Supervision Rates During Orthopaedic Fellowships: Are We Assessing Them Correctly?

2012 ◽  
Vol 94 (2) ◽  
pp. 1-3
Author(s):  
G McKay ◽  
G Kirby ◽  
C Jack ◽  
D Ricketts
Keyword(s):  
Orthopaedic Surgery ◽  
Fellowship Training ◽  
High Quality ◽  
Orthopaedic Training

Fellowships during orthopaedic training are intended to provide closely mentored and supervised high-quality training in a subspecialty interest. The benefits of a fellowship are widely recognised and some advertisements for consultant posts in orthopaedic surgery now include fellowship training in the person specification.

scholarly journals Augmented Reality, Virtual Reality and Artificial Intelligence in Orthopedic Surgery: A Systematic Review

2021 ◽  
Vol 11 (7) ◽  
pp. 3253
Author(s):  
Umile Giuseppe Longo ◽  
Sergio De Salvatore ◽  
Vincenzo Candela ◽  
Giuliano Zollo ◽  
Giovanni Calabrese ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Virtual Reality ◽  
Augmented Reality ◽  
Orthopaedic Surgery ◽  
Resident Training ◽  
Comprehensive Search ◽  
Virtual And Augmented Reality ◽  
Orthopaedic Training ◽  
Meta Analyses

Background: The application of virtual and augmented reality technologies to orthopaedic surgery training and practice aims to increase the safety and accuracy of procedures and reducing complications and costs. The purpose of this systematic review is to summarise the present literature on this topic while providing a detailed analysis of current flaws and benefits. Methods: A comprehensive search on the PubMed, Cochrane, CINAHL, and Embase database was conducted from inception to February 2021. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The Cochrane Risk of Bias Tool and the Methodological Index for Non-Randomized Studies (MINORS) was used to assess the quality and potential bias of the included randomized and non-randomized control trials, respectively. Results: Virtual reality has been proven revolutionary for both resident training and preoperative planning. Thanks to augmented reality, orthopaedic surgeons could carry out procedures faster and more accurately, improving overall safety. Artificial intelligence (AI) is a promising technology with limitless potential, but, nowadays, its use in orthopaedic surgery is limited to preoperative diagnosis. Conclusions: Extended reality technologies have the potential to reform orthopaedic training and practice, providing an opportunity for unidirectional growth towards a patient-centred approach.

scholarly journals Global variability in orthopedic surgery training

2019 ◽  
Author(s):  
Andrew D. Sobel ◽  
Davis Hartnett ◽  
David Hernandez ◽  
Adam E. M. Eltorai ◽  
Alan H. Daniels
Keyword(s):  
United States ◽  
Orthopedic Surgery ◽  
Orthopaedic Surgery ◽  
Educational Development ◽  
The United States ◽  
Surgery Training ◽  
Orthopaedic Care ◽  
The World ◽  
Orthopaedic Training ◽  
And Training

Medical and orthopaedic training varies throughout the world. The pathways to achieve competency in orthopaedic surgery in other countries differ greatly from those in the United States. This review summarizes international educational requirements and training pathways involved in the educational development of orthopaedic surgeons. Understanding the differences in training around the world offers comparative opportunities which may lead to the improvement in education, training, and competency of individuals providing orthopaedic care.

scholarly journals Local Intra-wound Administration of Powdered Antibiotics in Orthopaedic Surgery

2017 ◽  
Vol 2 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Andrew N. Fleischman ◽  
Matthew S. Austin
Keyword(s):  
Orthopedic Surgery ◽  
Spinal Surgery ◽  
Orthopaedic Surgery ◽  
Significant Morbidity ◽  
High Quality ◽  
High Quality Evidence ◽  
Orthopaedic Literature ◽  
Surgical Guidelines ◽  
Quality Evidence ◽  
Systemic Antibiotic Prophylaxis

Abstract. Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique. The majority of clinical studies on local intra-wound antibiotics have evaluated the use of topical powdered vancomycin in spinal surgery, though only a single prospective study currently exists. This review will discuss all the available evidence describing the effectiveness, pharmacokinetics, and potential adverse effects with the use of topical powdered antibiotics in orthopedic surgery.

Trends in Knee Articular Cartilage Treatments: An American Board of Orthopaedic Surgery Database Study

2018 ◽  
Vol 32 (01) ◽  
pp. 085-090 ◽  
Author(s):  
Robert Westermann ◽  
Alan Shamrock ◽  
Kyle Duchman ◽  
Brian Wolf ◽  
Annunziato Amendola ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Sports Medicine ◽  
Orthopaedic Surgery ◽  
Fellowship Training ◽  
Training Status ◽  
Surgical Volume ◽  
Patient Age ◽  
Cartilage Lesions ◽  
Osteochondral Grafting ◽  
Articular Cartilage Lesions

AbstractThis study aims to evaluate the trends in treatment of knee articular cartilage lesions over the past decade using data obtained from the American Board of Orthopaedic Surgery (ABOS) Part II database. The ABOS Part II database was queried from 2004 to 2013 for chondroplasty, microfracture, and osteochondral grafting procedures. All cases were analyzed for patient age and operating surgeon's fellowship training status. Univariate analysis including chi-square test for categorical variables and Student's t-test for continuous variables was performed to determine if any significant changes in practice patterns were present. Linear regression analyses were utilized to examine temporal trends in procedures performed and fellowship training status. From 2004 to 2013, 25,938 procedures addressing articular cartilage lesions from 3,586 surgeons were identified in the ABOS database. 46.8% of these orthopaedic surgeons had completed a 1-year sports medicine fellowship. Sixty-six percent of cartilage surgeries were performed by sports medicine-trained surgeons. The articular cartilage surgical volume decreased from 3,126 cases in 2004 to 1,690 cases in 2013. The most common procedure coded overall was chondroplasty (80.23%) followed by microfracture (21.37%) and osteochondral grafting (2.1%). The mean age of patients undergoing chondroplasty was 46.9 years; this was significantly higher than microfracture (mean age 40.5 years) or osteochondral grafting procedures (mean age 31.6 years), p < 0.0005. The age of all patients undergoing cartilage surgery significantly decreased between 2004 and 2013, p < 0.001. A dramatic decrease in reported chondroplasty volume was observed between 2011 and 2012. Concurrent osteotomies were used in <1% of procedures addressing cartilage injuries, while 65% of patients underwent concurrent meniscectomy. These described trends are most pronounced in surgeons with sports medicine fellowship training. In conclusion, knee articular cartilage surgical volume and patient age have both sharply declined since 2011, a trend driven by sports medicine-trained Part II examinees. This trend correlates with changes in billing and coding practices, as well as improved education from high-level studies.

scholarly journals The impact of COVID-19 on trauma and orthopaedic surgery in the United Kingdom

2020 ◽  
Vol 1 (7) ◽  
pp. 420-423 ◽  
Author(s):  
Charles N. Wallace ◽  
Christina Kontoghiorghe ◽  
Barbar Kayani ◽  
Justin S. Chang ◽  
Fares S. Haddad
Keyword(s):  
Orthopaedic Surgery ◽  
Hospital Admissions ◽  
Lessons Learned ◽  
Outpatient Clinics ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Ensure Patient Safety ◽  
Orthopaedic Training ◽  
The Uk ◽  
The Impact

The coronavirus 2019 (COVID-19) global pandemic has had a significant impact on trauma and orthopaedic (T&O) departments worldwide. To manage the peak of the epidemic, orthopaedic staff were redeployed to frontline medical care; these roles included managing minor injury units, forming a “proning” team, and assisting in the intensive care unit (ICU). In addition, outpatient clinics were restructured to facilitate virtual consultations, elective procedures were cancelled, and inpatient hospital admissions minimized to reduce nosocomial COVID-19 infections. Urgent operations for fractures, infection and tumours went ahead but required strict planning to ensure patient safety. Orthopaedic training has also been significantly impacted during this period. This article discusses the impact of COVID-19 on T&O in the UK and highlights key lessons learned that may help to proactively prepare for the next global pandemic. Cite this article: Bone Joint Open 2020;1-7:420–423.

scholarly journals Surgical Trends in the Treatment of Acute Achilles Ruptures

2017 ◽  
Vol 2 (2) ◽  
pp. 2473011416S0001
Author(s):  
Bryant Ho ◽  
Sandeep Soin ◽  
Ashlee MacDonald ◽  
Judith Baumhauer ◽  
John Ketz
Keyword(s):  
Achilles Tendon ◽  
Orthopaedic Surgery ◽  
Fellowship Training ◽  
Nonoperative Treatment ◽  
Geographic Region ◽  
Foot And Ankle ◽  
Functional Rehabilitation ◽  
Orthopaedic Surgeons ◽  
Tendon Ruptures ◽  
Level I

Category: Sports Introduction/Purpose: Historically, nonoperative treatment of acute Achilles tendon ruptures was felt to have significant re-rupture rates. With improved functional rehabilitation, recent studies have shown decreased rates of tendon re-rupture. Recent randomized control trials circa 2010 have shown no difference in re-ruptures between early functional rehabilitation and surgical repair. The goal of this study was to evaluate trends in surgical treatment of Achilles ruptures, based on data obtained from the American Board of Orthopaedic Surgery (ABOS), in response to evolving level I evidence. Methods: All operative cases submitted by part II applicants from 2003 to 2015 for primary board certification by the American Board of Orthopaedic Surgery (ABOS) were retrospectively reviewed. Isolated primary Achilles tendon repairs for acute ruptures were identified by ICD-9 and CPT code. Surgeon information including fellowship training and geographic region, and patient information including age, sex, and complications were collected. Results: Out of 1,118,457 cases, there were 4792 Achilles repairs (0.43%) with 510 complications (10.6%). The rate of Achilles repairs increased from 2006 to 2010, when rates peaked at 0.57% of all collected cases (Figure 1). Since 2010, there has been a decrease in rates back to pre-2006 values. The changing rates appear to be largely driven by non-fellowship trained orthopaedic surgeons. The rates of sports and foot and ankle fellowship trained surgeons had mild increases in 2006 and decreases in 2010, but overall have slightly increased. The rate for patients greater than 65 have decreased from 2002 to 2004. Since then, there have been yearly variations, with minimal overall change. Examination of regional differences demonstrate the greatest change in the Northeast. All regions had increased rates in 2006 and decreased rates in 2010, with the exception of the Northwest and South regions, who showed little overall change. Conclusion: Surgical trends for Achilles ruptures corresponded closely to high impact level 1 publications in the literature in 2005 and 2010, suggesting evidence-based responsiveness in newly trained orthopaedic surgeons. These trends are less pronounced in the Northwest and South regions and for sports and foot and ankle specialists.

scholarly journals The impact of COVID-19 on trauma and orthopaedic surgery in the United Kingdom

2020 ◽  
Vol 1 (7) ◽  
pp. 420-423
Author(s):  
Charles N. Wallace ◽  
Christina Kontoghiorghe ◽  
Barbar Kayani ◽  
Justin S. Chang ◽  
Fares S. Haddad
Keyword(s):  
Orthopaedic Surgery ◽  
Hospital Admissions ◽  
Lessons Learned ◽  
Outpatient Clinics ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Ensure Patient Safety ◽  
Orthopaedic Training ◽  
The Uk ◽  
The Impact

The coronavirus 2019 (COVID-19) global pandemic has had a significant impact on trauma and orthopaedic (T&O) departments worldwide. To manage the peak of the epidemic, orthopaedic staff were redeployed to frontline medical care; these roles included managing minor injury units, forming a “proning” team, and assisting in the intensive care unit (ICU). In addition, outpatient clinics were restructured to facilitate virtual consultations, elective procedures were cancelled, and inpatient hospital admissions minimized to reduce nosocomial COVID-19 infections. Urgent operations for fractures, infection and tumours went ahead but required strict planning to ensure patient safety. Orthopaedic training has also been significantly impacted during this period. This article discusses the impact of COVID-19 on T&O in the UK and highlights key lessons learned that may help to proactively prepare for the next global pandemic. Cite this article: Bone Joint Open 2020;1-7:420–423.

scholarly journals Simulation in orthopaedic training: would a national curriculum improve trainees’ surgical skills?

2014 ◽  
Vol 96 (10) ◽  
pp. 360-362
Author(s):  
Oliver Templeton-Ward ◽  
Matthew Solan
Keyword(s):  
Pilot Study ◽  
Surgical Training ◽  
Surgical Education ◽  
Orthopaedic Surgery ◽  
National Curriculum ◽  
Learning Opportunities ◽  
Surgical Skills ◽  
Orthopaedic Training ◽  
Large Investment

Orthopaedic surgical education is undergoing a transition, requiring trainees to learn a greater number of complex surgical skills but with a reduction in learning opportunities. simulation has been proposed as one way to help solve this dichotomy. The Joint Committee on Surgical Training (JCST) hopes to incorporate simulation into the curriculum for all specialties. Our findings indicate that there is as yet no clear consensus in the literature that simulation in orthopaedic surgery provides a reliable and valid way of improving surgical skills. We therefore urge the JCST to commission a pilot study using its recently published simulation curriculum before making the large investment that would be required to roll it out nationwide.

Orthopaedic In-Training Examination Resources and Residency Training for the Foot and Ankle Domain

2018 ◽  
Vol 12 (2) ◽  
pp. 146-152
Author(s):  
Cory F. Janney ◽  
Daniel Kunzler ◽  
Pejma Shazadeh Safavi ◽  
Vinod Panchbhavi
Keyword(s):  
Orthopaedic Surgery ◽  
Fellowship Training ◽  
Cross Sectional Study ◽  
Foot And Ankle ◽  
Self Assessment ◽  
Cross Sectional ◽  
Orthopaedic Surgeons ◽  
Scholarship Program ◽  
American Orthopaedic ◽  
Certifying Examination

Background. Residency programs use the annual Orthopaedic In-Training Examination (OITE) prepared by the American Academy of Orthopaedic Surgeons (AAOS) to monitor resident progress and prepare them for the part 1 of the American Board of Orthopaedic Surgeons (ABOS) Certifying Examination. The purpose of this study was to determine resources residents currently use to prepare for the OITE and also to learn about their perception of training they receive in the foot and ankle subspecialty in their program and their interest in foot and ankle fellowship after residency. Methods. An anonymous survey was sent to both allopathic programs and osteopathic residents to learn what resources residents used to study for the OITE, preparatory question sets, on-call resources, their perception on training received in foot and ankle surgery, and their intent to pursue fellowship training. Results. A total of 130 residents participated in the survey. The majority of residents in allopathic and osteopathic residencies used Orthobullets (OB) to prepare for the OITE and use this resource while on-call. Most residents also used OB question sets to study along with the AAOS self-assessment examinations. In total, 43.2% of osteopathic residents felt they did not get enough exposure to foot and ankle subspecialty while in training, in contrast to 31.2% of allopathic residents. A total of 35% of all orthopaedic surgery residents felt they lacked enough exposure to foot and ankle orthopaedic surgery. Only 7 residents (6%, 6 allopathic, 1 osteopathic) intended to pursue a foot and ankle fellowship following graduation. Conclusion. Online resources such as OB continue to be frequently used by residents for preparation for the OITE. Greater than one-third of orthopaedic residents feel they do not get enough exposure to foot and ankle orthopaedic surgery. Improvement in this area could be helped by continued endeavors from the American Orthopaedic Foot and Ankle Society such as the Visiting Professor Program and Resident Scholarship Program. Levels of Evidence: Level V: Single Cross-Sectional Study

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