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Summary

POSICON 2016, the 22nd Annual Conference of Paediatric Orthopaedic Society of India was conducted successfully between 7th and 10th of January 2016 at Hotel J W Marriott, Bangalore, India.

The conference was organised by Bangalore Paediatric Orthopaedic Foundation, a newly created charitable body with over 10 paediatric orthopaedic surgeons from Bangalore acting as founder members. Prof D Sundaresh who had conducted the previous POSICON in Bangalore was the Conference Patron along with Prof Rajagopalan, both well known for their lifetime contributions to Orthopaedic teaching.

POSICON also played host to the 6th Biannual POSI-POSNA workshops on 7th January 2016. Preparations for the workshops started in January 2015 with announcements for potential faculty from POSNA members. We received an overwhelming response from POSNA members representing all the disciplines of Paediatric Orthopaedics. Four workshops were planned on Paediatric Trauma, Cerebral palsy for the general orthopaedic surgeon, Upper limb disorders in children and Post-graduate Instructional Course (Resident teaching programme). Dr Sanjeev Sabharwal, POSI-POSNA Co-ordinator devoted much time and effort to the planning of the workshop programmes in great detail. For the first time in POSICON history, we conducted a hands-on cadaveric workshop on Advanced Hip Surgeries including complex pelvic osteotomies and surgical dislocation of the hip. Bangalore has the only purpose built cadaver lab in India and the organising committee were keen to utilise the facility as part of the academic programme.

Expectations were high in the run-up to the meeting with the entire Paediatric Orthopaedic community of India providing suggestions and help towards successful conduct of the conference. We were able to provide the conference scientific programme and faculty information in the form of a mobile app, another first for POSICON.

Pre-conference workshops:

POSNA faculty started to arrive on Tuesday 5th January 2016 with most of the surgeons landing in Bangalore in the early hours of 7th January. Braving travel fatigue and jet lag, the faculty arrived at the conference venue to be greeted by 4 halls full of interested surgeons and residents from all over India. The Trauma workshop included a hands-on bone model demonstration on TENS nailing, with approximately 75 delegates. The PG teaching workshop (60 delegates) was tailored to the needs of the resident and was well-received. The Upper limb workshop had standing room only with 50 delegates. The case discussions in the Upper limb workshop were particularly appreciated by many in the audience. The Cerebral palsy workshop (75 delegates) predictably went over the allotted time limit. Clinical case discussions and demonstrations added to the pressure. But the delegates insisted on listening to every lecture in the programme and the workshop eventually finished at 7:30PM. For delegates, it was “paisa vasool” (I got my money’s worth!).

After a gruelling day and an extended journey in Bangalore traffic, the faculty adjourned to the pleasant vistas of Karnataka Golfing Association for some well-deserved rest and refreshments.

Conference (419 delegates):

It was an early start for Dr Kocher lecturing on Patellofemoral Instability at the Breakfast session starting at 7:30AM. The conference programme rolled on with excellent lectures and discussions from POSNA and Indian faculty alternating to keep the audience glued to their seats. Our trade sponsors complained that there were hardly any orthopaedic surgeons seen wandering outside the lecture hall. The Free and Best paper sessions consisted of presentations of high-quality work undertaken in India, both basic science and clinical research.

The much awaited POSI Oration by Dr Michael Millis was titled "Hip Health for the 21st Century: Perspectives of a Paediatric Orthopaedic Outlier". Dr Millis delivered a comprehensive summary of the history and current state of the art with regard to hip preservation surgery – a nascent field in the Indian context. A standing ovation followed and Dr Vrisha Madhuri, President POSI presented a silver salver to Dr Millis.

Dr Ernest Sink debated the merits of pelvic osteotomy for late hip dysplasia against Dr Manoj Padman who spoke for femoral osteotomy. Dr Sink won with a narrow margin. Dr Ashok Johari and Dr Ramani Narasimhan chaired an excellent discussion on the pros and cons of both procedures.

A more spirited "filial dispute" followed on the treatment of lateral condyle non-unions with contributions from Dr Rujuta Mehta and Dr Sandeep Patwardhan. Clearly a case of irresistible force vs. immovable object! Drs Millis and Gopakumar, the chairpersons for the debate were left with little to say.

The guest lecture series on "Beyond Surgical Skills" by a Paediatric Rheumatologist, Radiologist and Psychologist were meant to equip surgeons with a perspective outside of conventional practice. An excellent case discussion on complex and troublesome problems in the management of infections was ably anchored by Drs Taral Nagda and Rujuta Mehta.

After a session on problems in the skeletally immature athlete, a colourful inaugural and faculty felicitation ceremony had the entire faculty and organising committee in traditional Indian turbans (Mysore Petas) posing for the group photo session.

The Gala Banquet in the evening witnessed delegates and various POSNA faculties showing off their Bollywood dancing skills. Dr Millis demonstrated that his dancing was just as good as his surgical and oratorical skills.

Day 2 of POSICON had an early start with Dr Tom Novacheck providing an excellent overview on the management of spasticity during the Breakfast Session. The day’s deliberations proceeded apace with symposia on congenital deformity, cerebral palsy and paediatric trauma. Dr Donald Bae and Dr Unni Narayanan were busy judging the poster presentations in the meantime.

Dr Lynn Staheli was unable to attend the conference but we played a video on Global Paediatric Orthopaedic Education project which Dr Staheli specially recorded for the occasion.

The conference concluded with the customary POSI Quiz and a case discussion session anchored by Dr Premal Naik. Dr Sanjeev Sabharwal was kind enough to donate a signed copy of his newly released book as the prize for the Quiz winner (Dr Sandeep Vaidya).

The feedback from the delegates was positive with many remarking that POSICON 2016 had set a new benchmark for the quality and variety of academic content.

We bid goodbye to Dr Sanjeev Sabharwal, Dr Donald Bae and Dr Min Kocher.

Post-conference workshop (90+ delegates):

The Advanced Hip Workshop was over-subscribed and places had to be increased from 50 to 80. In the end, an extra 20 places had to be created as “observers”. The organisers were able to subsidise the workshop to less than half the actual fees thanks to a generous educational grant from POSNA of $15,000. The overwhelming response from surgeons was gratifying.

Another early start with a 7AM bus to catch bound for M S Ramaiah Advanced Learning Centre for the Advanced Workshop. Dr Millis assisted by Dr Vrisha Madhuri kicked off the proceedings with a cadaveric dissection on surgical dislocation of the hip. This was relayed live to the delegates seated in a lecture hall. Dr Scott Nelson and Dr Unni Narayanan demonstrated the Triple Innominate Osteotomy. Dr Prasad Gourineni with Dr Ernest Sink performed the cadaveric dissection of the Ganz osteotomy.

The hands-on section of the workshop followed with delegates assigned cadavers in groups of five. A total of 16 cadavers were simultaneously made available for the workshop. POSNA faculty were kept busy as the delegates repeated the 3 procedures in turn. Specially manufactured Ganz osteotomes and pelvic instruments were provided free of charge at each table, a superb gesture by one of our trade sponsors M/S Universal Ortho Systems, Mumbai.

The workshop ended with a demonstration on the medial open reduction of the hip by Dr Abhay Khot, our invited faculty from Melbourne, Australia.

The delegates and faculty dispersed to their destinations with pleasant memories of 3 days of power-packed learning and excellent fellowship.