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The NHS has made significant changes to practice and specialty training in trauma and orthopaedics as a result of the COVID-19 pandemic. This article looks at the positive and innovative changes along with lessons learnt, which could affect policies in a new challenging post-pandemic health service. At a national level, Public Health England, the British Orthopaedic Association and the Royal Colleges have issued a number of guidelines, which have evolved throughout the pandemic. Developing resilient rotas, virtual clinics, teleconsultations, webinar-based training and operating theatre reorganisation are just some examples of how collaborative working has led to positive changes, despite the huge challenges and hardships created by COVID-19. As we emerge from this crisis, the field of trauma and orthopaedics will need to prepare for the challenges of patient backlogs, neglected trauma and long waiting lists. A continuation of the innovative and collaborative working seen during the pandemic will be crucial to cope with the post-COVID-19 world of orthopaedics.

Visiting clinicians need to be aware of the special considerations for orthopedic surgical care in patients with HIV/AIDS and the appropriate measures to prevent and treat occupational exposures. HIV disease and antiretroviral therapy have associations with various musculoskeletal disease entities, and may affect surgical outcomes in some cases. These considerations may assume great importance in locations with high seroprevalence of HIV disease.

Osteomyelitis and septic arthritis can result in considerable morbidity in adults, especially when the diagnosis is delayed. The physiologic status of the host is an important variable, and surgical care is frequently required in addition to antibiotics to eradicate infection and treat complications.

Musculoskeletal infections are a common cause of disability in economically underdeveloped regions. These are a challenge to treat because of delayed presentation and limited lab and antibiotics.