Introduction: Ankle injuries in cricketers are of topical interest with a number of elite fast bowlers sustaining injuries. Previous research has concentrated on the injury risk to the bowler’s vertebrae with no research focused on the ankle of the fast bowler and exploring the biomechanical basis for its predisposition to injury.

Materials and methods: Ten elite level cricket fast bowlers had their ankle biomechanics assessed during their bowling action. Using a nine-camera infra-red ViconTM 612 motion analysis system linked to a KistlerTM 9281CA force platform the moments of the subjects leading leg ankle during their delivery stride was calculated and analysed. Each subject performed ten trials at their maximum ball release speed (> 97km/hr) and ten trials at less than their maximum ball release speed (< 97km/hr) with the velocity of the ball tracked by a SR3600 radar gun.

Results: All six joint moments of the ankle were examined in both directions of all three orthogonal planes. Of these results only the difference in the ankle plantar flexion was found to be pertinent. The average ankle plantar flexion peak moment in the maximal ball release speed group was 2.008Nm/kg and in the sub-maximal ball release speed group 1.790Nm/kg. This difference was analysed using the paired Student t-test and was statistically significant (p< 0.02).

Discussion: This study shows the ankle plays a significant part in the fast bowler’s delivery action and suggests a biomechanical reason for ankle injuries in these individuals. It is recommended that in fast bowlers with ankle injuries a graduated return to maximal speed bowling is utilised in rehabilitation to prevent further injury and long term morbidity.

Conclusion: The increased ankle plantar moment reflects the important role the ankle plays in the generation of extra ball release speed in the cricket fast bowler.

Introduction The need for bone graft has increased in recent years partly due to the greater numbers of revision hip arthroplasties being performed secondary to the increasing life expectancy in the UK.

Method Our study prospectively reviewed the practice of bone banking at Portsmouth Hospital NHS Trust to look into the various factors responsible for exclusion of patients from donation of bone. All 55 patients under-went screening in a preoperative assessment clinic using a standard proforma to assess their suitability for femoral head donation during the course of their primary hip arthroplasty and records at the bone bank were then reviewed post operatively to check whether bone had been harvested from these individuals during surgery. Results 95% of the patients screened did not proceed to bone banking. After the initial screening stage 33 patients (60%) were excluded due to a variety of reasons. The majority of those excluded (23 patients) were not accepted as donors because of the potential risk of transmission of disease to their recipients.

Although 22 patients (40%) were consented for allograft donation, femoral heads from only 3 patients (5%) were harvested and sent for storage in the bone bank during hip arthroplasty.

Discussion The harvesting of viable bone stock was shown to be poorly utilised in our study. Orthopaedic surgeons must take an active part in bone banking and alternative sources of bone grafts need to be explored in the future to meet the increasing demand.

Bone grafting is used extensively in orthopaedic reconstructive surgery. Revision hip arthroplasty often presents surgeons with difficult bone loss problems, which can sometimes be addressed using donated bone. This need for bone graft has increased in recent years with greater numbers of joint replacements and increasing life expectancy after replacement, particularly as prostheses are being implanted into younger patients. Current practice of bone banking involves careful donor selection, stringent screening tests and internal safety systems in bone banks to prevent the ever present threat of communicable diseases. Introduction of strict monitoring systems to prevent allograft-related diseases has rendered a significant number of primary hip replacement patients unsuitable for bone donation. This study audited the practice of bone banking at Portsmouth Hospitals NHS Trust to look into various factors responsible for exclusion of patients from bone banking. All 55 patients underwent screening in pre-operative assessment clinics using standard Proforma to assess their suitability for femoral head donation during the course of their primary hip replacement surgery. After the initial screening stage 33 patients (60%) were excluded due to variety of reasons. The majority of those excluded (23 patients) were not accepted as donors because of their potential risk of transmission of disease to the recipients. The situation is likely to become worse in future as the incidence of communicable diseases is rising in the UK. Alternative sources of bone grafts should be explored in future to meet the demands for, example auto-banking.