Jacob Rannie – Independent Project

Jacob RannieĀ – Independent Project

Class of 2017

Introduction to Topic

In 2010 there were 5.5 million orthopedic surgeries, this number is expected to grow to 6.6 million by 2020(Lowe ). Orthopedics is an area of medicine that is not all about life or death, but more about comfortability. I chose this topic because I have had many visits to orthopedic offices and have had been exposed to much of this field. The older we get the more orthopedic problems we have with our joints in particular wearing down the fastest. Patients expect optimal care with excellent treatment and life changing results. The only way to provide this is with the fantastic Doctors and their amazing teams supporting them.

Project Description

In 2010 there were 5.5 million orthopedic surgeries, this number is expected to grow to 6.6 million by 2020(Lowe ). Orthopedics is an area of medicine that is not all about life or death, but more about comfortability. I chose this topic because I have had many visits to orthopedic offices and have had been exposed to much of this field. The older we get the more orthopedic problems we have with our joints in particular wearing down the fastest. Patients expect optimal care with excellent treatment and life changing results. The only way to provide this is with the fantastic Doctors and their amazing teams supporting them.

Experience Description

I shadowed through Towson Orthopedics for a combined 80 hours. During my time spent shadowing I met a wide variety of patients with a wider variety of complications and reasons for being there. On a daily basis, I would see patients with Mike and record what happened to the patient. While I was at the Bellona office shadowing Mike Mille PA-C, I mainly saw post-op patients who normally were 6 weeks out. Mike would start by asking them questions about how they felt and if they had started to wane themselves off of the narcotics. Many of the patients were completely off of the narcotics at this point because they were afraid of what the heavy drugs would do to them. Mike would then do a physical exam to test for range of motion and palpations to check for soreness in specific areas. The range of motion would differ widely from patient to patient and this is caused by the previous range of motion before surgery, and how hard they pushed themselves at physical therapy. Mike would then perform an incision exam which would require the patient to reveal the incision. Mike then said that if the incision was white it was healed, if it was pink it was healing, and if it was red then it was infected. The stitches used are dissolving sutures, but they also do not dissolve immediately, and many times pop through the skin. Mike took an alcohol wipe and wiped the incision to remove any sutures poking out. One of my many highlight moments while shadowing is when a patient came in with a knee stuck at 90 degrees and a pencil eraser sized hole oozing pus down his leg. Mike did not want the infection to go septic and had to call around to a bunch of doctors. We eventually went upstairs to ask Dr. McMillan and his PA Jason. While waiting for Dr. Mcmillan, Mike explained the situation to Jason while we were in a tight corner. Dr. Mcmillan then emerged from a nearby room and came over to see what was going on. Being in close quarters with two PA’s and a doctor all trying to figure out what the best thing to do with this patient was made me realize that this is what I want to do. The feeling of problem solving between three great minds and how I felt like an equal with the way they spoke to me gave me a feeling I will never forget.

Innovation Description

While shadowing Mike Miller PA-C, we were discussing the different variations of the hip replacement, including the metal or ceramic head, as well as a cemented or press fit model. The difference between a cemented and press fit model is in how they are held to the bone once implanted. A press fit has a texture to the center of it. This gives bone the ability to grow onto the implant and grab it so that it does not move(Mike). The main reason the press fit is a better alternative is because it gets rid of the chance of infection due to the cement. In 2010, there were 310,800 hip replacements done to patients over 45(Rath). Hip replacements on average fail about 4% of the time with the difference in press fit and cement models being the same(Rath). This means that 12,432 replacements fail on average every year. This is a problem because each model has a different reason for failing most of the time. For example, press fit models usually fail because the bone does not grab the implant fast enough and the implant starts the wiggle and cause the bone around it to calcify(Mike). This makes the bone unable to grab it and creates a lot of pain. Cemented implants on the other hand fail most of the time due to the bone not being able to attach itself to the cement and therefore the cement is the only anchor for the implant(Mike). My innovation utilizes both models and combines the best of both worlds. My innovation uses the textured implant that the bone can grab as well as cement at the point of the implant. This allows for instant fixation to the bone with the cement as well as long term implant fixation with the bone growing and grabbing the textured portion of the model. This would hopefully drastically lower the amount of failed replacements from 12,432.

Project Topic

Introduction to Topic

In 2010 there were 5.5 million orthopedic surgeries, this number is expected to grow to 6.6 million by 2020(Lowe ). Orthopedics is an area of medicine that is not all about life or death, but more about comfortability. I chose this topic because I have had many visits to orthopedic offices and have had been exposed to much of this field. The older we get the more orthopedic problems we have with our joints in particular wearing down the fastest. Patients expect optimal care with excellent treatment and life changing results. The only way to provide this is with the fantastic Doctors and their amazing teams supporting them.

Project Overview

Project Description

In 2010 there were 5.5 million orthopedic surgeries, this number is expected to grow to 6.6 million by 2020(Lowe ). Orthopedics is an area of medicine that is not all about life or death, but more about comfortability. I chose this topic because I have had many visits to orthopedic offices and have had been exposed to much of this field. The older we get the more orthopedic problems we have with our joints in particular wearing down the fastest. Patients expect optimal care with excellent treatment and life changing results. The only way to provide this is with the fantastic Doctors and their amazing teams supporting them.

Experience

Experience Description

I shadowed through Towson Orthopedics for a combined 80 hours. During my time spent shadowing I met a wide variety of patients with a wider variety of complications and reasons for being there. On a daily basis, I would see patients with Mike and record what happened to the patient. While I was at the Bellona office shadowing Mike Mille PA-C, I mainly saw post-op patients who normally were 6 weeks out. Mike would start by asking them questions about how they felt and if they had started to wane themselves off of the narcotics. Many of the patients were completely off of the narcotics at this point because they were afraid of what the heavy drugs would do to them. Mike would then do a physical exam to test for range of motion and palpations to check for soreness in specific areas. The range of motion would differ widely from patient to patient and this is caused by the previous range of motion before surgery, and how hard they pushed themselves at physical therapy. Mike would then perform an incision exam which would require the patient to reveal the incision. Mike then said that if the incision was white it was healed, if it was pink it was healing, and if it was red then it was infected. The stitches used are dissolving sutures, but they also do not dissolve immediately, and many times pop through the skin. Mike took an alcohol wipe and wiped the incision to remove any sutures poking out. One of my many highlight moments while shadowing is when a patient came in with a knee stuck at 90 degrees and a pencil eraser sized hole oozing pus down his leg. Mike did not want the infection to go septic and had to call around to a bunch of doctors. We eventually went upstairs to ask Dr. McMillan and his PA Jason. While waiting for Dr. Mcmillan, Mike explained the situation to Jason while we were in a tight corner. Dr. Mcmillan then emerged from a nearby room and came over to see what was going on. Being in close quarters with two PA’s and a doctor all trying to figure out what the best thing to do with this patient was made me realize that this is what I want to do. The feeling of problem solving between three great minds and how I felt like an equal with the way they spoke to me gave me a feeling I will never forget.

Innovation

Innovation Description

While shadowing Mike Miller PA-C, we were discussing the different variations of the hip replacement, including the metal or ceramic head, as well as a cemented or press fit model. The difference between a cemented and press fit model is in how they are held to the bone once implanted. A press fit has a texture to the center of it. This gives bone the ability to grow onto the implant and grab it so that it does not move(Mike). The main reason the press fit is a better alternative is because it gets rid of the chance of infection due to the cement. In 2010, there were 310,800 hip replacements done to patients over 45(Rath). Hip replacements on average fail about 4% of the time with the difference in press fit and cement models being the same(Rath). This means that 12,432 replacements fail on average every year. This is a problem because each model has a different reason for failing most of the time. For example, press fit models usually fail because the bone does not grab the implant fast enough and the implant starts the wiggle and cause the bone around it to calcify(Mike). This makes the bone unable to grab it and creates a lot of pain. Cemented implants on the other hand fail most of the time due to the bone not being able to attach itself to the cement and therefore the cement is the only anchor for the implant(Mike). My innovation utilizes both models and combines the best of both worlds. My innovation uses the textured implant that the bone can grab as well as cement at the point of the implant. This allows for instant fixation to the bone with the cement as well as long term implant fixation with the bone growing and grabbing the textured portion of the model. This would hopefully drastically lower the amount of failed replacements from 12,432.

By | 2017-05-12T03:46:16+00:00 May 12th, 2017|Biomed Capstone Project 2017|0 Comments

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