Abstract:
BACKGROUND:There are few data on the types of procedures orthopaedic oncologists perform in their first years of practice. Because fellowships are graduating fellows each year and the number of tumor patients is limited, defining the practice patterns of early-career orthopaedic oncologists may help diminish early employment discontent and enhance workforce discussions. QUESTIONS/PURPOSES:The aim of the study was to use the objective case log volumes of a cross-section of early career orthopaedic oncologists to describe (1) the number of operations performed annually; (2) the proportion of tumor, trauma, adult reconstruction, and other operations for individual participants, (3) individual practice characteristics that were associated with the number of tumor procedures; and (4) the sources of satisfaction and challenges in each individual's career and surgical practice. METHODS:Fifteen fellowship-trained orthopaedic oncologists out of a potential pool of 33 (45%) in their first 4 years of practice responded to a survey by submitting complete operative case lists for a 2-year period. We recorded the type of procedure and determined associations between the annual number of tumor operations and total operative caseload, years in practice, and some details of individual practice patterns. Each participant completed a survey regarding practice-related sources of stress and satisfaction. A total of 5611 surgical cases were available for review. For the entire cohort, there were 3303 (59%) tumor procedures, 973 (17%) trauma, 890 (16%) adult reconstruction, and 445 (8%) other. RESULTS:The median annual number of total operations was 214 (range, 63-356) and median annual number of tumor operations was 135 (range, 47-216). The median proportion of tumor operations in an individual practice was 56% (range, 43%-94%). The annual number of tumor operations correlated with the total annual number of operations (r = 0.73, p < 0.001). Sources of stress and satisfaction were similar to the general membership of the Musculoskeletal Tumor Society (MSTS), apart from more early-career surgeons regarding case volume as important (29 of 104 [28%] of MSTS versus 11 of 15 [73%] of early-career, p < 0.001). CONCLUSIONS:The typical early-career orthopaedic tumor surgeon had fewer than 60% of his or her operative procedures directly related to the subject of his or her fellowship training in orthopaedic oncology. Overall, the challenges and rewards of clinical practice are similar to oncologic surgeons later in their career. This study is a first step in assessing early practice characteristics and may be of value to the prospective orthopaedic oncologist, fellowship educators, and the society in workforce discussions. Early-career practice patterns have not been previously presented, to our knowledge, for any subspecialty of orthopaedic surgery, and we hope that this study will stimulate similar efforts throughout the field. LEVEL OF EVIDENCE:Level IV, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Miller BJ,Rajani R,Leddy L,Carmody Soni EE,White JR,Musculoskeletal Oncology Research Initiative.doi
10.1007/s11999-014-3934-xsubject
Has Abstractpub_date
2015-02-01 00:00:00pages
695-702issue
2eissn
0009-921Xissn
1528-1132journal_volume
473pub_type
杂志文章abstract:BACKGROUND:When considering arthroscopic surgery for treatment of hip pain, it is important to understand the influence of joint degeneration on the likelihood of success. Previous research has shown poorer outcomes among patients with osteoarthritis but new arthroscopic techniques including femoroacetabular impingemen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2594-y
更新日期:2013-02-01 00:00:00
abstract::The objective of the current study was to identify a new extraarticular anatomic landmark indicating the anteroposterior orientation of the tibia using computed tomography. In 39 volunteers (20 males, 19 females), computed tomography scans for healthy right knees in extension were done perpendicular to the tibial shaf...
journal_title:Clinical orthopaedics and related research
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doi:10.1097/00003086-200403000-00030
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abstract::This study was undertaken to evaluate the medial ligamentous stabilizers of the patella in restraining lateral displacement and to assess their relative contribution after individual repair. Seventeen fresh frozen human anatomic specimen knee joints were studied. The specimens were loaded onto a testing instrument tha...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199804000-00021
更新日期:1998-04-01 00:00:00
abstract::A solitary fibrous tumor is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that solitary fibrous tumors also affect extrathoracic regions. The current study presents a literature review with four additional patients with solitary fibrous tumor arising ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000065839.77325.b4
更新日期:2003-06-01 00:00:00
abstract::Rheumatoid arthritis (RA) affects the articular surfaces and the ligamentous supporting structures of synovial-lined joints. In approximately one-fourth of the patients with RA, the sacroiliac joints demonstrate radiographic changes of subchondral bony erosions and articular destruction, as well as ankylosis. Subluxat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-08-01 00:00:00
abstract:BACKGROUND:With cerebral palsy (CP), an equinus deformity may lead to genu recurvatum. Botulinum toxin A (BtA) injection into the calf muscles is a well-accepted treatment for dynamic equinus deformity. QUESTIONS/PURPOSES:The purpose of this study was to determine whether BtA injections into the calf muscles to decrea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2897-7
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abstract::Following peripheral nerve repair, tension on the suture line is regarded as an important factor in producing scar tissue. In some cases, one or more microsurgical epiperineurium-fascial stitches (EPFS) along the proximal and distal stumps of a transected nerve permit their firm approximation, shifting tensile forces ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::Bone tumors occurring in periarticular locations may cause a substantial risk of subchondral fracture and collapse. Poly-methylmethacrylate has been used for reconstruction in these instances because of its immediate structural stability. Allogeneic graft allows for biologic incorporation and remodeling, but it takes ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/blo.0b013e31804e8470
更新日期:2007-08-01 00:00:00
abstract::Molecular diagnostic strategies have been implemented to enhance the treatment of musculoskeletal infections. Once primarily a research tool, molecular-based assays, have become accepted clinical tests for the genomic detection of certain pathogens involved in bone and joint infections. Currently, culture remains the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000175126.37343.44
更新日期:2005-08-01 00:00:00
abstract::The minicondylar plate is used for unstable intraarticular and periarticular fractures of the phalanges and metacarpals to provide stability and to allow early motion. This low profile implant can be placed laterally to avoid injury to the extensor mechanism. The authors retrospectively reviewed 53 consecutive patient...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199606000-00007
更新日期:1996-06-01 00:00:00
abstract::The objective of this study was to evaluate the effect of muscle force and the posterior cruciate ligament on screw home motion in patients with total knee replacement in a posterior cruciate ligament retaining prosthesis (10 knees) and a posterior cruciate ligament substituting prosthesis (10 knees). Screw home motio...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Varus deformity is a common finding in candidates for total knee arthroplasty (TKA), but very little has been written concerning the problems encountered in correcting these deformities at the time of arthroplasty. Compared to patients without deformities, this group of patients require more attention to the technical...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::Black lines seen on magnetic resonance imaging in the middle part of the deltoid suggest the presence of fibrous bands. Anatomic study of 30 deltoid muscles was done. Eight half-cone shaped distal fibrous structures merged together into the distal tendon of the deltoid muscle. The middle part of the deltoid muscle con...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200105000-00029
更新日期:2001-05-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0966-8
更新日期:2010-03-01 00:00:00
abstract::Isolated bovine growth plate chondrocytes suspended in a synthetic cartilage buffer containing 10(-7) to 10(-3) M concentrations of calcium were treated with 1 microM ionomycin to induce changes in intracellular ionized calcium as measured by Fura-2 fluorescence. An increase in intracellular calcium of 10(-6) to 10(-4...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::Regional cortical blood flow was measured in 23 adult mongrel dogs using the hydrogen washout technique. Cortical blood flow in the rib was found to be 4.7 +/- 0.8 ml/min/100 ml (n=21). The concept of a dual blood supply to cortical bone is supported since eliminating the medullary supply did not affect the measurable...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-05-01 00:00:00
abstract::Femoral head collapse occurred in a 20-year-old ballet dancer with anorexia nervosa. The patient developed anorexia nervosa at the age of 11 years and had short stature. The condition never resolved, and she developed pain and stiffness in the right hip at the age of 18 years, with documentation of femoral head collap...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00
abstract::Eleven intraoperative femur fractures occurred during 605 total hip replacements at Rancho Los Amigos Hospital, an incidence of 1.8%. Fractures occur more often in women, are usually located in the proximal femur, and mostly occur during femoral reaming. The main predisposing factors were osteoporosis and previous hip...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1728-3
更新日期:2011-08-01 00:00:00
abstract::Sixteen human trabecular bone biopsies were obtained from sites located in the ilium and in the area of the greater trochanter of the femur. Patients ranged from 19 to 85 years old and included men and women. All bone surfaces observed contained osteoid. Flat, branched fibroblastic-like cells were observed lining bone...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::Pigmented villonodular synovitis, bursitis and tenosynovitis may present a variable picture depended upon the site and whether they are localized or diffuse. In the localized form of the disease occurring in association with tendon sheaths, complete surgical excision should result in a cure. Local recurrences probably...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1976-01-01 00:00:00
abstract::A technique of partial resection of the distal ulna ("wafer" procedure) for the treatment of patients with symptomatic tears of the triangular fibrocartilage complex or mild ulnar impaction syndrome or both is described. The distal 2-4 mm of the distal ulna is resected while preserving the distal radioulnar joint and ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::A prospective, randomized study was performed in 54 female total arthroplasty patients to determine whether straight catheterization in the recovery room might reduce the incidence of postoperative urinary infection, urinary retention, and urinary catheterization. Thirty-one patients were straight catheterized in the ...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1988-06-01 00:00:00
abstract::A 60-year-old man had severe unilateral wrist flexion contracture associated with psoriatic arthritis mutilans. Proximal row carpectomy provided realignment of the carpus. Arthrodesis occurred spontaneously in functional position. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:2006-10-01 00:00:00
abstract::A Replantation Team was instituted in Vienna 3 years ago. This team is the oldest in Europe. One hundred and eighty-one complete and incomplete amputated parts of 118 patients were replanted during this period. A survival rate of 86% and a useful functional result ("integrated parts") in 78% of the cases was obtained....
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-06-01 00:00:00
abstract::Fourteen knees were studied by a method called spatial location, to determine the contact and load-bearing areas between the femur and the upper tibia in non-loaded and loaded conditions, at various angles of flexion. Under no load, contact occurred primarily on the menisci; the lateral aspects contacted at 0 degrees...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197506000-00027
更新日期:1975-01-01 00:00:00
abstract::While the entity of nonsecretory myeloma is rare, its diagnosis may be delayed or remain undetected if too much reliance is placed on the presence of a serum or urinary M component, which traditionally has been considered an important, if not essential, feature of plasma cell myelomatosis. Nonsecretory myeloma is char...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::Juvenile rheumatoid arthritis (JRA) involves a wide range of joint tissues. Tissue changes include proliferation of synovial cells, alterations in synovial fluid, and degradation of articular cartilage. Synovial cell proliferation results in increased numbers of fibroblasts and lymphocytes. Changes in the synovial flu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1990-10-01 00:00:00