Healthy debate at the inaugural OPN Hip & Knee Conference 2013
Orthopaedic Product News recently chalked up a major achievement, with the first ever OPN Hip & Knee Conference, held in London on Thursday 27 June 2013 at the Royal College of Surgeons
With the orthopaedic industry still reeling from the metal-on-metal hip controversy, we have learned that consistent information and guidance at the time wasn’t rapidly trickling down to surgeons. Much time had passed between the discovery and call to action to stop using the allegedly defective implants: surgeons were still operating with them, simply because they knew no better.
This is one of the reasons why OPN decided to enter the highly competitive orthopaedic events market, to bring together experts to disseminate information on why things went so wrong, and how to prevent such a disaster from happening again.
More than 100 delegates met at the RCS to share and debate issues and ideas in hip and knee surgery, including the metal hip implant fiasco.
Researchers from across the globe offered new thoughts and techniques at the podium and poster sessions. Innovative studies included the analysis of sound to guide the reaming of a femoral canal, studying cement shear stresses in uncemented THA, and retrieval investigation of alumina ceramic-on-ceramic bearing couples.
The Best Podium prize went to Gavin Brigstocke for presenting his abstract, “Finite element analysis of cement shear stresses in augmented total knee replacement.” The Best Poster award went to Sunny Parikh et al. for “Outcome of prosthetic joint infections in Frimley Park Hospital”.
The Conference was honoured to have many high-profile speakers in its first year. Meanwhile, the proceedings were expertly chaired by Mr Nadim Aslam, a Worcester consultant with formidable management experience under his belt.
Former BOA President Peter Kay kicked off the presenting with a talk about the new Beyond Compliance initiative, a BOA/MHRA scheme for the safer introduction of orthopaedic implants. The industry saw the introduction of “me too” devices that slipped through regulation, all because similarly designed cups passed muster, and yet resulted in higher revision rates in patients.
Beyond Compliance is a drive to ensure devices are designed with comprehensive data and testing behind it, along with superior post-market surveillance to measure performance.
Metal on metal
The mid-morning session saw the main crux of the metal-on-metal debate come to a head, with Tim Wilton arguing the importance of publishing joint registry data following surgeries and revisions, adding that there are huge variations in outcomes which may or may not be causally related. The emphasis was on the surgeon to report data so that surgeons can get a gradually better picture of implant performance.
Chair Mr Aslam raised the fact that it is usually the hospital data clerk (on among lowest hospital wage scale) that inputs the data, and priority and accuracy issues may arises from this.
Derek McMinn delivered the Keynote speech, with a talk on the current state of hip resurfacing, and offered that metal joints still have a part in the future of orthopaedics, whether full metal or combined metal and ceramic for specific patient groups.
Complimenting this was the last presentation before the lunch break, by Professor Tom Joyce from Newcastle University, an instrumental figure in the investigation of failed metal hip joints. He argued that despite some joints having rigorous testing, much clinical data remained confidential, and the incremental changes in the design of these implants proved devastating, with surgeons even unaware as to what passes as acceptable when it comes to wear rates.
“There is no thing as a small change as design, as any small change can have disastrous consequences,” he argued. Greater transparency of implant testing, as well as a duty for surgeons to flag concerns in the proper way was the way forward to help minimise high failure rates.
The younger hip patient
Following the break John O’Hara highlighted the challenges treating a pre-arthritic hip patient, typically younger than many surgeons have seen in their career. He went onto extoll the merits of pelvic osteotomy to stabilise the hip, with the ultimate goal of bone alignment.
“Such procedures can be lucrative for any hospital,” he said. “Though the young adult requires skills both inside and outside the joint, and surgeons need to stop conning patients that intra-articular surgery is enough.”
Mr Satish Kale spoke on the management of patella problems, in which they were very a common indication for TKA, with an argued majority of cases being iatrogenic.
The penultimate session was hosted by Mr Ali Bajwa on the treatment of sports injuries and ACL reconstruction, a fast-growing sector as patients are being increasingly mobile and activity-led, with a need for a quick return to mobility the primary goal.
Lastly, Mr Richard Villar exploded onto the stage with a talk on hip arthroscopy, which seemed to reinvigorate those of the audience that started to flag after the busy day.
Villar promoted the work of the new International Society of Hip Arthroscopy (www.isha.net), as well as outlining the past, present and future of HA, explaining that now we are in a diversification period, with many burgeoning new treatments and technologies to treat such tricky conditions like femoroacetabular impingement and chondral defects.
The high attendance at this inaugural event was encouraging, while feedback and comments highly positive. This first conference gives us tremendous scope and optimism for medical events in the near future and beyond.
Feedback at a glance
94% satisfaction rate with venue and facilities
89% satisfaction rate with overall presentation speakers
77% satisfaction rate with the topical interest
90% would attend an OPN Conference in the future
“High-quality speakers on the crucial topic facing orthopaedics today”
“Expert speakers, interesting topics”
“I particularly enjoyed the MoM sessions”
“Thanks for a great day of fantastic speakers”
“A very enjoyable day, thank you!”
Stay tuned for the 2014 Conference announcement at www.opnconference.co.uk