FELLOWSHIP PROGRAM IN JOINT REPLACEMENT

Preamble: Joint Replacement is a fast evolving subspeciality of Orthopaedics . In this twenty first century Joint Replacement has become more robust than ever before with increasing number of Arthroplasties being performed year after year. Rapid advances, innovations and changes in ideas have to be disseminated and surgical skills need to be taught to surgeons interested in specializing in this branch of Orthopaedic Surgery. This fellowship program aims at empowering surgeons with this essential armamentarium towards providing a complete and scientific surgical treatment to individuals suffering from Arthritis. All areas of Adult Reconstruction are included with extensive experience in knee and hip evaluation and treatment that allows the fellow to acquire special expertise in their management. The technical goals are meant to facilitate the fellow to master advanced surgical techniques.

Objectives: To orient the fellow towards acquisition of technical skills required in Joint Replacement and Arthroscopy. To expose the fellow to the basic knowledge of Arthritis, Tribology, Biomechanics and Joint Replacement To involve the fellow in research activities involving Conservative, Surgical and supportive management of Arthritis. To support the fellow to in Medical management of undertake research Arthritis, pathology of Arthritis, newer surgical procedures and long term evaluation of Joint Replacement To involve the fellow in Community activities like Outreach Programs,

Eligibility: Basic: M. S. in Orthopaedic Surgery (recognized by MCI) or DNB in Orthopaedic Surgery OR D. Ortho. with two years of post diploma experience Preferable: Some exposure to Joint Replacement and must have participated in few surgeries Should have an interest and must intend to take up a career in this field

Duration: The length of curriculum will extend to one academic year Medium of Instruction English Attendance: 80%

Course Content:
Total Knee Replacement
Basic Science Anatomy and Imaging of the Knee Clinical Examination of the Knee Surgical Approaches to the Knee Biomechanics Basic Biomechanics Gait Normal and Abnormal Design Criteria for Total Knee Replacement

Knee Joint Replacement and Its Alternatives Surgical Pathology of Arthritis Non Operative Treatment of Knee Arthritis Anaesthetic Considerations in Knee Surgery Pain Management in Knee Surgery Osteotomy about the Knee Scoring Systems Historic Development , Classification and Charecteristics of Knee Prosthesis Preoperative Planning Surgical Technique and Instrumentation in Total Knee Arthroplasty (TKR) Transfusion Considerations in Total Knee Replacement Deep Vein Thrombosis (DVT) and its prevention Bone Graft, Wedges and Augments in TKR

Total Hip Replacement

Basic Biomechanics Clinical Examination Radiology Non Operative Management of Hip Arthritis Surgical Approaches to the Hip Evolution of Total Hip Replacement (THR) Preoperative Planning Cemented Total Hip Replacement Uncemented Total Hip Replacement Surface Replacement Postopertive Management Protocols Complications of THR Dislocation Infection Aseptic Loosening Revision THR

Teaching Hours: A total of 42 working hours a week which will be distributed as follows Out Patient Department : 3 hrs thrice a week Operative Sessions : 6 hrs twice a week Inpatient work : Regular Rounds: 1 hr five days a week Grand Round: 2 hrs once a week Academic Activities : Seminar: 2 hrs twice a month Case Discussion: 2 hrs twice a month Journal Club: 2 hrs twice a month Clinics with other specialties: 2 hrs once a month Research Activity : 6 hrs in a week Community Activity : 12 hrs in a month Saw bone workshop, cadaver dissection : 2 hrs in a week

Surgical Work: Surgery A PA P Pl

Knee Replacement 30 10 10 Hip Replacement 30 10 10Arthroscopy 10 10 5 Others 10 5

PA : Performed Assisted A : Assisted Log Book:

P : Performed

Pl : Planned

Log Book to be maintained for evaluation of the following: Interpersonal and communication skills

Scheme of Examination:
a. Internal Assessment : b. University Examination :

Nil

i. Theory Examination: Will comprise of one paper of 100 marks. The first section of the paper will be on Knee Replacement and Arthroscopy and the second section will cover Hip Replacement and allied topics.

Subject Duration Section I :Knee Replacement and Arthroscopy 3 Section II: Hip Replacement and allied topics

in hours Long Questions Short Questions Total number of 20 marks 10X3=30 marks 50

Marks

20 marks 10X3=30 marks 50

ii. Practical Examination: Will comprise of Case Presentations and Viva Voce
Duration in hours Distribution Total number of Case Presentation 3 Long Case (one) : 60 Marks

Short Cases (one / two) : 40 100

Reference Books: 1. Surgery of the Knee: Volume 1& 2 : Insall, Scot 2. Campbells Operative Orthopaedics 3. Adult Reconstruction by Berry, Daniel J.; Steinmann, Scott P.; Tornetta, Paul; Einhorn, Thomas A. Publication Date: 01 Jun 2007 4. Adult Reconstruction and Arthroplasty by Garino, Jonathan P.; Beredjiklian, Pedro K Publication Date: 10 Oct 2007

8. Interfaces in Total Hip Arthroplasty by Learmonth, Ian D. 9. Operative Arthroscopy - 3rd Revised edition by McGinty, John B.; Burkhart, Stephen S.; Jackson, Robert W.; Johnson, Donald H.; Richmond, John C. Publication Date: 01 Dec 2002 10. Hip Arthroplasty: Minimally Invasive Techniques and Computer Navigation by Dorr, Lawrence D. Publication Date: 11 Nov 2005 11. Revision Total Knee Arthroplasty by Whiteside, Leo A Publication Date: 31 Aug 2003 12. Journal of Bone and Joint Surgery - British and American Volumes Monthly peer review journal of orthopaedic surgery and research. 13. Orthopaedic Clinics of North America 14. Arthroplasty Journal Declaration of Results: a. Criteria for pass -The fellow has to satisfy the examiners and score at least fifty percent of the marks in the theory and practical papers individually. b . Declaration of Class-The fellow who shows exceptional merit will be awarded distinction Examiners: Two Examiners: One Internal and One External to conduct Theory Valuation and Practical Examination Eligilibility to become an Examiner Examiners will be Orthopaedic Surgeons with special interest in Joint Replacement and Arthroscopy.