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Dr. Tonino (seated at left) with Vietnamese physicians in Hue


Published 2/1/2011
Lynne Dowling

AAOS-Vietnam program enters third year

Positive changes in patient care and treatment outcomes seen

As 2011 unfolds, the U.S. faculty responsible for leading the AAOS-Vietnamese Orthopaedic Association (VOA) Visiting Faculty and Professional Development Programs are gearing up for a third successful year of programming. During March and April, courses will be held in the primary Vietnamese population centers of Ho Chi Minh City (formerly Saigon), Hue, and Hanoi.

AAOS course directors Stuart L. Weinstein, MD (pediatric spine), Pietro Tonino, MD (knee and shoulder arthroscopy), and Miguel Cabanela, MD (adult reconstruction) are equally delighted with the program’s early successes and the changes in patient care and safety they are seeing.

“The change in the quality of questions asked and the improved level of understanding of the underlying disease processes is impressive,” said Dr. Cabanela upon his return from the 2010 program in Hanoi. “The participants are asking really good questions, and their understanding and use of the English language has improved noticeably.”

Dr. Cabanela was also pleased to learn that Hanoi’s St. Paul Hospital has two new operating rooms (ORs) exclusively for joint reconstruction cases. “The older, more cramped quarters of the previous ORs were not conducive to the best surgical outcomes,” he said. St. Paul has also purchased new saws and blades, which had been in short supply and ill repair just one year ago.

In Hue, located along the coast exactly midway between Hanoi and Ho Chi Minh City, Dr. Tonino noted similar attention to details regarding patient safety. Sterile techniques have improved and program participants have a better understanding of the link between overcrowded ORs and infection risk. But he is most proud of the success of the “Sign your site” program, which he introduced and is now being used for most arthroscopy cases at Hue Central Hospital. His goal for 2011 will be to spread the practice to all surgical procedures.

Coming soon: Time-outs and checklists
The three AAOS fellows are combining their efforts in 2011 to introduce the concept and practice of preoperative check lists and time-outs before the surgery begins. The request to include this patient safety effort was made by a senior orthopaedic surgeon on staff in Hanoi. He had learned of the practice from reviewing information available on the AAOS Web site!

When they meet with the Vietnamese Minister of Health in April, Dr. Weinstein will advocate for the Ministry of Health to mandate that pediatric spine surgery can only be performed in hospitals that have intraoperative imaging capability. The AAOS-VOA representatives also hope to discuss issues related to earlier diagnosis and intervention for children with spinal deformities. Finally, they hope to identify potential sites as centers of excellence for the three specialty areas and to expand the program’s outreach.

All three U.S. faculty members rank their program experiences in Vietnam as among the highlights of their careers. Academy members who may be interested in serving as faculty for future programs or who could host a Vietnamese surgeon scholar in the United States should contact Lisa Cohen, manager of international education programs, at

Just the facts…
In the first two years of programming in Vietnam, AAOS faculty have

  • performed 52 surgical procedures
  • seen several hundred patients in outpatient clinics
  • conducted surgical skills workshops, grand rounds, and live patient case studies sessions with more than 250 Vietnamese participants

These programs would not be possible without the support of the following: the AAOS Board of Directors, Council on Education, and International Committee; the VOA leadership; the Orthopaedic Learning Center; the Arthroscopy Association of North America; and the generous support of the industry sponsors DePuy, ConMed/Linvatec, Medtronic, Smith & Nephew, Stryker Orthopaedics, and Thanh An-Hanoi Company, Ltd.

Lynne Dowling is the director of the AAOS international department. She can be reached at