *Moghe D.; *Ong K.K.; *Tasleem A.M.; Blick C.; Toia B.B.T.; Maduwe Gedara S.R.K.R.K.; Mohsin H.; Bleakley C.; McGrath M.J.; Ng M.G.; Parsons B.; Lindsay J.S.; Volanis D.; Wijayasuriya D.S.C.R.; Wilkinson J.; White A.; Cox A.; Calmuc A.; Fung C.; Taktak S.; Lazarowicz H.P.; Starmer B.; Chippagiri A.S.; Gallegos C.; Kerr E.; Penny N.M.; Green E.A.; Jones C.M.; Colvin H.V.; David R.; Davies M.; Qamar B.Q.; Humayun-Zakaria N.K.; Hussain A.; Dhanasekaran A.K.; Mangera A.F.; Pereca J.L.P.; Akinjise-Ferdinand O.; Rosario D.J.; *Dhother J.; *Mohamed G.; *Jenny Bo Y.N.; *Chin Chin Y.F.Y.F.; *Varma R.K.; *Elves A.; Elmansouri A.J.N.V.; Edris F.F.E.; Voss J.; Parfitt C.M.; Buckland G.R.E.; Antoniou V.; Sinha M.M.; Douglas J.; Campbell J.M.; Bondad J.; Khuoge S.; Gipson C.; Dawam D.; Lecoyte A.; Waley L.G.; Hawthorne R.; Ridgway A.; Warren K.S.; Maniarasu S.; Mistry R.; Stroman L.; Hassan M.; Ayres B.; Pinkney R.T.M.; El-Taji O.; McCabe J.; Oliyide A.E.; Chibuzo I.N.C.; Vaggers S.N.; Dyer J.E.; MacKenzie K.R.; Miller A.; Tait C.D.; Thorman H.E.; Ippoliti S.; Ilie P.C.; Babawale O.D.; Mitchell V.; O'Rourke S.; Ross A.; O'Halloran R.; Hayes J.; Gray S.B.; Day E.K.; Shirwac H.; jaibaji R.; Tang S.C.; Kennedy C.; Szabados B.; Baldini C.; Nowers J.; Sarmah P.P.B.; Williams K.G.; Tan L.J.; Boden A.K.; Simpkins S.J.; Clement K.D.; Khan R.S.S.; Ravindraanandan M.; Lango A.; Kitchen M.; Gommersall L.M.; Thomas M.; Al-Mitwalli A.; Featherstone J.M.; Catto J.; Chari N.; Nikolinakos P.; Ellis D.S.J.; Papadopoulos D.I.; Charitopoulos K.; Carey M.M.; Gordon E.M.; Lau D.H.W.H.; El-Koubani O.; Ayers J.R.S.; Hina S.; Gartner T.; James J.E.G.; Simpson K.R.S.; Mariappan P.; Ibrahim M.E.; Dallash M.H.; Jallad S.; Bencatova Z.; Karanjia R.N.; Whiting D.; Frymann R.J.; Farag S.S.F.; Whitburn J.A.S.; Miah S.; Khattab H.; Kondylis F.; Amin Alsayed Alkhawalka M.A.

Citation:

European Urology. (no pagination), 2025. Date of Publication: 2025.

Abstract:

Background and objective We aimed to determine whether audit, feedback, and education improves surgical performance after transurethral resection of bladder tumour surgery for non-muscle-invasive bladder cancer and as a secondary aim if it reduced recurrence rates. Methods This cluster randomised controlled trial compared audit and feedback plus peer comparison and education, with audit alone for four coprimary outcomes: (1) Single-instillation chemotherapy, (2) detrusor muscle sampling, (3) documentation of tumour features, and (4) resection completeness. Early recurrence was a secondary outcome. Key findings and limitations A total of 100 sites were randomised to intervention and 101 to control. In total, 14 915 patients were included. Intervention sites significantly improved documentation of tumour features (adjusted mean difference [95% confidence interval {CI}]: 6.0 [1.8, 10], p = 0.005) and of resection completeness (adjusted mean difference [95% CI]: 5.5 [1.5, 9.5], p = 0.007). There was no statistically significant difference in chemotherapy use (adjusted mean difference [95% CI]: 0.3 [-4.7, 5.3], p = 0.9) or detrusor muscle sampling (adjusted mean difference [95% CI]: 2.6 [-1.3, 6.4], p = 0.2). There was no statistically significant difference in early recurrence rate between arms (adjusted odds ratio [95% CI]: 1.02 [0.8, 1.4], p = 0.9); however, in the control arm, the early recurrence rate reduced compared with baseline (adjusted odds ratio [95% CI]: 0.7 [0.6, 0.9]). Conclusions and clinical implications Audit and feedback with education improved the documentation of important surgical findings that influence clinical management, but not the performance of detrusor muscle sampling, adjuvant chemotherapy use, or early recurrence rates. Improvements observed in the control arm may explain a lack of effect of the intervention in some outcomes.

DOI: 10.1016/j.eururo.2025.09.4174

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The Profound Impact of the COVID-19 Pandemic on the Epidemiology of Quadriceps and Patellar Tendon Ruptures: Insights From a Single Trust in the United Kingdom (2025)

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Type of publication:

Journal article

Author(s):

*Murugesan, Thivagar; *Abdullmalek, Hidayatul Rasyidah Syida; *Kondi, Suresh; *Rehman, Hamood Ur; *Carmont, Mike; *Heaver, Catriona; *Okoro, Tosan.

Citation:

Cureus. 17(11):e98022, 2025 Nov.

Abstract:

Introduction Quadriceps and patellar tendon ruptures are uncommon but disabling injuries that require surgical repair. Changes in physical activity patterns during and after the COVID-19 pandemic may have influenced their occurrence. This study compares the incidence, demographics, and seasonal distribution of these injuries before and after the pandemic within a single UK NHS trust. Methods A retrospective review was performed of all patients undergoing primary repair of quadriceps or patellar tendon ruptures at the Shrewsbury and Telford NHS Trust from January 2014 to December 2024. The pre-COVID period (2014-2019) was compared with the post-COVID period (2021-2024), with 2020 excluded due to major service disruption and atypical clinical pathways during the first pandemic year. Annual incidence rates were calculated as cases per 100,000 population, using year-specific catchment population estimates from the Office for National Statistics (ONS). Demographic variables, injury characteristics, and seasonal patterns were extracted from electronic records. Between-period comparisons used the Mann-Whitney U test. No adjustment for age, BMI, or comorbidities was performed. Results A total of 203 patients were identified, including 95 pre-COVID and 108 post-COVID. The median age was 63 years (range 15-90), with a male-to-female ratio of 7.8:1. Injuries occurred most frequently in autumn (28%). The median annual incidence increased from 4.6 per 100,000 pre-COVID to 8.3 per 100,000 post-COVID (incidence rate ratio 1.8, p = 0.0073). The median number of cases per year rose from 16 to 27 between periods. Conclusion The incidence of surgically treated quadriceps and patellar tendon ruptures increased in the post-COVID period. Although the study does not adjust for potential confounders, the findings suggest an association between the post-pandemic era and higher injury rates. Further research with multivariable analysis is needed to clarify contributing factors.

DOI: 10.7759/cureus.98022

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