From the Executive Editor

Simon Hodkinson

A warm welcome to the June edition of the JTO. A year ago, when I welcomed you to the June edition of 2022 in the pouring rain on the south coast, I contemplated the possibility of flaming June arriving. It did indeed arrive and continued unabated into July and August.

Sadly, many of last year’s issues remain, and we now have our nursing and junior doctor colleagues involved in a series of strikes, the like of which we have never seen before. However, we soldier on and in this edition, we start with congratulations to all our runners, cyclists, and last but by no means least, our home-grown Tough Mudder team, raising money for Joint Action. Many congratulations and thanks to all who took part. Judging by the photographs, I’m glad the BOA is not responsible for their laundry bill!

We move on to a reflective piece on the origins of the NHS by our own Head of Policy and Public Affairs, Gary Robjent, as we celebrate its 75th anniversary. As he mentions, so much of what we have today has its origins in the two worlds wars and their aftermath, and to the traumatic fallout of the industrialisation of the UK.

The first of a series of articles from the NJR, as it celebrates its 20th anniversary, reflects on the positive changes in the outcomes from joint replacement, noting the continuing fall in the mortality of the operation, to the fact that 90% of hip and knee replacements now last more than 15 years.

Following on the theme of joint replacement, Andrew Hamer et al records the development and roll out of the revision hip networks. I am sure that this will not be the last national networks we see develop in our speciality, all to the benefit of our patients.

Andrew Manktelow has produced a timely article on the activities in the independent sector, and raises the potential disconnect between practitioners in the independent sector and the BOA. As an addendum to this article, I would invite anybody who wishes to engage with the BOA on this or any other issue that needs our attention to use the JTO e-mail address (jto@boa.ac.uk).

Fergal Monsell discusses the evolution of the BOAST guidelines, highlighting that in the future BOAST guidelines will continue, but on subjects of a generic interest to all orthopaedic surgeons and these will now be supplemented by SpecS documents focusing on specific issues related to specialties.

The next two articles focus on health and safety at work. The article by Hannah Sevenoaks and her colleagues discusses the issue of improving the protection of the breast in female orthopaedic surgeons, raising issues of potentially inadequate protection from the conventional tabard-type lead gowns. The next article by Hiro Tanaka – the first in a series of health and safety articles to be produced – discusses in more detail the generic issues of radiation and how we should pay attention to protecting ourselves. Something that I suspect we have all at some stage in our careers ignored.

This month’s trainee section looks at the British Hip Society’s programme that they ran during their annual meeting, engaging non-selective state schools with the idea of a career in medicine, and subsequently trauma and orthopaedic surgery. We are indebted to Marietta Franklin and her colleagues in the British Hip Society for producing not only the article, but for creating the project as an example of engaging our profession with a wider audience.

Simon Britten, as chair of the medical legal committee at the BOA, has produced an interesting article on the issue of clinical guidelines and standards of care, and delves into their place in ours and our legal colleague’s practice.

Finally, but by no means least, we come on to our specialty features for the June edition, edited by Anna Clarke. As she says in her introduction to the three articles, they cover the big three paediatric problems that historically have caused a degree of stress to the coronary arteries in the general orthopaedic surgeon when on call. These three articles cover supracondylar fractures, infection in the paediatric patient and open tibial fractures. They’re excellent articles for both general and specialist orthopaedic surgeons alike and hopefully there’s something for everyone in the articles.

I do hope you enjoy the June edition of the JTO and let us hope for a quieter more peaceful summer.