Report of the SICOT International Travelling Fellowship

Mrinal Sharma SICOT Associate Member - New Delhi, India

 

I would like to thank SICOT and the Fellowships Committee at SICOT for selecting me for the International Travelling Fellowship for 2014. I was glad to hear from SICOT that I would be able to do my fellowship in computer navigated knee and hip arthroplasty at the Golden Jubilee National Hospital, Glasgow, Scotland (United Kingdom). My host and local SICOT contact was Dr Kamal Deep who made all the arrangements for my fellowship at the Hospital.

Golden Jubilee National Hospital, Glasgow, Scotland, United Kingdom

The Golden Jubilee National Hospital is the largest NHS national waiting times referral centre for lower limb arthroplasty in Scotland. It is located on the west side of Glasgow. I started my fellowship on 1 March 2015. I met Dr Deep's secretary, Mrs Rose, who had arranged for my occupational health clearance. She also introduced me to other members of the department and gave me my rota posting. In the evening I met Dr Deep who welcomed me to the department and showed me all around the wards and theatres.

Dr Deep is a senior consultant in lower limb arthroplasty who has a special interest in computer assisted arthroplasty of the knee and hip. He is also the Secretary General of CAOS International. I was posted in theatre on all days except Wednesdays when I used to attend outpatient clinics with Dr Deep. I used to assist him in the theatres on Tuesdays and Fridays and I used to scrub in all cases of navigated hip and knee arthroplasty. Dr Deep took a keen interest in teaching me the minute details of navigated arthroplasty starting from the pre-operating planning, set-up, registration, execution and bailout techniques of navigated knee arthroplasty. Dr Deep also specialises in navigated hip arthroplasty and he taught me the details of the same. During my stay I assisted him in numerous navigated arthroplasty of the hip and knee, including navigated unicondylar knee replacement and navigated patellofemoral arthroplasty. I also assisted him in many uncemented and cemented revision arthroplasties of the hip and knee. Each case was a new learning experience for me.

During my stay I managed to write a paper with Dr Deep on the 'Effect of traditional sequential medial soft tissue release on knee kinematics and alignment'.

With Dr Kamaldeep during one of our theatre days at the Golden Jubilee hospital

On other days I used to scrub in with different consultants who also performed navigated knee arthroplasty. I would like to thank Dr Frederic Picard, a pioneer in navigated knee arthroplasty, who taught me the basics of navigated arthroplasty and also gave me his autographed book on 'Computer Assisted Total Knee Arthroplasty'. Dr Picard took a keen interest in explaining to me the steps of navigated knee arthroplasty and understanding the basics of using the orthopilot system. Dr Picard also taught me the gap balancing method in knee arthroplasty and how to use navigation in high tibial osteotomy and epicondylar osteotomy to balance valgus knees.

Dr Frederic Picard shared his immense experience of using navigation in knee arthroplasty

 
Navigated TKA in progress and me in the scrubs

I would also like to thank Drs David Allen, Jason Roberts, Baines, Rohit Maheshwari, Sarungi, Arun and Rahul for giving me their valuable inputs and clearing my doubts regarding navigated knee arthroplasty.

During my stay I also attended the cadaveric course in navigated knee and hip arthroplasty at the University of Dundee which was coordinated by Dr Deep. In the evening I went for dinner with Dr Deep, Dr Rami Abboud and other faculty members at the University of Dundee.

Dinner with Dr Deep, Dr Rami Abboud and other faculty members at the University of Dundee

During my stay at the Golden Jubilee Hospital, I also attended the annual meeting of the Glasgow Research Society held at the Beardmore Hotel within the Golden Jubilee Hospital. I used to attend the biweekly CME conducted at the department and also accompanied Dr Deep on ward rounds. I was impressed by the coordination between the clinicians, surgeons, physiotherapists and the nursing staff, which all culminated to early rehab and early discharge (2-3 days post surgery). Also new to me was the use of pre-filled ropivacaine infusions into the knee joint for post-op pain relief.

Scotland is beautiful so I took the opportunity to visit the beautiful city of Glasgow and its surroundings. Every weekend I visited places such as Edinburgh Castle, Stirling Castle, the Highlands, Loch Lomond, Loch Ness, Inverness, and the surrounding areas, along with my friends. I have everlasting memories of one of the most beautiful places on Earth.

I had a fruitful stay at the Golden Jubilee Hospital and the experience I gained further strengthened my fundamentals of arthroplasty. I am happy that my main aim of learning navigated arthroplasty was fulfilled. I would like to thank all the doctors and OR staff at the Golden Jubilee Hospital who made my stay memorable and pleasant. I also made friends like Dr Arun, Dr Rahul and Dr Qamar at the hospital. I would like to thank Mrs Rose for her support.

Once again I would like to thank SICOT for giving me the opportunity to learn navigation and strengthen my arthroplasty skills as well0. I have benefited a lot from the SICOT International Travelling Fellowship as it helps you in travelling to a place of your choice, work with a surgeon of your choice and choose the speciality you wish to learn more about. I  would recommend it for other budding SICOT members as well...

My deepest regards to Dr Kamal Deep.