Aims

To identify unanswered questions about the prevention, diagnosis, treatment, and rehabilitation and delivery of care of first-time soft-tissue knee injuries (ligament injuries, patella dislocations, meniscal injuries, and articular cartilage) in children (aged 12 years and older) and adults.

Rheumatology and Musculoskeletal Sciences, NIHR Biomedical Research Unit, University of Oxford and the Nuffield Orthopaedic Hospital, Oxford. Purpose. The aim of this study was to use motion analysis to objectively study the learning curve of surgical trainees performing arthroscopic meniscal repair on a training model in a skills laboratory. Background. With improving technology and an appreciation of its likely chondroprotective effects, meniscal repair surgery is becoming more common. It remains a difficult procedure and is not routinely learnt during surgical training. Methodology. 19 orthopaedic surgical trainees watched an instructional video of a meniscal repair method (Smith & Nephew Fast-Fix) and then performed 12 meniscal repair episodes on a ‘sawbones’ knee simulator with a standardised lateral meniscal tear. The 12 repair episodes were performed during over a 3 week period. A validated motion analysis system was used to record: distance travelled by each hand; number of hand movements; and time taken to complete the task. Results. Time taken, number of hand movements and total path travelled all showed improvements over the twelve episodes. Time taken improved by 34%, Total path travelled by 21%, and Hand movements improved by 27% for the camera hand (right) and 19% for the instrument hand (left). There was evidence of plateau on the learning curve over the 12 episodes, with larger improvements in measured outcomes over the initial episodes compared to the last episodes. Conclusion. This study objectively demonstrates a learning curve for surgeons performing arthroscopic meniscal repair in a skills laboratory. It indicates the benefits to surgical trainees of practicing such arthroscopic techniques in a skills centre prior to progressing to the operating theatre

Aims

Stiffness is a common complication after total knee arthroplasty (TKA). Pathogenesis is not understood, treatment options are limited, and diagnosis is challenging. The aim of this study was to investigate if MRI can be used to visualize intra-articular scarring in patients with stiff, painful knee arthroplasties.