Aims. Our primary aim was to establish the proportion of female orthopaedic consultants who perform arthroplasty via cases submitted to the National Joint Registry (NJR), which covers England, Wales, Northern Ireland, the Isle of Man, and Guernsey. Secondary aims included comparing time since specialist registration, private practice participation, and number of hospitals worked in between male and
Aims. The number of females within the speciality of trauma and orthopaedics (T&O) is increasing. The aim of this study was to identify: 1) current attitudes and behaviours of UK
Aims. As an increasing number of
Orthopaedics has been left behind in the worldwide drive towards diversity and inclusion. In the UK, only 7% of orthopaedic consultants are female. There is growing evidence that diversity increases innovation as well as patient outcomes. This paper has reviewed the literature to identify some of the common issues affecting
Introduction. The medical field has long held largely anecdotal beliefs that polymethyl methacrylate (PMMA) vapors are dangerous to a growing fetus, and as such, women who are pregnant should avoid exposure. This study investigates the perceptions of
Aims. Global literature suggests that female surgical trainees have lower rates of independent operating (operative autonomy) than their male counterparts. The objective of this study was to identify any association between gender and lead/independent operating in speciality orthopaedic trainees within the UK national training programme. Methods. This was a retrospective case-control study using electronic surgical logbook data from 2009 to 2021 for 274 UK orthopaedic trainees. Total operative numbers and level of supervision were compared between male and female trainees, with correction for less than full-time training (LTFT), prior experience, and time out during training (OOP). The primary outcome was the percentage of cases undertaken as lead surgeon (supervised and unsupervised) by UK orthopaedic trainees by gender. Results. All participants gave permission for their data to be used. In total, 274 UK orthopaedic trainees submitted data (65% men (n = 177) and 33% women (n = 91)), with a total of 285,915 surgical procedures logged over 1,364 trainee-years. Males were lead surgeon (under supervision) on 3% more cases than females (61% (115,948/189,378) to 58% (50,285/86,375), respectively; p < 0.001), and independent operator (unsupervised) on 1% more cases. A similar trend of higher operative numbers in male trainees was seen for senior (ST6 to 8) trainees (+5% and +1%; p < 0.001), those with no time OOP (+6% and +8%; p < 0.001), and those with orthopaedic experience prior to orthopaedic specialty training (+7% and +3% for lead surgeon and independent operator, respectively; p < 0.001). The gender difference was less marked for those on LTFT training, those who took time OOP, and those with no prior orthopaedic experience. Conclusion. This study showed that males perform 3% more cases as the lead
The February 2023 Spine Roundup360 looks at: S2AI screws: At what cost?; Just how good is spinal deformity surgery?; Is 80 years of age too late in the day for spine surgery?; Factors affecting the accuracy of pedicle screw placement in robot-assisted surgery; Factors causing delay in discharge in patients eligible for ambulatory lumbar fusion surgery; Anterior cervical discectomy or fusion and selective laminoplasty for cervical spondylotic myelopathy; Surgery for cervical radiculopathy: what is the complication burden?; Hypercholesterolemia and neck pain; Return to work after surgery for cervical radiculopathy: a nationwide registry-based observational study.
Sufficient primary stability of the acetabular cup is essential for stable osseous integration of the implant after total hip arthroplasty. By means of under-reaming the cavities press-fit cups gain their primary stability in the acetabular bone stock. These metal-backed cups are inserted intra-operatively using an impact hammer. The aim of this experimental study was to obtain the forces exerted by the hammer both in-vivo and in-vitro as well as to determine the resulting primary stability of the cups in-vitro. Two different artificial bone models were applied to simulate osteoporotic and sclerotic bone. Polymeth-acrylamid (PMI, ROHACELL 110 IG, Gaugler &
Lutz, Germany) was used as an osteoporotic bone substitute, whereas a composite model made of a PMI-Block and a 4 mm thick (cortical) Polyvinyl chloride (PVC) layer (AIREX C70.200, Gaugler &
Lutz, Germany) was deployed to simulate sclerotic bone. In all artificial bone blocks cavities were reamed for a press-fit cup (Trident PSL, Size 56mm, Stryker, USA) using the original surgical instrument. The impactor of the cup was equipped with a piezoelectric ring sensor (PCB Piezotronics, Germany). Using the standard surgical hammer (1.2kg) the acetabular cups were implanted into the bone substitute material by a male (95kg) and a
Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review.Aims
Methods
To investigate the experience and emotional impact of prosthetic joint infection (PJI) on orthopaedic surgeons and identify holistic strategies to improve the management of PJI and protect surgeons’ wellbeing. In total, 18 prosthetic joint surgeons in Sweden were recruited using a purposive sampling strategy. Content analysis was performed on transcripts of individual in-person interviews conducted between December 2017 and February 2018.Aims
Methods
Introduction: To obtain secondary implant stability of acetabular press-fit cups, sufficient primary stability is essential. The aim of this study was to investigate the influence of cup insertion force and bone quality on the primary implant stability. Materials and Methods: The experiments were carried out using two commercially available press-fit acetabular cups (Trident PSL, Stryker und EP-FIT PLUS, PLUS Ortho-peadics), comparable in design and with identical diameters, which were inserted axially into artificial bone by a female and a male surgeon. Two bone substitute material models were used. To imitate osteoporotic bone, a PMI-model (ROHACELL 110 IG, Gaugler &
Lutz oHG) was employed. To simulate sclerotic bone, a composite-model made of a PMI-bloc with a 4 mm thick PVC-layer (AIREX C70.200, Gaugler &
Lutz oHG) was used. The cups were inserted using an insertion device, equipped with a force sensor, and an 1100 g surgical hammer. Additionally, all experiments were carried out using a dynamic testing machine (25 kN, Instron) utilising insertion forces of 4.0 kN and 8.0 kN respectively. Primary implant stability was determined via lever-out tests using a static universal testing machine (Z050, Zwick/Roell). Results: On average an insertion force of 4.8 kN (female) and 7.0 kN (male) using the PMI-model and 6.2 kN (female) and 7.5 kN (male) for the composite-model was assessed for the two different surgeons. The machined forces averaged 3.8 kN and 7.9 kN. Lever-out-moments of 17 Nm were determined for both the PMI- and composite-model for the