Purpose: To determine the level of promotion of minimally invasive surgery (MIS) & computer assisted orthopaedic surgery (CAOS) in total knee replacement (TKR) through internet sites by BASK members.

Methods: We obtained an updated list of active members of BASK in March 2007 and permission from the executive committee to undertake this study. Standard search engines commonly used in our daily lives (viz. Google, Yahoo and Ask.com) were used to search for websites related to each surgeon during Sep–Nov 2007 period. The surgeon’s name, initials and job title thereof were used as keywords in conducting the search. Thus for each surgeon, all websites found were browsed and evaluated for MIS/CAOS and TKR/UKR information. Both direct (surgeon’s personal website/private practice) and indirect (group practice/hospital/university affiliation) information from these websites were reviewed and a standard pre-formed questionnaire proforma was filled in against that particular surgeon.

Results: A total of 178 websites were found for 405 members (392 inland + 13 overseas). 2.8% and 4.5% made direct and indirect reference to MIS TKR respectively. The most commonly listed benefits of MIS were quicker recovery, smaller incision and hence lesser pain. Very few specific risks of MIS were outlined by these websites. None of the websites quoted any peer-reviewed publication to support their claims. CAOS was discussed in 1.7% and 2.8% of these sites respectively.

Conclusion: Our study suggests that many active members do not have personal websites and these procedures are not commonly promoted by them via the internet. Many of these are often associated indirectly with group practice/institutional affiliation websites which may not necessarily be endorsed the surgeon. Our plan in near future is to monitor the changes in internet dissemination of information and close the audit loop by next year.

Objective: To determine the in vitro difference in stability in a functional spinal unit (FSU) following bilateral laminotomy, and compare it to the instability resulting from laminectomy.

Design: The normal and injured spines were subjected to flexion, extension, lateral bending and torsional moments.

Subjects: Six fresh human cadaver lumbar spines were injured sequentially at the L4–5 level: bilateral laminotomy and laminectomy.

Outcome measures: The three-dimensional motion behaviour of each spine before and after the two injuries was recorded using a magnetic motion sensor. The data from all five spines was pooled for statistical analysis.

Results: With flexion and extension loading, bilateral laminotomy induced significantly less sagittal angulation and translation in the FSU than did laminectomy. Significant increase in coronal translation occurred with laminectomy in spines subjected to lateral bending loads. There were no significant differences between the two techniques in coronal plane angulation with lateral bending loads and torsional loads.

Conclusion: The increase in motion seen with laminectomy in sagittal angulation/translation, and coronal translation in this in vitro model may represent clinical instability, and may be responsible for continued symptomatology in these patients. Preservation of the lamina, spinous processes, and the posterior ligamentous structures significantly enhances the biomechanical stability of the FSU.

Giant-cell tumours of the sacrum are difficult to treat. Surgery carries a high risk of morbidity, local recurrence and mortality. Radiation is effective in some patients, but has a risk of malignant change.

We evaluated the effectiveness of serial arterial embolisation as an alternative to surgery. Five patients with giant-cell tumours of the sacrum which had been primarily treated by serial embolisation were retrospectively reviewed for changes in the size of the tumour. In four the symptoms resolved with full return of function and arrest in the growth of the tumour. They remained free from growth, recurrence, or metastases at follow-up (4 to 17 years). One patient died from metastatic disease within 18 months of the initial diagnosis.