The Royal Society of Medicine's Orthopaedic Section Podcast

Mr. Jamie Nicholson (Edinburgh, UK) provides us with the latest evidence in the management of clavicle fractures. This is a very detailed discussion that covers all of the key papers and decision making algorithms employed in their unit.  

Mr. Michael Pearse (Imperial College, London & President-Elect of the RSM Orthopaedic Section) is no stranger to managing patients with significant bone loss and open fractures. He established one of the first orthoplastic centres in the 1990s and has a breadth of experience in improving patient outcomes. This podcast episode will given the listener a detailed insight into how to approach these injuries.

Professor Robert O'Toole from the SHOCK trauma centre in Baltimore joins us to discuss the results of the FIXIT Study. This was a Prospective Randomized Trial to Assess Fixation Strategies for Severe Open Tibia Fractures: Modern Ring External Fixators Versus Internal Fixation. We also discuss his experience in managing open fractures in the tibia. 

Mr. Fergal Monsell (Bristol, UK) takes us through how to manage open fractures in kids. He also discusses the paediatric trauma network and what he thinks will be the next big thing to improve outcomes for patients. 

Fergal Monsell has been a Consultant Paediatric Orthopaedic surgeon at the Royal Hospital for Children Bristol since 2005.

He has a broad-based practice with a special interest in the management of patients with congenital limb abnormally and deformity following trauma and septicaemia. He is active in all aspects of paediatric trauma.

He is involved in education at all levels, is Visiting Professor at Cardiff University, Director of the Avon Centre for Musculoskeletal Education and Projector at the Grand Academy. He has an active clinical and basic science research portfolio and is widely published.

Mr. James Hunter (Nottingham, UK) discusses the FORCE, CRAFFT and SCIENCE studies. What are these trials? What should we know about them? And should these change our practice? We also discuss his role as the GIRFT (Get-It-Right-First-Time) paediatric orthopaedic lead for England. 

We speak with Ms Anna Clarke and Mr. Martin Gargan (Bristol, UK) who highlight several important tips, tricks and traps in managing paediatric patients with upper limb and lower limb injuries. This high yield episode is a must listen for any orthopaedic surgeon involved in treating children. 

In episode 12, we speak with Mr. Abtin Alvand (Oxford) who is an expert in treating patients with prosthetic joint infections (PJI). He delivers a powerful and comprehensive review of everything from identifying PJI to the management options. He also speaks about what the future holds in what some consider to be the 'next frontier' in arthroplasty surgery. 

We cover the following questions:

1.  What are the main methods for prevention of peri-prosthetic joint infections?

2.  Have we solved the problem of diagnosing infection?

3.  Should revision arthroplasty be a one or two stage procedure?

4.  What is the role of plastic surgery in revision knee arthroplasty?

5.  What advances do you see in the field of prosthetic joint infections?

Mr Abtin Alvand is a Consultant Orthopaedic Knee Surgeon in Oxford who undertook specialist clinical fellowships in complex hip and knee surgery in Oxford and Stanmore before completing a Fellowship focusing on peri-prosthetic joint infection at the Rothman Institute (Philadelphia, USA) with Professor J Parvizi. Abtin has an unrivalled experience in the management of peri-prosthtic joint and he is a member of the International Consensus Group for the management of peri-prosthetic joint infection and he also sits on the UK Revision Knee Surgery and Peri-prosthetic Joint Infection Working Groups. Abtin also has an interest in simulation-based training methods for teaching and assessing surgical skills.

We discuss revision knee surgery with Mr. Peter James (Nottingham).

Peter James is a consultant surgeon in Nottingham who undertakes a large number of hip and knee replacement operations each year both in the NHS and privately at the Park Hospital and has developed a national and international reputation for revision and complex knee replacement. He has particular expertise and experience in high performance knee replacements for active patients and difficult revision knee surgery. In September 2010 he was recognised by his peers as being amongst the UK’s top knee replacement surgeons in a survey conducted by the Daily Mail.

Questions that we cover include:

1.  Is some pain almost inevitable after TKR and how do you assess the painful TKR?

2.  Should revision TKRs be done at specialist centers and what have we learnt from the NJR?

3.  What are the key surgical steps in revision TKR and is there a role for robotics?

4.  Do you think robotic assisted surgery will reduce revision TKRs?

5.  What advances do you anticipate in the field of revision TKRs?

In this episode we cover knee osteotomy surgery and joint preservation with Mr. Matthew Dawson. 

Matthew Dawson is one of the leading authorities on osteotomy surgery in the UK and he is a founder member of the Osteotomy Expert Group. Mr Dawson is a strong advocate of the principle of joint preservation in order to prolong knee activity and knee function to the highest level. He launched the annual Northern Osteotomy Masterclass. in June 2015 and he is a founder member of UKKOR, the world’s first national osteotomy registry. He is the current chair of ESSKA’s Osteotomy committee.

Questions that we cover include:

1.  Is there an age or functional cut off for knee osteotomy and what pre-operative tests are essential?

2.  Is osteotomy ever a temporary solution?

3.  What are the recent technical advances in osteotomy surgery?

4.  What are the key intraoperative steps?

5.  How do you rehabilitate your patients?

Mr Dinesh Nathwani (Imperial College) discusses robotic technology in total knee replacement. 

Mr Dinesh Nathwani is a consultant orthopaedic surgeon at Imperial Healthcare Trust with extensive experience in computer assisted knee surgery in partial and total knee replacement, using both the NAVIO and the MAKO systems. Dinesh is the president elect of the computer assisted orthopaedic surgery uk society (https://www.caosuk.org) and he is a firm believer in the use of computer assisted navigation to increase the accuracy of bony resection and decreasing the chance of implant malposition, thereby maximising the likelihood of a successful outcome in knee replacement surgery.