40th Annual Percivall Pott Scientific Meeting

The 40th Annual Percivall Pott Scientific Meeting and Dinner 9th November 2012

Many thanks to our sponsors Lunchtime quiz at stands in the Great Hall Quiz prize giving after lunch

40th Annual Percivall Pott Scientific Meeting

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INVITED SPEAKERS Ms Natasha CurryNatasha Curry is a Senior Fellow in Health Policy at the Nuffield Trust. Her interests include clinical commissioning, integrated care, NHS reform and governance and accountability. She joined the the Nuffield Trust in July 2011 from The Kings Fund, where she was a fellow in health policy. During her six years at the The Kings Fund, Natasha published widely on a number of subjects, including practice based commissioning, the management of long term conditions and approaches to clinical and service integration. Prior to joining The Kings Fund, Natasha worked as a consultant in health at Matrix Research and Consultancy Ltd. Previously, Natasha worked as the evaluations officer at the Chinese National Healthy Living Centre, prior to this she lived in China.

Mr John AlbertMr Albert qualified from St. Bartholomews Hospital Medical College, University of London in 1974, and obtained his FRCS in 1980. He was appointed to the Percivall Pott rotation and trained at Princess Alexandra Hospital Harlow, St. Barts, Norfolk & Norwich Hospital (now NNUH), Royal National Orthopaedic Hospital and Great Ormond Street Hospital. He then undertook fellowships at The Toronto Western Hospital, Canada and Basel AO Fellowship, Switzerland. In 1987 he was appointed as Consultant at the Norfolk & Norwich Hospital, one of the countries largest and busiest units, where he has worked until the present day. He was chairman of the Orthopaedic department from 1998 to 1999 and Clinical Director of Trauma and Orthopaedic and Rheumatology Directorate until 2004. His areas of special interest include arthroscopy, post trauma limb reconstruction and frames, ankle arthroplasty, hind foot surgery and calcaneal fractures. He has also been heavily involved in developing a number of Orthopaedic implants including the IMHS. Throughout his career he has been heavily involved in training and education, with this he has spoken at many conferences and held many senior posts in Orthopaedic educational bodies. Member Education Committee, British Orthopaedic Association (1993 - 1996) - Court of Examiners, Intercollegiate Board in Orthopaedic Surgery (1996 present) - Elected member of Council, British Orthopaedic Association (2001 - 2003) - British Orthopaedic Association representative UEMS - European Union of Medical Specialists (2003 present) - Member, Specialist Advisory Committee, Trauma and Orthopaedics (2003 2007) - Royal College of Surgeons of England representative, Intercollegiate Board in Trauma and Orthopaedics, 2004 2008; Honorary Secretary (2005 2008) - President, UEMS board of Orthopaedics and Trauma (2009 - ) - Chairman, Intercollegiate Specialty Board in Trauma and Orthopaedics (2009 2011) He has also represented Great Britain in C1 kayaking at the Munich Olympics on the Augsburg slalom course.

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Dr Javad ParviziDr Parvizi qualified from the University of Sheffield School of Medicine in 1991 and obtained an MSc in Molecular Biology from the Mayo Foundation. After graduation he began his training in Cardiothoracic Surgery in the North of England and obtained his FRCS before leaving to train in orthopaedics at the Mayo Clinic, Rochester, New York. After this he returned to Europe to complete a fellowship at the University of Berne in Switzerland. He now works at the Rothman Institute and Thomas Jefferson University Hospital in Philadelphia where he holds a number of prestigious positions including Vice Chairman and Director of Research and is a Professor in the Department of Orthopaedic Surgeons at Jefferson Medical College. He is a member of the American Hip Society, AAOS, BOA, BORS, American Association of Hip and Knee Surgeons, American Board of Orthopaedic Surgeons, Orthopaedic Research Society, Interuban Orthopaedic Society, Eastern Orthopaedic Society, Mid-American Orthopaedic Association, AMA, Musculoskeletal Infection Society and AO foundation. He is actively involved in basic science research particularly related to Smart SelfProtective Implants that resist infection.

Dr Paul BeaulDr. Paul E. Beaul received his MD degree from University of Ottawa in 1992 and specialist certification in Orthopaedic Surgery in 1998 from the Royal College of Physicians and Surgeons of Canada. He pursued two years of Fellowship in Los Angeles one in Joint Replacement Surgery of the Hip and Knee and subsequent one in Hip and Pelvic Reconstruction. He became Fellow of the American Board of Orthopaedic Surgery in 2002. From 2000-2005, he was an Assistant Clinical Professor within the Department of Surgery of UCLA School of Medicine in Los Angeles, California. In 2005, he returned to The University of Ottawa as Head of the Adult Reconstruction Service for the Division of Orthopaedic Surgery at The Ottawa Hospital. He is currently Professor of Surgery in the Department of Surgery with cross-appointments in the Department of Pathology & Laboratory Medicine as well as School of Human Kinetics, Faculty of Health Sciences. His clinical interests are on hip disease especially in the treatment of pre-arthritic hip condition as well as minimally invasive surgery of the hip. Since 2001 he has been the Chairman of the International Symposium entitled Joint Preserving Minimally Invasive Hip Surgery. He has authored over 100 scientific publications/book chapters and have delegated as primary or co-supervisor of over 200 scientific presentations and over 110 Invited lecture presentations. In 2006 and 2008, he received the Prestigious Hip Society Award on Basic and Clinical Science Research Involving Joint Replacement Surgery of the Hip. He is a member of both The North American Hip Society and International Hip Society. He serves on The Editorial Board of The British Journal of Bone and Joint Surgery.

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PERCIVALL POTT TRAINEES PAST AND PRESENTThere has always been some debate about who should be regarded as the first trainee. This comes about because when the rotation began the existing holders of the posts that were being incorporated had to be included. In order to provide a vacancy at Norwich for a trainee Chang Chen was incorporated into the rotation because he was already working at Norwich. Bernard Meggitt likewise was also in Norwich in 1969. Similarly, in order to incorporate the RNOH we had to incorporate into the rotation somebody working at the RNOH, and that was David Dandy. Howard Smith was occupying one of the Barts Registrar posts and so he was easily incorporated although was re-interviewed to comply with the regulations by a Senior Registrar Appointments Committee when he was formally upgraded.1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 Chang Chen David Johns Bernard Meggitt Howard Smith Michael Hannon Paul Moynagh Carey Shaw David Dandy Hugh Phillips Lance Therkildsen John Talbot David Jones Jonathan Wilkinson Keith Tucker Louis Deliss Stephen Copeland Andrew Gibbs John Browett John Getty Mark Rowntree David Craig Nick Packer Nick Fiddian Jeremy Fairbank Gerry Kavanagh Ken Ross John Albert David Grace Adrian August Chris Bradish John Powell Charles Aldam Andrew Cobb Nick Goddard Charlie Blakeway Paul Allen Rob Hill Barry Irvine Howard Ware 40 Simon Donell 41 Danny Mok 42 James Maclean 43 Guy Broome 44 Paul Sherry 45 John Nolan 46 David Archibald 47 Peter Chapman 48 Brian Bradnock 49 Alison Hulme 50 Adrian Day 51 Steve Godsiff 52 Tony Gibbon 53 Anil Chakrabarti 54 Patrick Li 55 David Calder 56 Ian McNab 57 Paul Davies 58 Simon Smith 59 Stuart Tucker 60 Nirmal Tejwani 61 Jim Lewis 62 Sean Curry 63 Simon Owen-Johnstone 64 Stefan Weitzel 65 Caroline Hing 66 Alastair Davidson 67 Prim Achan 68 Marcus Lee 69 David Graham 70 Chinh Nguyen 71 Nick Saw 72 Bill Martin 73 Karl Logan 74 Najab Ellahee 75 Mike Oddy 76 Eric Yeung 77 Amit Amin 78 Nana Osei 79 Livio Di Mascio 80 Philip Mathew 81 Aria Ghassemi 82 Danyal Nawabi 83 James Reidy 84 Barry Andrews 85 Homa Arshad 86 Niel Kang 87 Saket Tibrewal 88 Denis Kosuge 89 TarunTaneja 90 Arj Balaji 91 Hanny Anwar 92 Arul Ramasamy 93 Markus Baker 94 Prakash Jayakumar 95 Anna Bridgens 96 David Mckenna 97 Ioannis Pengas 98 Daud Tai Shan Chou 99 Anna Peek 100 Steve Kahane 101 Alex Mulligan 102 Moataz El- Husseiny 103 Nick Aresti 104 Lucky Jeyaseelan 105 Jonathan Wright 106 Dan Williams

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08:30 09:00

MORNING SESSION Registration and Coffee in Great Hall Dr Javad Parvizi Career ending strategies Ms Natasha Curry Liberating the NHS? Implications of the Health and Social Care Act Mr John Albert Ankle arthritis, to fuse or replace? Dr Javad Parvizi Periprosthetic infection-what is on the horizon LUNCH REGISTRAR SYMPOSIUM Robot-assisted, patient-specific, medial unicompartmental knee arthroplasty: A pilot studyAndrews B, Aqil A, Manning V, Cobb JP

09:30

10:15

11:00

12:00 13:00 13:10

13:20

Early versus delayed revision anterior cruciate ligament reconstruction: Structural and functional outcomesMoataz El-Husseiny, Mohamed Sukeik, Shelain Patel, Fares S Haddad

13:30

Medium to long term MRI follow-up of Ultima TPS metal-on-metal total hip replacementsP J Bell, D Ebreo, H Arshad, S T Donell, J K Tucker, A P Toms, J F Nolan

13:40 13:50

Use of Botulinum toxin in Cerebral Palsy: A snapshot of current practiceA Peek, C Maizen

The ability of Orthopaedic Trainees to correctly assess adequacy of reduction following operative ankle fracture fixationJ Wright, C Bagley, D Park, P Ray

14:00 14:10

BREAK First metatarsophalangeal joint arthrodesis with a pre-contoured dorsal plate and spherical reamers provides early fusion and high patient satisfaction: A retrospective review of 100 casesT. Khan; T. Taneja; W. Chan, A. Watson

14:20

A Cost-minimization Analysis of Knee Arthroplasty Using Data From Two National RegistriesB Andrews, C Willis-Owen, Aqil A, Cobb JP

14:30 14:40

Osteochondromas of the Upper Limb: Natural History and Functional Effects Jayakumar P, Hartmann C, Eastwood DM Iatropathic brachial plexus injury: a complication of delayed fixation of clavicle fractures'Page 10


14:50

15:00

15:10

15:20

Jeyaseelan L, Singh V, Ghosh S, Sinisi M, Fox M Intraoperative Nerve Monitoring During Total Shoulder Arthroplasty Surgery Aresti NA, Kosuge DD, Plumb KM , Malik AA, Cowan J, Higgs D, Lambert S, Falworth M The effect of distal femoral resection on fixed flexion deformity in total knee arthroplasty. Reid JF, Liu D Meniscectomy & PFJ OA: The effects of knee meniscectomy on the patellofemoral joint 40 years post-operatively. Pengas, J. Hugh Phillips Memorial Lecture Dr Paul Beaul What should be our goals for joint preserving surgery of the hip? Presidents Address Mr David Nairn Changing Hands

16:05

16:50 Mr Prim Achan 17:10 19:00

Close of Scientific Meeting & Thanks Annual General Meeting Henry VIII Committee Room Drinks reception with dinner to follow Great Hall

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Robot-assisted, patient-specific, medial unicompartmental knee arthroplasty: A pilot studyAndrews B, Aqil A, Manning V, Cobb JP Introduction The combination of patient-specific implant manufacture and robotic technology remains unique to our current pairing of an active-constraint robotic guidance arm to a new unicondylar knee implant. The predecessor to the robot has been proven to enable accurate off-the-shelf unicondylar knee (1) arthroplasty (UKA).(1) Objectives To determine whether robot-assisted medial UKA using a new patient-matched implant was safe, accurate, and comparable in both time and cost to conventional arthroplasty. Methods All robotic medial UKAs were included. Component position, orientation and size were determined from pre-operative CT scans. Patient-specific femoral and tibial components were manufactured. Intra-operatively, the limb was connected via bone pins to the mobile tracking arm of the robot. A minimally-invasive technique was used. Following registration, bone was milled using a high-speed burr under haptic control. Implants were cemented and a mobile bearing inserted. An observer recorded surgical timings. Post-operative CT scans were compared to the pre-operative plans. Tibial and femoral translational and rotational errors were recorded and expressed as RMS error values. Oxford and EQ-5D scores were obtained. Cost of the procedure was calculated and compared to (2) published data for conventional UKA and TKA. (2) Results 40 robot-assisted medial UKAs (22F: 18M) have been performed in 38 patients. 21 patients have reached six months follow-up. Mean age was 67 (range 46-84). Mean robotic surgical time was 32 minutes (range 19-56), incorporating a mean registration time of 10 minutes (range 6-27) and mean sculpting time of 15 minutes (range 7-44). This contributed to a mean skin-to-skin time of 70 minutes (range 44-114). This is 10 minutes faster than the mean skin-to-skin time of 6035 UKA procedures from the New Zealand Joint Registry (p

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40th Annual Percivall Pott Scientific Meeting