Thanks very much, Ben. So one way of definitely winning the debate is to convert Autonis 2 into Autonis 1, which you've done that very smartly, but you can't ignore that large cyst out there, okay? Right, let's see what Femi has to say. Thanks for the invitation, Chairman. Somebody once told me, one of my mentors, that nothing ruins a good operation like long-term follow-up. So I think Ben should keep that in mind. With that being said, I give you my best wishes from Canada, and off we go with this debate in 3 minutes and 45 seconds. So this will be an audience-interactive style debate, because I think the audience really knows what they're up to and has enough sophistication to figure this one out. So here are my disclosures as well. And a plug, actually, for the Journal of Ithacos, which I really should be submitting your hit papers to. We really look forward to seeing some of your papers, so consider us as you, you know, ascending your careers. So I think the polling question for me is that, with this audience, how many of you typically use evidence-based medicine to inform your practice? Meaning, you look at the best evidence, as you can see. You look at your clinical expertise, and you incorporate patient values. So you use all of those components to make an evidence-informed or evidence-based decision. So how many people do that in the audience? Significant portion. Excellent. So now, second question is, how many of you have always aimed to be the best in the class? Undergrad, medical school, residency, aiming to be that A-plus student. So how many of you, show of hands, aim to be that top student in class? The vast majority. So now we're looking at people in this room. With your own raising of hands, that one, practice with an evidence-based approach, and two, aim for excellence. So we've established that at this moment. So now let's move forward. So if we look at the evidence now, the E-word, osteoarthritis and the impact on outcomes. We conducted a systematic review about three years ago looking at that, and we found that after including 39 of the world's most robust studies evaluating outcomes after hyperarthroscopy, we did find that tonus grade one is a significant predictor of a negative outcome after FEIS surgery. Survivorship, pain, dissatisfaction, and conversion to arthroplasty, all significantly higher if you had cartilage damage of that degree. Another paper looking at radiographic predictors by Ryan Deegan also showed that when you have tonus grades that were associated with grade two or higher, significant conversion to arthroplasty rates looking at the world's biggest databases. So right there, we again have an evidence-based group, and we're looking at what the evidence is all about. So now let's talk about evidence around arthroplasty. So what you see now in a recent systematic review is that 34 studies looked at this, and they saw a significant reduction in the complications we were all concerned about, aseptic, loosening, et cetera. And importantly, they found that more patients that they were seeing had undergone a previous hyperarthroscopy before the replacement. So now they're seeing patients who are having scopes and then being converted chiefly because of the cartilage damage. And I think that when you look at contemporary arthroplasty with new materials, you're looking at a pooled survivorship of 96 percent. And this is now addressing that A-plus grade we all want to get in this room, and we all got in school, undergrad and beyond, at survivorship. Now data is heterogeneous, but significant survivorship at 96-plus percent when you pool all the world's data on ceramic-bearing arthroplasty under the age of 60. So this is a very good operation. So I would say that these folks are getting A-pluses with their arthroplasty procedures. So overall, we should avoid cognitive dissonance, which is to say, try to be consistent. We agreed that we were evidence-based, and we agreed we were excellent students and practitioners, so please avoid what Dr. Dohm is doing with that emoji sign of, I don't know. So I would say that avoid cognitive dissonance, choose evidence, choose excellence, choose arthroplasty. Thank you.

evidence-based medicine

arthroplasty procedures

high-grade cartilage damage

survivorship rates

informed decision-making