Medical Student Research Fellowship for Summer 2010

Mentor: Michael H. Huo, MD
Department: Orthopedic Surgery
Room number: WA4.334
Mail Code:8883
Phone number: 214 645-3335 or 3345
E-mail: Michael.huo@utsouthwestern.edu
Project title: Registry of revision total hip replacement.

Human subjects IRB approved project number (where applicable): 062007-087

Animal subjects IRB approved project number (where applicable): n/a

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)

Brief Description of Project: This is a prospective registry of all patients who have undergone revision THR under a single surgeon at UTSW from 2004. Project objectives:
1. Input data of patients from 2008-09 academic/fiscal year
2. Obtain financial cost data from St Paul University Hospital to do financial analysis of the costs for different type of revision surgeries: cup alone, stem alone, both components, infections, elective vs urgent cases.
3. Extract data from the registry on the incidence of infection following surgery over the 5 years, and analysis of the root causes of such hospital acquired infections.

Expectations of student activities:

" Input additional data into this prospective database on revision hip replacements (specifically the cases done in 2009)
" Participating in preoperative and postoperative clinic evaluation of the patients with the attending surgeon
" Participate in the peri-operative care of revision hip and knee replacement patients in order to gain understanding of the clinical issues to facilitate analysis of database and writing of abstracts and manuscripts
" Extracting data for one specific project being planned for this summer:

** Dislocation following revision hip replacement surgery (it is the #1 reason for revision THR based upon US hospital discharge database analysis. Bozic K et al. J Bone Joint Surg 91A:128, 2009)

Within this particular subset of patients who received constrained liner (device to reduce dislocation or to treat recurrent dislocation).

1. How many cases:

We have now over 350 cases in the database. There were 82 additional cases for the student to enter data (surgeries done in 2009). The student will be working on clinic, and hospital records to extract data to input.

2. What are the questions being asked:

1. risk factors
2. clinical outcome with regard to success or failure of treatment for recurrent dislocation
3. fixation durability of the implants
4. patient outcome: Harris hip score (validated hip scoring scale), patient subject satisfaction
5. cost analysis for the management of this complication from hospital financial data

3. Will the students be able to write abstract/manuscript?

The project on revision THRs in the geriatric patient was done last summer (Zach Zhang & Will Morris). Data from that project were presented at the UTSW student forum as a poster (by Zhang). The abstract was also presented in New Orleans at a regional meeting. (by Morris) The abstract has been submitted to 2 national orthopedic meetings:

AAHKS 2010 (November): American Association of Hip and Knee Surgeons
AAOS 2011 (Feb): American Academy of Orthopedic Surgeons

I hope these additional specifications would meet your approval. Thank you for allowing me to participate in this program over the past 3 years.

Michael H. Huo, MD

Previous Research Activities or Publications with Medical Students:
1. I have sponsored medical student research each of the previous 3 summers.
2. Ho B, Huo, MH: Malignant neoplasia in total hip replacement. J Orthopedics 2008;5(3)e9 http://www.jortho.org/2008/5/3/e9
3. Swanson M, Schwann C, Huo MH: Total hip arthroplasty following surgical treatment of acetabular fracture. Seminar Arthroplaty 19:303-306, 2008
4. Phelps J, Zhang X, Huo MH: Current status of hip resurfacing arthroplasty. Current Orthopedic Practice 20:2-7, 2009
5. Espinoza-Ervin C, Zhang X, Huo MH,: Can we afford revision total hip replacement? Current Orthopedic Practice 20: 29-33, 2009
6. Huo MH, Ho B: DVT chemoprophylaxis in total joint arthroplasty: the affirmative. Seminars Arthroplasty. (in print for June 2010)