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The Mackay Clinic Newsletter #2 August 2020 -Jan 2021

The New Normal

Rising to the challenges of 2021

The second half of 2020 saw The Mackay Clinic fully resume treating patients, albeit under strict new corona protocols followed within hospitals.

Professor Mackay was delighted to be back seeing and treating patients again. Clinics resumed at both Kings Park and Ross Hall hospital. He saw a range of patients, many of whom injured themselves returning to more vigorous activity following a period of relative inactivity during the earlier lockdown.

Throughout the year and continuing into 2021 Professor Mackay enjoyed working closely and continues to collaborate with NHS colleagues to ensure that patient care continues smoothly.

Biomechanics research supports ACL preservation

Important results from Biomechanics research

This project involved research that was being carried out by Dr William Wilson who was assessing the clinical and biomechanical outcomes of sports patients recovering from serious knee injuries involving the cruciate ligament. Dr Wilson is the team doctor for the Northern Ireland Women’s Football Team, he is also an elite level referee and has a particular interest in sports surgery. He designed a rigorous testing protocol which included replicating a series of functional tasks, performed in the lab by recovering athletes, as if they were partaking in sport.

The study took place at the University of Strathclyde – Human Performance Lab in Glasgow and was overseen by Biomedical Engineers Dr Matthew Banger and Dr Philip Riches.

We filmed one particular session which saw  Lauren Perry, goalkeeper with the Northern Ireland national team, put through her paces in the lab. Lauren had her ACL repaired with the InternalBrace a year and a half prior to this session.

Results from the research so far show that:

1) Proprioceptive defects seen following ACL reconstruction are not found after augmented ACL repair surgery, with potential for improved patient outcomes.

2) ACL repair patients performed as well as, or better in PROMs, stability, and hop tests than matched patients following ACL reconstruction.

3) Despite early surgical intervention for ACL repair, the range of movement was not reduced, as was found for reconstruction. Concerns regarding arthrofibrosis in acute surgery for ACL tears leading to chronic knee stiffness are not supported by this study.

4) Hamstring weakness and asymmetry seen following ACL reconstruction is not evident following augmented primary ACL repair – with potentially improved patient outcomes.

This research is very encouraging evidence in support of ACL preservation. Dr Wilson will be publishing further gait analysis from this study which we will share on our website.

Our thanks as ever to our former patients for agreeing to take part in this research.

The video shows the testing in action.

Other published papers

To see more published InternalBrace research papers click here

Former patient reigns supreme

One of our former patients made big sporting news in 2020. Reece Wilson a Scottish Pro Downhill Mountain Biker has been treated several times by Professor Mackay for various injuries. He had his shoulder InternallyBraced after separating it in a high-speed crash during RedBull Hardline back in 2018 and prior to that he had already had his ACL and ankle ligament InternallyBraced. What a recovery he has made to come back and be crowned World Champion in 2020. You can see his amazing run to take the crown here.

Reece Wilson winning the 2020 MTB World Championships in Leogang, Austria

We documented the story of Reece's recovery from his shoulder injury in a Patient Story film.

Patients' stories

We saw a variety of patients over the latter half of 2020. Many had had problems getting the right treatment due to NHS services being too busy - we were able to help many of them receive the treatment they needed. We also saw a large number of active and sporting patients - some of whom appear (with permission) in our gallery below.

Top row from left: Iain Hamill keen motocross Enduro competitor, underwent surgery earlier this year, InternallyBracing his Cruciate, Medial and Anterolateral Ligmants he is now back competing again and also enjoying running and mountain biking again; Lesley Graham had previously had a cruciate reconstruction 30 years ago from which she had a slow and painful recovery, and that had put off seeing someone about her latest knee injury. However, Professor Mackay allayed her fears and she underwent a clearing of cartilage and her Anterolateral Ligament was InternallyBraced to add stability to her knee and she was delighted with her swift pain-free recovery; James enjoying walking with his dog again after recovering from partial knee replacement surgery on both knees. Second row from left: A knee arthroscope has given Michael a new lease of life; Ross Rutherford motocross expert, injured his knee, arthroscopic surgery removed a pebble size piece of bone/ loose body and allowed him to return to sport; Electrician Ryan Rutherford is also a keen rugby player - he had InternalBrace surgery on both his Cruciate and Posterior Cruciate ligament. Row three from left: Georgia Spence, a keen rugby player, crowd-funded her own shoulder surgery, her t-shirt shows the names of all her many supporters. She has now had both shoulders stabilised and is recovering well; Sally Conway is a Scottish Judoka who competed for Team GB in the Olympic games in 2012 and in 2016. She had an arthroscope on rough cartilage in her knee. Unfortunately, competitions were cancelled after this video was taken but she is continuing to train and we wish her luck on hopefully competing in the next Games. Busy saddler, Erlend Milne had his knee operated on after suffering for years. He was told by the NHS he would need a knee replacement however Professor Mackay performed arthroscopic chondroplasty and Erlend is enjoying being pain-free in his active job and being able to play with his children again. You can see more of our patient video stories online on our website and social media pages.

The fight against Corona

Two people definitely deserve a special mention in this update: Colin Mackay, Professor Mackay's brother has been in the news as his company Symbiosis Pharmaceuticals based in Stirling was involved in manufacturing the coronavirus vaccine being developed by AstraZeneca's and the University of Oxford at the time the vaccine was in clinical trials at various sites across the UK with Symbiosis being one of them. As we all know the vaccine known as AZD1222 has now been approved for full use after being shown to be highly effective against covid 19.

Read more here - 'Scottish firm helped develop vaccine'

Colin Mackay

“I am obviously very proud of my brother and his company’s involvement in the race to find an effective vaccine that will help save lives." said Professor Mackay

Duncan Allen aids fight heading in here

Many of our patients have met the fantastic consultant anesthetist Duncan Allen at Ross Hall hospital or indeed in the NHS. Because of his vast experience and previous use of the drug Dexamethasone, Duncan was able to explain how its use could be helpful for seriously ill Covid patients. This was proved to be the case in fact it has been shown to reduce deaths by up to a third. Duncan can be seen here talking about the drug here, unfortunately, as we know, the NHS is once again facing another wave of the virus, however Duncan's work on the use of the dexamethasone will have helped to save many lives. Read more here

Faculty meetings go online

Professor Mackay entered the brave new world of online Faculty webinars

In a normal year Professor Mackay attends many Orthopaedic Faculty meetings around the world. These are a fantastic way to share knowledge, find out the latest research in your field and catch up with friends and colleagues from around the globe. It is important that such knowledge and outcome sharing continues so these meeting became global webinars.

At the end of 2020 Professor Mackay took part in three such online discussions. The first, organised by Sicot – an international society of surgeons, was about ACL Repair, looking at the latest techniques and outcomes. Professor Mackay delighted to be part of a specialist panel hailing from as far and wide as the US, Spain, India, and Pakistan. The second webinar was hosted by Arthrex and was viewed by a largely Scandinavian audience who were discussing the latest ankle ligament repair techniques and research.

The third was hosted by students from the University of Glasgow Medical School who all had an interest in orthopaedics and sports surgery.

A remarkable story from The Duncan Hospital Charitable Trust

Selective abortion, a practice supposedly banned in India still goes on. Girls are not as highly prized as boys and some predict that there will be over 6 million fewer female births recorded in India by 2030.

India - where boys are prized over girls

It is still an inalienable truth in most parts of India, among both rich and poor, that sons are worth more than daughters. The Duncan fights hard for the education of girls, enrolling student nurses and, with its outreach programmes aimed at helping women and young girls.

The Duncan Hospital in Bihar had a difficult 2020 with over 50 members of staff contracting Corona virus as they struggled to keep treating patients and also to feed many local people in desperate need after a national lockdown was announced. Read more here

However by the end of 2020 staff at The Duncan were feeling more optimistic as they seemed to have weathered the storm. Patient numbers at the hospital recovered slowly and so the hospital was once again able to find full wages for staff and see long-term patients who had been unable to attend as well as treating new patients.

The remarkable tale of Aradhna and Prarthna

The twins with Blessy at The Duncan - they weighed just 1.1 and 1.2kg at birth.

We would like to bring you one story in particular which has lifted spirits at The Duncan recently - the remarkable story of baby twin sisters. In a moving 2020 Blog post Senior Paediatrician Blessy Suchi wrote about twin baby girls that had been abandoned at The Duncan after the death of their mother. Born prematurely, the sisters weighed 1.1kg and 1.2kgs. These tiny fighters survived against all odds. In India it is a terrible fact but baby girls carry little worth to many families and are often abandoned or even worse, electively aborted (a practice that is illegal but is often still carried out). Blessy and her team resuscitated and treated the tiny babies, saving them but she always wondered, at what cost to them as newly abandoned orphans? So how wonderful for her and everyone else involved to hear a year later that not only have the girls been adopted but they are loved and are thriving. Blessy told us, "I Just want to share something amazing. It gave me goose bumps when I heard of it yesterday. You remember Aradhana and Prarthna, who we have all prayed about. All of us were very broken the day they were taken away to an orphanage and never knew what happened to them since. But a few days ago one of the incharges of the home told us that they were adopted and are in safe hands."

Due to social-media confidentiality reasons we are sadly unable to show you the wonderful video we have seen of the two little girls now - smiling, laughing and clearly loved; but it is heart warming to watch and gives true meaning to the work that Blessy and her team carry out at The Duncan.

Fundraising begins again for the Nursing School and Accommodation block.

The planned new Nursing School and Accommodation building.

Our next major fundraising effort has the education and future of local women in mind - In 2021 we will be resuming our DHCT fundraising drive for the new Nursing School and Accommodation block. This is a huge project that will provide desperately needed modern living quarters for the wonderful female nursing staff at The Duncan, where an education saves many from a life of poverty and continual hardship. We will shortly be announcing fantastic news about match funding for the huge project. Keep up to date here.

Head to the Duncan Hospital Charitable Trust website for more information

Find out more about The Duncan Hospital Charitable Trust by heading to our new website or donate through our official Just Giving page.

The knife and times...

The author and Professor Mackay have been friends for over 10 years and have shared many adventures together.

Friend and esteemed colleague of Professor Mackay's, Bill Ribbans, has published at last his much-anticipated book, 'Knife in the Fast Lane - a Surgeon's Perspective from the Sharp End of Sport'. Having known Bill for well over 10 years now Professor Mackay and he have shared many adventures from the surgical to the sporting. The book takes the reader on a sweeping journey through the history of sports medicine care, includes some of Bill's own cases involving high-profile sportspeople, before ending with a valid discussion about some of the controversies surrounding aspects of sports medical care that arise today. It is highly recommended reading by The Mackay Clinic Book Club!

MACKAY CLINIC OPENING HOURS

Mondays, Wednesday and Fridays at BMI Ross Hall Hospital, Glasgow. Tuesday afternoons at BMI Kings Park Hospital, Stirling. To book appointments please call Ross Hall on 0141 810 3151 (handles both Ross Hall and King’s Park clinics).

Our office is open and takes calls from 9am – 1.30pm, Monday to Friday – 01786 406424, or you can email office@mackayclinic.co.uk

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