MIS Muscle Sparing Hip and KneeReconstruction Traveling FellowshipThe OhioHealth, Grant Medical Center MIS Muscle Sparing Joint ReplacementTraveling Fellowship Program will provide an intensive two week training in minimallyinvasive surgery of the hip and knee with a particular focus on Muscle Sparing JointReplacement techniques. The “traveling fellows” will get advanced training andeducation from three faculty members with unique abilities in total joint reconstruction.The faculty members are Dr. Ray Wasielewski (MIS and Muscle Spring THA (2–Incision) and TKA (Quad Sparing; www.minimallyinvasivesurgerymis.com), Dr. RogerPalutsis (MIS 2-incision THA, Unicompartmental TKA) and Dr Bill Seeds MD (MISsurgery and advanced office, operating room and Internet technology).Applicants must have completed an orthopaedic surgery residency program accredited bythe Accreditation Council for Graduate Medical Education (ACGME), the Royal Collegeof Physicians and Surgeons of Canada, or the American Osteopathic Association (AOA).Additionally, most candidates will have completed a standard reconstructive fellowshipin THA or TKA and be competent in all areas of hip and knee replacement surgery,including minimal incision techniques.Typical Week #1: Monday: Dr. Wasielewski Surgery - Quad Sparing TKA and 2-incision THA Tuesday: Dr Wasielewski Office – evaluation of preoperative and postoperativemuscle sparing patients Wednesday: Dr. Wasielewski Surgery - Quad Sparing TKA and 2–incision THA Thursday: Dr. Palutsis – 2-incision THA and Unicompartmental TKA Friday: Dr. Palutsis - 2-incision THA and Unicompartmental TKATypical Week #2: Monday: Dr. Seeds Surgery - MIS Technology enhanced TKA and THA Tuesday: Dr. Seeds – Office with technology and Internet interface Wednesday: Dr. Wasielewski Surgery - Quad Sparing TKA and 2–incision THA Thursday: Dr. Wasielewski Surgery - Quad Sparing TKA and 2–incision THA Friday: Dr. Wasielewski – Final didactic conferenceGoals and ObjectivesA. Surgical and Medical Knowledge I: Anatomy/Physiology
Goal: The traveling fellow will thoroughly know understand the anatomy and physiologyof the pelvis, hip, and knee and will use this knowledge in the execution of minimallyinvasive and muscle sparing hip and knee partial and total replacement.Objectives: The traveling fellow will 1. Understand the surgical anatomy and physiology of the pelvis and lower extremity, including muscles, tendons, ligaments, and bones. 2. Understand the location of vascular structures in the pelvis and lower extremity and identify the location of these vascular structures in relation to surrounding structures. 3. Understand the location of the major nerves and their branchings in the pelvis and lower extremity and identify their location in relation to surrounding structures. II. Functional Problems of the Lower ExtremitiesGoal: The traveling fellow will understand the minimally invasive and muscle sparingsurgical reparation of functional problems of the hip and knee. A didactic series oflectures will address the following areas of significance to the MIS reconstructivesurgeonObjectives: The traveling fellow will 1. Understand the indications and contraindications for Muscle Sparing Total Joint Arthroplasty 2. Understand the causes of hip and knee inflammatory contracture and range of motion loss. 3. Understand the basic pathophysiology of seropositive and seronegative arthritis of the pelvis and lower extremity. 4. Understand the common circulatory disorders of the lower extremity and their influence on muscle sparing arthroplasty including: 1. Arterial thromboses 2. Venous thromboses 3. Aneurysms 4. Embolic disorders 5. Thrombotic disorders 5. Understand neurogenic and vascular claudication. 6. Diagnose and treat common pain syndromes, including sympathetic dystrophy, lateral femoral cutaneous and saphenous neuromas. 7. Recognize and treat lower extremity lymphedema and understand its influence on the outcome of TKA and THA. 8. Understand the physical therapy and rehabilitation of the Muscle Sparing TKA and THA patient. III. Reconstruction and Clinical Care
Goal: The traveling fellow will thoroughly know the principles of joint reconstructionand will skillfully perform joint reconstruction to address various hip and knee problems.Objectives: The traveling fellow will 1. Describe the local and systemic etiologies of the surgical hip and knee 2. Perform examinations (history, review of systems, physical examination) of patients with diseased hip(s) or knee(s). 3. Diagnose using radiologic techniques, including plain films, CT scan, angiography, and MRI of the lower extremity. 4. Know the diagnostic techniques used to evaluate of function, including EMG and conduction studies, arteriography, CT scan, and MRI evaluation. 5. Understand the important of diagnostic lidocaine injection to very the joint as the origin of pain and the anticipated improvement after TJA 6. Understand the uses of bracing in pre- and post- arthroplasty patients. 7. Perform General Preoperative Planning 1. Templating 2. Selection of Implants 3. Have the necessary instruments and prosthetic devices for a given condition. 8. Know and use different surgical approaches to total hip and total knee arthroplasty 1. Total hip arthroplasty a. 2-incision THA b. Mini anterolateral and posterior approaches c. Anterior Approach d. Special surgical exposures and releases 2. Total knee arthroplasty a. Quad-sparing b. Sub-vastus c. Medial Parapatellar d. Special exposures and releases 9. Know and use different implant fixation techniques 1. Cementless, cemented, and hybrid total hip arthroplasty 2. Cementless, cemented, and hybrid total knee arthroplasty 10. Understand the applicability of Muscle Sparing Surgery: 1. Total hip arthroplasty a. Degenerative osteoarthritis b. Hypertrophic Degenerative osteoarthritis c. Avascular necrosis of the hip d. Seropositive Arthropathies e. Ankylosed Hip 2. Total knee arthroplasty a. Avascular necrosis of the knee b. Seropositive Arthropathy c. Reconstruction after fracture
d. Severe varus or valgus and flexion contracture e. Patella infera/baha 11. Understand the “Surgical Pitfalls” associated with Muscle Sparing Total Joint Arthroplasty 12. Describe the expected outcome after Muscle Sparing THA and TKA. 13. Evaluate and care for patients postoperatively. 14. Learn to recognize intraoperative and postoperative complications.B. Patient CareGoal: The traveling fellow will learn the unique aspects of patient care after MIS andMuscle Sparing joint replacement.C. Practice Based LearningGoal: The traveling fellow will observe and understand Muscle Sparing patient carepractices. In-patient hospital and office experiences will provide practiced based learningthrough direct observation.D. System Based PracticeGoal: The traveling fellow will observe how other health care services and agencies(including, but not limited to, imaging centers, rehabilitation centers, physical therapy,occupational therapy, implant and instrument companies, Workers’ Compensation) intopatient care.There is an opening for the OhioHealth, Grant Medical Center Joint ReconstructionTraveling fellowship Program beginning September 01, 2008.Please submit the following information with your application packet: • Curriculum Vitae • Residency and Fellowship Transcripts • Personal Statement of interest in MIS TJAMail your completed Joint Reconstruction Traveling fellowship Application to:Ray C. Wasielewski, MS, MDMininally Invasive Orthopedic Institute500 East Main Street, Suite 240Columbus, OH 43215Office: 614-566-8570Fax: 614-566-8548E-mail: RWASIEL2@OhioHealth.comIf you have any questions or require additional information regarding the Travelingfellowship, please do not hesitate to contact me.