Trampolines injuries are bouncing back.

AIMS: This observational study examines the effect of the COVID-19 pandemic upon the paediatric trauma burden of a district general hospital. We aim to compare the nature and volume of the paediatric trauma during the first 2020 UK lockdown period with the same period in 2019. METHODS: Prospective data was collected from 23 March 2020 to 14 June 2020 and compared with retrospective data collected from 23 March 2019 to 14 June 2019. Patient demographics, mechanism of injury, nature of the injury, and details of any surgery were tabulated and statistically analyzed using the independent-samples t-test for normally distributed data and the Mann-Whitney-U test for non-parametric data. Additionally, patients were contacted by telephone to further explore the mechanism of injury where required, to gain some qualitative insight into the risk factors for injury. RESULTS: The 2020 lockdown resulted in 30% fewer paediatric trauma presentations (441 vs 306), but no significant change in the number of patients requiring surgery (47 vs 51; p = 0.686). Trampolining injuries increased in absolute numbers by 168% (p < 0.001), almost four times more common when considered as percentage of all injuries observed in 2020 vs 2019. There was a decrease in high energy trauma from road traffic accidents and falls from height (21.5% decrease, p < 0.001). Despite a shift towards more conservative treatment options, trampolining injuries continued to require surgery in similar proportions (19.4 vs 20%; p = 0.708). Qualitative investigation revealed that the most common risk factor for trampolining injury was concurrent usage, especially with an older child. CONCLUSION: COVID-19 lockdown has resulted in a decrease in paediatric orthopaedic presentations and high energy trauma. However, due to a marked increase in home trampolining injuries, and their unchanged requirement for surgery, there has been no change in the requirement for surgery during the lockdown period. As home exercise becomes more prevalent, a duty of public health falls upon clinicians to advise parents against trampoline usage. Cite this article: Bone Jt Open 2021;2(2):86-92.

The learning curve of robotic-arm assisted acetabular cup positioning during total hip arthroplasty.

BACKGROUND: Robotic-arm assisted surgery aims to reduce manual errors and improve the accuracy of implant positioning and orientation during total hip arthroplasty (THA). The objective of this study was to assess the surgical team's learning curve for robotic-arm assisted acetabular cup positioning during THA. METHODS: This prospective cohort study included 100 patients with symptomatic hip osteoarthritis undergoing primary total THA performed by a single surgeon. This included 50 patients receiving conventional manual THA and 50 patients undergoing robotic-arm assisted acetabular cup positioning during THA. Independent observers recorded surrogate markers of the learning curve including operative times, confidence levels amongst the surgical team using the state-trait anxiety inventory (STAI) questionnaire, accuracy in restoring native hip biomechanics, acetabular cup positioning, leg-length discrepancy, and complications within 90 days of surgery. RESULTS: Cumulative summation (CUSUM) analysis revealed robotic-arm assisted acetabular cup positioning during THA was associated with a learning curve of 12 cases for achieving operative times (p < 0.001) and surgical team confidence levels (p < 0.001) comparable to conventional manual THA. There was no learning curve of robotic-arm assisted THA for accuracy of achieving the planned horizontal (p = 0.83) and vertical (p = 0.71) centres of rotation, combined offset (p = 0.67), cup inclination (p = 0.68), cup anteversion (p = 0.72), and correction of leg-length discrepancy (p = 0.61). There was no difference in postoperative complications between the two treatment groups. CONCLUSIONS: Integration of robotic-arm assisted acetabular cup positioning during THA was associated with a learning curve of 12 cases for operative times and surgical team confidence levels but there was no learning curve effect for accuracy in restoring native hip biomechanics or achieving planned acetabular cup positioning and orientation.

"Publish or perish"-presentations at annual national orthopaedic meetings and their correlation with subsequent publication.

BACKGROUND: Presentation of research at annual national orthopaedic conferences not only serves as a forum for the dissemination of knowledge but is also often a requirement of orthopaedic training programmes. The expected outcome is publication in a peer-reviewed journal. However, publication rates vary for a variety of reasons. The objective of this study was to determine publication rates of presentations from our local Singapore Orthopaedic Association (SOA) annual scientific meeting (ASM) and some of the potential associated factors. We also compared our findings to equivalent meetings worldwide to assess value of scientific content of various orthopaedic conferences. METHODS: All presentations of six SOA ASMs were entered into a database. Using presentation titles, author names and keywords in PubMed and Google Scholar, we determined how many presentations progressed to publication in a peer-reviewed journal. Various comparisons were made to determine factors that could influence publication rates. A comparison with national orthopaedic meetings of America, United Kingdom, Ireland, Australia, Germany, Turkey and Brazil was also conducted. RESULTS: Excluding the ASMs with less than 4 years of follow-up, the publication rate was 35.8%. Both podium and international presenters were found to have significantly higher publication rates than poster and local presenters, respectively, while basic science and clinical research were found to have equivalent rates. Publication rates from other countries' national conferences ranged between 26.6% and 58.1%. CONCLUSIONS: We suggest that the quality of a presentation is related to its subsequent publication in a peer-reviewed journal. Our findings support the general consensus that the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) is the gold standard for the dissemination of orthopaedic knowledge updates and advancements in our specialty. Each national orthopaedic association could determine the ratio of "presentations at ASM" to "publication within five years of presentation" and use this as a measure of their annual conference's impact on the addition and advancement to the orthopaedic literature. This tool may in turn assist clinicians in determining which meetings to attend.