British Orthopaedic Association Annual Congress Report 17th – 20th Sept 2024

I attended a couple of days of the BOA Annual Congress this year and assist in representing the ACPA. It was held in the centre of Birmingham at the ICC, an impressive venue, situated next to the bustling area of Brindley Place and the backdrop of historic canals, theatres and the classical Centenary Square.

The theme of this year’s annual congress was ‘Recruit, Sustain, Retain The T&O Work Force’ and it commenced on the first day with a variety of talks from Associations including BAJIS, BORS, BSSH and BPOS. Unfortunately, there was no representation on this day from the ACPA, but the majority of talks will hopefully be available on the BOA website.

On the second day, the busy schedule started promptly at 8.30am with a variety of presentations from another selection of specialist associations.

Being keen to maintain links with BASK and I attended their day of sessions. 

The morning session topic in focus was on Managing Complex Primary Arthroplasty of the Knee; This included arthroplasty post trauma, infection and where there were severe changes to the joint anatomy, which were likely to complicate the surgical approach. This session included a discussion by the panel, on how they would approach different cases.

Michael Held completed the first set of talks with a fascinating insight into the approaches to joint preservation/arthroplasty in South Africa as well as how the multi-disciplinary team work and the continued development of trainees to assist in ensuring a patient centred, progressive service.

After a refreshment break, the abstract presentations focused on Quality Improvement. It was certainly a more unique experience, being held in the Exhibitors area with interactive headphones and talks; it was good to see different ways of engaging the delegates in the presentations. 

The subject of digital consent was addressed and concluded that it positively impacts shared decision- making quality; A study on length of stay (LOS) for patients having revision knee replacement summarised that increasing age, male gender and higher BMI are significant independent predictors of LOS following RKR. Another looked at the necessity of post operative bloods and noted that anaemia and hyponatremia were the most common blood abnormalities with the majority of post op blood tests in ASA 1&2 showing only mild abnormalities, with an overall intervention rate of <4%, hence questioning the need for routine post op blood tests.

The afternoon session was again focused looked at joint preservation techniques including ACL injury prevention, graft choice and revision surgery and finished with a selection of varied case studies, which involved audience and panel participation on differing approaches to management.

The final session of the afternoon was at the Abstract and Innovation Theatre again, with a focus on the knee. The talks discussed areas including the biomechanics of lateral unicompartmental knee replacements, that suggested a near – normal anterior-posterior stability and extensor mechanism efficiency; continuing on with the theme of UKRs, was a talk on the gait characteristics at top walking speeds as well as the higher patient satisfaction compared to total knee replacements; the topics moved towards component size and type and its impact on outcomes.

The 3^rd day of the conference started with a BHS session on periprosthetic fractures; There was a consistent theme that, however the patient is managed, it should follow a multi-disciplinary approach.

There was also a key discussion on avoiding infection in such patients with points including appropriate skill set for the fracture, limiting surgical time, limit blood loss, topical antiseptics, intra-incisional antibiotics and the use of negative pressure dressings. Jonathan Evans’ final talk for the section discussed how success is defined after a periprosthetic fracture.

The late morning presentations moved on to the subject of wellbeing, specifically focusing on burnout in healthcare.

A recent study published by the RCS annuals in 2023 found that burnout amongst staff was prevalent and stated that 68.3% of Orthopaedic surgeons had experienced moderate levels of burnout whilst a staggering level of 22.1% had experienced high levels. The evidence presented, made it clear that enhancing the psychological well-being of healthcare professionals correlates with enhanced system performance and improved patient outcomes. Suggestions included taking a break or sabbatical as they could be instrumental in improving mental wellbeing, job satisfaction and overall productivity.

Management of the young adult hip had a fantastic selection of talks with differing members of the multidisciplinary team; there was a particularly interesting session presented by Lucie Gosling and Holly Doyle from the UK HIP NETWORK looking at prehab and rehab for patients with Femoroacetabular Impingement and Hip dysplasia. The presentation included conservative vs surgical management; conservative management needed to be personalised and supervised to achieve the best outcomes. It included advice, education, muscle strengthening, core strengthening, stretching and 6-10 supervised sessions, but there was emphasis placed on the importance of home exercise programmes to compliment the supervised sessions. It was also acknowledged the difficulties, in the present environment, with resources, and hence it can be challenging to provide the optimal programme. It was really encouraging that varying members of the MDT are having the opportunity to speak in such forums and to present such inspiring work.

The afternoon session was held in the Abstract and Innovation Theatre and was a free paper session focusing on the hip including infection. The studies presented included the local infiltration of TXA to reduce the incidence of HO after THA, utilising the SPAIRE approach instead of the lateral approach in hip hemiarthroplasty as it indicated that patients had less post operative pain and 3D planning to increase accuracy in restoration of native joint mechanics.

The Congress certainly has a great deal to offer for individuals working in the specialist area of Orthopaedics, irrespective of their role. It is also is a fantastic opportunity to network with peers, speak with industry experts and meet new individuals with a shared passion of improving Orthopaedic care for both the patients and the staff working to deliver optimal outcomes.

Report by Alex Cooper, ACPA President.