Week 7

This week was full of interesting patients! A teenager came in who had a syndrome known as congenital indifference to pain and presented with a huge effusion in their knee. The indifference essentially means they had a huge pain tolerance and their body was not very good at communicating when too much activity was actually damaging, which was a large issue when they were younger. Turns out just from squatting at the fridge, they tore their meniscus and were experiencing clicking, clunking, and shifting of their leg. All of this caused a loss of the horn, OCD, marrow edema, and they also had some bone collapse but a stable cartilage surface. Another person came in with a need for an ACL revision surgery, and they had to use the quad tendon since they did not have the standard patellar tendon from prior surgery. This was a source I did not know about until then. I also learned about a new PRP-like treatment where alpha-2-macroglobulin is isolated and injected into the joint to stimulate healing.

In the OR this week, I observed an especially cool procedure in which the patient had lost power in their shoulder and was experiencing pain. From MRI, it looked like the joint capsule had degraded and the subscap of the shoulder was torn and degenerative. To repair this, a part of the pec muscle was transferred over to the subscap insertion to makeup for the muscle loss. Interestingly, the joint capsule was repaired by using an achilles tendon allograft. I had no idea how large a tendon it is! It was not a perfect replacement, but it facilitates the tendon gliding and prevents interaction with the bone.

Outside of clinical time, I also listened to a talk presented by Hongsheng, my research project advisor here, about his work (and mine this summer!). He discussed research methods for being able to apply load to patients' legs during MRI and how images obtained can be quantified to answer clinical questions.

The rest of the week, I worked on finalizing my project data and also discussing loose ends after I leave as this study will continue. I also did some reading in the library on new research ideas to bring back to Cornell.