Search

Evidence shows that the majority of OMFS trainees undertook dentistry as their first degree, however, an increasing number of undergraduates undertaking OMFS training have completed medicine first. It is vital that all undergraduates wanting to commit to another degree have adequate exposure to, and understanding of, the specialty. The aim of our study was to evaluate the perspectives of final-year dental students concerning their exposure to, and perceptions of, OMFS during their undergraduate teaching. This is a cross-sectional cohort study that used an online survey to collect data. All final-year dental students at a UK dental school who will graduate in 2024 were included. Regarding the exposure to OMFS, 122 (71.8%) respondents reported that they had been offered OMFS-related clinical placements from their respective dental schools, while 48 (28.2%) had not. Of the 122 who reported receiving placements, the placement lasted a mean of 3.78 days. Participants were then asked if they thought they had adequate experience and information to make an informed choice regarding OMFS as a career, to which 70 (41.2%) responded that they did have that knowledge and experience whilst 100 (58.8%) responded that they did not. Our study overall shows a better understanding of the scope of oral and maxillofacial surgery amongst final-year dental students in the UK compared with their medical student counterparts from previous literature. However, our results reflect areas in which knowledge, exposure to, and perception of, OMFS can be improved amongst dental undergraduates., (Copyright © 2024 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Tibial spine avulsion fractures (TSAFs) account for approximately 14% of anterior cruciate ligament injuries. This study aims to systematically review the current evidence for the operative management of paediatric TSAFs., Methods: A search was carried out across four databases: MEDLINE, Embase, Scopus, and Google Scholar. Studies discussing the outcomes of the surgical management of paediatric TSAFs since 2000 were included., Results: Of 38 studies included for review, 13 studies reported outcomes of TSAF patients undergoing screw fixation only, and 12 studies used suture fixation only. In total, 976 patients underwent arthroscopic reduction and internal fixation (ARIF), and 203 patients underwent open reduction and internal fixation (ORIF). The risk of arthrofibrosis with the use of ARIF ( p = 0.45) and screws ( p = 0.74) for TSAF repair was not significant. There was a significantly increased risk of knee instability ( p < 0.0001), reoperation ( p = 0.01), and post-operative pain ( p = 0.007) with screw fixation compared to sutures., Conclusions: While the overall benefits of sutures over screws and ARIF over ORIF are unclear, there is clear preference for ARIF and suture fixation for TSAF repair in practice. We recommend large-scale comparative studies to delineate long-term outcomes for various TSAF fixation techniques.

Head and neck cancer (HNC) refers to malignancies found in mucosal surfaces anywhere from the paranasal sinuses to the larynx, including the various glands and cavities. Between the years 2016 and 2018, there were about 3900 new cases every year in women and 8600 in men, making it the thirteenth most common cancer in women and fourth most common in men. The aim of our study was to evaluate the amount and type of teaching United Kingdom (UK) medical students receive on HNC, and to assess their current knowledge of these cancers. An online survey distributed via university representatives was responded to by 311 final year medical students from 25 medical schools across the UK. Regarding HNC teaching, 72 students (23.2%) reported receiving no teaching at their medical school. Of the 239 who reported receiving teaching, 169 (54.3%) received it in the format of a non-interactive, large group lecture. A total of 271 respondents (87.1%) believed that medical students at their university would benefit from more teaching on HNC. Based on our sample, there appears to be an overall dissatisfaction and lack of confidence surrounding HNC in the undergraduate curriculum. With its increasing prevalence in the UK, it is vital that red-flag symptoms and referral criteria are understood by the future medical workforce., (Copyright © 2023 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Purpose: Meniscal injuries are increasingly common in older age groups. Age is often cited as a contraindication to undergoing meniscal repair due to concerns regarding failure rates. There has recently, however, been an increasing shift towards repair in older populations. The purpose of this study was to review outcomes of meniscal repair in patients over the age of 40., Methods: A systematic search of the following databases was conducted of PubMed, SCOPUS, Web of Science, and Cochrane Library to identify studies reporting failure rates of patients over 40 with meniscal injuries undergoing repair. The definition of meniscus failure was noted for each study evaluated in this systematic review. Further data surrounding clinical and radiological outcomes were recorded and evaluated, when available., Results: Thirteen studies were included in this review, encompassing a total of 316 meniscal repairs in patients over the age of 40 years. The overall failure rate was found to be 15.5% (49/316) (range 0-33.3%). There was no difference in the failure rate in those over 40 vs. under 40, and the two groups had equivalent functional outcomes., Conclusions: Age should not be considered a contra-indication for meniscal repair. Appropriately selected older patients can have acceptably low failure rates with meniscal repair and similar functional outcomes to those under the age of forty. Meniscal repairs in those over 40 achieved better functional outcomes than patients of the same age group who underwent meniscectomy., Competing Interests: The authors declare no conflict of interest.

We provide an up-to-date and accurate minimum point prevalence of genetically defined skeletal muscle channelopathies which is important for understanding the population impact, planning for treatment needs and future clinical trials. Skeletal muscle channelopathies include myotonia congenita (MC), sodium channel myotonia (SCM), paramyotonia congenita (PMC), hyperkalemic periodic paralysis (hyperPP), hypokalemic periodic paralysis (hypoPP) and Andersen- Tawil Syndrome (ATS). Patients referred to the UK national referral centre for skeletal muscle channelopathies and living in UK were included to calculate the minimum point prevalence using the latest data from the Office for National Statistics population estimate. We calculated a minimum point prevalence of all skeletal muscle channelopathies of 1.99/100 000 (95% CI 1.981-1.999). The minimum point prevalence of MC due to CLCN1 variants is 1.13/100 000 (95% CI 1.123-1.137), SCN4A variants which encode for PMC and SCM is 0.35/100 000 (95% CI 0.346 - 0.354) and for periodic paralysis (HyperPP and HypoPP) 0.41/100 000 (95% CI 0.406-0.414). The minimum point prevalence for ATS is 0.1/100 000 (95% CI 0.098-0.102). There has been an overall increase in point prevalence in skeletal muscle channelopathies compared to previous reports, with the biggest increase found to be in MC. This can be attributed to next generation sequencing and advances in clinical, electrophysiological and genetic characterisation of skeletal muscle channelopathies., Competing Interests: Declarations of Competing Interest None, (Copyright © 2023. Published by Elsevier B.V.)

Most of the current oral and maxillofacial surgery (OMFS) specialty trainees in the United Kingdom (UK) remain as those who first undertook a degree in dentistry. However, OMFS is an increasingly popular career choice amongst 'first degree' medical school graduates. The UK medical school curriculum should reflect this trend by ensuring that there is sufficient teaching and exposure to allow medical students to make informed career choices. The purpose of this study was to evaluate levels of awareness of, exposure to, and teaching on, oral and maxillofacial surgery amongst undergraduate medical students in the UK. An online survey was distributed via university representatives and responded to by 76 final year medical students from 15 medical schools across the United Kingdom. No OMFS-related clinical exposure was reported by 69 respondents throughout their time at medical school. Of the seven who did report exposure, the mean length of that exposure was four days. Sixty-three respondents believed that medical students would benefit from more guidance and information on OMFS. Clinical exposure to OMFS by medical undergraduates is low therefore awareness of the specialty is limited. With many dissatisfied with the OMFS exposure and teaching provided by their medical school it shows that there is no lack of interest in OMFS amongst medical undergraduates, rather a lack of opportunity for them., (Copyright © 2023 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Osteochondral lesions are a common clinical problem and their management has been historically challenging. Mesenchymal stem cells have the potential to differentiate into chondrocytes and thus restore hyaline cartilage to the defect, theoretically improving clincal outcomes in these patients. They can also be harvested with minimal donor site morbidity., Purpose: To assess the clinical and functional outcomes of mesenchymal stem cell implantation to treat isolated osteochondral defects of the knee. A secondary purpose is to assess the quality of the current available evidence as well as the radiological and histological outcomes. We also reviewed the cellular preparation and operative techniques for implantation., Study Design: Systematic review., Methods: A comprehensive literature search of 4 databases was carried out: CINAHL, Embase, MEDLINE, and PubMed. We searched for clinical studies reporting the outcomes on a minimum of 5 patients with at least 12 months of follow-up. Clinical, radiological, and histological outcomes were recorded. We also recorded demographics, stem cell source, culture technique, and operative technique. Methodological quality of each study was assessed using the modified Coleman methodology score, and risk of bias for the randomized controlled studies was assessed using the Cochrane Collaboration tool., Results: Seventeen studies were found, encompassing 367 patients. The mean patient age was 35.1 years. Bone marrow was the most common source of stem cells utilized. Mesenchymal stem cell therapy consistently demonstrated good short- to medium-term outcomes in the studies reviewed with no serious adverse events being recorded. There was significant heterogeneity in cell harvesting and preparation as well as in the reporting of outcomes., Conclusion: Mesenchymal stem cells demonstrated a clinically relevant improvement in outcomes in patients with osteochondral defects of the knee. More research is needed to establish an optimal treatment protocol, long-term outcomes, and superiority over other therapies., Registration: CRD42020179391 (PROSPERO).