The 2019 international Bristol Hip Arthroplasty Course was built around the theme‘The Zenith and Watershed in the Treatment of the Hip’.
The course saw a record number of delegates in attendance. Following last year’s successful conference ‘live feed’, we were once again able to enjoy the participation of orthopaedic surgeons in India, thanks to Dr Ashok Shyam and his team, as well as Dr Srikanth one of my former Fellows in Bristol.
We covered many aspects of hip replacement including implants, biomechanics and research, surgical approaches, new strategies, infection, primary and revision hip replacement and other critical orthopaedic issues facing hip surgeons today.
A regular multi-media feature, and one of the highlights of the course programme, was the issue of obesity and the effect of body mass index (BMI) on surgical outcomes. A high BMI not only instigates osteoarthritis, but affects the treatment and rehabilitation of patients following surgery. The optimisation of pre-operative haemoglobin was discussed as a significant factor in achieving satisfactory results in elective hip arthroplasty, and there was also an overview on problems relating to sickle-cell disease. Another presentation discussed an interesting, alternative strategy for periprosthetic fractures and this sparked intense debate.
A worldwide shift in the choice of articular bearing surface was highlighted, showing that cross-linked polyethylene coupled with either a ceramic head or a ceramtised metal head has now taken the place of ceramic on ceramic bearings as the favoured option.
A fascinating talk on AI machine learning discussed a project sponsored by Arthroplasty for Arthritis Charity, where a neural network successfully learned identification of femoral neck fractures, and was capable of a more accurate analysis than consultant radiologists.
We have reached a watershed moment in hip orthopaedics where three-dimensional technology is now a regular feature. From robot-assisted positioning equipment, patient specific instrumentation to custom made prostheses, the joint replacement surgeon must be equipped to utilise the most up-to-date technology in order to deliver the best possible outcome to the patient. Developing a three-dimensional skill set is now an essential part of the job, and the impact that robotics will have on the development and experience of surgical trainees was discussed.
One of the hot topics on the joint replacement agenda is revision hip surgery and we had some great coverage at the conference. People live longer and have more active lives than ever before, so hip replacement can occur at a younger age and as a result revision hip replacement is now likely to be a feature in the lives of many ordinary people. Daniel Kendoff, our esteemed guest from Berlin, shared a wealth of experience on the subject. He displayed his custom-built acetabular components for patients with significant bone stock loss. His work has only been exhibited in some highly specialist centres of the world.
Altogether, it was an excellent conference with an outstanding faculty and a great group of dedicated delegates who left feeling that the 2019 Bristol Hip Arthroplasty Course had been a valuable event.