Day 5 - Final OR cases and educational activities

Today was our last day of surgery at the Hospital General de la Plaza de la Salud, and the remainder of our trip will focus on education and inpatient care.  After finishing in the operating room this morning, our entire surgical team met to review the post-operative X-rays from all 56 joints we replaced.  We discussed both our operative successes and our struggles, with the goal of learning from each case.  This conference was one of the most educational and enjoyable times of the week, because the differences between the pre- and post-operative X-rays were dramatic.

xray rounds.jpg

Carl Harper and Tom Parisi (Orthopedic Surgery Residents) present X-rays to the group of Orthopedic Surgery Attendings.  Every surgery is reviewed and discussed by the entire surgical team.



This X-ray is of a patient with severe osteoarthritis of both knees.  We performed bilateral total knee replacements this week, which will hopefully provide pain relief and significantly improved function.


This is the post-operative X-ray of the previous patient, after she underwent bilateral knee replacements.


In addition to our final X-ray rounds, we also spent the afternoon in an educational session with the Dominican medical students.  The UNIBE (Universidad Iberico) medical students have had a series of informal daily lectures with Jeffrey N. Katz, MD (Rheumatology attending at Brigham and Women’s Hospital) that focus on different types of arthritis.  They used real case examples to learn the presentation, workup, diagnosis and treatment of joint disease like osteoarthritis, inflammatory arthritis, post-traumatic arthritis and infectious arthritis.


In this photo, Jeffrey N. Katz, MD (Brigham and Women's Rheumatology attending) goes through a case with the UNIBE medical students.


Today we also had a more formal didactic session in one of the medical school lecture halls.  The anesthesia and orthopedic surgery residents each gave a lecture on a topic related to joint reconstruction, including the history of hip and knee replacement surgery and the workup and management of post-operative complications.


This image is a screen shot from one of the presentations today ("A Brief History of Total Hip Arthroplasty"). 


Tomorrow we will round on the patients that we operated on today, and make sure that everyone is on track for discharge home.  It has been a very busy week, but all of the volunteers on the trip would agree that it has been a remarkably fulfilling experience.



Forrest H. Schwartz, MD (orthopedic Surgery Resident)