Patrick Morgan, MD, FAOA

"Although we successfully confirmed several risk factors in this dataset, including breech presentation, sex, & birthweight, the logistic regression models were unable to fully explain the variation in the prevalence of DDH".

#DDH #Dysplasia #PedsOrtho #OrthoSky #MedSky

ow.ly/R60j50WkjJv

This is a remarkable— and well deserved— achievement. A long time in coming.

Amazing accomplishment.

I thought about getting rid of my loupes when I went into recon. But there’s nothing better for taking out splinters.

Nothing says happy post-op appointment like a new pair of hand knit socks

My resident asking why I always use screws.
Also my resident staffing a new consult:

Friend from med school - now her program’s PD- found out her new onesie has a twin. Her residents are so lucky.

“Dad, they’re not sweatpants— they’re ninja pants.”

And just like that we’ve got a name change.

If anyone ever tries to convince you that working in a teaching hospital is a thankless job don’t believe them.

It’s pretty uncommon in my practice. The data and the AAOS guidelines are pretty clear it’s not going to make a difference for the average patient. I’ve been referred too many knee caps with AVN to be a big fan. Facetectomy seems fine to do. I do now but the level 1 studies didn’t and didn’t matter.

17 years without a patellar button. Asymptomatic.

New challenge: trying to edit NIH grant proposal and your 3rd grader just got home from school/music class with his new recorder.

Here’s how they were managed. The lateral OA was found in the setting of advanced PF OA. The patient wanted a total. On the other side the PF joint was good and with no lateral symptoms a medial uni was a reasonable option —and was the patient’s first choice.
#orthopedics

It’s an interesting one because of all the patient teaching involved. Very different conversations with those options on the table.

Bilateral painful knees with windswept deformity. Pain in affected compartment only. If treating operatively what would you recommend: lateral and medial unis? Total and medial uni? Bilateral total?
#orthopedics

Ladies and gentlemen, the hip spine axis.
#orthopedics #orthosky

Day 1 of Orthopedic Surgery residency interviews for UMN Orthopedic residency.
As always, completely knocked out by how accomplished the applicants are. Wish we could match every single student here.
#orthopedics

Explant. One versus two-stage but because it’s a difficult organism with a high failure rateI would counsel for a spacer. Aspiration before replant. At least two weeks abx post-op. And check an A1C and get nutrition labs. There may be a way to medically optimize to improve the odds.

15% of patient’s don’t like their TKA. Hasn’t changed for decades and neither have our implants.

20 yrs industry trying to say their knees aren’t going in right: “Here’s navigation, here’s a robot.” Needle hasn’t budged.

Maybe time to put resources into just designing better implants?

#orthosky

You learn more about the pt from 2 secs in the doorway than from 2 hrs on the phone

If you don’t have a dx from the hx you’ve got your work cut out for you.

If you haven’t reproduced the sx on exam you don’t have a dx yet.

One outlier will negate 100 hrs saved by your new shortcut.

Lindsey Vonn: American on skiing comeback which has 'exceeded' her expectations and could lead to Olympics - BBC Sport American skiing legend Lindsey Vonn explains why she returned to racing after a near six-year absence.

Bo Jackson would like a word.

www.bbc.com/sport/articl...
#kneereplacement #orthosky

Saturday interviews for UMN Adult Reconstruction Fellowship. Fantastic candidates!
#orthosky

A bar chart of the percentage of women who had a new morphometric vertebral fracture during 10 years of follow-up, stratified according to trial group.

Zoledronate administered every 12 to 18 months prevents fractures in older women. Ten years after initiation of this trial, zoledronate administered at baseline and 5 years prevented vertebral fracture. Full trial results: nej.md/4g6wlz3

#MedSky #OrthoSky

If you’re not going to do a PAO (this pt is in mid-50s and has developed OA) THA in dysplasia still not a chip shot. Hypermobility, small head size, uncommon anatomy make dislocation risk higher.
Preop planning especially important.
#orthosky

Risk management committee gets the transcripts — and we have to read them sometimes and ooooh boy.

Heard many arguments for using robots— none very convincing. But there is a very intuitive one that you don’t hear a lot— getting tight alignment for unis. Most that I revise were overstuffed into valgus or failed in varus. Maybe robotics finds a role in avoiding those outliers.
#orthosky #uniknee

Patellar resurfacing in Sweden is only 3.4% vs 89.7% in the US. This must be the starkest difference in practice patterns between American and Scandinavian Arthroplasty (medicine?). Anyone have a good explanation as to why?
#orthosky #totalknee

Never been better summation of life in the OR.
#surgsky #orthosky

Don’t treat burnout w/ modules. Ortho surgeon burnout: 40-60% prev rate; 28.2% of surgeon suicides (’07-’13); 6.3 suicides/10k (vs 3.3 gen pop); 31% meet CDC fitness goals; 80% prioritize family time. Residents: >80 hrs/wk →↓mental health; 30-50% depressive symp; 8% suicide ideation. EAP use: 4%.