“Things done well and with a care, exempt themselves from fear”

 The Life of King Henry VIII. Act 1. Scene 2.

William Shakespeare 1564-1616

In the UK the Omnicron variant, and a highly vaccinated population, has allowed us a better Winter than last year, but there are still a good few months to go.
Surgical practice here has also been less curtailed than in 2020/1 but never the less the task ahead for Surgeons is unprecedented.  The Guardian newspaper reported 6 million people currently waiting for all forms of surgical treatment in the UK, with a more detailed analysis of the situation given by the British Medical Association .
The mainstream press have also picked-up on on the plight of Surgical trainees, so severely impacted by the cessation of much normal practice over the last 2 years. The greatest effect in particular is for those now completing their training, as reported by The Telegraph: “Britain faces Surgeon shortage as cancelled operations leave graduates underqualified” , and across the water by The Irish News: “Warning of Orthopaedic Surgeon shortage as cancelled operations during the pandemic leave Trainees poorly prepared”.
Mitigating the effects of this predictable situation by all means possible is imperative, and yet again underlines the immediate need for detailed, fit for purpose, resources to support Surgeons at the start of their careers, and also throughout them.

It is always a pleasure to publish techniques from the world of Bone Tumour surgery, and Jonathan Stevensons’ Osteosarcoma resection also provides real insights into both the use of large intra-articular allografts as well as the increasingly common use of 3D printed Patient Specific Instrumentation.
It’s great to be able to bring you two spinal operative techniques this month, each definitively demonstrated by Steve Morris and Mark Nowell, from the spinal unit at Southmead Hospital in Bristol.
Though both operative techniques are very much the remit of the specialist, everyone will  gain useful insights into the many aspects of diagnosing and managing both the arthritic spine as well as a prolapsed disc, in addition to the surgical masterclass.
The fixation of a large osteochondral defect can be a relatively simple technique, but there are still many factors to be considered and understood if success is to be routinely achieved. James Donaldsons’ comprehensive instruction should be read by all.