Week 1 - Mary Clare

Summer Immersion has begun and so far my experience is off to a great start! I am shadowing Dr. Scott Rodeo who is a sports medicine surgeon at the Hospital for Special Surgery. This week I was able to see patients with him and watch him perform arthroscopic surgery on both the shoulder and the knee. Most of his patients are athletes with joint damage ranging from shoulder laxity to ACL tears. He has another patient population that tends to be a little bit older with various states of arthritis, either looking for symptomatic treatment or considering joint replacement.

One interesting case we saw during patient appointments was an older patient who had no prior knee pain. However, this patient began to experience knee pain after taking Ciprofloxin antibiotic. One of the side effects of the medication is cartilage erosion in load bearing joints. After examining his MRI, it appeared the patient had been developing arthritis for probably several decades due to a knee injury that occurred as a child. It is puzzling that the presentation of his pain is directly correlated with consumption of the antibiotic.

The department of sports medicine also does a weekly conference where they discuss specific patient cases as well as review any diagnostic tools used for the case. This week they discussed the use of X-Ray, MRI, CT, and SPECT for spondylolysis. We also reviewed two cases related to shoulder morbidity and mortality. This presentation spurred an interesting discussion of post operative infections that were likely in connection with an infection that occurred at a separate location in the body. For this specific case, the patient had dental surgery after the shoulder surgery in which the dental site became infected. This was followed shortly by infection of the same bug in the shoulder. Currently there is little research as to why this occurs, but several of the doctors in the audience had similar occurrences with their own patients.

In addition to clinical immersion, Dr. Rodeo has also arranged for me to do a research project with postdoc, Dr. Tony Chen.  Over the duration of Immersion I will be looking at how mechanical loading effects gene and protein expression in both juvenile and mature meniscus. We will be specifically comparing expression in the avascular and vascular portions of the meniscus. This week, I have been conducting some background research on the project and have been doing lab orientation and learning some techniques required for the project.

This upcoming week I plan to see more patients and surgeries, as well as begin doing some research analysis of controls for experiments in the lab.