This study proposes that aspirin may be an appropriate thromboprophylaxis agent when used as part of a multi-modal regimen, suggesting current guidelines should be reviewed. Cite this article: Bone Joint J 2016;98-B:585-8.

BackgroundTennis elbow is a common condition with a variety of treatment options, but little is known about which of these options specialists choose most commonly. Corticosteroid injections in tennis elbow may reduce pain in the short-term but delay long-term recovery. We have undertaken a UK-wide survey of upper limb specialists to assess current practice.MethodsCross-sectional electronic survey of current members of the British Elbow and Shoulder Society (BESS) and the British Society for Surgery of the Hand (BSSH).Results271 of 1047 eligible members responded (25.9%); consultant surgeons constituted the largest group (232/271, 85%). 131 respondents (48%) use corticosteroid injections as their first-line treatment for tennis elbow. 206 respondents (77%) believed that corticosteroid injections are not potentially harmful in the treatment of tennis elbow, while 31 (11%) did not use them in their current practice. In light of recent evidence of the potential harmful effects of corticosteroid therapy, 136 (50%) had not changed their practice while 108 (40.1%) had reduced or discontinued their use. 43 respondents (16%) reported having used platelet-rich plasma injections.ConclusionsRecent high-quality evidence that corticosteroids may delay recovery in tennis elbow appears to have had a limited effect on current practice. Treatment is not uniform among specialists and a proportion of them use platelet-rich plasma injections.

Purpose: To determine in what way the proposed simulation-based intervention (SBI) is an effective intervention for use in basic arthroscopic skills training. Methods: Twenty candidates were recruited and grouped according to experience. Performance metrics included the time to activity completion, errors made, and Global Rating Scale score. Qualitative data were collected using a structured questionnaire. Results: Performance on the SBI differed depending on previous arthroscopic training received. Performance on the simulator differed between groups to a statistically significant level regarding time to completion. A difference was also present between participants with no previous training and those with previous training when assessed using the Global Rating Scale. The SBI was deemed acceptable, user-friendly, and realistic. Participants practicing at the expert level believe that such an SBI would be beneficial in developing basic arthroscopic skills. Conclusions: The results of this study provide evidence that the use of an SBI consisting of a benchtop workstation, laptop viewing platform, 30 arthroscope, and defined performance metrics can detect differences in the level of arthroscopic experience. This format of SBI has been deemed acceptable and useful to the intended user, increasing the feasibility of introducing it into surgical training. Clinical Relevance: This study adds to the existing body of evidence supporting the potential benefits of benchtop SBIs in arthroscopic skills training. Improved performance on such an SBI may be beneficial for the purpose of basic arthroscopic skills training, and we would support the inclusion of this system in surgical training programs such as those developed by the

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