“One of the penalties for refusing to participate in politics is that you end up being governed by your inferiors”

Plato

Greek Philosopher  428-348 BC.

At OrthOracle our objective has always been to disseminate an experienced surgeons insights on exactly how to execute each technique, from the initial patient assessment through to every actual step of the operation.

This month we have again more spinal surgery for you, and a particularly useful explanation of how to to perform a radiofrequency ablation of the lumbar facet joints, in Lumbar spondylosis. Steve Morris’ Facet Joint Denervation (lumbar spine) using Abbott IonicRF Generator gives great insight into this straightforward technique, which for anyone dealing with the musculoskeletal system, spinal surgeon or not, is a “must read”.
James Murrays’ Tibial tubercle osteotomy  is comprehensive and “end to end” in all aspects of this surprisingly utilitarian operation. It can be used to improve patella instability, mal-tracking or chondral lesions in the native knee as well as to aid exposure at the time of arthroplasty or to avoid patella baja in the revision knee situation.
Peter Rosenfelds  Long Flexor Hallucis Longus transfer for Chronic Achilles rupture now brings to 7 the number of operative solutions for Achilles ruptures that we have on the platform. The FHL transfer is a key technique for any Surgeon who regularly deals with Achilles ruptures and Petes’ instructional technique is arguably the best route-map available anywhere on how to get this right. 
Even if you are a Surgeon already experienced in forefoot surgery Hari Harans’ demonstration of the Distal Minimally Invasive Metatarsal Osteotomy (DMMO) is something you should be aware of. Whether it changes your mind on minimally invasive forefoot surgery, it is a technique very much worth knowing about, and Hari shares his wealth of experience in this article.
It also brings our foot and ankle operative techniques now to 135.

My best wishes

Mark Herron FRCS, London, Uk.