Week 4 - Tyler McNeill

Though we had a shortened week because of the Independence Day holiday, I was able to make significant headway on my research project, focusing on analyzing some of the existing literature that exists on customization in total knee arthroplasties. I’ve spent a lot of time studying the different types of customization – which includes the use of custom jigs during surgery and the use of patient-specific implants. So far, I’ve read a lot of studies that compared a wide array of outcomes amongst different surgical cases. One interesting review that I read compared patient outcomes in three different scenarios: surgery that involved traditional tools and components, surgery that involved patient-specific customization (such as custom jigs or custom implants), and computer-aided surgery.

There was a lot of variability within the outcomes of the studies that this review covered; this seemed to mimic a lot of the variability that I’ve noticed in most of the cases that I’ve heard discussed while working in the hospital. As I’ve mentioned before, I think this stochasticity is one of the main differences between research-based and clinical-based studies. Personally, coming from a research-based perspective, I find it pretty difficult to imagine having to draw conclusions off of studies with such high variability. I think it would be pretty fascinating to learn about some of the different statistical techniques that clinical researchers use to account for this in their work.

After work on Monday this week, I was able to attend a Mortality and Morbidity (M&M) meeting with the reconstructive surgery department at Weill Cornell Medical College. During this, some of the fellows in reconstructive surgery presented a wide variety of cases that experienced some form of complication and required subsequent revision work. In one case, the fellow and the attending clinician discussed the complexities of working with surgeons from different departments. In this particular case, the reconstructive surgery team had to remove mesh from the patient per request of surgeons from another department, because they feared that it could cause complications for patient recovery. Despite feeling that the mesh would not lead to any complications, the reconstructive surgery team went forward with the mesh removal in order to ensure success for the patient, who had a history of surgical complications. Seeing this discussion first-hand gave me a better understanding of the dynamics and variety of professional opinions coming together to determine the optimal process to reach surgical success.

On Independence Day, a large group of us got together and had a potluck-style picnic in Central Park! It was a lot of fun to get out of the lab and spend some time together as a large group. We initially intended to see the fireworks over the East River, but lost track of time and didn’t have a chance to make it towards Brooklyn. Overall, though, it was a great time!