The Great Debate is now in its third year and was once again hosted in the IMAX Theatre at the Science Museum, London. I had eyed the previous two events with a certain jealousy in '07 and '08, and the gossip amongst previous attendees was that the event was scientifically sparkling, well organised, and here's the real draw: fun.

One of the real draws for me was the interactive voting, which invites analysis and results on-screen seconds after votes are cast.

Friday's lectures kicked off with talks from international faculty covering topics such as 'How can we report knee function?' and 'Are very early interventions cost effective?' Notable speakers included Andrew Amis, speaking authoritatively on kinematics, and Richard Field on clinical follow up at all stages of the patient journey.

From the keypads: “What matters most to you (in arthroplasty scoring)?” Answer – Functional: 62% and Survivorship: 31%. We moved on to debates on ACI, MACI and mosaic with the observation that everything works fine for 1-2 years; finally a great talk from Fares Haddad ending in his call for an ACL Reconstruction Registry, the NARR perhaps..?

Patello-femoral arthroplasty felt the spotlight of peer attention next; the highlight was Philippe Cartier reporting on 115 PFJ replacements followed up for 10-16 years. Words of wisdom and a fantastic French accent on PFJR and soft tissue balancing. 'Unis last forever', true or false? Sounds like the easiest multiple choice question ever, but once again Monsieur Cartier owned-up to 2000 unis over the years 1974 to 1998. His advice: Choose your patients well and when needed revise them to a stemmed tibial component TKR.

Boutique arthroplasty was next with the hardy/gifted/insane faculty on bi-compartmental and tri-compartmental arthroplasties. Stand up and be counted John Skinner with the Deuce implant (S&N) and David Barrett putting in three separate bits of femoral metal for three worn out compartments. I thought I already knew a solution for this