“You only live once, but if you do it right, once is enough”

Mary Jane “Mae” West

1893-1980

American actress, playwright, screenwriter and singer

Revision surgery is very much the theme this week, and an increasing part of our practices, as patients live longer, more active lives, and require that their musculoskeletal systems keep pace with the rest of them.

The surgical principles are the same whatever the anatomical region though the skills and tools required for execution are very different, which reading through todays published techniques will emphasise.
Meticulous soft tissue handling, debriding back to a healthy bone bed and attention to anatomical alignment and functional positioning are the common features. Bi-valving a tibia to remove a failed stemmed implant, recreating a normal hindfoot from a significantly undertreated calcaneal fracture and carefully judging the bone resection possible during the re-functioning of a hallux require different touches though.

We are also publishing a technique from the cutting edge of knee arthroplasty, resurfacing using a HemiCAP. It’s a technology that is still defining its place in the range of solutions for limited articular damage, but is demonstrating value in the knee and several other joints as well.

Todays video is from Tahseen Chaudhry, who specialises in peripheral nerve and brachial plexus reconstruction, at the Queen Elizabeth trauma unit in Birmingham, UK. His theme is also one of general principles, and as such a “must watch” for anyone learning the specialised techniques of nerve surgery.