Labral tears are commonly associated with femoroacetabular impingement. We reviewed 151 patients (156 hips) with femoroacetabular impingement and labral tears who had been treated arthroscopically. These were subdivided into those who had undergone a labral repair (group 1) and those who had undergone resection of the labrum (group 2). In order to ensure the groups were suitably matched for comparison of treatment effects, patients with advanced degenerative changes (Tönnis grade > 2, lateral sourcil height < 2 mm and Outerbridge grade 4 changes in the weight-bearing area of the femoral head) were excluded, leaving 96 patients (101 hips) in the study. At a mean follow-up of 2.44 years (2 to 4), the mean modified Harris hip score in the labral repair group (group 1, 69 hips) improved from 60.2 (24 to 85) pre-operatively to 93.6 (55 to 100), and in the labral resection group (group 2, 32 hips) from 62.8 (29 to 96) pre-operatively to 88.8 (35 to 100). The mean modified Harris hip score in the labral repair group was 7.3 points greater than in the resection group (p = 0.036, 95% confidence interval 0.51 to 14.09). Labral detachments were found more frequently in the labral repair group and labral flap tears in the resection group. No patient in our study group required a subsequent hip replacement during the period of follow-up.

This study shows that patients without advanced degenerative changes in the hip can achieve significant improvement in their symptoms after arthroscopic treatment of femoroacetabular impingement. Where appropriate, labral repair provides a superior result to labral resection.

Introduction: Since the first meeting in 1875, and the subsequent introduction of the concept of evidence based medicine in the 1990s, the journal club has become an integral part of keeping abreast with current literature.

There is no study assessing orthopaedic journal clubs amongst training programs across the UK. This study had two aims: the first was to determine whether journal clubs still play an important part in orthopaedic training programs, the second was to evaluate the frequency, format and goals of journal clubs conducted in orthopaedic training programs in the UK.

Method: We surveyed fifty seven hospitals across the UK. This included hospitals from all the orthopaedic teaching regions of which twelve were teaching hospitals and forty five district general hospitals.

Results: A total of 57 hospitals were surveyed. Of these hospitals 28/57(49%) had a journal club programme in place. On average journals clubs were undertaken once a month and lasted about 1 hour. Most occurred during the working day and were chaired by a consultant. Specialist registrars presented the vast majority of papers (average of 1.9 each per session), with the JBJS Br being the most widely used journal (100% of journal clubs).

Of the twelve teaching hospitals questioned, five (42%) had journal clubs, and twenty three of the forty five (51%) district general hospitals had journal clubs. The average number of articles critically appraised by trainees who attended journal clubs was 5 (0–15) compared to 3 (0–18) in those not attending a journal club.

When asked whether there was any alternative way in which a trainee might otherwise learn how to critically appraise an article, fourteen suggested online journal forums and eighteen suggested self-directed learning or personal study.

Although only 49% of hospital had journal clubs, 88% of trainees believed that it formed a valuable part of training and 56% thought it should be compulsory.

Discussion: This study shows that journal clubs occur in around half of the orthopaedic departments surveyed across the country. This is despite the importance trainees’ associate with journal clubs being part of their training.

In contrast, studies from North America show that a regular journal club occurs in 99% of residency programs.

It may therefore be suggested that for those trainees who do not attend a journal club, an alternative method to learning the skills of critical appraisement may have to be sort. One suggested modality is through on-line journal clubs or forums within regions which trainees may be encouraged to undertake from their regional directors.