Week 8 - Alessandra

 Alessandra Coogan | Clinical Mentor: Dr. Scott Rodeo

    My final week consisted of one last day in the operating room, completing my SOP, planning future collaborations, and writing thank-you cards to the people who made this experience so meaningful.

    On Tuesday, I invited Manav to observe one of Dr. Rodeo’s total knee arthroplasty cases because he had not yet seen a TKA performed using traditional bone guides and saws. He explained that Dr. Andreas Gomoll, whom he has been shadowing, uses a computer-assisted approach in which the bone resections are guided by measurements determined through both computer modeling and surgeon input. In contrast, Dr. Rodeo uses the more manual technique I described in my Week 7 post. It was interesting to compare how two different surgical approaches can be used to achieve the same goal.

    We also observed an osteochondral allograft transplantation. During the procedure, the surgical team harvested a cylindrical plug of bone and cartilage from a donor femoral condyle and fitted it into the patient’s damaged joint surface (Figure 1 & 2). The drilling and sizing process was fascinating, though I wonder just how much damage this procedure causes to the allograft that may make long-term integration into the patient's body trickier. 

         

Figure 1. Harvesting an osteochondral allograft from a donor femoral condyle. A cylindrical osteochondral plug is first drilled from the donor condyle (left) before being extracted (right). The graft contains both viable articular cartilage and its underlying subchondral bone for transplantation.

Figure 2. Preparation of the osteochondral allograft prior to implantation. The harvested graft is measured to determine the appropriate depth (left) before excess bone is trimmed (right) to achieve an optimal press-fit within the recipient defect.

    On the research side, I officially completed my Dragonfly segmentation SOP (Figure 3). It contains GIFs, images, links, helpful tips, and troubleshooting advice. The lab and Dr. Rodeo were extremely pleased with the final workflow, which was very rewarding after weeks of troubleshooting and refinement. We are now establishing plans for me to continue collaborating with the lab and analyzing additional μCT datasets. I am still completing the interclass correlation coefficient analysis, but the preliminary results appear promising.

Figure 3. Dragonfly µCT Analysis Protocol. 

    Although the immersion program is ending, I am excited that the project and collaborations will continue. This experience allowed me to connect clinical observations with imaging research and gave me a much deeper appreciation for the teamwork, technical skill, and decision-making involved in orthopedic care. I hope this program continues in the future!!