Week 6

Week 6 started with a full day in the OR observing more surgeries. I was able to present one of the cases for that day to the surgical team and it allowed me to perform some background research into one of the implants we would be using that day for the 2nd, 3rd, and 4th metatarsal fusion. It was interesting to look at the clinical results for different surgical techniques, especially since the recommendation for one publication stated that both the implant and k-wire fixation achieved equal results. Therefore the paper advised the surgeon to choose the more economical choice. Sometimes in basic science studies one can forget that companies and clinicians still need to make an income, and therefore the costs of different surgical techniques must also be considered. On this day, I was also able to witness a microfracture drilling paired with biocartilage implantation. It would be interesting to study the long term success of biocartilage and to analyze how well it (1) stays in the lesion and (2) integrated with surrounding native tissue.

On Tuesday I presented on the outline of my manuscript, and also discussed different grading scales for osteochondral lesions. We decided to change to the International Cartilage Repair Society grading system for the osteochondral lesions, so I will have to meet with Dr. Deyer again to go through the images. We will be able to be much more efficient now that we have all the other information and only need to add the staging. I was also able to get stats preliminary results from Robin that afternoon, and there was statistical significance for a few factors that could act as predictors for which patients are more likely to develop osteochondral lesions on the tibia if they have an osteochondral lesion on the talus.

On Wednesday morning I presented these results to our morning group, and received great comments and feedback. The rest of the week I spent either in clinic or working on the manuscript. By the end of next week I would like to have finished a first draft of the manuscript, and start going through revisions and key discussion points of the paper. This will allow me to maximize the time I have with Dr. Kennedy and Yoshi who have a wealth of knowledge for the clinical implications of the results of this study. This immersion experience has been wonderful and I am excited that I am seeing results.