Week 7

It is hard to believe next week is our last week of the immersion term.  It has really flown by.  This week was another interesting one.  Again, I split my time between the OR, clinic, and working on my research project.  I have been going with Dr. Bostrom to his clinic at the Helen Hayes hospital in Haverstraw on Tuesdays the past couple weeks.  It is nice to get out of the city and see patients in a different location.  This week the trip back to the city was made particularly interesting by a crane collapse which shut down the Tappen Zee Bridge, our route back across the Hudson River.  Ultimately the trip back took over 3 hours due to detours, traffic, and ultimately the train ride, but I was able to get a scenic tour of the Hudson River Valley which was very pretty!

I was again able to see some very interesting surgeries this week.  One which was particularly interesting was a hip revision surgery for a loose stem.  However, once the joint was opened up the implant became lodged in the femur and would not come out.  Ultimately the surgeons had to split open the femur and drill out the stem, which was still partially cemented in.  When the implant finally was removed, it was replaced with a new one and the two pieces of the femur were help together with a series of wires.  Additionally, the greater trochanter was fixed with a claw mechanism which screwed through the bone into the new stem in a very clever design.  This particular implant was another example of clever engineering to fix unanticipated issues that can arise in the OR.  Eventually the patients bones will heal and the new implant will be locked into place and very stable.

I also spent a bunch of time this week working on my project, which is updating and finishing a manuscript on a post-traumatic osteoarthritis study which examines the role of subchondral bone in OA development following ACL, PCL, and medial meniscus transection in a rabbit model.  It has been very interesting to be reading all of the relevant literature on this topic while also seeing how these issues effect regular people in the clinic and OR each day.  Overall, I have been enjoying working on this project and have only become more interesting in the cartilage-bone interactions in relation to PTOA.