Citation: The Surgeon. 2021, S1479-666X(21), 00057-3. Online ahead of print
Author: Malwattage Lara Tania Jayatilaka, Mohammed As-Sultany, Ayman Gabr, Luke Thornton, Simon Graham, Lyndon Mason, Nicholas Greville Farrar, COVI-ORTH UK
Abstract: Introduction: COVID-19 was declared a pandemic by the World Health Organization on the 11th of March 2020 with the NHS deferring all non-urgent activity from the 15th of April 2020. The aim of our study was to assess the impact of COVID-19 on Trauma and Orthopaedic trainees nationally.
Methods: Trauma and Orthopaedic (T&O) specialty trainees nationally were asked to complete an electronic survey specifically on the impact of COVID-19 on their training. This UK based survey was conducted between May 2020 and July 2020.
Results: A total of 185 out of 975 (19%) T&O specialty trainees completed the survey. Redeployment was experienced by 25% of trainees. 84% of respondents had experienced a fall in total operating numbers in comparison with the same time period in 2019. 89% experienced a fall in elective operating and 63% experienced a fall in trauma operating. The pandemic has also had an effect on the delivery of teaching, with face to face teaching being replaced by webinar-based teaching. 63% of training programmes delivered regular weekly teaching, whilst 19% provided infrequent sessions and 11% provided no teaching.
Conclusion: This study has objectively demonstrated the significant impact of the COVID-19 pandemic on all aspects of T&O training.
Keywords: COVID–19; Coronavirus; Education; Pandemic; Training; Trauma & orthopaedics.
Thursday 25 March 2021
WUTH publication: Collaborative Overview of coronaVIrus impact on ORTHopaedic training in the UK (COVI - ORTH UK)
Wednesday 24 March 2021
WUTH publication: COVID-19 Vaccine Prioritisation for Medical Students: The Forgotten Cohort?
Citation: Clinical Oncology. 2021, S0936-6555(21), 00084-4. Online ahead of print.
Author: J S Lim, T P T Au Yong, C S Boon, I S Boon
Tuesday 9 March 2021
WUTH publication: Functional outcomes & metal ion levels following ceramic on metal total hip arthroplasty: 9 Year follow-up
Citation: Journal of orthopaedics. 2021, 24, 131-34
Author: Nisarg Mehta, Dhawal Patel, Justin Leong, Phil Brown, Fintan Adrian Carroll
Abstract: In this study, we evaluate the mid-term functional and radiological outcomes of Ceramic on Metal Total Hip Arthroplasty (CoM THA) THA. 66 CoM THAs were performed between 2008 and 2010. These were evaluated and followed up in 2017-18, at a mean follow-up of 9 years to record the Oxford Hip Score [OHS] and whole blood Cobalt and Chrome levels. Our all cause revision rate was 4.5% (3 out of 66). At mid-term follow up, patients with CoM THAs are mostly asymptomatic with reasonable functional outcomes, we have reported similar revision rates in conjunction with raised blood metal ion levels and frequency of radiolucent lines.
Keywords: Arthroplasty; Ceramic on metal; Chromium levels; Cobalt levels.
Thursday 4 March 2021
WUTH publication: Theatre ventilation
Citation: Annals of the Royal College of Surgeons of England. 2021, 103(3), 151-54
Author: C Theodorou, G S Simpson, C J Walsh
Abstract: Introduction: Owing to the COVID-19 pandemic, there has been significant disruption to all surgical specialties. In the UK, units have cancelled elective surgery and a decrease in aerosol generating procedures (AGPs) was favoured. Centres around the world advocate the use of negative pressure environments for AGPs in reducing the spread of infectious airborne particles. We present an overview of operating theatre ventilation systems and the respective evidence with relation to surgical site infection (SSI) and airborne pathogen transmission in light of COVID-19.
Methods: A literature search was conducted using the PubMed, Cochrane Library and MEDLINE databases. Search terms included "COVID-19", "theatre ventilation", "laminar", "turbulent" and "negative pressure".
Findings: Evidence for laminar flow ventilation in reducing the rate of SSI in orthopaedic surgery is widely documented. There is little evidence to support its use in general surgery. Following previous viral outbreaks, some centres have introduced negative pressure ventilation in an attempt to decrease exposure of airborne pathogens to staff and surrounding areas. This has again been suggested during the COVID-19 pandemic. A limited number of studies show some positive results for the use of negative pressure ventilation systems and reduction in spread of pathogens; however, cost, accessibility and duration of conversion remain an unexplored issue. Overall, there is insufficient evidence to advocate large scale conversion at this time. Nevertheless, it may be useful for each centre to have its own negative pressure room available for AGPs and high risk patients.
Keywords: COVID-19; Coronavirus; General surgery; Laminar flow; Operating room; SARS.