This week I learned a great deal about how orthopaedics is practiced clinically. I was able to watch a complex hip arthroplasty revision surgery, observe Dr. Bostrom seeing patients, and participate in his lab's research. For the surgery, the patient's previous total hip arthroplasty (THR) had failed and the articular cup and the femoral stem and ball were dislocated. Due to poor pelvic support, the surgeon's (led by Dr. Bostrom) used a custom made pelvic mesh designed by a research engineer at HSS and made by Biomet. The surgeons successfully extracted the previous articulating cup and implanted the pelvic mesh, a new cup into the mesh, and a new femoral ball. In the clinic, I watched how Dr. Bostrom take all of the clincial data he had on hand (CT results, patient testimony, and phyical exams) and create a thoughtful diagnosis in the best interest of the patient. Dr. Bostrom only recommends joint replacement surgeries to patients with severe, lasting pain with mechanical joint problems, often going with less invasive measures such as steroid treatment. A number of patients complaining with hip pain actually had problems in their spine. In one interesting case, a patient who had had a heart transplant and was on immunosuppressants had failed to take his antibiotics for one week after having the polyethylene surface in his TKR replaced. Due to not taking his antibiotics for a week, he developed a severe infection in the knee. He had some of the infected synovial fluid aspirated from the knee; he will have his implants explanted and will be put on antibiotics to get rid of the infection. It is possible that he will lose his leg. This case showed me that a successful outcome from a major operation like a TKR or a THR is not only due to the skill of the surgeon but also the patient's ability to follow the instructions given to them by their doctors. I have not found a project to work on as of yet but I was able to observe and participate in research done in the Bostrom Lab looking at how bone-implant ingrowth is affected by PTH treatment. Mice have been implanted with porous titanium devices in their tibiae and treated with PTH. Once sacrificed, the tibiae will be analyzed for osteoblast/osteoclast content and the bone ingrowth will be observed with back-scattered electron microscopy.
This week I learned a great deal about how orthopaedics is practiced clinically. I was able to watch a complex hip arthroplasty revision surgery, observe Dr. Bostrom seeing patients, and participate in his lab's research. For the surgery, the patient's previous total hip arthroplasty (THR) had failed and the articular cup and the femoral stem and ball were dislocated. Due to poor pelvic support, the surgeon's (led by Dr. Bostrom) used a custom made pelvic mesh designed by a research engineer at HSS and made by Biomet. The surgeons successfully extracted the previous articulating cup and implanted the pelvic mesh, a new cup into the mesh, and a new femoral ball.
ReplyDeleteIn the clinic, I watched how Dr. Bostrom take all of the clincial data he had on hand (CT results, patient testimony, and phyical exams) and create a thoughtful diagnosis in the best interest of the patient. Dr. Bostrom only recommends joint replacement surgeries to patients with severe, lasting pain with mechanical joint problems, often going with less invasive measures such as steroid treatment. A number of patients complaining with hip pain actually had problems in their spine. In one interesting case, a patient who had had a heart transplant and was on immunosuppressants had failed to take his antibiotics for one week after having the polyethylene surface in his TKR replaced. Due to not taking his antibiotics for a week, he developed a severe infection in the knee. He had some of the infected synovial fluid aspirated from the knee; he will have his implants explanted and will be put on antibiotics to get rid of the infection. It is possible that he will lose his leg. This case showed me that a successful outcome from a major operation like a TKR or a THR is not only due to the skill of the surgeon but also the patient's ability to follow the instructions given to them by their doctors. I have not found a project to work on as of yet but I was able to observe and participate in research done in the Bostrom Lab looking at how bone-implant ingrowth is affected by PTH treatment. Mice have been implanted with porous titanium devices in their tibiae and treated with PTH. Once sacrificed, the tibiae will be analyzed for osteoblast/osteoclast content and the bone ingrowth will be observed with back-scattered electron microscopy.