The ABC of global orthopaedics: Meet Professor Alex Aarvold
Professor Alex Aarvold is a Children’s Orthopaedic Surgeon at University Hospital Southampton (UHS) and Honorary Professor at the University of Southampton. His research is supported by UHS through the Research Leaders Programme.
He has recently used an American-British-Canadian (ABC) travelling fellowship to advance his research into hip dysplasia - a condition where the ball and socket joint of the hip does not properly form in babies and young children.
He shares what he’s been doing in North America and his hopes for future collaborations.
What research are you advancing in Southampton?
We have strong international collaborations in developmental dysplasia of the hip (DDH). Southampton Children’s Hospital remains the largest contributor worldwide to the Global Hip Dysplasia Registry. This has regular academic outputs and advances the care of DDH across the world.
In Southampton, we have devised a novel growth stimulating mini pelvic osteotomy. This is a minimally invasive surgical procedure to treat DDH. The long-term results of this were published in the spring. This technique is being increasingly adopted across the world.
Southampton is a leading contributor to the growing number of national clinical trials in paediatric orthopaedics. A national clinical trial on the optimum management of hip displacement in cerebral palsy will be led out of Southampton.
Why did you decide to apply for a travelling fellowship?
The American-British-Canadian (ABC) travelling fellowship is the most prestigious one in orthopaedic surgery. It is a biennial five-week knowledge, leadership and cultural exchange, for seven selected surgeons from Australia, New Zealand, South Africa and the UK.
On alternate years, seven surgeons from USA/Canada make a return visit. Within orthopaedic surgery it is high profile, and something that I have wanted to experience for years.
My ABC colleagues were a unique combination of personalities, cultural backgrounds and academic interests. We fused into something special - a highly functional team. This is never guaranteed when strangers come together and live in each other’s pockets for five weeks. We learned, experienced, shared, defended, became vulnerable and looked after each other. This is everything that I had hoped for, and more.
What did you do for the fellowship and who did you work with?
The travelling fellowship took us across USA and Canada. Specifically, we visited Albuquerque (New Mexico), Phoenix (Arizona), San Diego, San Francisco (both California), Salt Lake City (Utah), Edmonton (Alberta), Toronto (Ontario) and St John’s (Newfoundland).
Seven orthopaedic surgeons were selected, from New Zealand, South Africa, Australia, England, Scotland and Wales. Instead of an itinerary, it is best described as a triad of friendships, experiences and inspirations, all accumulated on a five-week tour of academic centres in North America.
We gave lectures at every centre that we visited. I talked about the novel Southampton mini pelvic osteotomy, the clinical trial on cerebral palsy hip migration, the biochemical aetiology of DDH and a national consensus study on DDH that I have led. These were incredibly well received and are changing practice.
The North American centres bid to host the ABC tour, as it’s so prestigious. Aside from the academic excellence, professional friendships and collaborations, it is an excellent marketing tool for the North American institutions. Thus no expense was spared in hosting us, using enviable hospital marketing budgets that are not a luxury that exists in the NHS.
What do you feel this experience has helped you achieve?
The cultural experience has opened my world to possibilities. At every stop, the difference in North American philanthropy and investment in innovation, compared with our other commonwealth countries, was stark.
I was also inspired by the strong culture of intellectual curiosity and continuous improvement. Healthy academic competition was encouraged as a means of driving innovation, raising standards and ultimately improving patient outcomes, while remaining nurturing and kind. It was evident that excellence is not viewed as a destination but as a continual pursuit, supported by robust systems of education, feedback, accountability and mentorship.
These are all aspirations within the NHS, which of course we can do better, and I return with renewed vigour for that aim.
What are your plans now that you are back?
The time away has enabled consolidation of research ideas that I have progressed since my return.
The frequency with which I gave lectures on the tour has provided me with increased confidence in such public speaking. I have subsequently had numerous lecture invitations both here and in North America.
There is no better way to advance collaborations and research than at these visiting opportunities, meeting teams and discussing ideas at each stop. The calendar is full for the rest of the year.