Specialty Society Updates

Simon Barker and Dan Perry

Consensus is booming in children’s orthopaedic surgery! Consensus guidelines are now available on the BSCOS website for DDH, Clubfoot and MSK Infection. The success of the infection guideline has now resulted in the publication of a new BOAST. An adolescent ACL injury BOAST has also resulted from joint working with BASK. There is lots of consensus – and lots of ongoing friendly debate! As a group we now know where we agree (and where we don’t!) and have committed to try to overcome variation through consensus until high-quality evidence is available.

The generation of evidence continues to be a growing (and is now a massive) part of BSCOS. The BOSS study was published in the BJJ in April and involved almost every centre in Britain treating SCFE and Perthes’ disease children. BOSS formally demonstrated the variation that occurs and the potential for RCTs. This has now resulted in an NIHR RCT being funded for children with severe SCFE (called BigBOSS) and another (hopefully to be) funded amongst children with Perthes’ disease. Our ongoing portfolio of NIHR RCTs continues to grow with the first big NIHR trial (FORCE – torus

fractures) soon to publish. Others are recruiting well with the sunny playground weather! The others going - Medial Epicondyles (SCIENCE – 60% recruited), Distal Radius Fractures (CRAFFT – 52% recruited). The new studies to look out for include ODDsocks (SH2 fracture RCT) and PICBone (decision making in infection cohort). There are even more to come (though they remain top secret… be excited!).

The consensus is that children’s orthopaedics will soon be an awesome evidence rich zone – and we all agree that recruitment to studies is our team game!

The triannual Congress of the International Federation of Societies for Surgery of the Hand, hosted by the BSSH, takes place at the ExCel in London, 6th – 10th June, with over 3,000 delegates. In advance, 33 International Fellows are participating in Travelling Fellowships, showcasing hand surgery in the UK.

The BSSH has established a Student and Trainee Association for Surgery of the Hand (STASH), introducing new membership categories for student and foundation/core trainees. The launch takes place on 10th June at the ExCel. Book your place on the BSSH website www.bssh.ac.uk.

Together with the Federation of European Societies for Surgery of the Hand, BSSH has created a series of weekly webinars focussing on the complex and extraordinary hand trauma colleagues in Ukraine are facing. The first webinar attracted 300 attendees, with 104 from Ukraine.

Mentoring Our fledgling mentoring programme is running successfully with 14 paired mentors and mentees. Mentees are BSSH members between CCT and the end their fifth year of consultant practice. Early feedback is very positive.

The BSSH has committed £100,000 to launch a hand unit within the Lilongwe Institute of Orthopaedic and Neurosurgery in Malawi. The project plans to provide the continuous presence of a volunteer Hand Surgeon, Hand Therapist and Hand Trainee in Lilongwe for five years. Those involved will work with and train local surgeons, aspiring to a staged withdrawal of support after five years leaving a self-sufficient hand unit.

Best practice pathways for Carpal Tunnel Syndrome and Traumatic Amputations of the Digits, Hand and Wrist have been developed by BSSH and published on the GIRFT website. Further pathways will be released in 2022, including Dupuytren’s contracture, hand lacerations, trigger digits, ganglia and bites.

Vikas Khanduja, BHS President

After a hiatus of two years, we hosted a face-to-face meeting and had a record attendance of over 550 delegates in Bournemouth. The theme for the instructional course was the ‘Young Adult Hip’ which had excellent Faculty from the UK and abroad. The Charnley Lecture was given by Thorsten Gehrke from the Endo Klinik in Hamburg on their outstanding work with single stage revision for infection and the Presidential guest lecturer was Robert Townsend, a microbiologist from Sheffield. We had an amazing range of ‘Topic in Focus’ presentations on dual mobility bearings, training, digital pathways and the Non Arthroplasty Hip Registry.

After the excellent introduction of the Culture and Diversity Committee (C&D) last year, we had an inspirational and challenging session on C&D including a talk from Amy Grove about the issue of unconscious bias.

Thank you to all those who attended and we look forward to seeing you in Edinburgh next year. For those who were not able to attend, the content is available via our on demand access at www. britishhipsociety. com/annualmeeting-2022.

The portfolio of the society has expanded significantly as has the membership and we continue evolving to be a diverse, inclusive, and stronger society. The mantra for this year is to maintain and strengthen all the activities on our portfolio with continued responsible fiscal management. We wish to focus on curating and storing our rich history, harnessing the power of technology to support our trainees via virtual and augmented reality training, support our patients on the waiting list through scientifically robust prioritisation and help the BOA and RCS in their strategy for addressing the ever-growing waiting lists. We endeavour to broaden our membership, further develop our international reputation and collaborate with other hip societies globally.

I would like to congratulate the following who were elected to the Executive Committee: Satish Kutty, Education Committee Chair; Joanna Maggs, Culture and Diversity Committee Chair; Matt Wilson, Honorary Treasurer; Kate Gill, Honorary Secretary and Anil Gambhir, Vice President.

Finally, a note of appreciation and thanks to my predecessors Andy Hamer, Jonathan Howell and Steve Jones who have been inspirational leaders and whose tireless energy and vision have seen the society blossom. It is certainly an honour, pleasure, and a privilege to be serving as President of the BHS in such an exciting phase.

Enis Guryel and Hemant Sharma

On 24th and 25th March 2022 we held our annual conference in Brighton and tickets sold out within a few weeks. The theme of the meeting was limb reconstruction in a major trauma centre and started with a fascinating paediatric session looking at using modern 3D planning software to correct upper limb post traumatic deformities and novel implants to correct rotational deformities with guided growth.

The talks are available to view on demand if you would like to see the thoughtprovoking discussions regarding the management of open pilon fractures. The keynote presentations discussed modern trauma solutions and insights into limb reconstruction. Leaders from BLRS, BOA, BAPRAS, BOFAS, BGS and OTS discussed the management of open elderly ankle fractures as well as funding problems facing MTCs as complex cases become regionalised.

The hugely entertaining and interactive session on managing open fractures with bone loss involved delegates planning and describing their management.

The ability of MTCs to manage these complex injuries with plastic surgeons formed the discussion of their soft tissues management, timing of surgery and how to manage the first stage of open fractures.

Our allied professionals enjoyed sessions on trauma psychology, nutrition, wound healing, pain control, rehabilitation together with managing flaps and amputation. The registrars also had a separate educational session with industry together with over 50 free paper presentations.

The principles of limb reconstruction haven’t changed but the collaboration with plastic surgeons and the regionalisation of complex trauma evoked the theme of this meeting and provided an alternative insight into limb reconstruction.

BLRS, which was founded in 1997, is a diverse organisation with wide representation incorporating allied health professionals (AHP) as full members. BLRS provides travel bursaries to Consultants, Trainees and AHP’s.

Please join us in Belfast March 23rd-24th March 2023 for our next annual meeting.

Ashley Cole, BSS President

The British Scoliosis Society, founded in 1976, represents surgeons, healthcare workers and researchers to ensure the highest possible standards of management for individuals with spinal deformities; patientand professional education; and research into the origin, natural history and management of spinal deformities.

In June this year, the BSS is supporting the Zorab Symposium in London which is very much a research orientated spinal deformity meeting attracting an international audience. The last face-to-face BSS meeting was in Cardiff in November 2019 and we are looking forward to meeting up again in Edinburgh in November this year. In 2015, we realised that whilst all the surgeons are away at an annual BSS meeting, other members of the team have less clinical work to do with no clinics or theatres running. So in addition to the educational day for the trainees, we started meetings for our AHPs, those doing spinal cord monitoring (Neuromonitoring UK), the paediatric spinal anaesthetists (National Paediatric Spinal Anaesthetists Network) and this year, a meeting for Spinal Orthotists (a new addition). They each hold their own separate meetings in the same venue as the main BSS event and joint sessions relevant to the different groups are planned. This has created a more diverse and inclusive Society and the exchange of ideas must enhance patient care.

As is the case for several Societies, we are currently changing the structure of the BSS to a Charitable Incorporated Organisation which will allow us to continue our objectives. We are producing a few ‘Standards of Care’ documents to ensure that patients with spinal deformity get the same high-quality care across the UK. The BSS has committed to support a candidate for the BOA Future Leaders Programme this year and will soon be advertising for a new Research Fellowship combined with ORUK and BASS. There seems to be a new enthusiasm for research in the BSS and the Research Committee led by Professor Adrian Gardner will take advantage of this and advance the UK input into spinal deformity research.