News and specialist society updates

World Orthopaedic Concern (WOC) update

Alberto Gregori, WOC Chairperson

It was a great pleasure having the 2022 Annual WOCUK Meeting take place in person. After two years of virtual meetings, returning to a physical environment reminded us that organisations such as WOCUK thrive on human contact. How enjoyable meeting up with colleagues, friends and greeting new members of WOCUK face to face!

The Annual Meeting was ably hosted and organised by outgoing Chair Deepa Bose and was well attended with many new faces.

The programme demonstrated how far WOCUK has come in recent years. Lightning updates on WOCs diaspora of projects such as those in multiple sites in Ethiopia, Malawi, Guyana and Zambia demonstrated our focus on collaboration and education. Updates on other sites including Sierra Leone and Ukraine were also given. The desire for WOCUK to develop itself as the humanitarian arm of the BOA was highlighted to our

Guest Speaker, Deborah Eastwood. Presentations on research in Malawi, practical preparations for deployment, Global Health and the background on recent Ethiopian developments were given by trainees.

The need for more evidence based delivery of humanitarian care was highlighted by our guest speakers. This included Ashtin Doorgakant’s FLP project report on virtual follow up in LMIC environments (also featured on page 48) as well as the excellent presentation by Kiran Agarwal-Harding of Harvard’s Global Health Collaborative looking at Health Inequality in resource poor settings. A recurring theme underlying all the presentations, but particularly well brought into sharp relief by Amer Shoaib’s thoughtful heartfelt exposition, was of the ethical background as to what WOC does and how it impacts both the recipient and the volunteer. At the AGM it was also confirmed that Ashtin Doorgakant was elected unopposed, to be Vice Chair of WOCUK.

I left the meeting enthused and confident that WOCUK has a bright future ahead, in no small part because of the involvement of so many enthusiastic young trainees and consultants. •

British Orthopaedic Oncology Society (BOOS) update

Tom Cosker, BOOS Honorary Secretary

The focus of this year’s work by the British Orthopaedic Oncology Society has been wider education of the orthopaedic community with a particular focus on the treatment of metastatic disease. We have delivered several educational seminars with this theme in mind, most notably at the 2021 BOA Congress in Aberdeen but also at regional meetings (for example in Bristol and Leicester) and have recently published a BOAST in the Treatment of Metastatic Disease (www.boa.ac.uk/ metastatic-bone-disease-BOAST).

The metastatic seminar at BOA was led by representatives of each of the five English primary bone cancer centres, from Professor Rob Ashford in his capacity as President of BOOS and by the local metastatic leads in Aberdeen itself. It was a hugely successful and oversubscribed session and we had some superb comments about how educationally useful it had been. The key points of discussion were that patients presenting with suspected MBD should be managed along a defined pathway from presentation to rehabilitation. Low energy fractures in the non-osteoporotic population, antecedent pain, night pain, absence of injury, and insidious pain are suspicious for underlying malignancy. We encouraged surgeons and trainees to ensure that each unit should have an agreed policy for the multidisciplinary discussion and management of MBD including clear pathways for onward referral. Further, all specialist centres should have agreed pathways to enable prompt opinion, advice, and transfers within their network. We were clear that all of the primary bone tumour centres are willing and able to provide advice on a 24/7 basis for the treatment of these often challenging patients. This is particularly the case in those with solitary metastatic disease where new chemotherapeutic agents mean that survival has been dramatically extended. We will continue the work in this area and are already presenting for the 2022 BOA Annual Congress in Birmingham.

The Society as a whole moves from strength to strength and our educational offering has further been strengthened by the completion of the first British Orthopaedic Oncology Society Diploma in Orthopaedic Oncology which has been undertaken by over 40 delegates over a one year period and has recently been accredited by the Royal College of Surgeons of England. •

Combined Services Orthopaedic Society (CSOS) update

Simon Hodkinson, CSOS President

This year the CSOS held its Annual Meeting met in the serene setting of the China Fleet Club in Saltash, Cornwall.

The peaceful setting was in contrast to the memory of the short but brutal conflict to retake the Falkland Islands 40 years ago this year. Those of us of a certain age will never forget the images of the casualties from the Sir Galahad arriving at the field hospital in Ajax Bay, subsequently becoming better known as the ‘Red and Green Life Machine’.

The Combined Services Orthopaedic Society was setup 48 years ago, and as a forum for military T&O surgery it has gone from strength to strength. This has been particularly true in the last ten years or so with the astonishing advances in the understanding and management of battle injuries, much of which has translated into civilian practice.

This year our guests were Prof John Skinner, current BOA President, and Brigadier Duncan Wilson, Head of Research and Clinical Innovation. In their presence, we had an excellent series of presentations in basic science, military surgery and general orthopaedics.

The Fulford Prize for the best overall paper was won by Maj Louise Robiati for her work with Professor Hamish Simpson on ‘A new animal model for infected fracture non-union after external fixation of the tibia with real-time in-vivo monitoring of infection’.

The Templeton Memorial Prize for the best trainee presentation went to Maj Neil Eisenstein on his work entitled ‘Interconnectivity explains high canalicular network robustness between neighbouring osteocyte lacunae in human bone’.

Finally, the Best of the Best section was awarded to Maj Charles Handford’s paper on the ‘Cost effectiveness following osseointegration for trans-femoral amputation and the relationship between the pre and post operative EQ5D health utility value’.

Next year’s meeting will be held on the 31st of March 2023, at Keble College, University of Oxford. The 2024 meeting will mark the 50th anniversary of CSOS Society. Previous members who have lost touch with the Society, or individuals who believe they may be eligible for membership and would like to join us to mark this occasion are invited to contact secretary@csos.org.uk.

British Elbow and Shoulder Society (BESS) update

Jonathan Rees, BESS President

BESS 2022 Annual Scientific Meeting and Instructional Course

BESS was very excited to be back face-to-face this year for our first in person meeting since 2019. Despite the rail strike, we all manged to travel to the ACC in Liverpool with over 600 delegates joining us across four days.

The week started with our Instructional Course (IC) on 21st June, focused on shoulder and elbow trauma. We were delighted that our international faculty guests Samuel Antuña (Spain) and Ram Chidambaram (India) made themselves available for the IC and were able to share their experiences with us. The day was split into lectures, mini symposiums, and case-based discussions and ending with a final faculty debate. The course was very well received and like the annual scientific meeting, we have made the virtual content available to purchase via our website for those that were unable to attend.

The Annual Scientific Meeting followed the IC and ran from 22nd – 24th June. Our AHP Symposium and Research Symposium opened the meeting, running in parallel, with the Research Symposium featuring

its own mini free paper session on meta-analysis and systematic reviews. Responding to feedback from our members, this year we integrated more masterclass sessions into the main programme across two sessions on two days. Our ever-popular Hot Topics session featured some of the latest news and updates from BESS including the many national trials BESS members are now running and supporting. This year a highly informative President’s Guest Lecture on NJR outlier analysis was delivered by Peter Howard, while Ram Chidambaram delivered the Local Organisers Lecture. We were also grateful to Samuel Antuña for providing a third guest lecture focusing on the Elbow.

We ended the week awarding several BESS funded fellowships and, of course, our prizes for the best papers.

Despite the packed programme we were also pleased to host a conference dinner for all, at the inspiring Liverpool Cathedral.

On behalf of BESS, I would like to thank our colleagues in the Northwest for helping organise and host this most enjoyable and successful conference. We now look forward to BESS 2023 in Newport, Wales. For more information, please see www.bess.ac.uk. •

British Indian Orthopaedic Society (BIOS) update

Amit Tolat, BIOS President

The Society completed a trainee Webinar Series earlier this year and which was very well attended and received numerous visits to our BIOS YouTube channel (www.youtube.com/c/ britishindianorthopaedicsocietybios).

The Society held its first face-toface Annual Meeting since the COVID pandemic, in Mansfield which was organised locally by Vikram Desai and the Mansfield Hospital Orthopaedic team. The meeting was oversubscribed and registrations had to be closed two weeks prior to the meeting. It was a huge success with invited international speakers of repute and more than 50 scientific papers. The chief guest was Rebecca Adlington a local sporting hero, after winning Olympic Gold in swimming at the Beijing Games. There was an outpouring of support from industry, which was very gratifying.

BIOS has started a number of new fellowships which are fully funded, for all categories of surgeons – trainees (BOTA), junior and senior travelling fellows and industry supported (Medacta) fellows (two per year). We simultaneously have hosted two fellows from Rajasthan state at Wrightington Hospital, which they thoroughly enjoyed and learned a lot about the UK system.

BIOS will be participating at the BOA Annual Congress this September with a revalidation session on Trauma and will also be proudly hosting the Indian Summer – a triennial event to showcase the best of talent from India in the world of orthopaedic and trauma surgery. •

Joint Action Update - 2022 TCS London Marathon

On Sunday 2nd October, ten amazing runners will be taking part in the TCS London Marathon to raise money for Joint Action appeal of the British Orthopaedic Association. They are aiming to raise over £13,000 to support vital research into Trauma and Orthopaedics, transforming lives and giving people back their freedom and independence.

We’d like to wish the best of luck to our team of runners: Imran Ahmed, Jen Barwell, Alex Chipperfield, Tim Davies, Jake Ellis, Rob Gregory, William Paton, Richard Secular, Ben Skinner and Amol Tambe. A special mention to Ben Skinner, who is planning to run the distance carrying a 6-foot-high model of the Tree of Andry: a symbol for orthopaedics used around the world.

Please support our runners and help raise much needed funds for the Joint action by going to our London marathon page at: www.boa.ac.uk/london-marathon and selecting either of the donation links.

British Orthopaedic Trainees Association (BOTA) update

Oliver Adebayo, BOTA President

It’s been an exceptional busy 12 months for the British Orthopaedic Trainees Association. Amongst many things, one of the hangover effects of the COVID-19 pandemic has been disruption of our usual terms of office and Congress date.

Our first job following our delayed virtual Congress and AGM in July 2021 was organising the BOTA sessions at BOA Congress 2021 at short notice. Our morning session had an update on the GOAST study followed by our keynote lecture, ‘Thrive, Not Just Survive’ by Dr Uttam Shrilkar, an expert in cognitive learning for surgery. In the second session, our customary TPD question time was well attended with key questions about the new curriculum answered by our hilarious ‘ISCP the Great’ skit with anything outstanding expertly dealt with by our select SAC and TPD panel.

At the RCS Future Surgery Show 2021 in November, we ran a lecture series and panel discussion session in association with BBraun on Training in Navigated Arthroplasty. Led by Professor Picard, one of the pioneers of computer assisted arthroplasty surgery, it was a great look at the benefits of using navigation technology not only to provide great care but also help teach arthroplasty fundamentals.

Hard at work throughout 2021, our Culture and Diversity working group delivered by recruiting the BOA/BOTA Culture and Diversity champions in early 2022. To kick start the initiative, we held our

first Culture and Diversity Champions Day sponsored by Depuy Synthes in April 2022 at the RCS England. It was an excellent day filled with invaluable information on dealing with difficult situations, signposting and change mentality. Watch this space for the fantastic work from this group of motivated T&O surgeons, keen to push change within the speciality.

In June 2022, our Sustainability working group organised the first ever Sustainability in Orthopaedic Surgery Conference. A completely virtual offering with over 150 delegates from around the world tuning in via the MedAll platform we heard from leading voices about some of the key issues around sustainable orthopaedic surgery and how we can move forward as a speciality. The first of its kind from any speciality group, we hope that it will become a staple in the orthopaedic calendar over the next few years as the NHS moves to net zero carbon emissions.

To continue our theme of training in navigated arthroplasty this year, we organised the first trainee focussed Robotic Knee Arthroplasty course in association with Smith and Nephew. A fantastic two days with both saw bones and cadavers, it was a truly ground breaking session allowing 24 delegates unparalleled training in some of the newest technology available right now. We believe that training in computer assisted surgery needs to be a mandatory part of the T&O curriculum, as this technology will become a necessity within many spheres of orthopaedics.

At BOA Congress this year in Birmingham, our first session on ‘Improving Trainee Confidence’ will deal with some of the issues around training post pandemic and include our annual TPD question time. While our second session, ‘Innovation in Training and Research’ looks at the advances and opportunities trainees, trainers and researchers have at their disposal right now to push the boundaries of T&O.

Finally, the BOTA Congress 2022 will take place this year November 22nd – 25th at the Liverpool Hilton. It will be our first face-to-face conference in three years and it promises to be an epic one. With five preconference courses (two of which are virtual), space for over 350 delegates, workshops and content from AO, BESS, BASK, OTS as well as many of our industry partners and sponsors, it promises to be our biggest one yet. Most importantly, offered to trainees at the lowest possible price, FREE*. So there’s no excuse not to book your study leave if you are an orthopaedic junior of all levels, and we welcome input from all consultants and senior orthopaedic surgeons alike.

Visit our website at www.bota.org.uk and feel free to get in contact with me at president@bota.org.uk.

*Free – £50 deposit refunded minus booking fee on confirmation of attendance.