Shadow Day 2: Orthopedic Surgery

This past week I again shadowed orthopedic surgeon Dr. Eric Boyden, yet this time I had the opportunity to go into surgery. After getting clearance from the hospital and communicating with Dr. Boyden’s assistant Kristan, I was able to see two surgeries, one total knee replacement, and one total hip replacement. Overall, I saw what life is like for a doctor in surgery.

Given I was in the operating room and just feet away from the patient, I wore scrubs, eye protection, and a mask and could look upon the surgery and ask questions. For obvious reasons, I was not able to touch the patient, but from a few feet away I was able to see the surgeries unfold.

The main scrub nurse and other nurses in the room were all very skilled. They prepped the patient, made sure all the necessary supplies were accounted for and set up properly, and that Dr. Boyden had everything he needed. In the total knee replacement, the nurses began by giving the patient a spinal, which essentially numbs the patient from the waist down, and then they covered up the entire lower half of the patient except for the knee. The anesthesiologist administered the anesthesia, the entire leg was covered in Betadine to avoid infection, and all people in the room were prepped on the name and age of the patient and which surgery was to take place. Dr. Boyden then made a straight incision vertically down the knee and began the surgery.

Throughout the surgery Dr. Boyden pointed out different anatomical parts of the knee to me, and though he was very focused, he was able to explain certain steps. A total knee replacement involves a lot of different orthopedic implants and entails removing part or all of the existing bones associated with the knee (femur, tibia, fibula, patella…). Using different orthopedic drills and sizers, Dr. Boyden and his assistants created the optimal area and surfaces for the new implants to be placed which would ease the movement of the knee and stop the painful bone-on-bone situation the patient was experiencing. Once the correct size was fitted to the patient, the implants were secured with a special type of cement. The scrub nurse gave me a piece of this cement to feel, and after about ten minutes of holding it, it began to heat up and turn hard. After the new implants were checked for range of motion and stability, the knee cavity was further cleansed and eventally perfectly sutured with non-absorbing sutures.

The preperation for the total hip replacement was similar to that for the knee. While the patient was being prepped, Dr. Boyden had me read the x-rays. It was evident that this patient had a rare hip abnormality which made the femoral head not rest in the correct place thus creating bone-on-bone and discomfort. In the hip replacement, the femoral head was removed, and the enire hip joint was sized for a new hip prosthesis. Throughout this surgery it was amazing to watch Dr. Boyden work with such ease and efficiency.

My first two surgeries are ones I will never forget, and I am fortunate to have had this experience as a high school student.