From the Executive Editor

Simon Hodkinson

A warm welcome to this first edition of the JTO in 2023. It has been unseasonably warm, but all is not well in the NHS with previously unheard of strikes from our nursing colleagues and at the time of writing, our junior medical colleagues voting overwhelmingly for industrial action – very challenging times lie ahead!

I am sure you are all aware of the sad loss of Dame Clare Marx in November last year. Much has been written about her in the orthopaedic and national literature, however we wanted to include in this edition a piece in celebration of her life (page 20), a life well-lived to say the least. We hope we have done justice to a remarkable human being.

This edition covers a number of topical issues that many of us are currently facing. Andrew Manktelow’s update (page 24) for those of us engaging in private practice is timely. PHIN has had a difficult gestation, but it is gathering pace and he reminds us that the CMRs ruling are a matter of law and cannot be ignored.

He appears again in this edition in conjunction with Bertie Leigh, BOA Council lay member and senior solicitor, to discuss the medico-legal implications of the pandemic and the current waiting lists (page 46). A sobering article to say the least.

Trainees from the Wessex rotation, lead by Adam Stoneham, present their experience in running a novel course in peer-to-peer learning from one’s mistakes (page 28). We all make them, but do we learn from them in a supportive environment? Frequently not, it would seem.

Jonathan Howell and Mary Stocker discuss the development of the Exeter short stay arthroplasty unit (page 32). Whilst we may not all have the luxury of the real estate required, the article presents their experience of setting up such a unit and the considerable success they have had in ‘day case’ arthroplasty, and the advances in patient care as a result.

Further on, Paul Roberts discusses his considerable experience in developing and bringing to market new implants (page 38) and Bev Fitzsimons invites us to get off the production line, (page 42). A thought provoking article that reminds us that whilst an element of standardisation can help our practice and our patients, surgery is not a production line!

Last but by no means least, is this month’s speciality series of articles, this month covering spinal surgery. Introduced by Niall Eames discussing the evolution of spinal surgery in the UK (page 49), and followed by articles covering topics we can all be exposed to on call –those of cauda equina syndrome (page 50), spinal infection (page 54) and thoracolumbar fracture stability and its classification (page 58).

I hope you enjoy reading this March edition of the JTO.