EHS Travel Fellowship 2019 Report by Alex Brunner and Loris Perticarini (Alex writes…)
We would like to thank the European Hip Society for giving us the opportunity to perform this fellowship. We had a very rewarding time in the UK.
26.03.2019: Circle Hospital Reading
The first stop on our journey was Reading, a large town in Berkshire about 50km from London. There we visited Circle Reading, a private hospital offering a wide spectrum of elective orthopaedic surgeries. In the morning we met Mr Tony Antrade, a senior orthopaedic consultant with many years of experience in hip arthroscopy.
We attended him during a number of arthroscopic procedures including arthroscopic labral repairs, resection of cam deformities, and fixation of a partial tear of the gluteus medius tendon.
During the procedures, we had the opportunity to discuss some of our own cases with Mr Andrade and he was very committed to share his experience.
We also got in touch with new technologies such as the MiEye2 needle arthroscope, which may be used in clinic to perform minimally invasive life arthroscopy of joints with the patient wide-awake and watching. Mr Andrade furthermore invited us to the London Hip Meeting planned April 3rd 2019.
In the afternoon we joined Mr Tom Polland who performed another arthroscopic surgery on a patient with cam-impingement.
Since we had only one day to visit Reading we said goodbye at around 5pm and took the train to our next stop Exeter.
27.03.2019 – 29.03.2019: Exeter Hip Unit
The Exeter stem represents one of the most famous orthopaedic implants for total hip arthroplasty in the world. Therefore, we were quite excited to visit the “Exeter Hip Unit” in the Princess Elisabeth Orthopaedic Centre in Exeter. This is the place where Professor Robin Ling developed and implanted the first Exeter stem in 1970.
In the morning Mr Mathew Hubble, a senior consultant, picked us up at our hotel. Initially we visited Nuffield Hospital, a private hospital located next to the Princess Elisabeth Orthopaedic Centre just across the street. There we met Professor John Timperly performing a primary total hip replacement via SPAIRE approach using a MAKO robot (Stryker). Thereafter, we joined Matt Hubble again who performed another MAKO procedure using a piriformis sparing approach. After a rich lunch we moved to the Exeter Hip Unit in the afternoon. Mr Matthew Wilson welcomed us at his office and gave us a short guide across the unit. Afterwards we joined the radiological review meeting usually taking place every Wednesday afternoon. We discussed the postop cases of last week and the preop cases of next week and got to know almost the whole surgical staff of Exeter Hip Unit.
In the evening, the guys took us out for dinner J.
The following two days we saw a number of primary and revision cases including a complex dysplasia, a severe osteoarthritis in a coxa profunda requiring impaction bone grafting, and removal of a kiwi spacer that had been in situ for more than 5 years.
We further got to know the Exeter recovery program allowing patients to be discharged one day after THA surgery.
After three delightful days we left Friday evening and took the train to Bristol Temple Meads.
29.03.2019 – 05.04.2019: Bristol Southmead Hospital
Mr Richard Baker picked us up at Bristol Temple Meads Railway Station in the evening of the 5th of April.
Richard is a consultant for orthopaedic surgery with special interest in hip and knee arthroplasty and the chief editor of “Hip International”. He had organized the EHS fellowship and we were looking forward to meeting him. After driving us to our apartment situated directly next to the Brightside ground cricket field Richard took us out for dinner.
The next morning we joined him in the Spine private hospital to see a revision THA after failed fracture fixation and a total knee replacement, again with the MAKO robot.
The afternoon was off and we took a walk to the city centre to get more familiar with Bristol’s pub scene J.
Monday morning Richard picked us up again and introduced us to the orthopaedic staff at Southmead Hospital.
Southmead Hospital is a large NHS hospital, situated in the north of Bristol, providing level 1 trauma care and the complete spectrum of elective orthopaedic surgery.
During the first two days we attended Mr Richard Baker and Mr Stephen Eastaugh-Waring during primary THA and hip arthroscopy. Furthermore, we met Mr Michael Kelly, a trauma surgeon, who demonstrated to us the Bristol concept of open fracture treatment. Tuesday night we went out for dinner with Richards’s registrars Henry and Oli and his fellow James. Thanks guys for that great evening!
Wednesday morning we had to get up early to catch the train to London at 5am. Two hours later we arrived at the Queen Elizabeth II Centre close to Westminster to visit the London Hip Meeting. An international faculty, including Adolfo Lombardi (USA) and Carsten Perka (Germany), presented current concepts in diagnosis and treatment of hip pathologies. We spent the whole day there and arrived back in Bristol late in the evening.
The next day we attended Mr Jason Webb during a complex total hip replacement for a fracture and a revision for infection. At night the consultants took us out for dinner. The restaurant was located close to the house where the famous pirate Blackbeard was born in 1680…. Very exciting!!!!
A final highlight was the visit of the Bristol University research centre. We met Professor. Asley Blom who leads the analysis team of the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, which represents the largest joint registry in the world. Based on the data from this registry Professor Blom and his team perform epidemiological basic research. During our visit they presented to us current results from their research including data regarding implant survival and infection management.
After this very interesting Friday morning it was time to say goodbye to everybody. We went to the railway station in the afternoon and took the train north.
08.04.2019 – 09.04.2019: Wrightington Hospital
After a great weekend in Manchester including a visit to Old Trafford stadium and the famous “Alberts Schloss” Bar we took the train to Wigan on Sunday evening to visit Wrightington hospital. Wrightington is a very historical place. It is the hospital where Sir John Charnley developed and performed his first total hip replacements in the 1960s. Paul Siney, a research fellow who works for Professor Wroblewsky, picked us up at the hotel and took us to the Centre for Hip Surgery. This historical place includes a museum were you can find a nice exhibition of different types of historical hip and knee prosthesis as they were used during the first and second half of the 20th century. Several patients’ charts from the early days and an original issue of Charnleys book “Low friction arthroplasty of the hip” can also be found there. Furthermore, a model of the original “Green House” as it was used by Sir John Charnley to reduce bacteria load in the air during surgery has been re-built at the entrance area of the hospital.
Nowadays, Wrightington hospital is the largest Orthopaedic hospital in the North West of England performing more than 1000 joint replacements each year.
Paul gave us a comprehensive guide through the museum and eventually brought us into theatre were we met Professor Tim Board. Tim is a senior consultant specialized on hip arthroplasty. We spent the whole day with him performing several un-cemented (unusual for the UK) total hip replacements. At night he took us out for dinner. The next day we met Mr. Bodo Purbach. Bodo is a German surgeon who came to Wrightinton 25 years ago to learn hip replacement surgery from John Charnleys follower Professor Wroblewski. He still performs the original Charnley procedure including a lateral approach to the hip with trochanter osteotomy. We attended him during two procedures (one primary and one revision). Bodo gave us a great review of the development of total hip replacement surgery during the last thirty years. Thank you Bodo for your great commitment. You turned this day into one of the most rewarding during our fellowship. Unfortunately, we had only two days in Wrightington so we left Tuesday afternoon to travel south again.
10.04.2019 – 12.04.2019: Birmingham
Wednesday morning at 8am we entered our last station the Royal Orthopaedic Hospital in Birmingham. This hospital is one of the largest specialist orthopaedic units in Europe offering planned orthopaedic surgery to national and international patients.
At the entrance we met Mr Michael Parry who was our contact person for Birmingham. Michael is a consultant specializing in tumour surgery and lower limb arthroplasty.
He gave us a quick guide around the place and took us into theatre. There he introduced us to Mr Callum McBryde a consultant specializing in hip surgery. During the next two days we joined Callum into theatre. He performed a number of hip resurfacings and one hip arthroscopy. Between the surgeries he spent a lot of time to discuss with us his experiences regarding hip resurfacing and told us about current research projects that are recently undertaken to develop a resurfacing without metal on metal bearing.
The final day we visited the hip indication meeting on Friday morning and got to know most of the consultants specializing on hip surgery.
After three very rewarding days we had to say goodbye and went to the airport to travel back home. After three weeks abroad we were both looking forward to seeing our families again.
Overall, the fellowship was a very rewarding time, which broadened our minds in many ways.
We would like to thank all the people who made these three weeks such an unforgettable experience.
In particular:
Reading
Mr Tony Andrade, Mr Tom Polland
Exeter
Prof. John Timperley, Mr Mathew Hubble, Mr Matthew Wilson, Mr AL-Assam Kassam,
Mrs Harriette Branford White
Bristol
Mr Stephen Eastaugh-Waring, Mr Sanchit Mehendale, Mr Jason Webb, Mr Michael Whitehouse, Prof. Ashley Blom
Wrightington
Prof. Tim Board, Mr Bodo Purbach, Paul Siney
Birmingham
Mr Michael Parry, Mr Callum McBryde
Our very special thanks go to Mr Richard Baker who put so much commitment into the organization of the fellowship. We felt very much welcome all the time. Thanks Richard!
Looking forward to see some of you soon at the next EHS congress.
Alex and Loris
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