From the Executive Editor

Simon Hodkinson

A warm, but currently damp welcome to the September, Congress edition of the JTO.

As I write this editorial, the orthopaedic and national media is reporting the sad loss of one of our young colleagues, cut down in his prime on holiday. A sad reminder of the frailty of human life.

We also mourn the loss of Rolfe Birch, a true giant of our profession. Both are remembered in this edition and our sincere condolences go to the bereaved families.

Turning to this edition, the theme is on sustainability, reflecting the theme for this year’s Congress, ‘Sustainable Systems’.

I would like to start by congratulating the recipients of the BOA’s Honorary Fellowships for this year, listed here with their significant contributions to our profession.

Our first article is about advancing MSK health through research and innovation by Arash Angadji from ORUK. Many of us of a certain generation will remember Ronnie Furlong who was the driving force behind ORUK, and this is an important article at this time of huge waiting lists and an ever increasing workload in our profession, much of it driven by an ageing population and poor health.

Continuing the theme of the ORUK article, Chetan Khatri et al discuss how to introduce new technologies into our practice. This is a very relevant article, given the current issues we face with implant availability in the UK. The authors are all hugely experienced in both research and regulation of the subject.

Moving to the crux of this edition and this year’s Congress theme, there are a series of diverse articles, all with a common theme of sustainability in our profession.

First off is an article from Irrum Afzal et al, about the need to share best practice in sustainability in T&O, pointing out that the NHS is the largest single contributor to greenhouse emissions in the public sector and we in T&O are a big part of that statistic!

Sharon Scott then reviews the real and present issue of sustaining our trauma services against an avalanche of issue familiar to all of us. My generation starting to create a peak in the frail population at the same time as the trough in the younger age group that provide the care occurs. The perfect storm. The article reflects on the need to follow evidence-based practice as best we can, informed and supported by such initiatives as GIRFT in elective care.

We then move on to our invited section of articles on the subject of sustainability in T&O, edited by Steve Bendall in Brighton. These three thought-provoking articles start with a discussion of what sustainability means and what elements are realistic aims in our practice.

Benedict Rogers then covers the issue of ventilation in theatres and what is really required to reduce SSI’s, and whether the time has come to challenge the paradigm that all orthopaedic surgery has to be done in an ultraclean environment.

Finally, Hussameldin Nour et al looks at whether we should do a U-turn in our practice, and return to reusable gowns and drapes.

Three articles that look at what we can realistically do to change our carbon footprint in the practice of Trauma and Orthopaedic surgery.

This is a packed edition and I do hope all recipients find something of interest to themselves in these challenging times.

I look forward to seeing you at this year’s Congress in Liverpool.