Week 6: Katelyn

This week was the sixth week of immersion and I have continued to experience a variety of opportunities this week.

For research this week, I finished segmenting the patient scans. As mentioned previously, the primary goal of this segmentation is to isolate the patient's distal femur from the CT scans. The next step is to mark the anatomic landmarks used in a TKA to remove the articulating surface and perform a BMD analysis.

During the clinic this week, I saw a wide array of patients including bone health work-ups, pain follow-ups, post-ops, and others. Something that has become apparent within my time of shadowing is the variation in recovery between TKAs and THAs. While both procedures entail full joint replacement, the recovery time frame for THA patients is much shorter than those for TKA patients. Both include a transition from walker to cane; despite this, often THA patients are on canes by 4weeks post-op whereas TKA patients are on canes by 8-12weeks post-op. 

In the OR this week, I saw a HHA, an intramedullary rod insertion, and a THA. At this point, I have seen these procedures multiple times, but it is interesting to see what varies between patients. Notably, since my clinician specializes in orthopedic oncology, these procedures were done to provide the bone with additional stability. More specifically, the bone had been weakened by a tumor or lesion, all benign in these particular cases. While typical arthroplasty procedures were used for reinforcement, often the procedure varied since the surrounding bone is often weaker than a typical arthroplasty patient. 

This week I also got to sit in on the orthopedic trauma surgery M&M. During this, there were two primary points of discussion: pulmonary embolism (PE) mitigation and periprosthetic joint infection (PJI). Both of these can occur postoperatively and were discussed primarily in terms of THA and HHAs. The occurrence of PE is often associated with usage of cemented implants. The PJI occurrence is often associated with existing hematoma formation. It was interesting to hear the various opinions between the attending surgeons and the residents as to their procedure for prevention.

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