April 11 through 14—London
Ms. Eileen Arnold (secretary for the ABC Fellowship) and Mr. David Jones (Honorary Secretary of the British Orthopaedic Association) met us at London's Heathrow Airport for a brief discussion and coffee. Six of the seven Fellows were present. (Emil had missed a connection in Chicago due to bad weather and arrived later that day.) Ms. Arnold and Mr. Jones transported us to the British Orthopaedic Association office at the Royal College of Surgeons of England, which served as our lodging while we were in London. We had a briefing with our host and received the essential tickets and passes. That afternoon we found Emil, minus his luggage, and went sight-seeing in London and had a wonderful dinner at a local pub. We delineated responsibilities among the group (Regis O'Keefe would be in charge of the Web site, Kurt Spindler would be the scribe, and Larry Lenke would oversee correspondence) and viewed our Web site together.
On Monday, April 12, our academic program began. We traveled by taxi from the Royal College to the Royal National Orthopaedic Hospital at Stanmore, a part of the College of London, where Professor G. Bentley hosted us. The morning academic program included lectures by the Stanmore staff, such as "Advances in Bone Tumors," by Dr. J. Pringle; "British Low-Back Pain Study," by Mr. M. Sullivan; "Surgery for Severe Spinal Deformity Methods," by Mr. J. Lehovsky; and "Replantation of Spinal Nerves," by Mr. T. Carlstedt. The session ended with a clinical pediatric conference by Mr. A. Catterall, Ms. D. Eastwood, and Mr. A. Hashemi-Nejad. The Fellows' presentation, "Halo Traction and Treatment of Complex Pediatric Spinal Deformity," was by Lawrence Lenke. We enjoyed an on-site lunch at Stanmore and then split up in the afternoon. Some of the Fellows visited the Biomechanical Engineering Research Unit, where prostheses are designed and custom prostheses are made, and the other Fellows visited the Human Performance Unit for a demonstration of "wobbliness" in determining the proprioceptive deficits of balance in the elderly. We then took taxis back to London for a brief period of exercise, followed by dinner at Ye Olde Cheshire Cheese, an old English pub on London's famous Fleet Street.
The next morning we again took taxis to the Royal National Orthopaedic Hospital to visit either the Bone Tumor Unit or the Tissue Culture Laboratories, where investigations of articular cartilage cells and potential cartilage resurfacing were being performed. The morning academic lectures at the Royal National Orthopaedic Hospital included "Technical Advances in Rehabilitation," by Professor M. Ferguson-Pell; "Spinal Cord Injury and Monitoring," by Mr. H. Noordeen; "Clinical Applications of Cartilage Resurfacing Methods," by Professor G. Bentley; "Articular Cartilage Cells—Their Potential," by Dr. D. Lee; "Dynamic MRI of the Knee," by Mr. A. Williams; "Tibialis Posterior Deficiency Syndrome," by Mr. J. Angel; "Wear of Total Knee Replacement," by Dr. G. Blunn; "International Standards for Total Knee Replacement," by Dr. H. Haider; and "Bone Cell Systems for Biomaterials," by Dr. L. Di Silvio. Kurt Spindler delivered the Fellows' talk, "The Response of Knee Ligaments to Growth Factors TGF-ß and PDGF." We enjoyed an excellent lunch at the hospital and then returned to our accommodations at Nuffield College to prepare for the first formal event of the trip, a black-tie council dinner of the British Orthopaedic Association in the Old Hall at Lincoln's Inn, where we met the president of the British Orthopaedic Association, Mr. David Dandy. This concluded our two-day visit to the Royal National Orthopaedic Hospital at Stanmore. The former ABC Fellows whom we met at Stanmore were Professor G. Bentley, Mr. A. Catterall, and Ms. D. Eastwood.
The Fellows met again the next morning, Wednesday, April 14, for a visit to the British offices of The Journal of Bone and Joint Surgery at 22 Buckingham Street in London. We enjoyed a lively discussion with Mr. Frank Horan, the Editor, regarding policy principles and the role of The Journal. We proceeded on a tour of the facility and learned how an article progresses from submission to publication. This was followed by a traditional lunch at an old English pub hosted by Mr. Horan, where the discussion continued. We then toured some of downtown London near the port and learned some of its history. That evening we were on our own in London, and the seven of us chose to see a performance of Woman in Black at a local theater.
April 15 through 18—Bristol and Bath
Thursday morning, at around sunrise, we took taxis to board a train from London's Paddington Station to Bristol, arriving at 9:00 A.M. Our gracious hosts, Professor I. D. Learmonth and Mr. J. Hardy, met and transported us first to the Berkeley Square Hotel and then to the Avon Orthopaedic Center, Southmead Hospital. We immediately began the academic program, which ran from 10:00 A.M. to 1:00 P.M. We heard talks on "Severe Compound and Intra-articular Fractures of the Tibia," by Mr. M. Jackson; "The Avon Patellofemoral Joint," by Mr. C. E. Ackroyd; "Unicompartmental Knee Replacement," by Mr. J. H. Newman; "The Efficacy of Intravenous Regional Blockade in the Post-Traumatic Algodystrophy," by Mr. J. Livingstone; "Gentamicin Release from Old Cement during Revision Hip Arthroplasty," by Mr. R. Spencer; and "Genetic Response to Wear Debris," by Dr. C. P. Case. The Fellows gave three talks: the first, by Emil Schemitsch, was on "Current Concepts of Open Tibial Fractures"; the next, by Guy Grimard, was on "New Fixation for Supracondylar Fractures in Children"; and the last, by Cato Laurencin, was on "Adhesive Capsulitis." Following a brief lunch, we participated in an ongoing course of the Fellows of the Royal College of Surgeons, where candidates preparing for their Orthopaedic Boards were going through mock examinations and oral presentations. It was fascinating to see these individuals learning in a simulated setting and to be able to participate in this process. We finished up at approximately 6:00 P.M. and returned to the Berkeley Square Hotel. That evening we walked from our hotel through scenic Bristol to the riverfront at River Station for a combined ABC/Fellows of the Royal College of Surgeons dinner.
The next day, Friday, April 16, our scientific program at the Avon Orthopaedic Center continued. The morning talks were "Instrumented Spinal Fusion for Low-Back Pain," by Mr. Alistair Ross; "Calcaneal Fractures and the Extended Lateral Approach to the Heel," by Mr. Roger Atkins; "Tensile Testing of Bovine Zone-II Medial Meniscal Tears Repaired with Horizontal Sutures and Meniscal Arrows," by Mr. Andrew Porteous; "Total Knee Replacement with TC3," by Mr. Louis Pozo; "The Role of Cytokines in Periprosthetic Osteolysis," by Dr. Mark Perry; "Prevalence of Pediatric Sporting Injuries in Bath," by Mr. Cledwyn Jones; "A New Method for the Analysis of the Permeability of Drapes to Bacteria," by Mr. John R. W. Hardy; "Upper Limb Arthroplasty in Avon," by Mr. Neil Blewitt; "The Initial Stability of a Tricalcium Phosphate Hydroxyapatite Bone Graft Extender for Use in Impaction Grafting of the Femur," by Mr. Ashley Blom; and a social talk on "A History of Bath," by Mr. Ross. Four Fellows gave presentations: Kurt Spindler spoke on "The Role of Diagnostic Studies in the Knee"; Regis O'Keefe, on "Periprosthetic Loosening: Molecular Mechanisms to Therapeutic Intervention"; Paul Di Cesare, on "Evaluation of the Potential Infected Total Joint Arthroplasty"; and Larry Lenke, on "Adolescent Idiopathic Scoliosis Classification." After a brief lunch, we had a group picture taken, and then our host, Mr. Ross, transported us to Bath. Former ABC Fellows whom we met during our stay in Bristol and Bath included Professor Ian D. Learmonth, Christopher E. Ackroyd, and Mr. A. H. C. (Tony) Radliff. In the afternoon we toured the ancient Roman baths, which arose from a hot spring and were originally constructed over 2000 years ago, were buried, and then were rediscovered and partially restored around 100 years ago. The temperature of the water was approximately 40 degrees Celsius. It was absolutely unbelievable to stand on a site that is more than 2000 years old, where the original stonework and baths remain essentially unchanged. We enjoyed afternoon tea at the museum of the Roman bath ruins and then visited Mr. Alistair Ross's home, followed by a fantastic dinner at the Priory Hotel in Bath. After dinner, we returned to the Berkeley Square Hotel in Bristol.
We spent the next morning exercising and leisurely catching up from our extremely busy week. Mr. Alistair Ross met us at noon and transported us to his home and then to the Hope and Anchor Pub for lunch. In the afternoon, we participated in clay pigeon shooting in Bath, which was a new and unique experience for most of us. Paul Di Cesare upheld our honor by winning the shooting contest. That evening, we returned to Bristol, where we were met by our host, who took us to an old English pub for a lager and then to dinner at the Belgo Restaurant. Finally, after being rescued from an elevator that was stuck between floors at the hotel, we retired for the evening.
On Sunday morning, Professor Learmonth took us to Lloyds Fitness Club, where we all had a great workout. Professor Learmonth and Mr. J. Hardy graciously opened up their homes to us for brunch. We chatted with their families and shared great fellowship. That afternoon, we took a train from Bristol to London-Paddington, where our hosts from the Imperial College at Charing Cross Hospital, Professor Sean Hughes and Mr. Robin Strachan, both former ABC Fellows, met us and took us from the train station to our hotel. We met them again later that evening for a walk over the Waterloo Bridge for a breathtaking view of London. We went on to dinner at the Oxo Restaurant in the Oxo Tower, where we enjoyed another spectacular view of the skyline, and then we leisurely walked back to our hotel.
April 19—London
On Monday morning, Ms. Eileen Arnold escorted us to Holburn, where we took the Piccadilly Line to Hammersmith. We soon discovered at Hammersmith that we had purchased zone-1 instead of zone-2 tickets. After much discussion with the authorities, we were able to talk our way out of a fine of ten pounds per individual. We took a bus to the Charing Cross Hospital, where Professor Sean Hughes hosted us for an all-day academic session. Professor Hughes chaired the first session, "Orthopaedic Trauma," and we heard talks including "The Blood Supply of Bone," by Dr. I. Reichert; "Nitric Oxide in Fracture Healing," by Mr. S. Corbett; "Open Tibial Fractures," by Mr. M. Pearse; and "Case Presentations on Trauma," by Mr. Pearse and Mr. A. Forester. Emil Schemitsch presented the Fellows' talk on "DC Versus LC-DC Plates: Is There a Difference?" After a brief coffee break, Professor Hughes chaired the next session, on "Spinal Surgery." Talks in this session were "Measurement of Growth and Intervertebral Spinal Motion," by Dr. A. McGregor; "The Spinal Squeeze," by Mr. J. Nixon; "Spondylolisthesis," by Mr. J. Johnson; "Observations on the Importance of a Knowledge of Vertebral Vascular Anatomy in Spinal Surgery," by Mr. H. Crock; and "Minimal Access Surgery and Allied Technologies," by Professor A. Darzi. We then enjoyed lunch in the seminar room.
Mr. R. Strachan chaired the afternoon session on "Arthritis Surgery." Talks included "The Role of Thermal Shrinkage and Other Novel Strategies in the Management of Glenohumeral Instability," by Mr. Andrew Wallace; "RSA in the Prediction of Glenoid Migration," by Mr. R. Emery; "Articular Zoning in the Knee," by Mr. R. Strachan; "Female Knee Problems," by Mr. R. Thomas; "Computer Prediction of Periprosthetic Bone Changes," by Mr. A. Amis; and "The Impact of Tissue Engineering in Musculoskeletal Disorders," by Professor J. Polak. Mr. P. Baird presented cases on upper-limb surgery for the treatment of arthritis, and Cato Laurencin gave the Fellows' talk on "Tissue Engineering of Bone." That evening Professor Hughes, Mr. R. Strachan, and Professor N. Wright treated us to a traditional English dinner at the classic Athenaeum Club in London.
April 20 and 21—Manchester
On Tuesday morning, we arose at sunrise and departed by train from London-Euston to Manchester, where our hosts, Mr. Peter Kay, Professor Charles S. B. Galasko, and Mr. Martyn Porter, all former ABC Fellows, kindly met us. Our luggage was delivered to the Midland Hotel in Manchester, and we were taken to Wrightington to begin the academic sessions. We observed a revision hip arthroplasty and a wrist arthroscopy and then visited the fascinating Charnley Museum, where the history of the failures and successes of hip replacement by one of the original masters is depicted. Following a light lunch at the Charnley Research Institute, we began the afternoon academic session. We were divided into two groups, one of which focused on the upper extremities and one of which focused on the lower extremities. Kurt Spindler, Cato Laurencin, and Guy Grimard participated in the upper-extremity group, and Lawrence Lenke, Regis O'Keefe, Paul Di Cesare, and Emil Schemitsch participated in the lower-extremity group. The lower-extremity group heard talks on "Ankle Replacement," by Mr. Peter Wood; "The Use of Allograft in Total Hip Replacement for Congenital Dysplasia of the Hip," by Peter Bobak; "The Load Angle Inlay Knee Replacement," by Bodo Purbach; "Ten-Year Results of the Wrightington Metal-Backed Cup," by Manzoor Sheikh; "Total Hip Replacement, Fatal Pulmonary Embolism, and the Weather," by Mr. Peter Kay; "Proximal Femoral Replacement in Hip Revision Surgery," by Scott Crawford; "Treatment of Periprosthetic Fractures in Total Hip Replacement," by Aslam Mohamed; and "Orthopaedic Spin," by Martyn Porter. The upper-extremity group heard talks on "Wrist Arthroscopy," by Professor J. K. Stanley; "Forces Transmitted Along Human Flexor Tendons," by Dr. E. Powell; "Culture of Tendon Cells and Effects of Mechanical Stimulation," by Dr. Carol Evans; "Studies on the Souter Strathclyde Elbow Arthroplasty," by Dr. D. Nuttall; and "Survivorship of Global Shoulder," by Mr. A. Weber. Traditional English tea and cakes followed this session. The two groups then combined for the Fellows' talks: "Shoulder Instability," by Cato Laurencin, and "The Evaluation of Potentially Infected Total Joint Arthroplasty," by Paul Di Cesare.
Our gracious hosts took us to the Wrightington Country Club for exercising, including swimming and weight-lifting. Professor Stanley, Mr. Kay, and Mr. Porter then hosted us for a delicious dinner at the High Moor Restaurant with the Wrightington faculty. We then returned to the Midland Hotel at Manchester.
The next morning Professor Galasko met us for an academic session at Hope Hospital in Manchester. The morning session included talks on "Scoliosis and Duchenne Muscular Dystrophy," by Professor Galasko; "Infection and Arthroplasty," by Mr. Peter Kay; "Revision Surgery for Hip Dislocation," by Mr. J. Hodgkinson; "Cyclical Pressure in Cytokine Production," by Mr. A. McEvoy; and case presentations on spinal problems in children by Mr. E. R. S. Ross, Mr. J. Spilsbury, Mr. Tim Meadows, and Mr. E. Jago. This session was followed by a light lunch.
At the afternoon session, we had two talks by ABC Fellows: "Molecular Mechanism of Bone Metastasis: A Search for Therapeutic Intervention," by Regis O'Keefe, and "Anterior Instrumentation for Adolescent Idiopathic Scoliosis," by Lawrence Lenke. In addition, Mr. J. Noble (a former ABC Fellow) spoke on "Total Knee Replacement: How Do We Choose?" and Mr. G. Andrew spoke on "Fracture Healing." Mr. G. Andrew, Mr. R. Wilkes, Mr. H. Maxwell, and Mr. R. Samarji conducted trauma conference case presentations. After a stimulating discussion regarding the cases, we had dinner that evening at Christie's Bistro at the Manchester University.
April 22 through 25—Edinburgh
On Thursday morning, we said good-bye to our hosts, Professor Galasko and Mr. Peter Kay, and traveled by bus to Manchester Airport for a flight to Edinburgh, Scotland. We arrived in Scotland at 10:00 A.M., and our individual hosts, Mr. Malcolm Macnicol, Mr. Michael McMaster, Mr. W. A. Souter, and Mr. C. M. Court-Brown, met us. We reconvened for lunch at the Grand Sheraton-Edinburgh. In the afternoon, Professor James Scott and Mr. and Mrs. Michael McMaster treated us to a scenic bus tour, a walking tour of the gardens and the city of Edinburgh, and a tour of the Scotland Whiskey Museum. We then met at the Sheraton, where our gracious hosts took us to their homes for a delightful evening of dinner and fellowship.
Friday morning began with an excellent academic session in the Princess Margaret Rose Hospital Lecture Theater. The talks in this session were "The Trauma Victim—Behind the Mask," by Professor J. D. Hutchison from Aberdeen; "The Modern Management of Unstable Fractures of the Distal Radius," by Ms. M. M. McQueen; "Proximal Humeral Fractures: Is Surgery Necessary?" by Mr. C. M. Court-Brown; "The Role of Elbow Arthroplasty Management of Trauma," by Mr. W. A. Souter; "Coagulative Response to Intramedullary Nailing," by Mr. C. M. Robinson; "The Natural History of Congenital Kyphosis and Kyphoscoliosis," by Mr. M. J. McMaster; "Perthes Disease—Shaping up to the Future," by Mr. M. Macnicol; and "A Thirty-Year Follow-up of Patients After Open Meniscectomy in Adolescence," by Mr. M. J. McNicholas from Dundee. The Fellows' talks, "Current Concepts of Open Tibial Fractures" and "Treatment of Open Tibial Fractures in Children: Factors Affecting Healing," were presented by Emil Schemitsch and Guy Grimard, respectively. Following lunch at the Saddle Bar, the afternoon academic session was held, which included talks on "Failing Hip Replacements: How Can They Be Detected?" by Professor D. L. Hamblen from Glasgow; "Mechanical Aspects of Particle Compaction for Proximal Femoral Bone-Grafting," by Mr. C. R. Howie; "Thromboembolic Phenomena During Hip Replacement Surgery," by Mr. J. Christie; "Do We Operate on Rheumatoid Shoulders Too Late?" by Mr. I. J. Kelly from Glasgow; and "Osteoporosis: Diagnosis with Computerized X-Ray Analysis," by Mr. C. Wigderowitz from Dundee. Paul Di Cesare gave the Fellows' talk on "Alternate Bearing Surfaces for Total Hip Arthroplasty." We were honored that several orthopaedists from Aberdeen, Dundee, and Glasgow traveled to Edinburgh for our visit.
Later, we enjoyed a reception at the Princess Margaret Rose Hospital Library and then a Scottish dinner at the magnificent Balmoral Hotel, which had a beautiful view of old Edinburgh. During this black-tie dinner, our hosts wore authentic Scottish kilts and we enjoyed a traditional Scottish meal with bagpipes, haggis, and Scottish poetry recited by Mr. Malcolm Macnicol. The next morning we all exercised before a wonderful brunch with our hosts and then traveled to the George Intercontinental Hotel in Edinburgh for our final stay on Saturday. That afternoon we were treated to golf at Gullane Golf Club, which was established in 1882 as a traditional links course. The course has beautiful scenery, windy conditions, classic narrow fairways, and heightened rough, and it is along the water's edge. Several Fellows visited the countryside and the birthplace of Rob Roy. In the evening, our hosts graciously provided dinner for us at the hotel.
It was a pleasure to meet a tremendous number of former ABC Fellows during our stay in Edinburgh. They included Mr. Malcolm Macnicol, Mr. C. M. Court-Brown, Mr. M. J. McMaster, Professor D. L. Hamblen, Mr. I. J. Kelly, Mr. W. A. Souter, and Mr. J. H. Scott. The next day we enjoyed some of the sights of Edinburgh, including the Edinburgh Castle, inside of which the Scottish crown jewels were impressively displayed, and Old Towne, and we did some shopping. Our hosts then transported us to Edinburgh Airport for our flight to Nottingham; however, the flight was delayed because of a thick sea fog. We were rerouted by bus to Glasgow for our flight to East Midlands Airport in Nottingham.
April 25, 26, and 27—Nottingham
After a long delay, we arrived in Nottingham, where Professor Angus Wallace, our host and a former ABC Fellow, met us at the airport. A coach took us to our accommodations at the Waltons Hotel, and, after a quick drink, we retired for the evening.
On Monday, April 26, following breakfast, our host transported us to Queen's Medical Center for an academic session. The first part consisted of ward rounds, and the Fellows were split into two groups: the trauma unit, led by Mr. C. Moran, Mr. E. P. Szypryt, and Mr. D. Hahn, and the spinal unit, led by Mr. M. Grevitt, Mr. H. Mehdian, and Mr. A. Wild. After two hours of very interactive case discussion, the lecture session began. We heard presentations on "Clubfeet," by Mr. J. B. Hunter; "Sports Medicine at the University of Nottingham," by Mr. K. Boyd; "Reconstruction of Severe Elbow Injuries," by Mr. B. J. Holdsworth; "Measuring and Adjusting the Soft Tissues at the Time of Total Knee Replacement," by Mr. T. J. Wilton; and "Scoliosis Surgery," by Mr. J. K. Webb. Lawrence Lenke gave the Fellows' talk on "Anterior Instrumentation for Adolescent Idiopathic Scoliosis." Professor Wallace then took us to Nottingham City Hospital for ward rounds at the Shoulder and Elbow Unit led by him and Mr. L. Neumann. We reviewed and discussed hospitalized patients who were being managed for a wide spectrum of shoulder and elbow problems. After a quick lunch at Nottingham City Hospital, the academic session continued with talks on "Fractures of the Distal Radius," by Mr. T. R. C. Davis; "The Nottingham Shoulder Replacement," by Professor W. A. Wallace; "Errors and Recovery in Hip Replacement," by Mr. C. J. Howell; "Imaging of Soft-Tissue Tumors," by Dr. J. Fairbairn; and "Orthopaedic Training in the United Kingdom," by Professor W. A. Wallace. Regis O'Keefe gave the Fellows' talk, "Bone Morphogenetic Proteins Are Autocrine Regulators of Chondrocyte Maturation." After a quick tea, the local consultants presented cases on total hip arthroplasty and shoulder replacement. We enjoyed a private tour of the Newstead Abbey followed by dinner at the White Lady Restaurant adjoining the Abbey. Following a short night's rest, we went by coach to Birmingham the next morning.
April 27, 28, and 29—Birmingham
We arrived at the Royal Orthopaedic Hospital in Birmingham at 11:00 A.M., where our host, Mr. Robert J. Grimer, a former ABC Fellow, met us. Following a brief coffee break, we visited the Oncology Unit's Clinical Pathology Conference, where we reviewed a multitude of cases on lower and upper-extremity tumors. This was followed by a quick lunch and then an afternoon academic session. We heard talks on "Management of Cervical Flexion Injuries," by André Jackowski; "The Cause of Sciatica?" by Alistair Stirling; "What's New in Shoulder Stability?" by Duncan Learmonth; "Developments and Results of Metal-on-Metal Hip Resurfacing," by Ronan Treacy; "Treatment of Children with Bone Tumors," by Simon Carter (a former ABC Fellow); "Complex Osteotomies in the Treatment of Hip Disorders," by John O'Hara; "The New National Health Service," by Andrew Thomas; "Internal Fixation for Dorsally Displaced Intra-articular Fractures of the Distal Radius," by Mike Craigen; "Rationale of Ultrasound Screening for Congenital Dysplasia of the Hip," by John Clegg; and "Litigation U.K.," by Richard Cherry. Two Fellows gave talks: the first, by Kurt Spindler, was on "Pain Studies After Anterior Cruciate Ligament Reconstruction of the Knee," and the second, by Guy Grimard, was on "Clinical Research Designs: Applications to Orthopaedics." That evening the Fellows were split among seven different hosts, Mr. Rob Grimer, Ronan Treacy, Duncan Learmonth, Alistair Thompson, Andrew Thomas, Jeremy Plewes, and John O'Hara. That night the group of hosts living in Birmingham hosted Kurt, Guy, and Emil at a local pub while Alistair Thompson hosted Regis, Larry, Cato, and Paul at his truly unique home, a 300-year-old converted barn that was a tongue-and-groove structure built without the use of nails.
The next day we were transported to the medical center, where each Fellow spent the morning with the local host whose academic and clinical interests were most similar to his own. Following a light lunch, we took an afternoon tour of Warwick Castle, which was constructed in the twelfth century. The castle was magnificent, the dungeon and torture rooms were frightening, and all seven Fellows got a good workout by ascending and then descending the 530 steps leading to the peak of the tower. At that point, we were taken by bus to Stratford-upon-Avon, where we toured Shakespeare's birthplace and home and the Shakespeare museum. We were surprised to learn that Shakespeare wrote, on average, two plays per year, as he was part of the London Company of actors. (An interesting aside: the number-one nationality of the visitors who signed in at the Shakespeare Museum was American.) We then had a quick lager and supper at the Dirty Duck Pub. That evening our hosts met us and we attended the Swan Theatre of the Royal Shakespeare Company for a presentation of Tales from Ovid. The Swan Theatre is a replica of the original 270-degree theatre, and the play was magnificent. The next day we met again at the Royal Orthopaedic Hospital for our departure to Oxford.
April 29 through May 1—Oxford
After a leisurely coach trip through the Cotswolds and a brief stop in a historic pub, we arrived at the Randolph Hotel in Oxford, where Professor John Kenwright and colleagues met us. After we checked into the hotel, we walked with Professor Kenwright and the others to the Old Parsonage Hotel for lunch. That afternoon we had a guided tour of parts of Oxford University. We were intrigued to learn that Oxford University is an amalgamation of thirty-one independent colleges, each having separate admission structures and testing and graduation requirements, but all granting a singular degree from Oxford University. Each separate college is arranged around a chapel, a library, and student accommodations with a grassy quad area for lounging and sports. The magnificent buildings of the colleges date back to the twelfth century. We returned to the Randolph Hotel for a couple of hours of relaxation and then joined the Nuffield Orthopaedic Clinic and Research Team for a black-tie dinner at the Wadham College of Oxford (Fig. 1). This was a spectacular hall where we had a splendid dinner in traditional English style at a long table, changing to a second table for the final toast and final course. After a most gracious toast by Professor Kenwright, Larry Lenke responded by reciting from memory the eleven former ABC Traveling Fellows from Oxford in alphabetical order: Michael Benson, Christopher Bulstrode, Andrew Carr, Stephen Copeland, Jeremy Fairbank, John Goodfellow, John Kenwright, Hamish Simpson, John Spivey, James Wilson-McDonald, and Peter Worlock. After this truly delightful evening of fellowship with our hosts and their wives, we returned to the hotel.
The next morning we were transported by minibus to the Nuffield Orthopaedic Clinic, where our academic session consisted of a "balloon debate" by four Oxford consultants and two of the ABC Fellows. In a balloon debate, multiple topics are debated, and, on the basis of their debating style, enthusiasm, and arguments, a limited number of individuals would theoretically be allowed to take off in the balloon to be saved from catastrophe on a volcanic island. The debates centered around the quality of orthopaedic care, in particular the measurement of outcomes. The debaters were Mr. Martin McNally, who spoke on "The Value of Local Audits"; Mr. James Wilson-MacDonald, who spoke on "The Value of Nationwide Registers"; Mr. Jeremy Fairbank, who spoke on "The Value of Observational Studies"; Mr. Christopher Bulstrode, who spoke on "I Know Best"—and our two Fellows, Guy Grimard, who spoke on "The Value of Prospective Randomized Trials," and Cato Laurencin, who spoke on "The Value of Continuing Medical Education and Reaccreditation for Orthopaedic Surgeons." The debate, interaction with the audience, and questions and answers were very lively and informative. Both of the Fellows did a splendid job; Cato won with fifteen votes but he was followed closely by Guy with thirteen votes. The next part of the morning was a very informative interactive session, with the pairing of each Fellow with the local host whose research and academic objectives most closely matched his own. After lunch and a photograph with our hosts, we were taken by minibus to the John Radcliff Trauma Service, where Mr. Wilson-MacDonald, Mr. Peter Worlock, and Mr. Keith Willett presented fracture cases. Additionally, Mr. Willett gave a talk on "The Oxford Protocol for Clearance of the Spine," and Emil Schemitsch followed this with "DC Versus LC-DC Plates: Is There a Difference?" The last case presentations were on "Upper Extremity Nonunions." Afterward, we were hosted by the trauma staff for nine holes of golf at the Hinksey Heights Golf Club. From the hilltop on which the golf club is situated, we had a spectacular view of Oxford on this crystal clear, sunny day. A superb dinner followed at the White Heart Pub in the outskirts of Oxford with Mr. Wilson-MacDonald and Mr. Willett.
The next morning (Saturday) we awoke at 5:00 A.M. for May Morning Ceremonies, a local Oxford tradition, where we were in a festive crowd of 10,000 to 20,000 people listening to a choir singing from a tower. We had a final breakfast with Professor Kenwright and the trauma staff before returning to London by coach.
May 1, 2, and 3—London
After returning to London, our bus driver became lost. Two Fellows, Cato Laurencin and Kurt Spindler, obtained maps and guided the bus driver back to our accommodations at Lincoln's Inn Fields. Following our convoluted course to the hotel, we had a free afternoon, during which several of us went for a jog and the others opted for a bus tour of London. In the evening, the Fellows got together for an Italian dinner at the Pizza Express and an excursion to see the musical Miss Saigon, which was truly entertaining. We then had two days of much-needed rest and relaxation. On Sunday, two former ABC Fellows, Mr. Tim Briggs and Ms. Deborah Eastwood, hosted us for an exciting morning of quad-biking and all-terrain driving in Hertfordshire. Given the performance of several of the Fellows in driving the quad bikes or the all-terrain vehicle, qualification for licenses would definitely be questionable. In the afternoon, we enjoyed an English ale in a local pub followed by a tremendous lunch at the Briggs home, the Lane Farm, which is an active farm. In the evening, we participated in an ABC Club Dinner organized by Ms. Eastwood at Magno's Brasserie in Covent Garden with Mr. Andrew Cobb, Mr. Briggs, Professor Kenwright, Professor Wallace, and Professor Bentley. After a restful night, Mr. Cobb, a former ABC Fellow, hosted us on Monday for a day of golf and swimming at the Royal Automobile Country Club (Fig. 2). The course and hills were challenging and certainly far outshined our game of golf that day. After a brief lunch at the club and a short rest, we headed back to London, where the Fellows had an Italian meal together and enjoyed a movie at the Odeon Theatre in central London with Ms. Eastwood.
May 4—London (Great Ormond Street Hospital for Sick Children and Middlesex Hospital)
On Tuesday morning, Mr. David Jones took us for a leisurely walk from the Royal College of Surgeons to the Great Ormond Street Hospital for Sick Children. The first place that we visited was the chapel at St. Christopher, which was a small, ornate, and unbelievably beautiful chapel established over a century ago for families of hospitalized patients.
We then had an academic session at the lecture hall at the Great Ormond Street Hospital, where Mr. R. Creighton, Chief Executive Officer, spoke to us on the history of the hospital. We heard lectures on "Anterior Spinal Surgery in Children," by Mr. H. Noordeen; "Running Rings Around Deformity," by Mr. R. A. Hill; "It's a Bug's Life" (infections in children), by Mr. F. Monsell; and "Tendon Adaptations and Maladaptations in Animal Models," by Mr. A. Goodship. The Fellows' talk, "The Treatment of Open Tibial Fractures in Children: Factors Affecting Healing," was given by Guy Grimard.
Lunch was served in the boardroom of the hospital and was followed by a fifteen-minute walk to Middlesex Hospital. At Middlesex Hospital in the Courtauld Lecture Theatre, we heard talks by Mr. M. A. Edgar, who spoke on "The Cliffhanger, or Grade-V Spondyloptosis"; Mr. D. H. A. Jones, who spoke on "Uneasy Lies the Head on Slipped Capital Femoral Epiphysis"; Mr. R. L. Williams, who spoke on "Tibialis Posterior: One Step Beyond"; Mr. J. D. Witt, who spoke on "Triage and Treatment of the Bombing Victims of Soho London"; Mr. J. P. Cobb, who spoke on "How to Do Automated Knee Replacements in 3.5 Hours"; and Mr. B. H. Cohen, who spoke on "Chip on the Shoulder." Cato Laurencin gave the Fellows' talk on "Tissue Engineering of Bone."
In the evening, Mr. David Jones and Mr. M. A. Edgar hosted us at the Royal Airforce Academy's Royal Airforce Club at Piccadilly. We were pleased to be joined by Mr. Horan, Editor of the British volume of The Journal of Bone and Joint Surgery. After our final night's stay in London at Lincoln's Inn Fields, we continued on to Southampton the next morning.
May 5 and 6—Southampton
We left the college at 7:30 A.M. and were transported by train from Waterloo Station to Winchester, where we were met by two former ABC Fellows, Mr. N. M. P. Clarke and Mr. D. S. Barrett. They transported us to Southampton General Hospital, where we participated in a case conference by the registrars, which provided lively discussions of cases. After a quick lunch and a brief tour of the orthopaedic laboratories, we participated in a scientific program during which "The History of Orthopaedics in Wessex (The Lord Mayor Treloar Hospital)" was presented by Professor J. Wilkinson, a former ABC Fellow and Professor Emeritus. Talks included "Pediatric Distal Radius Fractures: Outcomes Analysis," by Mr. G. R. Taylor; "Chondrocyte Apoptosis in Bone Development and Disease," by Mr. H. I. Roach; "Sealing the Interface: Prevention of Wear Debris Migration," by Mr. D. S. Barrett; "Mesenchymal Stem Cell Differentiation and Therapy," by Mr. R. O. C. Oreffo; "Thromboembolism in Orthopaedics," by Mr. D. Warwick; and "Ultrasound in the Early Management of Congenital Dysplasia of the Hip," by Mr. Clarke. Three Fellows gave presentations: the first, by Kurt Spindler, was on "The Response of Knee Ligaments to Growth Factors PDGF and TGF-ß"; the second, by Regis O'Keefe, was on "BMPs Stimulate Growth Plate Chondrocyte Maturation"; and the last, by Paul Di Cesare, was on "Results of Long-Stem Prosthesis in Revision Hip Surgery." That evening we were taken to the Lainston House Hotel, truly a classic resort, for a brief period of relaxation followed by a wonderful dinner. We then enjoyed fellowship with several consultants and former ABC Fellows in the lounge before retiring to luxurious rooms.
The next morning we were picked up at 7:15 for participation in a two-hour trauma conference with the registrars and consultants at Southampton General Hospital. We visited the operating rooms and observed a femoral osteotomy for nonunion, reconstruction of the anterior cruciate ligament with hamstring tendons, and anterior arthrodesis of the spine. The morning session gave us tremendous one-on-one interaction with the consultants and registrars and was an excellent educational experience. We were then taken back to the hotel, where we packed a lunch for an afternoon of recreation including trout-fishing at the Marquis of Camden's Estate on the River Test. Cato Laurencin and Paul Di Cesare upheld our honor by catching trout. Fly-fishing proved to be a very difficult technical task that we began to master only after some expert instruction. This was the first visit to Southampton for an ABC Fellowship, and it was outstanding. That night we departed by coach to Heathrow Airport and stayed in the Radisson Hotel adjacent to the airport. At noon the next day, we departed on Qantas Flight 308 for Perth, Western Australia.
May 8 through 11—Perth, Western Australia
All seven Fellows survived a twenty-hour flight stopping at Singapore and arriving in Perth at 2:30 P.M. Our hosts met us for a relaxing evening; several of us went to dinner and a soccer game while others took a small tour of the city before heading off to sleep, as we were still adjusting to the time difference. We had a restful Sunday morning and then had lunch at Fraser's Rest overlooking beautiful Perth. That afternoon we played golf and spotted many kangaroos on the course, but, given our golfing abilities, they were perfectly safe on the greens. That evening, Mr. Peter Bath (who had organized our stay in Perth) hosted a barbecue at his house, treating us to many native Australian delicacies.
George Sikorski hosted the Monday-morning academic session at the Sir Charles Gairdner Hospital in Perth. In the medical school lecture theater, we heard talks on "Antibiotic Delivery into Bone Allografts Utilizing Iontophoresis," by David Wood; "A Temporary Prosthesis for Infected Revision Total Hip Replacement Surgery," by Richard Beaver; "Management of IIIB Comminuted Tibial Shaft Fractures," by Doug Sneddon; and "Arthroscopic Posterior Shoulder Stabilization," by Keith Holt. At this meeting, all seven Fellows gave presentations. First, Guy Grimard spoke on "New Fixation for Supracondylar Fractures in Children," then Emil Schemitsch spoke on "Humeral Shaft Fractures: Nailing Versus Plating," Paul Di Cesare spoke on "Alternate Bearing Surfaces of Total Hip Arthroplasty," Cato Laurencin spoke on "Anterior Cruciate Ligament Infection," Lawrence Lenke spoke on "Adult Long Fusions to the Sacrum," Regis O'Keefe spoke on "Periacetabular Reconstruction of Severe Metastases Restores Ambulation and Independence," and, finally, Kurt Spindler spoke on "The Response of Knee Ligaments to Growth Factors TBG-ß and PDGF."
During the afternoon, the Fellows were divided into three groups: those who would attend a Trauma Conference at Royal Perth Hospital, those who would attend a research meeting at Sir Charles Gairdner Hospital, and those who would attend a pediatric session at Princess Margaret Hospital. The Fellows then met back for an informal presentation of research by the registrars at Sir Charles Gairdner Hospital, which finished at about 5:30. Alan Skirving and Ken Kozak hosted an informal discussion regarding training differences among Australia, Canada, and the United States as well as the importance of research in academics. That evening we enjoyed excellent food and fellowship at the Australian Orthopaedic Association dinner at the Mead Seafood Grill on the harbor overlooking Perth. We then retired in preparation for the next day's flight to Adelaide.
May 11, 12, and 13—Adelaide
We arrived in Adelaide, where our local hosts, including two former ABC Fellows, Mr. Bruce Foster and Dr. Michael Sandow, met us and took us to their homes. We later met at the College of Surgeons building in North Adelaide for the presentation of cases by the registrars, followed by a reception hosted by Mr. Peter Tamblyn for the local orthopaedists, ABC Fellows, and registrars. We retired that evening to the homes of our hosts.
On Wednesday morning, we participated in a scientific session at the Royal Adelaide Hospital, chaired by Professor D. W. Howie. Talks included "Patellar Resurfacing Versus Not Resurfacing at Total Knee Replacement," by Mr. David Campbell; "The Diagnosis and Treatment of Lumbar Discitis," by Dr. John Hutchinson; "Osteoblast-Osteoclast Interactions," by Professor David Findlay; "Bone Resorption in Relation to Periprosthetic Wear," by Dr. David Haynes; "Hemiarthroplasty or Total Shoulder Replacement in Shoulder Osteoarthritis," by Dr. Michael Sandow; "Stiffness and Strength Relationships in Fracture-Healing," by Dr. Mellick Chehade; "Antenatal Orthopaedic Surgery," by Mr. Bruce Foster; and "Repairs to Distal Biceps Tendon Rupture," by Mr. Greg Bain. The ABC Fellows gave four talks: "The Role of Diagnostic Studies in the Knee," by Kurt Spindler; "Humerus Fractures: Nailing Versus Plating," by Emil Schemitsch; "Periprosthetic Loosening: Molecular Mechanisms to Therapeutic Intervention," by Regis O'Keefe; and, finally, "Tissue Engineering of Bone," by Cato Laurencin.
After a quick lunch, we had the pleasure of playing golf at Lake Karrinyup Country Club, where the only thing more erratic than our golf game was the weather, which went from bright sun, to rain, to rainbows, all on the same hole. After a brief stop at the "nineteenth hole," we dined on local food and wines at the Universal Wine Bar in Adelaide; this was followed by an entertaining evening in Adelaide with our hosts.
The next morning we arose at 4:30 A.M., packed our luggage, and met at Dr. Michael Sandow's house for a trip to Barossa Valley for a balloon flight over the vineyards. This was the first balloon flight for Dr. Sandow, as well as for the majority of the ABC Fellows, and it was an inspiring visual experience. We then toured Southcoup Winery, where we learned the difference in making white and red wine. We were then shuttled back for a scientific session at Flinders Medical Center, hosted by Dr. J. Krishnan. We heard talks on "Dynamic Three-Dimensional Carpal Motion," by Dr. Sandow; "Effect of Locking Plate Fixation on the Anterior Crucial Cervical Fusion," by Mr. John Costi; "Bone Plate Mechanics in Surgical Trauma," by Dr. John Field; and "The Biomechanics of Normal and Prosthetic Metacarpophalangeal Joint," by Mr. Dan Barker. The ABC Fellows' talks were "The Response of Knee Ligaments to Growth Factors TGF-ß and PDGF," by Kurt Spindler; "Periacetabular Reconstruction of Severe Metastases Restores Ambulation and Independence," by Regis O'Keefe; "Clinical Design in Orthopaedics," by Guy Grimard; and "DC Versus LC-DC Plates: Is There a Difference?" by Emil Schemitsch. After the session, Dr. Sandow took us to the airport for our brief flight from Adelaide to Melbourne.
May 14, 15, and 16—Melbourne
We arrived in Melbourne at 7:00 P.M., and two former ABC Fellows, Richard De Steiger, our local organizer and host, and Jonathan Rush, met us. We were then transported to our accommodations at the Melbourne Club, where we had time to change quickly before dinner at the club. At dinner we met a third former ABC Fellow, William G. Doig, and the President of the Australian Orthopaedic Association, Mr. John Hart. That night we retired relatively early, having been up since 4:30 A.M. for our balloon flight.
On Friday, Richard De Steiger picked us up at 7:15 and took us to Western Hospital for a clinical presentation and x-ray session to discuss difficult cases. After a brief sight-seeing tour of the city, we enjoyed coffee and a light breakfast overlooking a lake in Melbourne. On arrival back at the college, we had several hours on our own for sight-seeing and shopping followed by a quick lunch and then a scientific meeting at the Royal Australasian College of Surgeons. The program was conducted by Richard De Steiger, and we heard talks on "Early Postoperative Morbidity Following Anterior Cruciate Ligament Reconstruction: Patellar Tendon Versus Hamstring Graft," by Julian Feller; "Treatment of Type-II Odontoid Fractures in Halo Thoracic Vests," by Peter Wilde; "The Clinical Significance of Hip Dysplasia in Gage Type-IV Hemiplegia," by Gary Nattrass; "Autogenous Chondrocyte Grafting: The Melbourne Experience," by John Hart; and "Functional Nuclear Scans in Management of Musculoskeletal Tumor," by Peter Choong. All seven Fellows gave presentations: "Pain and Temperature Studies after Knee Arthroscopy," by Kurt Spindler; "Algorithmic Approach to Adolescent Idiopathic Scoliosis," by Lawrence Lenke; "New Fixation for Supracondylar Fractures in Children," by Guy Grimard; "Periprosthetic Loosening: Molecular Mechanisms to Therapeutic Intervention," by Regis O'Keefe; "Tissue Engineering of Bone," by Cato Laurencin; "Alternative Bearing Surfaces for Total Hip Arthroplasty," by Paul Di Cesare; and "Humeral Shaft Fractures: Nailing Versus Plating," by Emil Schemitsch.
In the evening, we were hosted at the Melbourne Cricket Grounds for dinner and a game of Australian-rules football. It was an evening of outstanding food and fellowship. The next morning John Hart and Richard De Steiger took us on a sight-seeing adventure in the state of Victoria. The first stop was the Healesvile Sanctuary. There, in addition to observing the native foliage and animals, we visited the veterinary clinic, where we saw radiographs of birds that had had internal fixation for broken wings. It was there that we learned that humeral nailing is for the birds! It was quite fascinating to see several animals indigenous only to Australia, such as the kangaroo, platypus, Tasmanian devil, koala, wombat, and other marsupials. We also had a brief session on the history of the native Australian people, the Aborigines. After this tour, we enjoyed wine-tasting at Victoria's first vineyard, Yering Station, in the Yarra Valley. We then went to John Hart's home for food and fellowship. We toured his native art collection and learned the history of Aboriginal art and its progression from the use of dots of color to stone painting and then to watercolors. In the evening, the Fellows gathered for an Italian dinner at the Roberto Ristorante, where Richard De Steiger, our gracious local host, joined us for dessert and conversation.
On Sunday, Richard De Steiger transported us to the Melbourne Airport for our delayed flight to New Zealand. The check-in at the Melbourne Airport was the first one at which we were all together. The luggage for the seven of us weighed in at a total of 381 kilograms; we checked 304 kilograms of luggage and had seventy-seven kilograms of carry-on luggage. (Note that we had already sent several boxes of luggage back to the United States and Canada before our departure from England.)
May 16, 17, and 18—Christchurch, New Zealand
On Sunday, May 16, we arrived at 2:00 P.M. and were met by former ABC Fellow Mr. Gary Hooper, who transported us with our luggage to the Chateau on the Park in Christchurch. After a short debriefing, he kindly introduced us to several local orthopaedists for a casual evening of barbecue, tennis, and exercise at his home.
On Monday, Mr. Hooper met us at 8:00 A.M. and transported us to his private orthopaedic office and hospital, where we got a view of the clinical setup, support staff, and hospital facilities. An academic session followed at the Bevin Lecture Theatre at Christchurch School of Medicine, part of Otago University. After being welcomed by Mr. Alan Panting, president of the New Zealand Orthopaedic Association, we heard studies on "Mobile Bearing Total Knee Replacement—The Christchurch Experience," by Mr. Gary Hooper; "Endoscopic Spinal Surgery," by Mr. Grahame Inglis; "The Articular Cartilage Matrix Matters," by Professor Keith Jeffrey; "The CLS Total Hip Arthroplasty—The Christchurch Experience," by Mr. Edmund Newman; "Surgery for Recurrent Shoulder Dislocations," by Professor Geoffrey Horne; "Polyethylene Creep Revisited," by Dr. Fiona Timms; "Polywear Version 1999," by Mr. Peter Devane; "Spinal Cord Monitoring in an Animal Model," by Dr. Tony Dalnesh-Clough; "Pedicle Screw Monitoring in Thoracic Spine," by Dr. Bruce Hodgson; "The History of the Control of Sepsis," by Mr. Alan Thurston; "Tetraplegic Upper-Limb Surgery," by Professor Alastair Rothwell; and "FES," by Mr. Khalid Mohammed. Five of the ABC Fellows gave talks; the first, by Kurt Spindler, was on "Diagnostic Knee Studies." This was followed by a talk by Paul Di Cesare on "Cartilage Oligomeric Matrix Protein," one by Regis O'Keefe on "Mechanisms of Periprosthetic Loosening," one by Cato Laurencin on "Anterior Shoulder Instability," and one by Larry Lenke on "Anterior Scoliosis Surgery."
The Fellows were particularly impressed by the support of the meeting by the Wellington Orthopaedic Group, represented by Professor Geoffrey Horne, Mr. Alan Thurston, Dr. Fiona Timms, and Mr. Peter Devane, who actually traveled by plane to the meeting, and the support of the Dunedin Orthopaedic Group represented by Professor Keith Jeffrey, Dr. Tony Dalnesh-Clough, and Dr. Bruce Hodgson. In Christchurch, we met five former ABC Fellows: Mr. Peter Devane, Mr. Gary Hooper, Professor Keith Jeffrey, Professor Alastair Rothwell, and Mr. Alan Thurston. After the academic session, we returned to the hotel, where we quickly changed clothes to attend a dinner hosted by the local faculty at Mona Vale.
The next morning Mr. Peter Devane led us on a walk through Hagley Park to Christchurch Hospital for a visit with Professor Alastair Rothwell and a registrar session in the Orthopaedic Department of Christchurch Hospital. We heard talks by Dr. Matt Brick on "Femoral Neck Stress Fractures" and Dr. David Gwynne-Jones on "Radiation Exposure in Spinal Surgery." The two talks given by the ABC Fellows were "Clinical Research Designs: Applications to Orthopaedics," by Guy Grimard, and "Current Concepts of Open Tibial Fractures," by Emil Schemitsch. This session concluded with case presentations, after which we went back to the hotel, had a brief lunch, and departed for Queenstown.
May 18, 19, and 20—Queenstown
We took a picturesque flight to Queenstown, where we would be hosted by Mr. Peter Devane. After arriving at the Millennium Hotel, we had time for brief exercise and then gathered for a walk downtown for dinner at a Chinese restaurant. After a lengthy debate on which activities we would participate in the next day, as it was quite clear that this was the "extreme-sport capital of the world," we finally decided to split up. In the morning, Cato and Paul went fishing on the lake. Kurt, Regis, and Emil took the gondola ride up the mountain and hiked past the paragliders to the peak. Peter Devane, Guy, and Larry took a jet-boat ride over the Shotover River. Peter and Guy did the pipeline bungee, which is a 102-meter plunge down the gorge above the river. It was then that we learned the reason why Peter was there—he was the only one from the Christchurch group who was as adventurous as some of the Fellows. That afternoon Kurt and Regis joined Peter, Guy, and Larry for a helicopter ride over the Shotover River followed by a challenging rafting trip down the river. As true ambassadors for North America, we pulled four individuals out of the freezing water in the midst of a rapid in which their boat had overturned. Cato, Paul, and Emil had a wonderful golfing trip in the afternoon. We wrapped up this exciting day with dinner at the Britannia Pub, where we talked about the day's adventures. After a restful night's sleep, Peter, Cato, and Paul played golf on Thursday morning while the others went shopping, sight-seeing, and exercising in the Queenstown area. That afternoon we parted company with Peter as he returned to Wellington and we continued on to Auckland via a stopover in Christchurch.
May 20 through 23—Auckland
That evening we arrived in Auckland and were met by four former ABC Fellows: Anthony Hardy, Peter Robertson, D. H. Gray, and Michael Barnes. They kindly hosted us and transported us for the entire stay, both from the airport to the hotel and then returning to the airport on Sunday. At the hotel, we had a brief conversation regarding the schedule for the next few days, and the Fellows ate dinner in the Heritage Hotel, an outstanding lodging and dining facility.
Friday morning was perfectly clear in Auckland, so we took a trip up the sky tower, the tallest structure in the Southern Hemisphere. We could see for at least fifty miles in all directions and really got a feel for the city nestled within the mountains, islands, and harbor. We had a bird's-eye view of the preparations and the sailboat lodging for the America's Cup 2000 race that was to begin in the fall of 1999.
That afternoon our academic session, chaired by D. H. Gray and J. Cullen, began. Michael Barnes presented pediatric cases; B. Twaddle, T. Astley, and M. Wright presented spinal deformity and sports medicine cases; and K. Karpik, B. Twaddle, and T. Hong presented trauma cases. This session concluded with presentations of tumor cases by G. French and M. Hanlon and hip and knee arthroplasty cases by A. Campbell, R. Street, and G. Heynen. The session inspired lengthy discussion among the Fellows and presenters regarding the management of their respective patients. In the evening, the Fellows reconvened for dinner at the hotel before sight-seeing in Auckland.
On Saturday, we began an academic session chaired by Mr. O. Ross Nicholson, a former ABC Fellow. At the academic session, we met the final ABC Fellow at Auckland, Barry Tietgens, who later hosted our dinner at the Royal New Zealand Yacht Squadron. G. Tragonning hosted the afternoon session. During the academic session, we heard talks by René Flachsmann, who spoke on "How Tissue Maturity Influences Osteochondral Failure"; Dr. C. Anthony Poole, who spoke on "Articular Cartilage Chondrons: Form, Function, Failure, Future"; Dr. Sue Stott, who spoke on "Limb Development"; Peter Robertson, who spoke on "Instrumented Posterolateral Lumbar Fusion: An Outcomes Study"; D. H. Gray and Dr. A. Rogers, who spoke on "Pulmonary Embolus Prevention Trial with Aspirin"; and Dr. Peter Mutch, who spoke on "Accurate Dynamic Traction for Closed Proximal Interphalangeal Fractures of the Hand." All of the Fellows gave presentations: Kurt Spindler spoke on "Magnetic Resonance Imaging Evaluation in the Knee"; Paul Di Cesare, on "Cartilage Oligomeric Matrix Protein"; Emil Schemitsch, on "Fat Embolism"; Regis O'Keefe, on "Molecular Mechanism of Bone Metastasis: A Search for Therapeutic Intervention"; Larry Lenke, on "Radiographic and Clinical Outcomes of Titanium Mesh Cages of the Spine"; Guy Grimard, on "Clinical Research Designs: Applications to Orthopaedics"; and Cato Laurencin, on "Drug Delivery and Tissue Engineering in Orthopaedic Surgery" (the final talk of the tour).
Later that afternoon, Mr. John Tonkin treated us to a trip through the harbor of Auckland on his yacht. We toured the islands and the site of the upcoming America's Cup and had a wonderful meal. Continuing with recreational pursuits and his love of golf, Cato played golf with Tony Hardy at a local golf course. That evening we enjoyed our final dinner, a splendid black-tie event hosted by the chairman of the Auckland Orthopaedic Society, Mr. B. R. Tietgens, at the Royal New Zealand Yacht Squadron in Westhaven. We saw the actual America's Cup, which resides in New Zealand, and learned about its history. The Fellows enjoyed a final evening together, reflecting on their recent adventures, and then headed off to prepare for the return flight to North America and to go to bed. The next morning four former ABC Fellows took us to the airport, where we boarded our flight from Auckland to Honolulu to Vancouver and then on to our respective destinations and loving families.
In summary, the Fellows wish to express sincere appreciation to the American Orthopaedic Association, the Canadian Orthopaedic Association, the British Orthopaedic Association, the Australian Orthopaedic Association, and the New Zealand Orthopaedic Association for their gracious support, their tremendous generosity and hospitality, and the unique educational experience of this trip. We also thank our wives and families for their ongoing patience and support. Finally, we are most appreciative of all of our hosts and former ABC Fellows for the generous hospitality that will be forever embedded in our minds and hearts.