3D-Printed Heel Bone Averts Amputation for Australian Man
Len Chandler of Melbourne, Australia had a cancerous tumor in his left calcaneus and was facing a below-the-knee amputation because of the difficulty entailed in achieving a functional limb salvage procedure. Surgeon Peter Choong teamed with an implant manufacturer and Australia’s national science agency to create an exact titanium replica of the involved bone. The 3D-printed bone had to be both porous, to allow tissue in growth, and ultra-smooth so that it could articulate with hind and midfoot joints, and allow smooth tendon gliding.
After this ground-breaking surgery in July, Chandler is now able to carry more than half his body weight on that foot. The prognosis is for Chandler to be off crutches by the end of 2014. Click here to read the full story. Also, read the related OrthoBuzz article about the first 3D-printed cervical disc implanted in a minor.
Publisher’s Note: Leaving Behind a Stronger Journal and a Stronger Organization
One measure of success for leaders is whether the organization they’ve led is stronger upon their departure. That’s a responsibility I’ve taken seriously for nearly 5 years as CEO/Publisher of STRIATUS/JBJS, Inc.
In the near future, I will be leaving STRIATUS/JBJS, Inc. to become Publisher at the American Association for the Advancement of Science (AAAS), which publishes the journal Science, along with Science: Translational Medicine, Science: Signaling, and Science: Advances.
While I’m sad to leave my colleagues and this audience, I’m happy to report that over the last 5 years, STRIATUS/JBJS, Inc. has improved and grown in a number of ways:
- This year, The Journal’s impact factor increased nearly 33% to its highest level ever, while The Journal remains the most-read journal in the specialty.
- Our new review journal, JBJS Reviews, is already one of the top online journal destinations in the field.
- The new JBJS Recertification Course has proven popular and effective with surgeons preparing for their maintenance-of-certification exams.
- JBJS Case Connector is improving clinical awareness and acumen on a monthly basis, with “Case Connections” synthesizing old and new information and “Watches & Warnings” alerting the field to emerging trends.
- With a growing video library, JBJS Essential Surgical Techniques continues to provide in-depth, step-by-step guidance on new surgical techniques, and plans to take practical surgical video to a new level in 2015.
With an excellent editorial team led by our new Editor-in-Chief, Marc Swiontkowski, MD, these journal and educational products are poised for long-term success.
In addition to improving and extending its core products, STRIATUS/JBJS, Inc., has diversified into new areas, adding important tools to the scientific literature, products emphasizing quality evidence and peer review. SocialCite, which allows feedback on the quality and appropriateness of journal citations, has major publishers participating in its pilot phase. PRE-val, which brings increased transparency and accountability to peer review, is also generating significant interest across the sciences.
It has been an honor working with the superb staff and editors at STRIATUS/JBJS, Inc., as well as serving the orthopaedic community – orthopaedic surgeons, physical therapists, physician assistants, and others – over the last 5 years. Thank you.
Global Trauma Study Gets $500K Boost from CIHR
Canadian Institutes of Health Research (Image via Wikipedia)
The Canadian Institutes of Health Research (CIHR) recently awarded a $500,000 grant to an international trauma study called INORMUS (International Orthopaedic Multi-center Study in Fracture Care). According to lead researcher Mohit Bhandari, MD, of McMaster University in Canada, the observational cohort study hopes to enroll 40,000 patients; its goal is to determine both patient and institutional factors in developing nations such as China and India that help predict complications within 30 days after a fracture or dislocation.”From the data on our initial 6,000 patients, we found that some people wait up to four days to have an open fracture treated,” Dr. Bhandari told Orthopedics This Week. He added that in rural India, 30-day mortality after a fracture arising from a major traffic accident is 2%. “While 2% may not sound shocking,” Dr. Bhandari said, “imagine that many people coming into a US hospital with only a fracture and being dead within 30 days.”
For more information about INORMUS, click here.
IDSA Releases New Surgical-Site Infections Guidelines
In a comprehensive 43-page document freely available in Clinical Infectious Diseases, the Infectious Diseases Society of America has updated its guidelines for diagnosing and managing skin and soft-tissue infections. Of special interest to orthopaedic surgeons, the guidelines include an algorithm for simpler analysis and treatment of surgical-site infections and updated approaches to treating localized purulent infections in light of concern about drug-resistant strains of Staphylococcus aureus.
Scheduling Changes Can Make a Bottom-Line Difference
Many practices are investing in expensive EMR systems while overlooking simpler ways of lowering costs and increasing efficiencies. According to Jay Crawford, MD, pediatric and adolescent specialist at Knoxville Orthopaedic Clinic, optimizing patient scheduling is one of many simple improvements that could maximize practice revenue. Crawford has developed a new mobile app and cloud-based solution that helps redirect patients who don’t need to be seen by an orthopaedic surgeon, increases brandawareness for a private practice, and drives efficiencies.
Dr. Crawford’s custom mobile app, NextDocVisit.com, helps increase revenue per patient by identifying patients whose level of injury does not warrant a visit to an orthopaedic surgeon. Patients benefit also because after entering their information through the app, they get a message letting them know when they can expect a call back. Dr. Crawford estimates this type of system can weed out low-revenuepatients and potentially increase revenues by 1 to 2%. Dr. Crawford is currently building custom scheduling apps for two other practices. He concludes, “Changes coming to our industry are so significant that you must change how you do business in order to survive. That’s a hard thing to make people understand.”
JBJS Deputy Editor Gives Publishing Tips to Chinese Researchers
The number of manuscripts submitted to The Journal of Bone & Joint Surgery (JBJS) from physicians and researchers in China has been steadily increasing, but the overall acceptance rate is relatively low. While the quality of the research performed in China is rapidly improving, orthopaedic researchers in China recognize the need for education related to experimental design, manuscript preparation and manuscript review. In June 2014, Dr. Thomas Bauer, JBJS deputy editor for research, participated in a two-day workshop in Shanghai that focused on helping Chinese researchers prepare and submit high-quality journal manuscripts.
During an afternoon workshop, Dr. Bauer and three other experienced Chinese editors/reviewers provided “face-to-face” reviewing with individual researchers who had provided and presented draft manuscripts. Dr. Bauer’s subsequent lectures included recommendations with respect to selecting the most appropriate journal for a specific paper, the contents of each section of a scientific manuscript, tables and figures, and how to respond to a manuscript review. He also described the general review process at JBJS and discussed “misbehaving authors,” including issues related to attempted duplicate publication, fraud, image manipulation, and plagiarism.
Based on review of 50 manuscripts from China that had been rejected, Dr. Bauer tabulated the reviewers’ comments to identify the most frequent reasons for manuscript rejection. The most frequent criticism reflected insufficient information about the number of patients or specimens and the lack of an explanation for sample size. Dr. Bauer also illustrated several recent manuscripts from China that have been published in JBJS and in JBJS Case Connector. Several other speakers also discussed issues related to experimental design and statistics.
The lively discussion from the audience of more than 100 researchers reflected intense desire to publish the best possible work in JBJS. We anticipate a striking increase in the number and quality of manuscripts from China in the near future.
Publisher’s Note: Building on Early Success
Journals provide third-party validation for research reports. If you get published in a better journal, your work will likely be perceived as having been more successful. Editors and publishers feel the same way when it comes to how our audience rates our products. So we were very pleased when a recent independent third-party study found that our new review journal, JBJS Reviews, has rapidly become the #3 online journal in orthopaedics.
JBJS Reviews was launched just over six months ago, but it is already viewed as one of the top 3 professional resources for quality content, helping run an orthopaedic practice, and keeping surgeons informed. There are many other categories, but you get the idea – JBJS Reviews is already proving its worth.
Our Editor-in-Chief for JBJS Reviews, Tom Einhorn, MD, has done a fabulous job getting this new journal off the ground, and dozens of authors have contributed excellent reviews, and more are scheduled. We’re excited about the potential here.
That being said, the Journal of Bone & Joint Surgery still ranks #1 in nearly every category, so we have a lot to build upon there, as well. And that’s how we view it – being #1 is not a destination but an expectation, as is quickly joining the top 3. We need to keep working at a high level, improving what we do, and delivering great information in all formats.
Earlier this year, the Journal introduced the Peer-Review Statement, granting readers insight into how articles are peer-reviewed. A high percentage of readers find this valuable, we’ve learned. We are also introducing an integrated tablet app for iOS and Android devices. All our journals – the Journal, JBJS Reviews, JBJS Case Connector, and JBJS Essential Surgical Techniques – will appear in the single app. Best of all, if you already use the JBJS Reviews app, your next update will give you the integrated app seamlessly.
We value our readers and know how important your work is and how valuable your time is. I hope these improvements and high-quality resources serve you well.
Patient Personality Affects TKA Outcomes
A 2007 JBJS study suggested that patients who are psychologically distressed have slightly greater levels of postoperative pain following total knee arthroplasty than non-distressed patients. Now, a study in the Journal of Orthopaedic Science finds that a patient’s overall personality can also influence outcomes after TKA. Using the Eysenck Personality Questionnaire, Chinese researchers divided 387 TKA patients into one of four personality types: choleric, sanguine, melancholic, and phlegmatic. They then measured clinical TKA outcomes and satisfaction using the SF-36 and WOMAC instruments. Melancholic patients had the worst outcome scores, with sanguine patients (who are typically sociable, cooperative, and easygoing) scoring highest. The authors say clinicians could use these findings to identify people at risk of poor postoperative outcomes, and that such people might benefit from “better communication and individual treatment strategies during perioperative periods.”
A Conversation with Dr. Marc Swiontkowski, Editor-in-Chief of JBJS
JBJS welcomes Dr. Marc Swiontkowski as our new Editor-in-Chief. Dr. Swiontkowski is a trauma specialist and professor in the Department of Orthopaedic Surgery at the University of Minnesota Medical School. He is also the former CEO of TRIA Orthopaedics and past president of the American Orthopaedic Association and the Orthopaedic Trauma Association.
We are excited to work with Dr. Swiontkowski to continue strengthening JBJS as it supports the practice of orthopaedics and musculoskeletal health for everyone.
As Dr. Swiontkowski works with our departing Editor-in-Chief, Dr. Vern Tolo, during this transition, he was gracious enough to answer a few questions for OrthoBuzz.
JBJS: As you transition into the role of Editor-in-Chief at JBJS, what are you most excited about?
Dr. Swiontkowski: The opportunity to work with a highly talented group of editors and authors to influence the course of musculoskeletal medicine and surgery is what excites me the most.
JBJS: What are your goals for JBJS?
Dr. Swiontkowski: I hope to maintain our excellence in peer review while innovating in new ways to deliver information to surgeons in ways that are most useful for clinical decision making.
JBJS: As JBJS celebrates its 125th anniversary this year, how would you describe the impact the Journal has had on orthopaedics?
Dr. Swiontkowski: JBJS has been at the forefront of all the important developments in the field, and those developments have directly impacted patients with musculoskeletal disorders.
JBJS: How do you think JBJS can best support orthopaedics going forward?
Dr. Swiontkowski: In the future, JBJS will continue to support and recognize our highly skilled panel of reviewers, while developing new mechanisms for educating and delivering highly refined information to surgeons.
JBJS: You helped found and have served as the CEO of TRIA Orthopaedics, a full-service outpatient orthopaedic center in Bloomington, MN. What have you learned about community orthopaedics as a result of starting and growing that practice?
Dr. Swiontkowski: Community surgeons are interested in access to the highest quality scientific information to support their clinical decision making. They are also willing to contribute to new-knowledge development if the process is well refined with appropriate support.
JBJS: What trends in orthopaedics are you most intrigued by?
Dr. Swiontkowski: Four trends come to mind:
- The move away from general hospital-based care.
- The move toward patient-oriented functional outcomes to evaluate the results of care
- The openness to consider better ways to identify patients most likely to benefit from a particular treatment….and
- The move away from incremental implant design improvements toward understanding surgeon factors that have the greatest impact on patient results.
JBJS: Looking ahead to the next 20 years or so, what three significant advances or changes in orthopaedics do you foresee?
Dr. Swiontkowski: I think we’ll see the following changes:
- The full transition to milestone-based surgeon education
- The ability to identify patient and surgeon characteristics that have the biggest impact on outcomes for use in shared decision making processes
- The move away from general hospital-based care toward musculoskeletal treatment centers.
JBJS: What is your favorite thing about your profession?
Dr. Swiontkowski: It’s incredibly fulfilling to be completely trusted by patients to act in their best interest with the use of very powerful orthopaedic interventions.
Must-Have Knee-Replacement App for Patients
TopOrthoApps.com, a medical-app review site, gives My Knee Guide a top rating for patients who are thinking about having a knee replacement. The app, available for iPhones and iPads, received the highest ratings for functionality, coolness, and overall features. This app includes a calendar of specific surgery details, email alerts to remind patients of things to do, and a guide that tells patients what to expect on the days prior to and after surgery. From the physician perspective, My Knee Guide helps orthopaedic surgeons set expectations for patients and educates them throughout the process. The app also includes commentaries from patients about their actual experiences with knee replacement.
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