Programme

The desperately long waiting lists following the pandemic give an opportunity to do things better. Perioperative care is everything from the moment an operation is contemplated through to full recovery.

This session starts the BOA congress and is co-badged with the Centre for Perioperative Care (www.cpoc.org.uk). The aim is to harness massive benefits for each patient and for the service. Clear pathways standardising care involve all staff and identify where a patient needs an individual intervention. A perioperative approach can reduce complications by 30%-80% and length of stay by 1-2 days.

Getting It Right First Time (www.gettingitrightfirsttime.co.uk) has highlighted unwarranted variation in practice and results. GIRFT reported on Orthopaedics in 2015 and 2020, showing individual units their own data and identifying how to aim for top decile working. For Orthopaedic surgeons (Consultants, SAS, Registrars, in training and others) the main issues are: creating pathways, maximising preparation of patients and good team working.

Pathways should be co-designed locally with nurses, geriatricians, anaesthetists, GPs, AHPs, patients and administrative staff. A pathway effectively gives every patient the benefit of a specialist approach even where workforce deficiencies persist.

Most pre-assessment services have evolved, with pockets of excellence. Several interventions, principally smoking cessation and regular exercise can reduce complication rates by up to 50%. Nutrition, alcohol moderation, psychological preparedness, medication review and practical preparedness help and empower patients. Pre-operative assessment and optimisation could be improved, including with virtual surgery schools. Staff should be trained in motivational interviewing and local signposting, for example about the practicalities of cycling or swimming for Orthopaedic patients with difficulty weight-bearing.

A ‘Trans-Disciplinary team’ needs team-working and education - so skills are shared and key steps still occur even if specialist staff are not present.
Please search the CPOC website www.cpoc.org.uk for:
• New Day surgery guideline (from GIRFT, CPOC, BADS)
• New diabetes guideline
• Shared Decision Making – listening to patients expectations and discussing Benefits, Risks, Alternatives and what happens if Nothing is done (BRAN)
• Patient information
• Preparation for surgery
• Evidence reviews
• Pre-operative Assessment and Optimisation Guidance
• Work on frailty, anaemia and working across primary and secondary care.

There is a three-fold variation in proportion of people admitted for surgery, rather than being a day case. New Day Surgery guidance could maximise day surgery, avoiding cancellations or competition for beds, and creating geographically-distinct pathways. Many trauma pathways could be converted to day case. Education, empowerment, pathways, team-working - Perioperative care is key.

Conference Suite 1A
Chaired by Scarlett McNally
Speakers: Dr Kim Russon, Dr Jugdeep Dhesi and Professor Tim Briggs

The BOA is committed to support all the orthopaedic surgeons including the SAS surgeons and Locally Employed Doctors (LED).  They are playing an important role in NHS service delivery. In recent years an increasing number of doctors have chosen to become SAS surgeons rather than enter higher specialty training. Due to the evolving demographic of the medical workforce this trend may continue in future years. SAS surgeons and LED are confident and competent healthcare professionals, delivering clinical services in partnership with orthopaedic consultants and other health workers.

They are a diverse group with a wide range of knowledge, surgical skills and experience from novice to expert. Sustaining good quality services to NHS patients requires SAS surgeons to remain up to date with advances in trauma and orthopaedic surgery. Therefore, meeting the professional development needs of SAS surgeons is vital at organisational and individual level.  For successful SAS surgeon’s development, appropriate training, and regular assessment linked to the annual appraisal should lead to satisfactory career development.

CESR is not a route for everyone. Do you really want this? If you are happy in your current grade as SAS surgeon and with what you are doing, you may want to ask yourself whether it’s worth applying.  This session is targeted at SAS surgeons about how to approach the CESR application and overcome its hurdles to be successful. The CESR route will be presented by the SAC committee members who directly deal with T&O CESR applications.

Conference Suite 1C
Chaired by Mamdouh Morgan

Agenda:

This session will provide an update on the current value proposition, evidence and research in progress in robotic MSK surgery with a general summary of the activities of the RCS robotic and digital group and updates on current thinking and future directions in hip, knee and spinal surgery.

Conference Suite 2A
Chaired by Professor Fares Haddad
Co-Chaired by Professor Andy Toms
Speakers: Professor David Beard, Mark Blyth, Andrew Metcalfe, Chloe Scott, Peter Wall and Khai Lam

Agenda:

08:30 - 08:35  Introduction  Professor Fares Haddad and Professor Andy Toms
08:35 - 08:45  The RCS Robotic and digital strategy  Professor David Beard
08:45 - 08:50  Discussion
08:50 - 09:00  Knee – value proposition and options  Mark Blyth
09:00 - 09:10  Knee – Current and future research  Andrew Metcalfe
09:10 - 09:20  Discussion
09:20 - 09:30  Hip – value proposition and options  Chloe Scott
09:30 - 09:40  Hip – Current and future research  Peter Wall
09:40 - 09:45  Discussion
09:45 - 09:55  Spine – value proposition and options  Khai Lam
09:55 - 10:00  Discussion 

This session will highlight the sort of tumour cases that you may run into in a typical trauma meeting (or FRCS(Tr. & Orth.) Viva.

Cases will be interactive and cover diagnosis and management.

Conference Suite 3
Chaired by Louise McCullough
Speaker: Robert Ashford

In 2019 the UK Government enshrined in law the requirement to bring all greenhouse emissions to net zero by 2050. For this target to be met, all industrial areas need to reconsider the way they operate. This session will examine future trends in bridge engineering and what bridge designers can do to reduce the embodied carbon (CO₂e) of the structures they design.

Infrastructure accounts for 13% of global cement use. While small compared to buildings (83%), it is also one of the most difficult industrial sectors to fully decarbonise. While use of structural alternatives such as timber is growing in building design, such practice is difficult to replicate in bridges. Bridges are designed for a 120 year design life and require - and will continue to require - durable materials like concrete. A high proportion of process emissions from concrete can only be offset through carbon capture, a technology which remains unproven. This means the civil engineer's role in reducing emissions through design efficiency is vital.

Main Auditorium
Speaker: Oliver Budd

Main Auditorium
Chaired by Anandu Nanu

Agenda:

14:15 - 14:45  The Posterior Malleolar Fracture - An Evolution  Lyndon Mason
14:45 - 15:15  Investigations of the mechanisms of infection in Ultra Clean Air Operating Theatres  Andrew Thomas
15:15 - 15:45  The WHiTE hip fracture studies: the ghosts of past, present and future  Xavier Griffin

An overview of current management including non-operative management and surgical options of arthroplasty and osteosynthesis.

Conference Suite 1C
Chaired by Amol Tambe
Co-Chaired by Mark Pritchard
Speaker: Rohit Gupta

Interactive review of current trauma trials. Including presentation of new results and discussion on future projects and collaborations. A comprehensive review contributing towards trauma revalidation.

Conference Suite 2B
Chaired by William Eardley
Speakers: Xavier Griffin, Jamie Ferguson and Professor Joy Adamson

The session will provide an overview on the management of metastatic bone disease, tailored to the learning requirements of the General Orthopaedic Surgeon. The session will focus on investigation, diagnosis, surgical management and patient outcomes and provide a complete overview of the patient with metastatic bone disease.

Conference Suite 3
Chaired by David Boddie
Speaker: Tom Cosker

This talk will focus on the value and importance of orthopaedic surgeons collaborating with engineers and other scientific disciplines to further improve orthopaedics.

Main Auditorium
Chair: John Skinner
Speaker: Sarah Muirhead-Allwood

Main Auditorium
Chaired by Anandu Nanu

Agenda:

16:55 - 17:25  Improving hip fractire outcomes using routinely collected health data  David Metcalfe
17:25 - 17:55  Unicompartmental Knee Replacement  Professor David Murray
17:55 - 18:25  Evaluating the Role of Novel Technologies in Optimising Arthroscopic Management of Femoroacetabular Impingement  Vikas Khanduja

This session will include insights into the management of orthopaedic infections in low and middle income countries. Free papers on Developing World Orthopaedics will also be presented.

Conference Suite 1A
Chaired by Deepa Bose
Co-Chaired by Alberto Gregori

Agenda:

16:55 - 17:10  Arthroplasty in HIV positive patients  Simon Graham
17:10 - 17:25  Beit-Cure classification of childhood osteomyelitis  Jim Harrison
17:25 - 17:40  Management of osteomyelitis in Gondar, Ethiopia  Alwyn Abraham
17:40 - 17:55  Management of spinal tuberculosis in Malawi  Professor Nyengo Mkhandawire/Ashtin Doorgakant
17:55 - 18:25  Free papers (Developing World Orthopaedics)

Conference Suite 1B
Chaired by Philippa Rust
Co-chaired by Ian McNab

Agenda:

17:00 - 17:08  Articular cartilage and soft tissue damage from radiofrequency thermal ablation wands at wrist arthroscopy  Grey Giddins
17:08 - 17:16  The management of suspected scaphoid fractures in the United Kingdom: a national cross-sectional study  Ben Dean
17:16 - 17:24  Association of trapeziometacarpal joint shape with clinical symptoms and radiological severity of thumb base osteoarthritis: Analysis of a cohort from the osteoarthritis initiative study using a statistical shape model  Jenna Shepheard
17:24 - 17:32  The Value of Calibration of Radiographs in Total Wrist Arthroplasty  Nastaran Sargazi
17:32 - 17:40  The Aberdeen outpatient dedicated percutaneous needle fasciotomy clinic for the treatment of Dupuytren’s Disease. A valuable resource in the re-establishment of orthopaedic service following the coronavirus pandemic  Yasmeen Khan
17:40 - 17:45  Free
17:45 - 17:53  A Meta-Analysis of Proximal Scaphoid Fractures - Does Terminology Affects Reported Union Rates?  Han Hong Chong
17:53 - 18:01  Cone-beam CT in the diagnosis of radiocarpal fractures: A Systematic Review and Meta-analysis  Emma Fitzpatrick
18:01 - 18:09  Delaying fixation of distal radius fractures beyond the best practice guidelines does not affect the final outcome  Sanjay Chilbule
18:09 - 18:17  A case series of patients treated with percutaneous intramedullary screws, for 5th metacarpal fractures, using the WALANT technique at Hinchingbrooke Hospital  Nauful Ahmed
18:17 - 18:25  Custom-Fashioned Antibiotic Impregnated PMMA MCP Joint Arthroplasty in the Acute Settling Long Term Outcome: A Novel Technique Revisited: Our Own Experience  Frances Bowerman

Conference Suite 1C
Chaired by Mark Pritchard
Co-Chaired by Addie Majed

Conference Suite 2A
Chaired by Caroline Hing
Co-Chaired by Chloe Scott and Matthew Brown
Speakers: Helena Kennedy

Case based session generating debate on how to manage the increasing number of fragility fractures. New concepts, techniques and kit will be discussed, with a focus on fractures around the knee. Tips and tricks for more challenging fractures will be presented as an update for trauma revalidation.

Conference Suite 2B
Chaired by Jayne Ward
Co-Chaired by Mike Kelly
Speakers: Sunit Patel, Mateen Arastu and Jim McVie

Discussion session with updates on policy and practice from the trauma community. Incorporating the introduction the BOA trauma exchange group. Get involved and influence how trauma is managed in your local trauma network.

Main Auditorium/Hall C
Chaired by Alex Trompeter
Speakers: Bob Handley

The session will cover assessment and management plan for painful joint after surgery to include Shoulder, Hip, Knee and Foot surgery. The session will have presentation from Expert Surgeons as well as Pain Management Consultants.

Conference Suite 1A
Chaired by Maneesh Bhatia
Co-Chaired by Professor Bijayendra Singh
Speakers: Simon Lambert, Sanjeev Patil, Peter James, Senthil Kumar, Dr Raja Reddy and Dr Sadiq Bhayani

Agenda:

I Have a Painful Hip After Surgery  Sanjiv Patil
I Have a Painful Knee After Surgery  Pete James
Managing Pain After Hip & Knee Surgery  Dr Raja Reddy
I Have a Painful Ankle After Surgery  Senthil Kumar
I Have a Painful Shoulder After Surgery  Simon Lambert
Managing Pain After Shoulder & Ankle Surgery  Dr Sadiq Bhayani

Conference Suite 1B/C
Chaired by Nikki Kelsall
Co-Chaired by Robert Clayton

Agenda:

08:30  Welcome & Introduction  Nikki Kelsall
08:35  Clinical assessment & disease pattern in the rheumatoid foot  Vivek Dhukaram
08:45  What is rheumatoid arthritis? Do DMARD’s increase infection risk in F&A surgery?  Dr Alan Macdonald
08:55  Anaesthetic assessment of the Rheumatoid Patient  Dr Colin Patterson
09:05  What are the principles of orthoses in the rheumatoid foot?  What should I write on my request form?  Effect of foot wear on body image and self esteem  Nick Gallogly
09:15  Discussion  Nikki Kelsall & Rob Clayton
09:20  Principles of rheumatoid foot surgery  Hari Prem
09:30  Hints & Tips – Forefoot surgery and its complications  Howard Davies
09:40  Hints & Tips – Ankle replacement surgery and it’s complications  Heath Taylor
09:50  Discussion  Nikki Kelsall & Rob Clayton

Collaborative session introducing the fracture liaison academy and network.

Topics include:

• Secondary fracture prevention for the trauma team - opportunities for getting started and becoming more effective
• Global Progress in Fragility Fracture
• Life is kyphogenic; the effects of age and fragility on the spine
• Operative techniques in fragility fractures
• Toolkits to enhance fracture liaison success

Main Auditorim/Hall C
Chaired by Andrew Gray
Speakers: Dr Kassim Javaid, Professor David Marsh, Lee Breakwell, William Eardley and Paul Mitchell

This is a triennial session run in conjunction with BIOS and speakers from India. This year we have 4 eminent speakers talking about their experience and sharing their expertise on different aspects of infection - keeping in line with the theme of the meeting.

Conference Suite 1A
Chaired by Professor Amit Tolat
Co-Chaired by Sunil Garg

Agenda:

Reconstructing a Post Septic Hip in Child  Dr Ashok Johari
Management of Infection after Trauma  Dr Vivek Trikha
Management of Hand Infection  Dr Hemant Patankar
Management of Spinal Infection  Dr S Rajasekaran

Conference Suite 1B/C
Chaired by Nikki Kelsall
Co-Chaired by Robert Clayton
Speaker: Simon Hodkinson

What the Carousel Associations do best, and how they do it.

Conference Suite 4

Main Auditorium
Speaker: Professor Stephen Powis

Main Auditorium
Speaker: Professor Martin McNally

Main Auditorium
Chaired by Phil Turner
Speaker: Professor Robin Paton

During the conflicts in Iraq and Afghanistan UK service personnel sustained significant injuries including single, double and triple amputations. These patients have developed significant rehabilitation issues that were unable to be addressed using conventional sockets. UK Defence was awarded LIBOR funding to undertake Direct Skeletal Fixation in twenty patients with femoral amputations who had failed the conventional treatment that was available within the NHS.

Conference Suite 1A
Chaired by: Paul Hindle
Co-chaired by: Alan Mistlin
Speakers: Alan Mistlin, Paul Hindle, Louise McMenemy and Charles Handford

The rehabilitation problem  Col Alan Mistlin
Direct Skeletal Fixation  Wg Cdr Paul Hindle
UK outcome data  Surg Lt Cdr Louise McMenemy
Economic case  Major Charles Handford
The patient experience  TBC

Conference Suite 1B/C
Chaired by Nikki Kelsall
Co-Chaired by Jayne Ward

Agenda:

15:40  Welcome & Introduction  Nikki Kelsall
15:45  All ankle fractures should be assessed with CT scans  Anthony Sakellariou
15:55  Elderly patients should all be treated in a plaster (AIM)  Matt Solan
16:05  Elderly patients should all be treated with hind foot nails  Mr Howard Davies
16:15  Discussion  Nikki Kelsall & Jayne Ward
16:25  Fibular nails are the answer to all our worries  Tim White
16:35  There’s no problem with ORIF as a tried and tested method (& FAME)  Xavier Griffin
16:45  Discussion  Nikki Kelsall & Jayne Ward
16:50  Non-weight bearing post-op ankle fractures treats the surgeon not the patient  Nigel Rossiter
17:00  How soon can an ankle fracture patient run  Bob Carter
17:05  Discussion  Nikki Kelsall & Jayne Ward

This session chaired by BORS will provide four fascinating talks which provide an overview of current concepts and many of the latest developments in osteoarthritis research. We are proud to present 4 distinguished academic experts who will cover a breadth of topics.

Conference Suite 2A
Chaired by Wasim Khan
Co-Chaired by Salma Chaudhury

Agenda:

Epidemiology and Risk Factors for Osteoarthritis  Mark Wilkinson
Advances in Cell Therapies for Osteoarthritis  Cosimo de Bari
Advances in Bioengineering for Osteoarthritis  Ruth Wilcox
Advances in Health Technologies for Arthritis  Liba Sheeran

The session will focus on the young patient with articular cartilage defects, including the use of osteotomy and stem cell therapies for osteoarthritis of the knee.

Conference Suite 2B
Chaired by Leela Biant
Speakers: Michael McNicholas, Professor Martyn Snow and Professor Andrew McCaskie

T&O clinical research is currently very healthy in the UK, with many trials ongoing and results from these filtering through to the clinic. So what are the latest findings and how could and should we all apply them? And how do we continue working to ensure a healthy pipeline of clinical research continues to benefit our current and future patients? Come to this session to hear more and join the debate!

Main Auditorium
Chaired by Hamish Simpson
Co-Chair: Yuri Kulikov (1st half), Chinmay Gupte (1st half), Paul Baker (2nd half), Hemant Sharma (2nd half)
Speakers: Professor Sallie Lamb, Mike Whitehouse, Professor Alan Montgomery, Professor Dan Perry, Chloe Scott and Professor Xavier Griffin

Agenda:

17:20 - 18:00 - PART A: The past, present and future of T&O clinical research

Chairs Hamish Simpson, Yuri Kulikov, Chinmay Gupte

• Welcome and latest updates on BOA research activities: Professor Hamish Simpson

• Introducing the BOA-funded CTUs at Nottingham and Exeter: Professor Alan Montgomery (University of Nottingham) & Professor Sallie Lamb (University of Exeter)

• Keynote: The Evolution of Trauma and Orthopaedic Clinical Research: Professor Sallie Lamb

Profession Sallie Lamb is the Mireille Gillings Professor for Health Innovation and the Associate Dean of Research at the University of Exeter. She is an internationally recognised scholar in ageing, disability and rehabilitation. She is also an experienced methodologist in the area of clinical trials and high quality evaluation of health care practice. In particular, she strives to ensure research is translated into practice.

She has served as a Chair of the Health Technology Assessment Board and other senior roles in National Institute of Health Research and is a Trustee of the Versus Arthritis charity.

18:00 - 18:50 - Part B: Latest research that has or should change practice

Chairs: Hamish Simpson & Paul Baker & Hemant Sharma

• 1 stage or 2 stage Revision Hip Arthroplasty: Which Should I do?
The INFORM trial: Professor Mike Whitehouse, North Bristol NHS Trust & University of Bristol

• Which patients are suffering the most?
Worse than death: Miss Chloe Scott, Royal Infirmary of Edinburgh & University of Edinburgh
Discussion Lead: Mr Paul Baker

• Should we change how we treat children's forearm fractures?
The Force Trial: Professor Dan Perry, Alder Hey Hospital Liverpool & University of Liverpool

• How the WHiTE Trials have changed my Practice.
WHiTE trials 1-...: Professor Xavier Griffin, Barts and The London School of Medicine.
Discussion Lead: Mr Hemant Sharma

In this revalidation session we will look at trauma knee admissions with a focus on the frail patient. The talk will cover periprosthetic knee fractures, distal femoral fractures, proximal tibial fractures in the elderly including proximal tibial replacement.

Main Auditorium/Hall C
Chaired by James Murray
Speakers: Phil Hopgood, Alexander Dodds, Mike Kelly and Chloe Scott

Orthopaedic surgeons who report regularly on cases of potential medical negligence will discuss marginal cases with a final comment from a barrister. The audience will have opportunities to ask questions and vote on the cases.

Conference Suite 1A
Chaired by Professor Grey Giddins
Speakers: Simon Britten and Simon Royston

Conference Suite 2A
Speakers: J Trivedi, Lee Breakwell, Andrew Frost and R Verma

Agenda:

08:30 - 08:35  Introduction
08:35 - 08:50  Painful Spine in the child  J Trivedi
08:55 - 09:10  Congenital Scoliosis and the orthopaedic Surgeon  Lee Breakwell
09:15 - 09:30  Inflammatory Spine Conditions  Andrew Frost
09:35 - 09:50  Diagnostic Dilemmas in Acute Spine conditions  R Verma

Come join BOTA and our guest speakers as we reflect on T&O training throughout the COVID-19 pandemic and set out our vision for the road to recovery. We aim to deliver an insightful and engaging session that will give both Trainees and Trainers inspiration in the wake of the COVID-19 pandemic.

Conference Suite 2B
Chaired by President of BOTA
Co-Chaired by Vice President of BOTA

The chairman presents a trauma case that is controversial and the English, Welsh and Scottish perspective on the case is discussed by the Major trauma consultants. The invigilator then gives a final verdict from the perspective of the FRCS (Tr&Orth). 

Conference Suite 3
Chaired by Mr Ansar Mahmood
Speakers: Mr Tim White; Professor Ian Pallister and Professor Benjamin Ollivere
Invigilator and referee: Mark Bowditch 

Chondral and osteochondral lesions represent a difficult treatment problem for the Sport’s Surgeon. There is no uniform approach to managing these patients. In this session we will explore the presentation and the different management options available. We will see how this problem affects various joints commonly affected by sport.

Conference Suite 4
Chaired by Professor Deiary Kader
Co-Chaired by Guido Geutjens

Agenda:

08:30 - 08:40  Diagnosis and assessment of chondral and osteochondral lesions  Joanne Banks
08:40 - 08:50  Microfracture, Mosaicplasty or Allograft for the defect?  Vipul Mandalia
08:50 - 09:00  Focal cartilage resurfacing  Jon Smith
09:00 - 09:10  The multi-operated articular cartilage defect  Andy Metcalfe
09:10 - 09:20  Discussion
09:20 - 09:30  Loose body in the adolescent’s knee. When to operate and the role of fixation  Joanna Thomas
09:30 - 09:40  Talar dome lesions  Carolyn Chadwick
09:40 - 09:50  Repetitive stress injuries in the elbow  Adam Watts
09:50 - 10:00  Discussion

In this session we look at delivering a unicompartmental knee arthroplasty practice, including decision aids, training and starting a practice.

Main Auditorium/Hall C
Chaired by Andrew Price
Co-Chaired by Andrew Porteous
Speakers: Phil Hopgood and Daniël Saris

In this medico-legal session, we will find out whether there is a gender imbalance in medico-legal reporting. Then we will hear from 3 experienced medico-legal experts, all female, on how, when and why they run their medico-legal practices. An accomplished lawyer will tell us exactly what the legal profession do and don’t want to see in their medical experts. Finally, there will some tips on how to set up a medico-legal practice and how mentoring can help.

Conference Suite 1A
Chaired by Professor David Warwick
Co-Chaired by Sarah Johnson-Lynn
Speakers: Jacquelyn McMillan, Jan McCall, Simon Britten, Deborah Eastwood, Charlotte Lewis and Jo Round

Conference Suite 2A
Speakers: Santosh Baliga, James Walkden, Pragnesh Bhatt and Peter Bodkin

Agenda:

10:30 - 10:45  Immediate assessment, care and referral of spinal trauma  Santosh Baliga
10:50 - 11:05  Spinal Infection  James Walkden
11:20 - 11:35  Cauda Equina Syndrome  Pragnesh Bhatt
11:40 - 11:55  Metastatic Spinal Cord Compression  Peter Bodkin

Don't miss out on your chance to get your burning questions on T&O training after COVID-19 answered. Join BOTA as we welcome TPDs and the SAC chair to the stage, where they attempt to tackle the most topical and challenging questions submitted by Trainees and Trainers across the UK. Audience participation will be encouraged and we will ensure that no stone is left unturned.

Conference Suite 2B
Chaired by Rob Gregory
Co-Chaired by President of BOTA

Conference Suite 4
Chaired by Nick Nicolaou and Neil Jain
Speakers: Ben Gooding and Kapil Kumar

Agenda:

Free Papers - Sports Trauma  (45 mins)
Shoulder Instability in athletes  (20 mins)  Kapil Kumar (Aberdeen)
Elbow Instability in athletes  (20 mins)  Ben Gooding (Nottingham) 

This session will update delegates knowledge of the current treatment of PJI in hip arthroplasty. This is based on the recently published BOAST and will cover presentation, investigation and treatment options. The session will be followed by the Charnley Lecture delivered by Thorsten Gehrke (Enuo-Klinik, Hamburg) on single stage revision for infection.

Main Auditorium/Hall C
Chaired by Professor Dominic Meek
Speakers: Richard Westerman, Jason Webb, Tim Petheram and Paddy Ashcroft

PJI setting the scene – Dominic Meek
MDT structure – Tim Petheram
Clinical Presentation & Diagnosis – Jason Webb 
DAIR – Richard Westerman
Revision surgery options for PJI – Paddy Ashcroft 
Case discussions – All 

An update in surgical decision making, investigation and management strategy in chronic osteomyelitis and fracture related infection.

Conference Suite 1B
Chaired by Peter Calder

Agenda:

14:30 - 14:35  Introduction  Hemant Sharma
14:35 - 15:10  Evolution Not Revolution in Managing Bone Infection  Professor Martin McNally
15:10 - 15:20  Diagnostic Update: Beyond Hot Spots – Nuclear Medicine & Molecular Imaging Innovations in MSK Infection Diagnostics  Dr Zia Saad
15:20 - 15:30  Diagnostic Update: Phage Therapy, What is on the Horizon for MSK Infections?  Dr Kordo Saeed
15:30 - 15:55  Fracture Related Infection Update  Nima Heidari
15:55 - 16:00  Closing Remarks  Om Lahoti

Conference Suite 2A
Chaired by Rohit Shetty
Co-Chaired by James Tomlinson

The concept of biological joint regeneration is hugely attractive to patients and to the medical community. We have strived for many years to look at options to repair or replace articular cartilage and maintain joint function in order to allow patients to continue pain-free activity and to avoid the consequences of osteoarthritis and its associated symptoms and the ultimate need for joint arthroplasty.

Whilst there has been tremendous progress and development in the joint arthroplasty field, research into regenerative therapies has been slower to translate to the bedside. There is, however, renewed interest, and a global industry valued at over £5 billion looking at joint preservation through biological means.  There is some concern that indiscriminate use of these approaches may undermine targeted clinical use and legitimate clinical research.

While we very much hope that this will be part of the long-term solution to joint injuries and joint degeneration, considerable debate remains over which strategies to use, their mechanism of action, and their potential short and long term effects on patients. There are important considerations in relation to unvalidated treatments, uncontrolled marketing, short term symptomatic control and the possibility of long term regenerative effects. We are now at a critical stage where we really need to consider the strategies are available to us and how they should be regulated and used in clinical practice. 

This symposium will cover the current dilemmas in this area and the options available and will assess the available peer reviewed literature. We will explore the most appropriate means for reporting and evaluating these interventions, consider how best to educate patients and surgeons on emerging research evidence, and discuss potential future challenges and regulatory frameworks.

There is great controversy in this area. The holy grail of biological joint restoration remains integral to orthopaedic thinking. We must for now however agree systems for the evaluation, the reporting, the translation and the regulation of biological therapies for joint arthritis.

Conference Suite 2B
Chaired by Mark Bowditch
Co-Chaired by Fares Haddad and Caroline Hing
Speakers: Andrew McCaskie, Connie Chu and Iain Murray 

In the mid-nineties, orthopaedic surgeons mainly driven by spine and joint replacements surgeons introduced computer assisted and robotic devices into their practice with the potential to reduce outliers in surgical practice and ultimately improve outcomes and reduce short and long-term complications and revisions.

Three main classes of devices were conceived and developed over the years to achieve these goals: there were the navigation systems, the patient-specific instruments (PSI) and the robotic devices. All three used either pre-operative planning issued from patient specific medical imaging (MRI or CT scan) or only intra operative anatomic data collection or “image free guidance”. All three aimed to assist the surgeons intraoperatively. Navigation and robotic systems both adopt user-interfaces depicting simultaneously the pre/intraoperative plan and tracked instruments to perform the surgery. PSI uses preoperative planning and manufactured guides to fit the patient’s anatomy to perform the surgery. Robotic technology relies on similar concepts implemented in navigation, but the final surgical action is either performed or guided by a robotic arm or hand held smart device (Active or controlled robotic technology) instead of only the surgeon.

Computer assisted and robotic technology has been used all over the world for more than 25 years with variable success but is not yet mainstream standard of care and is only used by a limited number of surgeons. The technology has confirmed its benefits in improving the accuracy and precision of the surgery and clinical evidence is growing to support the implementation of these systems in everyday practice.

Orthopaedic implant companies have invested heavily in the development of these new technologies as evidenced by the recent growth in robotic technology, developing different systems in design and execution. The goal of this session is to present these devices in the most clinically objective way for the audience to understand how they work and what they can expect from their use-the faculty are taken from leading UK and International clinicians who are involved in their development and use the systems regularly.

It is undeniable that computer and robotic technology has invaded all workplaces and has demonstrated its efficiency. The orthopaedic speciality won’t escape this new paradigm. However, it is still difficult to identify not only the long-term benefits of these new “tool-boxes” but also the real differences between all these systems. We hope to discuss some of these issues during the course of this session.

Conference Suite 3
Chaired by Dinesh Nathwani and Fred Picard
Speakers: Professor Ferdinando Rodriguez y Baena; Professor Fares Haddad; Kamal Deep and Ajeya Adhikari

Agenda:

14:30 - 14:35  CAOS UK President introduction  Mr Dinesh Nathwani
14:35 - 14:48  Introduction to Robotics in Orthopaedics: Background and overview from an engineering perspective  Professor Ferdinando Rodriguez y Baena
14:48 - 15:00  Image based Robotic arm assisted arthroplasty- the evidence is growing  Professor Fares Haddad
15:00 - 15:12  Hand-held image free robotic knee replacement- the introduction of Personalised hybrid Alignment  Mr Dinesh Nathwani
15:12 - 15:24  Robotics versus navigation in hip replacement  Mr Kamal Deep
15:24 - 15:36  Clinical overview of the Robotic Surgical Assistant (ROSA®)  Mr Akash Sharma
15:36 - 15:48  The Digital Innovation “The Velys System”  TBC
15:48 - 16:00  Q&A Roundtable discussion  Chair: Fred Picard/ Ajeya Adhikari

Today’s NHS demands innovative, creative, adept, reflective, experiential leaders to deal with the complex and unpredictable world of healthcare.  Our leaders need to be able to see the bigger picture, manage risk and be able to cope with solving problems resulting from increased longevity with chronic disease burden and the social pressures of unemployment and poverty· This session is aimed at leaders and potential leaders at every level of the organisation: from trainees through to established consultants and leaders. Leadership has been fully integrated into our T&O curriculum through Generic Professional Capabilities and Capabilities in Practice.  But the real need to integrate leadership training goes well beyond such rules and regulations.  

Conference Suite 4
Chaired by Hiro Tanaka
Co-Chaired by Lisa Hadfield-Law
Speakers: Pramod Achan, Andrea Sott and Professor Tim Briggs

Agenda:

14:30 - 14:40  Introduction  Hiro Tanaka
14:40 - 14:55  National Director of Clinical Improvement for the NHS & NHSI  Professor Tim Briggs

• Tips and tricks on how to scale up QI at a national level
• How he came up with the GIRFT idea and then took it national

14:55 - 15:10  Interview with Prim Achan

• What leadership development is available and feasible
• What do you need as a trainee to meet leadership requirements
• What do trainers need to train for leadership 

15:10 - 15:25  Interview with Andrea Sott

• What would you have done differently as a leader
• What were the lessons you’ve learned
• How have you done it?

15:40 - 15:55  Q&A
15:55 - 16:00  Summary

This session will explore the challenges facing hip surgery in the presence of endemic Covid-19, from patient consent, the practicalities of surgery, risk management and training.

Main Auditorium/Hall C
Chaired by Simon Buckley

Agenda:

Waiting is worth than death  Chloe Scott
REJOIN study. Is it safe to operate?  Tim Board
NAHR study of COVID safety and patient outcomes  Ajay Malviya
Prioritisation for surgery, a National picture  Andrew Hamer
Strategies to support patient waiting  Andrew Gordon
Training under pressure  Rob Gregory
Questions and Discussion

This session will give an overview of Publishing in 2021 and an insight into the considerations authors and reviewers should have when approaching a manuscript. We will provide practical guidance on how to get funding for research, how to setup a trial properly as well as how to write a good paper. We will also cover how to maximise engagement after publication and setting up a journal club.

Conference Suite 1A
Chaired by Professor Fares Haddad
Co-Chaired by Elizabeth Ashby
Speakers: Elizabeth Ashby, Professor Daniel Perry, Professor Duncan Tennent, Professor Matt Costa and Chloe Scott

An update on what is new in Limb Reconstruction followed by a free paper session

Conference Suite 1B
Chaired by Peter Calder

Agenda:

16:30 - 16:50  What’s New in Limb Reconstruction?  Bilal Jamal
16:50 - 18:00  Free Paper Session (10 papers)

An interactive session discussing sports injuries in the child and adolescent age group. A combined session between the British Society for Children's Orthopaedics (BSCOS) and the British Orthopaedic Sports Trauma and Arthroscopy Society (BOSTAA).

Conference Suite 1C
Chaired by Emily Baird
Co-Chaired by Nick Nicolaou

Agenda:

16:30 - 17:10  Overview of Paediatric ACL Reconstruction  Fazal Ali
Interactive Case Discussions - ACL reconstruction  Moderator Nick Nicolaou
David Hollinghurst, Chinmay Gupte and Hywel Davies
17:10 - 17:30  Current Concepts in Paediatric Injury Prevention  Nev Davies
17:30 - 18:00  The Paediatric Athlete with disability  Moderator - Emily Baird
Introduction and overview  Virginie Pollet
Clinical Cases  Rachel Hutchinson
Discussion

The aim of the NOTSS project was to develop and test an educational system for assessment and training of non-technical skills in the intra-operative phase of surgery. NOTSS is a behaviour rating system based on a skills taxonomy that allows valid and reliable observation and assessment of four categories of surgeons' non-technical skill: situation awareness, decision making, communication & teamwork, and leadership.

These are the essential non-technical skills surgeons need to perform safely in the operating room and NOTSS allows measurement of several ACGME (Accreditation Council for Graduate Medical Education) competencies, including professionalism, interpersonal and communication skills, and systems-based practice. The skills taxonomy can be used to structure training and assessment in this important area of surgical competence.

Conference Suite 1A
Chaired by Nigel Kiely
Co-Chaired by James Tomlinson

This session will describe the purpose of Good Clinical Practice (GCP) and outline the significant milestones in the history of GCP development. It will look at the impact of ICH GCP changes on investigator sites and sponsors. The current legislation relating to clinical trials and medical devices will be discussed. The practical application of GCP will be reviewed.

Conference Suite 1B
Chaired by Sue Fitzpatrick

08:30 - 10:00

- Welcome and Introduction
- History and purpose of GCP
- Development of ICH GCP
- Roles and responsibilities in clinical research according to ICH GCP
       ~Sponsor
       ~Monitor
       ~Investigator
       ~Ethics Committees
- ICH GCP E6 R2
- Changes in Data Protection with GDPR
- The EU Clinical Trial Regulation 536/2014, Directive 2001/20/EC and GCP Directive 2005/28/EC in addition the Directive 93/42/EEC on medical devices (EU MDD) Directive 90/385/EEC on active implantable medical devices (EU AIMDD) Directive 98/79/EC on in vitro diagnostic medical devices (EU IVDD) and current position
- The UK Statutory Instruments

10:00 - 10:30 Break

10:30 - 12:00

- GCP in action
- Essential Documentation
- Maintaining data integrity
- Informed consent
- Safety reporting
- Drug accountability
- Enforcement procedures

On completion of the session a GCP certificate will be awarded.

The BOA Clinical Examination Course was set up almost a decade ago with the aim that trainees will attend on an annual basis whereby skills could be learnt at an early stage of training and repetition would result in perfecting a technique and consequently improvement in patient care and examination success.

It is taught by an experienced group of lecturers on clinical examination techniques. The format includes a morning of lectures covering all regions of the body. This is followed in the afternoon by a hands-on session where participants rotate in groups of similar skill level. In these tutorial groups there is a demonstration by an experienced consultant followed by practice in pairs of the techniques learnt.

The feedback in previous years of this format of learning has been exceptional.

Conference Suite 1C
Chaired by Fazal Ali
Co-Chaired by Karen Robinson

Agenda:

08:00 - 08:30 Registration
08:30 - 08:50 Examination of the Hip Paul Banaszkiewicz
08:50 - 09:10 Examination of the Knee Paul Haslam
09:10 - 09:30 Examination of the Foot and Ankle Stanley Jones
09:30 - 10:00 Examination of the Spine Alex Baker
10:00 - 10:30 Coffee
10:30 - 10:50 Examination of the Shoulder Ben Gooding
10:50 - 11:05 Examination of the Elbow Amjid Ali
11:05 - 11:30 Examination of the Hand Joe Garcia
11:30 - 12:45 Lunch
12:45 - 15:45 Practical Stations

Participants rotate in groups (based on experience) through stations every 20 mins. ALL FACULTY

Station

Hip  —  Holloway, Thiagarajah (Fernandes)
Knee  —  Chandrasenan, Quah (Haslam)
Foot & ankle  —  Obakponovwe, Myint (Lasrado)
Spine  —  Qaimkhani, Isaacson (Baker)
Shoulder  —  Gooding, MacInnes (Shahane)
Elbow  —  Booker, Sinha (A Ali)
Hand  —  Azhar, Gillott (Garcia)
Peripheral nerve  —  Robinson, Blakey (Wembridge)
Spare/Circulating  —  F Ali, Jones, Banaszkiewicz

16:00 CLOSE

Faculty:

Fazal Ali - Convener (Chesterfield)
Karen Robinson- Convener (Sheffield)
Joe Garcia (Chesterfield)
Shantanu Shahane (Chesterfield)
Jeevan Chandrasenan (Chesterfield)
Amjid Ali (Sheffield)
James Fernandes (Sheffield)
Paul Haslam (Doncaster)
Paul Banaszkiewicz (Gateshead)
Simon Booker (Sheffield)
Irwin Lasrado (Portsmouth)
Caroline Blakey (Sheffield)
Kevin Wembridge (Rotherham)
Saeed Qaimkhani (Qatar)
Stan Jones (Qatar)
Ben Gooding (Nottingham)
Alex Baker (Preston)
Antonia Isaacson (Newcastle)
Scott McInnes (Doncaster)
Azhar Armughan (Lincoln)
Ed Holloway (Chesterfield)
Yulanda Myint (Nottingham)
Oghor Obakponovwe (Chichester)
Shankar Thiagarajah (Doncaster)
Apurv Sinha (Chesterfield)
Elizabeth Gillott (Derby)
Conal Quah (Derby)

Conference Suite 3
Chaired by: Lisa Hadfield-Law

Can you spare 8 hours to learn how to supervise trainees to be the very best they can? The programme will be blended. Some of it virtual and 3 hours face to face on the Friday of Congress. We will open the programme on the 17th August and run our live meeting from 9-12 on Friday 24th September 2021.

Programme:
No more box ticking and number crunching. Life for you, as a trainer should be better and richer from August 2021. All the curriculum work over the last 3 years is coming to fruition. It will address concerns expressed by many trainers about the over refined structure of ISCP: of tick boxes and forms. Our trainees need to acquire professional judgement, insight, leadership, and the ability to work with others, alongside the operative skills required to be a safe surgeon. The new updated curriculum should help us do this more effectively. This 8-hour programme is designed to help Educational Supervisors make the necessary changes work for them and their trainees.

Learning Outcomes:
At the end of this programme, participants will be able to:
• Summarise changes to the T&O curriculum and how these will affect you
• Make the best use of assessment tools including the Multi Consultant Report
• Integrate the new Capabilities in Practice and Generic Professional Capabilities
• Plan how to conduct or contribute to a Multi Consultant Report (MCR)
• Make best use of their trainer portfolio
• Use assessment of reflective writing to maximise trainee progress

Learning Methods:

Most of the 8 hours of work required can be done at the time and convenience to suit you with just a 3 hour live session.
Register here
1. Eliza Khalid will set up a team in MS TEAMS
2. You will be issued with a learning login your channel file
3. Work through this at your own pace before 23rd September
4. Facilitator reviews 1st 3 completed logs submitted to understand local issues
5. Once you have completed ALL modules you will swap with an allocated AES partner
Confirm that all modules are complete
Provide some written feedback in their partners learning log
Pass to the facilitator if there are any problems eg failure to complete
7. Facilitator will summarise how to handle the 3 trainee scenarios

The International Orthopaedic Diversity Alliance (IODA) is honoured to co-host a free virtual symposium with the British Orthopaedic Association & Women in Orthopaedics Worldwide (WOW).

Chaired by: Kristy Weber
Co-Chair: Camila De Mattos
Speakers: Deborah Eastwood, Zoe Little, Udo Anyaegie, Olof Linden & Scarlett McNally

Agenda:

Keynote  Deborah Eastwood (President-Elect BOA)
A return-to-work program for orthopaedics  Zoë Little (UK)
Returning to work from parental leave  Udo Anyaegie (Nigeria)
Returning to work from parental & research leave  Olof Lindén (Sweden)
Returning to work after a health issue  Scarlett McNally (UK)
Panel Discussion: Deborah Eastwood, Zoe Little, Udo Anyaehie, Olof Linden & Scarlett McNally