Providing the latest news in orthopaedics

As an international newspaper for orthopaedic surgeons, Orthopaedics Today reports on research and latest trends.

Issue: Issue 3 2004

ByDavid L. Hamblen, PhD, FRCS

David L. Hamblen, PhD, FRCS [photo] --- David L. Hamblen, PhD, FRCS

My last task at the end of my year as chairman of the editorial board for Orthopaedics Today was to moderate the annual meeting of the editorial board. The review of our publishing activity in 2003 led me to reflect on our aim to provide orthopaedic surgeons throughout the world with news coverage of the latest clinical developments in orthopaedic surgery. But how well do we do this in comparison with the well-established peer-reviewed journals, including our own sister publication, Orthopedics?

The trigger for this thought process was the recognition of the top five orthopaedic stories of 2003. Summaries of those five stories were published in our January/February issue.

The winning stories were selected by a ballot of the editorial board members, representing views from 34 different countries from around the world. In that sense it represents a consensus view from a wide range of senior established surgeons, but does our broader readership hold the same opinions? Our readers are often younger and will include surgeons in training so that the value of stories in providing education may be as important as their role in providing new information.

We make no claim to provide the results of long-term studies of treatment techniques, but prefer to concentrate on issues and new ideas at the leading edge of orthopaedics. Inevitably, not all the new concepts in treatment that we report go on to become established methods for the management of musculoskeletal disease.

However, we do make every attempt to verify the accuracy and scientific validity of the stories prior to publication. The majority of the findings we report have been presented at national and international meetings and therefore have already been subjected to a form of peer review. The stories, once written by our staff reporters, are again checked by medical members of our editorial board prior to their publication.

Do we select the right stories?

We do not know whether our readership shares the opinions of the editorial board in their selection of the top stories. Certainly, there were some surprises among the wide range of topics selected among the top five stories for 2003. The cynics might have predicted that they would have all been reports of newly introduced technologies, representing high cost but relatively unproven treatment methods.

In fact, this proved not to be the case. Only one article dealt with the new design concepts that appear to have improved the results of ankle arthroplasty to a level comparable to other joint replacements. In the remaining stories, there was a greater emphasis on biology than technology, and these included two reviews of the role of stem cells and biologics in orthopaedic treatment. These not only served to inform readers of new innovative approaches to musculoskeletal disease but also reminded surgeons of the need to understand the basic science knowledge underpinning our specialty.

Another of the selected stories questioned the need for revision of failed anterior cruciate ligament reconstructions and emphasized the need for constant critical reappraisal of our treatment outcomes. This message is an important one in relation to the last of the top articles that dealt with the emerging role of minimal invasive surgery. This is not a totally new concept in orthopaedics, where arthroscopy and limited-access spinal surgery are already well-established techniques. What is new and slightly alarming is the enthusiasm with which patients have accepted the application of minimal access to joint replacements, based on the promise of shorter hospitalization and fewer complications.

The debate on this topic will continue for some time and must be balanced by careful long-term follow-up studies to demonstrate that the results are as good as with conventional methods.

These stories, though newsworthy, are not necessarily the most appropriate educational tools in a publication aimed at such a wide international readership as Orthopaedics Today. It was therefore important to provide a balance by introducing the concept of the “virtual round table.” The round table is designed to profile an exchange of views on current problems among leading surgeons and how these problems are managed in different countries around the world.

The first of these round tables, on the management of fragility fractures, also appeared in our January/February issue and was well received (click here to read the round table online). We plan to include others in future issues and would welcome suggestions for topics from our readers.

Your input and ideas for the future direction of the publication are always welcome and can be sent to the editors by letter or e-mail.

David L. Hamblen, PhD, FRCS, is emeritus professor of orthopaedic surgery at the University of Glasgow and visiting professor to the University of Strathclyde in the Prosthetics and Orthotics Centre in Scotland. He is the immediate past chairman of the Orthopaedics Today Editorial Advisory Board.