Preoperative priming results in improved operative performance with surgical trainees.

Background: Preoperative warm-up regimens are increasingly utilised in the surgical field, however no consensus on benefits of priming across surgical experience has been realised. The aim of this study was to evaluate the impact of simulation preoperative priming on operative performance across levels of resident experience.

Methods: A single-blinded randomised control trial was carried out in a regional surgical training centre.

Surgical Priming Improves Operative Performance in Surgical Trainees: A Crossover Randomized Control Trial.

Objective: The aim of this study was to evaluate the impact of a surgical warm-up using a virtual reality simulator on operative performance.

Design: This was a single-blinded cross-over randomized control trial in a single tertiary Orthopedic training center.

Participants: Orthopedic trainees were recruited, and each morning participants rostered to theatre were randomized to either undergo a simulated surgical procedure on a virtual reality simulation system prior to their first case as primary operator (priming arm), or to perform their usual preparatory routine for surgery (control arm).

Evaluating the Impact of Supervision on Surgical Trainees Stress Response During Simulated Surgical Procedures; A Crossover Randomized Trial.

Objective: The aim of this study was to evaluate the cumulative impact of supervision on technical skills and surrogate stress markers in surgical trainees.

Design: This was a quasi-experimental crossover study to evaluate the impact of attending supervision on orthopedic trainee stress response during a simulated surgical procedure. Enrolled residents performed a proximal femoral nail module with the Precision OS system twice; once independently, and once under direct attending supervision, whilst wearing a heart rate monitor.

Use of procedure specific preoperative warm-up during surgical priming improves operative outcomes: A systematic review.

Background: Preoperative warm-up in preparation for surgery is a technique used in recognition of similarities between surgeons and performance based professionals. The aim of this review was to evaluate the use of simulation-based preoperative warm-up on surgical performance in the operating room and its impact on both clinical and patient outcomes.

Materials And Methods: A systematic review of the literature was carried out in accordance with PRISMA guidelines between August-September 2021.

The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial.

Aims: Platelet-rich plasma (PRP) intra-articular injections may provide a simple and minimally invasive treatment for early-stage knee osteoarthritis (OA). This has led to an increase in its adoption as a treatment for knee OA, although there is uncertainty about its efficacy and benefit. We hypothesized that patients with early-stage symptomatic knee OA who receive multiple PRP injections will have better clinical outcomes than those receiving single PRP or placebo injections.

Trauma Assessment Clinic: A virtual fracture clinic model that delivers on its PROMise!

Background: The use of virtual fracture clinics across the United Kingdom and Ireland is growing and have been shown in an increasing number of studies to be safe, cost-effective and associated with good functional outcomes and patient satisfaction rates for certain fracture types. Initially pioneered at Glasgow Royal Infirmary, many centres have adopted similar templates, or variations of, and the overall aim of this study was to assess functional outcomes and injury recovery satisfaction rates of patients discharged directly following review in a specific virtual fracture clinic model known as the Trauma Assessment Clinic (TAC).

Methods: A prospective observational study was carried out of paediatric (aged <17 years) and adult (aged >17 years) patients, with the five most commonly observed fracture types, who were discharged directly following review at the TAC in a single hospital centre over a 12 month period from January to December 2018.

Cost-effectiveness analysis of routine follow-up for hip fracture patients after dynamic hip screw and intramedullary nail fixation.

Introduction: The rising number of hip fractures has incentivised several quality improvement initiatives aimed at improving outcomes. These include the national hip fracture audit and the best practice tariff. Whilst there is an established standard of care for inpatients, the optimal outpatient management of patients after hip fracture fixation remains undefined.

Hand dominance and experience improve bimanual performance on arthroscopic simulator task.

Purpose: The aim of this study was to identify if experience in arthroscopy confers ambidexterity to the operator and the role of baseline characteristics in arthroscopic simulator performance.

Methods: A prospective comparative study was carried out across four regional Orthopaedic training centres. Participants were divided into novice, intermediate or experienced groups based on arthroscopic experience.

The specialty mentor effect in enhancing surgical experience of medical students: A randomised control trial.

Introduction: The positive learning experiences of students on surgical rotations which subsequently influence career choice may be delineated into practical and interpersonal themed factors. It remains unclear the relative impact each component has on the student experience and subsequent specialisation.

Aims: We evaluate the influence of having senior resident mentor during practical simulation in orthopaedic surgery has on medical student interest in surgery; their comfort in theatre; and its role in enhancing knowledge acquisition within the rotation.

Erysipelothrix rhusiopathiae Prosthetic Joint Infection in an Immunocompromised Patient: A Case Report.

Case: We report the case of an immunosuppressed 65-year-old man with prosthetic joint infection (PJI) 23 years postoperatively because of Erysipelothrix rhusiopathiae, through hematogenous seeding of cutaneous erysipeloid. Immunotherapy was discontinued, washout was performed, and antimicrobial therapy was guided by laboratory sensitivities. The patient was discharged on suppressive oral ciprofloxacin monotherapy.

Under viral attack: An orthopaedic response to challenges faced by regional referral centres during a national cyber-attack.

Background: A national ransomware attack on the Irish Health Service Executive left the Healthcare system bereft of access to IT systems, electronic patient records, and the national imaging system. Widespread disruption to internal and external referral pathways, and both trauma and elective Orthopaedic services occurred as a result. The purpose of this paper to discuss the challenges faced by Regional trauma units and adjustments made to overcome these.

A Portable Hip Arthroscopy Simulator Demonstrates Good Face and Content Validity with Incomplete Construct Validity.

Purpose: We evaluate the face, content, and construct validity of a portable hip arthroscopy module in a regional orthopaedic unit.

Methods: Participants were recruited from a regional orthopaedic centre, and categorized into novice (0 arthroscopies), intermediate (1-29 arthroscopies), and expert (>50 arthroscopies) groups based on reported experience in arthroscopy. Face and content validity was evaluated by feedback from users immediately following completion of modules.

Achilles' tendon rupture dancing the 'Jerusalema' - A case series.

Introduction And Importance: The weekend warrior has long been prey to musculoskeletal injuries as a result of intermittent, high intensity activity. The Achilles tendon is known to be particularly vulnerable in this population cohort but during the COVID-19 lockdowns in Ireland and all over the world there has been a certain level of detraining and deconditioning among all age groups and populations. Throughout the worldwide restrictions, viral internet challenges and dances have encapsulated the spirit of a global community with the 'Jerusalema' dance being no exception.

Injuries associated with arm wrestling: A narrative review.

Objective: Arm wrestling is common sport amongst amateur enthusiasts. Multiple injuries are described as a result of the sport. The authors present a narrative review of the common injuries associated with the sport.

A pilot study to evaluate the face & construct validity of an orthopaedic virtual reality simulator.

Aims: This study aimed to identify the face and construct validity of the Precision OS trauma module proximal femoral nail procedure. Secondary outcomes included perceived use of simulation in surgical training, with structured feedback from participants.

Methods: A comparative interventional study was carried out in a regional orthopaedics trauma unit hospital.

Trends in Irish hip fracture surgery over a 7-year period and international registry comparison.

Background: Hip fractures are a significant cause of morbidity and mortality in elderly patients. Timely surgical fixation and early mobilisation are the cornerstone to successful outcomes. The Irish Hip Fracture Database (IHFD) was established in 2012 and publishes annual reports on hip fracture care.

The Association of Gastrocnemius Tightness, Genu Valgum and Hallux Valgus: A Prospective Case-Control Study.

There has been much debate regarding the aetiology and pathogenesis of hallux valgus and it appears to be multifactorial with contracture or tightness of the Achilles tendon and more specifically the gastrocnemius being implicated as an intrinsic factor. The purpose of this study was to look at the association of gastrocnemius tightness, genu valgum and hallux valgus. A prospective case-control study with 25 patients in each group was carried out over a 12-month period.

Hip fracture care during Covid-19: a regional trauma centre's experience.

Introduction: The Covid-19 pandemic has caused worldwide upheaval from early 2020. Trauma and orthopaedic services are no different. A fundamentally important and significant portion of trauma services is the treatment of fragility fractures of the proximal femur, otherwise known as hip fractures.

Intraosseous schwannoma of the femur in a patient with monoclonal gammopathy of undetermined significance.

Introduction: Schwannomas are slow-growing, benign tumours normally originating from the schwann cells of the nerve sheath. Intraosseous schwannomas account for 0.175% of primary bone tumours and are extremely rare, especially outside the axial skeleton.

Virtualised care and COVID-19.

Following the declaration by the World Health Organization (WHO) of the Covid-19 pandemic on March 11, 2020, health organisations and staff have had to adapt and restructure services in order to respond to this global health emergency. Numerous containment strategies have been, and continue to be, introduced in this rapidly evolving and fluid situation with a significant shift towards virtual or remote patient assessment. The concept of virtual patient evaluation has previously been adopted across a range of medical and surgical specialities yielding safe and efficient pathways associated with good Patient Reported Outcome Measures (PROMs) and patient satisfaction rates.