Abstract. Introduction. In recent years, CTA has been an effective training adjunct for orthopaedic procedures. ACLR is a complex procedure with a steep learning curve. Aim. To design a multimedia CTA learning tool for ACLR using a modified Delphi methodology. Methodology:. CTA generation: A modified Delphi method was used to generate a list of Technical Steps (TS), Decision Points (DP) and errors/solutions for an ACLR that was approved by an expert consensus amongst four, fellowship-trained knee surgeons. A technical workflow was designed to generate the audio-visual tool. Pilot study: 30 novice trainees were granted access to the CTA tool and then performed the ACLR in a cadaveric simulation workshop. A 5-point Likert scale aimed to qualitatively assess if the CTA was useful to their learning. Results:. CTA generation: 156 TS and 79 DP were included for an ACLR procedure which was divided into 7 phases. The audio-visual component was combined with the written tool to design the final CTA tool. Pilot study: 95% of trainees suggested the CTA tool would be useful before carrying out an ACLR in the operating theatre. They agreed it made their ACLR learning more effective. Conclusion:. We have designed a novel and easily accessible CTA tool to standardise teaching of ACLR surgery. Novice surgeons verify the value of the CTA as an adjunct to their apprenticeship training. Future work: A Randomised Controlled Trial (RCT) is currently being planned to evaluate whether there are any objective benefits of this CTA to train surgeons performing an ACLR

Purpose of the study. To investigate the feasibility of undertaking a definitive Randomised Controlled Trial (RCT) to determine the effectiveness of early physiotherapy for sciatica. Methods. Patients over 18 presenting to their G.P with sciatica were eligible to participate in the study, those without a clear understanding of English or had co-morbidities preventing rehabilitation were ineligible. Process and patient reported outcomes including self-rated disability, pain and general health, were collected at baseline, 6,12 and 26 weeks post randomisation. Participants were randomised into either early physiotherapy, receiving treatment within 2 weeks after randomisation or usual care with physiotherapy commencing 6 weeks post randomisation. Both groups received up to 6 treatment sessions of a patient-centred, goal orientated physiotherapy programme specific to their needs. Results. 80 participants were recruited in 10 G.P practices over 34 weeks and randomised to either early physiotherapy (n= 42) or usual care (n=38). Follow-up rates at 26 weeks were 36 (86%) in the early intervention physiotherapy group and 32 (84%) in the usual care. All feasibility objectives were achieved. The mean area under the curve for the Oswestry Disability Index (ODI) over the 26 weeks was and 16.0 (SD 14.0) in the early physiotherapy group and 16.6 (SD 11.4) in the usual care group. A difference of −0.6 (95% CI: −0.68 to 5.6) in favour of the intervention group. Conclusion. The results of the study suggest a full RCT is feasible and will provide evidence as to the optimal timing of physiotherapy for patients with sciatica. No conflicts of interest for any authors. Sources of funding: MR is the recipient of a HEE/NIHR Clinical Doctoral Research Fellowship, which funded the study