By: 1 March 2007

The Great Debate - Early Intervention in the Hip and Knee was held over the 19th and 20th of January in the IMAX Theatre at the heart of the Science Museum in South Kensington, London. The meeting, which was sponsored and organised by Finsbury Orthopaedics, was designed to encourage an atmosphere that would allow the 33-strong faculty to explore the technologies that enable them to manage the early symptoms of osteo-arthritis in the hip and knee. The numerous sessions were also careful to take into particular account the high demand that healthy adults place on their bodies today.

The meeting attracted over 220 delegates from all over the globe, including Germany, Iceland, Spain and the US, making it the second largest orthopaedic event to be held in Britain. This impressive level of attendance was particularly poignant for the organisers of the meeting, for whom panic had set in, when the rather inclement weather conditions threatened to close motorways, airports and rail lines. Despite these minor set backs the meeting ran smoothly and Professor Cobb, the Chair of the meeting, seemed to be incredibly happy with the outcome stating: “The Great Debate certainly lived up to its name and succeeded in stimulating us all to reflect on our current practice and the direction we wish to take, whether it be conservative or invasive.”

Delegates of varying seniority were evenly split between trainees and consultants, this mixture made for interesting and surprising results especially when delving into the more controversial technologies such as navigation and arthroscopy. The knee sessions kicked off the debate on Friday morning with issues on opening wedge versus closing wedge osteotomy expounded as well as their impact on the ACL deficient knee. Interestingly delegates registered they would like to learn more about what has seemingly become a lost art in British orthopaedics. The place of uni-compartmental knee arthroscopy was debated with Medial UKA's revealing themselves as the most popular choice for the future. Specialist subjects such as joint biomechanics and arthroplasty were also dissected.

The hip sessions which began on Friday afternoon focused on a variety of different topics such as the advantages of navigation in hip arthroplasty, by the end of the session a surprisingly high number of delegates said they would like to use navigation during hip resurfacing admitting that it would improve levels of accuracy. Unsurprisingly the resurfacing versus replacement issue was perhaps the most heated, with parties ranged on both sides of the argument.

The most rewarding aspect of the meeting was arguably the interactive element. On arrival at the venue, each delegate was given a handset which allowed them to vote on numerous issues throughout each of the sessions. This anonymous system allowed everybody to air their views and to feel a part of the proceedings despite varying levels of seniority. Mike Tuke, Managing Director of Finsbury Orthopaedics commented: “The result of this Old English style of debate was that the audience got the chance to learn from the experts, who invariably don't all agree, and to form a broad opinion. We felt that the meeting offered a unique and exciting opportunity to teach people in an informative and interesting way.”

Although it has not yet been announced whether or not the meeting will be repeated, with such tremendous feedback, there seems to be no doubt that it would be a great shame to cut the Great Debate off in its prime. For more information on this event or to read more about the issues discussed, log on to