| Primary Surgeon | Assisting | |
|---|---|---|
| ACL | 32 | 16 |
| Multiligament | 10 | 3 |
| Osteotomy | 8 | 3 |
| Meniscal repair | 29 | 19 |
| Chondral procedures (OCD/OATS etc) | 5 | 0 |
| Others | 128 | 50 |
| Total | 212 | 91 |
What have you learnt the most from this fellowship?
The Soft Tissue Knee Fellowship at Nottingham has been a significant phase of my surgical career and major step towards an independent knee practice. As my first post CCT fellowship, the biggest transition was from moving beyond performing operations to understanding and managing complex instability and joint preservation problems as a whole.
Theatre: I performed primary ACL reconstructions using bone-patella-tendon-bone (BTB), hamstring and quadriceps tendon grafts and progressed to leading revision and multiligament cases. I learnt intra-operative judgement, adapting to unexpected findings, and incorporating patient-specific factors into the decision-making process. Meniscal repairs, patellofemoral instability and joint preservation procedures provided a broad and consistent experience.
Clinics: There was exposure to a variety of cases in clinics, including second opinion and referral of complex cases. I became confident in assessing patients, planning surgery, and counselling them with realistic expectations regarding recovery, particularly in complex instability cases. Patient-centred care and tailored graft choice became an important part of my decision-making.
Overall, the fellowship refined my approach to managing soft tissue knee pathology in a holistic and patient-specific manner.
Good things about the fellowship
The fellowship provided a broad exposure to soft tissue knee pathology with progressive autonomy. Continuity of care from clinics to surgical planning and follow-up was particularly useful in developing a patient-centred approach.
Expectation setting was clear from the start and resources were provided, such as a work laptop and textbook. Regular meetings were held with supervisors to discuss progress and adapt the fellowship to personal requirements.
Pre-operative planning was emphasised, particularly in joint preservation and osteotomy cases, with opportunities to review planning in advance and executing this in theatre. There was ample opportunity for complex case discussion with supervisors, with a focus on indications and forming high-level judgement. The experience supported a confident transition towards independent practice.
Things that could be better / improved
No significant changes required. The fellowship was well-structured and provided a very positive training experience.
Any other comments
The fellowship provided a valuable transition from training to independent knee practice, with a favourable case mix and supportive supervision. It also offered the opportunity to develop a patient-reported outcome measures (PROMs) system and lead clinical projects, with abstracts accepted at national and international meetings. I would recommend it to trainees pursuing a career in soft tissue knee surgery.
