Aim: The aim of our study was to review the massive rotator cuff tears that were repaired arthroscopically and evaluate the clinical results in respect to repair integrity as well as the effect on the progression of osteoarthritis.

Materials and Methods: We reviewed 56 (39 male,17 female) consecutive patients who underwent arthroscopic repair of their massive rotator cuff tears using biodegradable anchors by the senior author. The technique relies on the suspension bridge principal as described by S.Burkhart (1997). The mean age was 68.2 years (30–86) with most patients between 75 and 85 years. The mean follow up was 31months (24–41). Objective evaluation was done using the Constant score and subjective with the Oxford score. Osteoarthritis was investigated with radiographs and repair integrity with ultrasound. SPSS 16 for Windows was used for the statistical analysis of out results.

Results: 93% of the patients had good (11%) or excellent results according to the Oxford score and 91% had Constant score over 75. The improvement in the scores was significant statistically in all parameters (p=0.000, p for strength=0.001). Thirteen patients had postoperative OA, but this was not correlated with the results or the improvement and 11/13 had excellent Oxford scores and Constant scores over75. Seventeen patients had a re-tear which was not correlated with the results or the improvement and 15/17 had excellent Oxford scores and Constant scores over 75. Seven patients had both osteoarthritis and retear but again improvement and results were not affected.

Conclusion: Arthroscopic repair of massive rotator cuff tears has excellent clinical results regardless of the development of osteoarthritis or the repair integrity and should be the first line of treatment.

Aim: Retrospective evaluation of the clinical results of arthroscopic capsulolabral stabilisation using suture anchors with a mattress technique.

Materials and Methods: Sixty five consecutive procedures in sixty-two patients (50 male, 12 female) with mean age of 38 years (14–66) underwent capsulolabral stabilisation by the senior author between 2005 and 2008. There was a history of dislocation in 38 shoulders (58.4%), 16(42.6%) had recurrent and 6 bilateral instability, 27 patients (41.5% shoulders) presented with pain. Thirteen patients had gradual onset and 14 after an injury. The mean follow up was 29 months (14–54).

Results: Arthroscopic findings included three patients (5%) with glenoid bone loss more than 15%, Hill Sachs lesions greater than 20% in eighteen patients (27.6%) and six cases where the torn labrum was partially absent. Three shoulders had a panlabral tear (4.4%). A mean of 2.3 (1–4) anchors were used. The mean Rowe score was 92.3 (30–100) with 90% excellent or good and the mean Oxford Score was 41(16–48) with 89% excellent or good. All heavy manual workers returned to work in a mean of 15.4 weeks. Four professional athletes are back to preinjury level in a mean of twenty weeks. There were two (3%) failures with redislocation.

Conclusion: Reinforcement of labral repair with capsule plication is an effective means to treat shoulder instability with a 97% success rate and no exclusion criteria.

Purpose: To determine the level of promotion of minimally invasive surgery (MIS) & computer assisted orthopaedic surgery (CAOS) in total knee replacement (TKR) through internet sites by BASK members.

Methods: We obtained an updated list of active members of BASK in March 2007 and permission from the executive committee to undertake this study. Standard search engines commonly used in our daily lives (viz. Google, Yahoo and Ask.com) were used to search for websites related to each surgeon during Sep–Nov 2007 period. The surgeon’s name, initials and job title thereof were used as keywords in conducting the search. Thus for each surgeon, all websites found were browsed and evaluated for MIS/CAOS and TKR/UKR information. Both direct (surgeon’s personal website/private practice) and indirect (group practice/hospital/university affiliation) information from these websites were reviewed and a standard pre-formed questionnaire proforma was filled in against that particular surgeon.

Results: A total of 178 websites were found for 405 members (392 inland + 13 overseas). 2.8% and 4.5% made direct and indirect reference to MIS TKR respectively. The most commonly listed benefits of MIS were quicker recovery, smaller incision and hence lesser pain. Very few specific risks of MIS were outlined by these websites. None of the websites quoted any peer-reviewed publication to support their claims. CAOS was discussed in 1.7% and 2.8% of these sites respectively.

Conclusion: Our study suggests that many active members do not have personal websites and these procedures are not commonly promoted by them via the internet. Many of these are often associated indirectly with group practice/institutional affiliation websites which may not necessarily be endorsed the surgeon. Our plan in near future is to monitor the changes in internet dissemination of information and close the audit loop by next year.