Purpose Patient-specific instrumentation (PSI) has the potential to offer numerous benefits-not least of all, improved resection accuracy; but its potential has not been realised in clinical studies. An explanation may be the focus of such studies on the total knee replacement (TKR-a common procedure, with which surgeons are generally very familiar. Consequently, we sought to investigate the potential role of PSI in guiding novice surgeons to perform the more technically demanding and less familiar lateral unicondylar knee replacement (LUKR). Methods Twelve orthopaedic trainees naive to LUKR were instructed to perform the procedure according to a preoperative plan. These were carried out on synthetic sawbones and were completed once with conventional instrumentation alone and once with the adjunct of PSI, allowing a comparison of the plan adherence achieved by the two sets of instrumentation. Results There was a tendency for PSI to demonstrate improved plan adherence, though a statistically significant improvement was only seen in compound rotational error of the femoral implant (p = 0.004). PSI was, however, able to produce narrower standard deviations in the mean translational displacement of the femoral implant and also the mean rotational displacement of both implants, suggesting a higher degree of precision.Conclusions Our study provides some evidence that PSI can improve the ability of novice surgeons to replicate a preoperative plan, but our results suggest the need for largerscale clinical studies to establish the role of PSI in this procedure.

Vivien Thomas (1910-1985) was an African-American scientist, pioneer, and renowned educator. Thomas's contributions to cardiovascular surgery were unequivocal, and yet it was only after his death that he gained more widespread recognition. Thomas's more notable work involves aiding in the discovery of the cause of traumatic shock, designing and guiding the first operation to treat Tetralogy of Fallot, carrying out the first atrial septectomy, and helping develop the electrical defibrillator. Thomas struggled amidst the adversities of racism and the Great Depression (1929-1941), armed merely with a high school degree. Nevertheless, his genius and determination eventually led him to receive an honorary doctorate from John Hopkins University. His story inspired the creation of the award winning PBS documentary in 2003 Partners of the Heart and also the 2004 Emmy Award-winning HBO film Something the Lord Made. This article will aim to provide an overview to the more notable events in Thomas's amazing tale, with a particular focus on his work on the Tetralogy of Fallot.