In March 2013, three of my colleagues—Gregory Deirmengian, MD (Rothman Institute, Philadelphia); Guoqiang Zhang, MD (General Hospital of PLA, Beijing, PR China); Henry Wynn-Jones, MD (Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, Lancashire, UK)—and I were honored to become the inaugural class of The Hip Society’s Rothman-Ranawat Traveling Fellowship. In creating this program, The Hip Society was driven by a goal to foster the talents of young hip surgeons by providing them with a unique, inspiring, and educational 4-week tour of outstanding centers for hip surgery in North America.
Our tour started in Chicago with the 2013 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting. As we drove to the convention center, we learned about each other’s clinical practices, including surgical approach and implant selection, discussed complex cases we had performed, and asked each other for advice on everything from upcoming revisions on our schedules to conducting research efficiently. This dialogue continued throughout our fellowship, and the opportunity to learn from one another and share common experiences faced early in our careers was an invaluable benefit of participating in this program.
The next month was a whirlwind that took us from coast to coast, across the heartland of the United States, and north to Canada. Along the way, we collected a wealth of information and experiences, as the following highlights demonstrate.
At Chicago’s Rush University, we observed a variety of procedures, including primary hip arthroplasty through mini-posterior, modified-Hardinge, and Watson Jones approaches; hip resurfacing; and complex revision hip arthroplasty. In addition, we received clinical and basic science lectures regarding same-day discharge joint replacement surgery and retrieval analysis for trunnion corrosion.
During the site visit to the Mayo Clinic in Rochester, Minn., we received a comprehensive tour of the quite impressive biomechanics and basic science labs and observed a variety of surgical procedures.
In Mooresville, Ind., at the Center for Hip and Knee Surgery, we toured the research department, attended case conferences, and heard informative lectures from the research staff on current projects. The highlight in the operating room was observing a complex total hip arthroplasty in a patient with femoral deformity.
Our last Midwest stop was at Joint Implant Surgeons, Inc., in New Albany, Ohio. The faculty had arranged a regional academic conference involving joint arthroplasty faculty from the entire Columbus area. The staff also arranged for a very educational cadaver lab that enabled us to explore the direct anterior approach as well as more complex revision exposures.
East Coast explorations
At the Hospital for Special Surgery in New York City, Chitranjan S. Ranawat, MD, treated us to several lectures on topics as varied as the history of arthroplasty surgery and balancing work with family life.
The educational program at Massachusetts General Hospital (MGH) in Boston included lectures in the historic Ether Dome and visits to several hospitals including MGH, the New England Baptist Hospital, and Newton Wellesley Hospital. We observed a variety of cases and engaged in discussions with prominent hip arthroplasty surgeons throughout the area.
During our visit to OrthoCarolina in Charlotte, N.C., we had two mornings of complex case presentations that offered unique teaching points for discussion with the faculty. At the Anderson Clinic in Alexandria, Va., our day began with a case conference, which included a discussion of the operative plan for surgeries that day. We also toured the Anderson Orthopaedic Research Institute, including the implant retrieval lab, which provided insight into the workings of a productive academic enterprise.
At the Rothman Institute in Philadelphia, we observed both supine direct lateral and anterior approaches to the hip while learning about the numerous efficiencies surgeons had developed. Following presentations on research by the arthroplasty fellows, we participated in a discussion of the most pressing issues in hip surgery moderated by Richard H. Rothman, MD.
At the University of Southern California in Los Angeles, we were able to observe live robotic hip surgery through a sophisticated viewing arrangement that allowed us to appreciate every nuance of the procedure. The faculty took the time to guide us through both preoperative planning and the surgical procedure.
While at Stanford University, we watched primary and revision hip surgery in the operating room and spent time in the outpatient clinic as well. Our visit concluded with a discussion of cutting-edge topics in hip surgery with faculty and
The Canadian perspective
At the London Health Sciences Centre in London, Ontario, we enjoyed two days of rigorous academic activities, including faculty research presentations. The round-table format surrounding the faculty presentations was a great way to foster dialogue about various approaches to current clinical problems. Our tour of the research facilities included an introduction to the joint registry and implant retrieval laboratory.
Finally, we returned to Chicago. As we waited for our respective flights home, we reflected on what we all felt was the tour of a lifetime. The opportunity to become personally acquainted with leaders in our field, learn from their experiences, and continue to benefit from their mentorship was an honor. The four of us developed life-long friendships during our travels and were enlightened by the exchanges with contemporaries who shared a common desire to provide outstanding patient care and make meaningful contributions to our field.
One by one, for the first time in over a month, we flew separately, grateful for our experiences together and eager to approach our practices with a renewed vigor and an expanded vision.
This tour would not have been possible without the tireless efforts of the members of The Hip Society and their staff, the hosts and faculty of the participating institutions, and the support of our colleagues and families at home.
Sumon Nandi, MD, is a staff surgeon at the New England Baptist Hospital and assistant professor of orthopaedics at the Tufts University School of Medicine. He can be reached at email@example.com
For more information on The Hip Society Rothman-Ranawat Traveling Fellowship, visit www.hipsoc.org