“Common sense is the collection of prejudices acquired by the age of eighteen”

Albert Einstein

German-born Theoretical Physicist

1879-1955

This month we have two advanced techniques in large joint arthroplasty, both very much for the more experienced surgeon, but none the less with great perspective for those of you discovering the range of solutions to difficult surgical problems. Peter Biberthalers’ Periprosthetic tibial fracture fixation, recorded at the MRI University Hospital in Munich, provides both a detailed review of the management options for these difficult injuries as well as a clear demonstration of the Zimmer-Biomet NCB plating system, well suited to preservation of the original tibial knee component. Jonathan Stevensons redo revision of a multiply failed total hip replacement using the Adler Pantheon modular EPR  at the Royal Orthopaedic Hospital in Birmingham on the other hand demonstrates precisely how to remove the majority of the femur safely, and replace it with something much shinier and better engineered.
James Donaldsons’ ACL reconstruction using hamstring allograft and the TLS system also provides a broad overview of ACL reconstruction as well as the detail around using this well established method of optimising graft tension and fixation. It is accompanied by the British Orthopaedic associations guidelines on ACL reconstruction and a link to their excellent free to download Best practice book for ACL injuries.
For those readers who feel that proper orthopaedic surgery should involve the use of a microscope, which I suspect will not include Jonathan Stevenson, Steve Morris Lumbar Microdiscectomy should tick the boxes, and now brings our total of discectomy techniques (including both thoracic and cervical discs) to six.