Research and Publications

June, 2014

This month, James joined other sub-specialised orthopaedic shoulder surgeons from all over the world at the Nice Shoulder Course. This course is one of the largest, multi-national shoulder meetings in the world and is held every 2 years. It provides the opportunity for surgeons to meet and discuss interesting cases, cutting edge techniques and surgical advances. The meeting combines lectures, case discussions, surgical workshops, cadaveric workshops and live surgical demonstrations. The course aims to keep surgeons up-to-date and enable them to learn new skills. To find out more about the Nice Shoulder Course - Click here.

Since there are often only a few sub-specialised shoulder surgeons in practice per city (or even per country in some cases), surgeons often have to travel internationally to keep up-to-date with advances in surgical techniques and equipment. Meetings that include live surgical demonstrations are one way that surgeons remain up-to-date and learn new skills. Surgeries are performed in a normal operating theatre where audiovisual equipment is used to project the operation live to a lecture theatre. In this way, hundreds of interested surgeons can watch a single surgery at one time, without having to crowd into a small operating theatre and risk decontamination of the sterile operating field. To see an example of a live shoulder surgery seminar - Click here.

This month, James helped with demonstrating surgical approaches and techniques at a surgical workshop held at the Evelyn Cambridge Surgical Training Centre. Training days like this are rare and valuable opportunities for training orthopaedic surgeons to be taught new surgical skills in a supervised, controlled environment. The East Anglia Orthopaedic Training Programme conducts a few of these training days a year. This helps trainee surgeons work towards developing a high level of proficiency in arthroscopic surgery. James was pleased he could contribute and give an "Australian perspective" to the training day.

May, 2014

This month, James took the opportunity to visit Dr Tomas Smith, a prominent Shoulder Surgeon practicing in Hannover, Germany. Dr Smith is the Head of the Schulter-, Knie- und Sportorthopädie Unit Medizinische Hochschule - Hannover. This Clinic is a part of the Specialist Orthopaedic Clinic of Annastift and contributes to the excellent national reputation of the institution with internationally-recognised research, development and teaching in the field of orthopaedics. It is also one of the first and largest orthopaedic university clinics in Germany and is considered one of the most prestigious and modern, specialized orthopaedic clinics in Germany.

This opportunity enabled James to participate in several shoulder joint replacement surgeries and trial equipment that is not currently available in Australia. Hopefully this will lead to new, state-of-the art equipment being made available for trial in Adelaide soon.

April, 2014

Wrightington Hospital's status as a Centre of Excellence in the treatment of musculo-skeletal disease has its origins in the seminal work of Professor Sir John Charnley, who pioneered joint replacement surgery and performed the very first hip replacement in the early 1960s.

Wrightington's reputation for excellence continues to attract highly-talented Consultant Orthopaedic Surgeons from all over the world, who specialise in microsurgery, key-hole surgery and joint replacement surgery.

The Upper Limb Unit has recently been recognised and certified as an ESSKA Teaching Centre. This month, James attending their Cadaveric Hand & Wrist Trauma Course, as well as their Elbow Trauma Course. James used the opportunity to discuss current management trends with leading British Upper Limb Surgeons, and learn a variety of cutting-edge techniques in upper limb surgery. Click here for the Wrightington Upper Limb Unit's upcoming courses.

April, 2014

The Royal National Orthopaedic Hospital receives tertiary referrals for complex orthopaedic problems from all around the United Kingdom. This month, James attended the Sedden Society Annual Meeting held at The Royal National Orthopaedic Hospital. He also took the opportunity to meet with orthopaedic doctors at Stanmore to discuss their research and practices; and gain an understanding of their decision-making in rare and unusual orthopaedic cases. To learn more about the Royal National Orthopaedic Hospital (Stanmore) - Click here.

April, 2014

A modified ulnar translocation reconstruction technique for Campanacci grade 3 giant cell tumors of the distal radius using a clover leaf plate McLean JM, Clayer M, Stevenson AW, Samson A. Techniques in Hand & Upper Extremity; Tech Hand Up Extrem Surg. 2014 Sep;18(3):135-42.

ABSTRACT

Background: Campanacci grade 3 giant cell tumors of the distal radius are locally aggressive and in close proximity to the median nerve; articular cartilage; flexor and extensor tendons; and the radial artery. Although several reconstructive techniques have been described, it is unclear to what degree these procedures restore function.

Description of technique: We present a modified ipsilateral ulna translocation technique using a clover leaf plate, for reconstruction of en bloc resected distal radius. This has the theoretical advantage of ensuring a solid, pain-free wrist arthrodesis, while preserving the forearm rotational axis and minimizing functional loss; without the associated donor site morbidity or allograft rejection issues of other reconstructive techniques.

Patients and Methods: Between 2006 and 2013, three patients underwent this procedure for Campanacci grade 3 giant cell tumors. All patients were right-hand dominant females, aged 24, 35 and 46 years respectively. Two cases involved the right radius. Patients were reviewed retrospectively with clinical examination, functional assessment (the Toronto Extremity Salvage Score for upper limb) and radiographs. The review period was 30, 51 and 41 months respectively.

Results: The length of distal radius resected was 70mm, 50mm and 35mm respectively. All achieved clear margins. There were no complications and there have been no recurrences. All ulno-carpal translocations achieved radiographic fusion. Patient’s averaged 800 pronation, 700 supination and clinical TESS scores of 86 at most recent follow-up.

Conclusions: This technique achieved a painless and functional wrist arthrodesis with partially restored wrist motion, without complications. This technique has the advantage of negating remote donor site morbidity and/or allograft rejection issues of other techniques.

Level of evidence: Level III, therapeutic study.

March, 2014 Live surgical seminars are one way that surgeons keep up-to-date and learn new skills. Surgeries are performed in a normal operating theatre, where audiovisual equipment is used to project the live operation to a lecture theatre full of interested surgeons. In this way, hundreds of surgeons can watch a single surgery at one time, without having to crowd into a small operating theatre and risk decontamination of the sterile operating field. To see an example of a live shoulder surgery seminar - Click here. This month James helped Graham Tytherleigh-Strong demonstrate how to perform an arthroscopic knotted Bankart repair for the management of recurrent shoulder dislocations, at the Queen Elizabeth Hospital - Birmingham. This live surgical seminar was a good opportunity for shoulder surgeons from around the United Kingdom and Europe to meet and discuss developing techniques in arthroscopic shoulder surgery.

February, 2014 James is excited to be starting work at Addenbrookes Hospital, a Cambridge University NHS Trust Hospital. The Unit specialises in shoulder and elbow surgery and is a tertiary referral centre for complex orthopaedic problems. The team is regularly involved in teaching of orthopaedic surgical trainees and University of Cambridge medical students. Their research is regularly published in peer-reviewed journals. The Consultant team is also involved in reviewing for several journals including the British Bone & Joint Journal. James feels that the Unit offers a comprehensive training experience that few other centres in the world can match.  While working with the team, James plans to develop and refine his arthroscopic skills of the shoulder, elbow, scapulothoracic and sternoclavicular joints. To find out more about the Orthopaedic Department of the University of Cambridge - Click here. To find out more about this Shoulder & Elbow Fellowship - Click here.  

Gregory I Bain, Adam C Watts, James M McLean, Yu Chao Lee, Kevin Eng
Techniques in Hand and Upper Extremity Surgery
Vol 17, Issue 1, Mar 2013, p 13–19.
2013

Full article

Yu Chao Lee, Kevin Eng, Angus Keogh, James M McLean, Gregory I Bain
Techniques in Hand and Upper Extremity Surgery
Vol 16, Issue 4, Dec 2012, p 225-229."
2012

Full article

James M McLean, Perry C Turner, Gregory I Bain, Nimah Rezaian, John Field, Quintin Fogg
The Journal of Hand Surgery (European)
Vol 34E, Issue 6, Sep 2009, p778-782.
2009

Full article

James M McLean, Robert Atkinson, Luke Mooney, David Lovett
The Australian Defence Force Health Journal
Vol 8, Issue 2, Oct 2007.
2007

Full article

James M McLean, Gregory I Bain, Adam C Watts, Luke T Mooney, Perry C Turner
The Journal of Hand Surgery (American)
Vol 34, Issue 6, Jul-Aug 2009, p1044-1055.
2009

Full article

Gregory I Bain, James M McLean, Perry C Turner, Aman Sood, Nicholas Pourgiezis,
The Journal of Hand Surgery (American)
Vol 33, Issue 10, Dec 2008, p1770–1776.
2008

Full article

Ian Galley, Gregory I Bain, James M McLean
The Journal of Hand Surgery (American)
Vol 32, Issue 6, Jul-Aug 2007, p842-7.
2007

Full article

James M McLean, Gregory Bain, Michael Eames, Quintin Fogg, Nicholas Pourgiezis
The Journal of Hand Surgery (American)
Vol 31, Issue 4, April 2006, p601-607.
2006

Full article