The JBJS Journal of Orthopaedics for Physician Assistants (JOPA) continues the tradition of recognizing outstanding review articles and case studies submitted during the previous year by practicing PAs, NPs, and PA students. OrthoBuzz is pleased to spotlight the winners of the 2020 JBJS JOPA Writing Awards.
Name: Katherine Crandall, PA-S
Affiliation: Keck School of Medicine, University of Southern California
JOPA Article: “Physician Assistant Roles in Prevention and Management of Anterior Cruciate Ligament Injury”
Tell us about your paper.
I chose to write a review article on the topic of physician assistant roles in the prevention and management of anterior cruciate ligament (ACL) injury. The roles and responsibilities of physician assistants — both in primary care and in orthopaedics — seamlessly translate to ACL care from primary prevention to long-term management.
PAs can help to prevent ACL rupture by screening for patients at risk for this injury, providing patient education on neuromuscular training techniques, and referring patients to available ACL rupture-prevention programs. Furthermore, I propose that the creation of a standardized screening tool assessing for ACL rupture risk may aid primary care PAs in screening patients for this injury.
Additionally, patients recovering from ACL ruptures can experience apprehension to return to sport, as the injury and the recovery process can be mentally traumatizing. As PAs frequently perform long-term care for patients during this process, they are well positioned to assess and intervene as needed for patients experiencing psychological obstacles throughout the process.
PAs embody the training, skills, and scope of practice to prevent and manage ACL injury; therefore, it becomes imperative to promote PA involvement in this injury.
How did you decide to write on this topic?
After working alongside physician assistants in orthopaedics both prior to PA school and throughout my clerkships, I witnessed firsthand the ability of PAs to help their orthopaedic teams meet goals in patient care. This stood true whether they were working on an orthopaedic team in the clinic, the OR, or other settings.
Additionally, while working in sports medicine and seeing patients recovering from ACL rupture, I noticed that there was overlap between the care required for this particular injury (i.e. prevention, acute care, long-term continuity of care) and the roles and responsibilities of PAs. I suspected that PAs could play a particularly instrumental role in preventing and managing this injury, and decided to investigate further.
What was the most interesting “take-away,” in your opinion?
The recovery period from an ACL rupture can be challenging both physically and psychologically. While there is ample focus placed on the physical recovery from this injury, patients frequently lack adequate psychological assessment and care during their recovery — an element of the healing process that is fundamental to an athlete’s safe return to activity.
Physician assistants are often involved in long-term care for patients recovering from ACL rupture. They have the opportunity to assess patient progression and recovery, both in the physical and psychological perspectives, and to act or intervene as needed. One way PAs can monitor their patients’ psychological progress is by using the ACL Return-to-Sport Index (ACL-RSI), which assesses a patient’s mental readiness to resume their activities. PAs regularly utilize clinical screening tools such as the PHQ-9 for depression or the CAGE questionnaire for alcohol abuse; therefore, PAs could utilize the ACL-RSI to monitor their patients’ readiness, and subsequently counsel or refer to psychological professionals as needed.
What do you enjoy most about your career?
Currently a PA student, I am scheduled to soon take (and hopefully pass!) my PA Boards. While I do not have a career yet, I can say that my greatest enjoyment as a student (outside of patient care) has been connecting with individuals and groups that are similarly passionate about the PA career, orthopaedics, and other similar health-care interests of mine such as advocacy, community involvement, and preventive medicine. I have been fortunate to participate in leadership and advocacy positions in my own USC program as well as with various PA organizations such as the Physician Assistant Education Association and the American Academy of PAs. In doing so, I have collaborated with numerous passionate and driven students, PAs, and others throughout the country, which has endured as a source of inspiration throughout my studies.
I would also like to thank Dr. Jennifer Beck for her assistance and continued support.
How do you stay informed about new developments in orthopaedics?
I keep up-to-date through JBJS, Physician Assistants in Orthopaedic Surgery, and other orthopaedic journals. I will now be sure to tune in to OrthoBuzz as well!
What are you currently reading/listening to/watching?
Listening to the Home Cooking podcast, reading The Body Keeps the Score, and watching The Crown.
More details about the JBJS JOPA Writing Awards can be found here.
