01 Dec 2014

Volume 2 Issue 4


From the new Editor – What’s the Agenda?

Firstly I would like to thank Colin Howie for his time as Editor and for maintaining an extremely high standard. In the final issue of this year we look back at the BOA’s 2 day meeting in Brighton including reviews from various perspectives on pages 3 and 4. We welcome four new Trustees to the BOA who give you an insight into their lives on page 8 and 9. 

This issue has some excellent features including an article about the BOA’s plans for funding clinical research through the York Trials Unit by creating the BOA Orthopaedic Surgery Research Centre, on page 16.   You will also read an article about how to engage juniors in T&O surgery on page 18.

 Benjamin Ellis from Arthritis Research UK has written an interesting piece about bridging the musculoskeletal measurement gap on page 24 and Phil Lewis from NHS Supply Chain updates us on procurement and performance data collection which you can read on page 20.
Our Medico-legal Editor, Mike Foy brings you two articles about knowing the limits of your competence and indemnity for treating NHS patients from page 36. Our trainee section this issue focuses on JCST guidelines which you can find on pages 34-35.
Our peer review section focuses on the spine, with thanks to our Guest Editor, Alistair Stirling. You will find a general interest piece on footdrop which is written as a debate between two orthopaedic surgeons, a scientific piece on chronic low back pain and a controversial article on adult spine deformity on pages 40-49. Our second “How I Do…” piece submitted by a member of the Orthopaedic Trauma Society (OTS) follows these on page 50.
We also pay tribute in this issue to three great men – John Fixsen, Stuart Calder and Louis Solomon who will be sorely missed (pages 52-53).
Just for fun on pages 26-27 have a go at our quiz with your family over the festive period.
The Agenda is that this is your BOA, your JTO. You want to tell your colleagues something, you want to challenge their thoughts and perceptions on issues that matter to us all in our professional lives -this is your voice, feel free to suggest things, gives us content, give us controversy ([email protected])!
Season’s Greetings.


Ian Winson – BOA Vice President Elect


Reference Lists


The Implications of an Increased Use of New Oral Anticoagulants In the Community for Fracture and Elective Surgery


1. Baumann Kreuziger LM, Morton CT, Dries DJ. New anticoagulants: A concise review. J Trauma Acute Care Surg. 2012 Oct;73(4):983-92. 
2. Eerenberg ES, Kamphuisen PW, Sijpkens MK, Meijers JC, Buller HR, Levi M. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation. 2011 Oct 4;124(14):1573-9. 
3. Pernod G et al. Management of major bleeding complications and emergency surgery in patients on long term treatment with direct oral anticoagulants, thrombin or factor Xa inhibitors: proposals of the working group on perioperative haemostasis (GIHP)- March 2013. Arch Cardiovasc Dis. 2013 Jun-Jul; 106 (6-7): 382-93. 
4. National Hip Fracture Database. National Report. London: British Geriatrics Society 2012. 
5. Alikhan R, Rayment R, Keeling D, Baglin T, Benson G, Green L, et al. The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran. Emerg Med J. 2013 Feb 22. (Epub ahead of print) 
6. Esnault P, Gaillard PE, Cotte J, Cungi PJ, Beaume J, Prunet B. Haemodialysis before emergency surgery in a patient treated with dabigatran. Br J Anaesth. 2013 May 5. 
7. Breik O, Tadros R, Devitt P. Thrombin inhibitors: surgical considerations and pharmacology. ANZ J Surg. 2013 Apr;83(4):215-21.