Raashad Hasan

Aims/Background: This study explores the attitudes and barriers faced by UK orthopaedic trainees regarding less than full time (LTFT) training. LTFT training has become more accessible since 2022, yet surgical trainees have been slower to adopt it compared to other specialties. Methods: A cross-sectional, questionnaire-based study was carried out via a 16-item online questionnaire which was distributed to aspiring orthopaedic surgeons registering for an orthopaedic themed teaching programme. Results: 216 respondents met the inclusion criteria. The study found that 42% of respondents would consider LTFT training, with higher interest among female trainees. Key barriers identified included extended training duration, financial concerns, potential decline in surgical skills, and negative perceptions from colleagues. Conclusion: The research highlights the need for clearer guidance, better support, and a cultural shift within orthopaedic departments to address these barriers. Initiating education and awareness programmes for senior staff and providing comprehensive information to trainees are essential steps to fostering a more inclusive and supportive environment for LTFT training in orthopaedic surgery.

The medial patellofemoral ligament (MPFL) is a key soft tissue stabilizer of the medial patella, with deficiency proven to be a key contributor to patellar dislocation. Reconstruction of this ligament has become a widely employed procedure in managing patients with recurrent patellar dislocation, and is also gaining popularity in the setting of primary dislocation. A wide variety of techniques have been described, differing in the type of graft used, sites for fixation and fixation technique. A number of complications have also been reported in the literature, including post-operative stiffness, apprehension, patellar fracture and recurrence of instability and dislocation. Here we report a case of an endobutton used in MPFL reconstruction becoming displaced after minimal trauma in a young female patient, subsequently causing patellofemoral irritation, patellar cartilaginous damage and functional limitation. This complication has not been previously reported to our knowledge and is one that surgeons must be aware of.