Most patients undergoing total knee arthroplasty (TKA) in Ireland are referred to orthopaedic services by their general practitioners (GPs). We aimed to evaluate Irish GPs’ expectations for their patients’ perioperative experience and post-operative return to function. A questionnaire was mailed to 350 GPs in all provinces. This included questions relating to GPs’ expectations for their patients and their knowledge and sources of information on TKA. 111 completed questionnaires were returned (response rate 31.7%). Overall expectations for functional and psychological outcomes were high, especially regarding pain relief (108 (97.3%)) expected relief from most or all pre-operative pain), mobility (108 (97.3%)) expected patients to walk medium or long distances) and psychological wellbeing (95 (85.5%) considered this somewhat or very important). Only 22 (20.2%) reported receiving any relevant information or training within the previous year. Overall expectations for functional outcomes were high, however greater communication between surgeons and GPs may improve GP information. To receive CPD credits, you must complete the questions online at www.imj.ie. CPD available online at www.imj.ie and questions on page 255. 101703_IMJ_SEPTEMBER_2015.indd 229 11/09/2015 14:41

Introduction: Perinatal mortality and morbidity rates are higher in twins than in singletons. Monochorionic twins have a high risk of low birth weight, preterm delivery and neurologic morbidity. TTTS occurs as a serious complication in 10 to 15% of monochorionic diamniotic (MCDA) pregnancies. The assessment of term corrected MRI brain has not been investigated to the best of our knowledge in this specific area to date. Objective: The aim of this study was to evaluate term corrected MRI brain as a surrogate short-term marker for neonatal outcome of twins with TTTS. Study Design: We conducted a prospective trial in the Rotunda hospital which had ethical approval. We obtained informed consent from parents of infants in 3 groups: 1:Twin pregnancies that underwent intrauterine laser. 2: MCDA twins who did not meet the clinical criteria for TTTS. 3: Dichorionic diamniotic (DCDA) twins. The MRIs took place at term using a Siemens 1.5 Tesla MRI scanner. T1, T2, ADC and diffusion images were acquired. Results:10 sets of twins and 1 set of triplets have consented. (n=23). 7 sets have reached term and have had an MRI (n=14). In our cohort gestation ranged from 25 weeks to 34 weeks. To date 2 MRIs have been reported as abnormal. 1 sibling in the laser group and 1 sibling in the DCDA group. Conclusion: This group of infants and their MRI findings represent a spectrum of findings in multiple births. Follow up at 2 years with Bayleys is planned and will ascertain any long-term correlation.