Clinical updates, teaching notes, and editorial context.
A compact update layer for evidence shifts, practical clinical learning, and changes to the reference library. Articles are organised for fast scanning before deeper study.
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- 20 Aug 2026
Evidence notes and learning essays
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Featured article
Hip-Spine Syndrome Before Total Hip Arthroplasty: Spinopelvic Mobility, Cup Position, and Instability Risk
A practical 2026 guide to hip-spine syndrome for orthopaedic trainees. Learn how spinopelvic mobility changes functional cup position, why lumbar fusion matters, and how to reduce instability risk before THA.
Article archive
369 articles in the update journal
Run Charts and SPC for Surgeons
Two bars cannot tell you whether anything changed. Run charts and control charts distinguish real signal from ordinary noise — and stop you reacting to variation that means nothing.
OrthoVellum
quality improvement / statistics
Never Events: Wrong Site, Wrong Implant, Retained Items
Wrong site surgery is the single most common never event, and orthopaedics owns a disproportionate share of the wrong-implant category. Why they still happen, and what actually prevents them.
OrthoVellum
patient safety / never events
Root Cause Analysis After a Serious Incident
There is rarely a single root cause, and England has now moved away from mandating RCA altogether. What replaced it, how systems analysis actually works, and why hindsight bias ruins most investigations.
OrthoVellum
patient safety / human factors
Duty of Candour: What It Requires and How to Do It Well
Being open after harm is both a professional obligation and, above a threshold, a statutory one. The rules are clearer than most surgeons think — and the instinct to wait until you know more is the wrong one.
OrthoVellum
duty of candour / medico-legal
Running an M&M Meeting That Changes Something
Most morbidity and mortality meetings are a list of cases followed by a shrug. The ones that work share a structure, a classification, and an actions register that gets read out first.
OrthoVellum
clinical governance / patient safety
Capacity and Best-Interests Decisions in Orthopaedic Practice
Capacity is decision-specific, time-specific, and presumed until disproved. The commonest error in surgical practice is treating a refusal you disagree with as evidence of incapacity.
OrthoVellum
capacity / consent
PDSA Cycles That Actually Finish
Most surgical improvement projects die between the first measurement and the second. The reasons are predictable — and so are the fixes.
OrthoVellum
quality improvement / audit
Informed Consent After Montgomery: How Standards Differ Worldwide
The legal standard for disclosure is no longer set by the profession — it is set by reference to the patient. What that means in orthopaedic practice, and how the test differs across jurisdictions.
OrthoVellum
consent / medico-legal
What Clinical Governance Actually Is
Clinical governance is not a committee or a mandatory training module. It is the accountability framework that connects audit, incidents, guidelines and appraisal — and knowing how it fits together makes all of them less painful.
OrthoVellum
clinical governance / quality improvement
Showing page 1 of 41 (369 articles)