Research Award Details

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Improving Trainee Understanding of Pelvic Osteotomies for the Treatment of Developmental Dysplasia of the Hip

Grant Recipient: Daniel Miller

Co-Investigators:
Institution:
Children's Hospital of Philadelphia
Presentations & Publications:
Further Funding:
Additional Information:
Improving Trainee Understanding of Pelvic Osteotomies for the Treatment of Developmental Dysplasia of the Hip – Grant Summary Report
Daniel J. Miller, MD and Wudbhav N. Sankar, MD
Brief summary description of your project, include what worked and what did not work.
This project aimed to create educational video content to improve trainee understanding of pelvic osteotomies used in the treatment of Developmental Dysplasia of the Hip (DDH).  We conceived this venture with the idea that the osteology of the pelvis (both native and dysplastic) is complex and difficult to appreciate on existing two dimensional educational materials. 
Our project began with acquisition of intraoperative footage using a GoPro Hero 4 camera and a custom head mount designed for intraoperative videography.  With lab experimentation and consultation with a videographer, we were able to adjust the camera settings to significantly improve the quality of our intraoperative footage.  We have since shared these camera settings with other surgeons who have noted similar improvements in image quality. This knowledge will facilitate future video projects designed for POSNA academy and the POSNA Video Theater. 
The next phase of our project consisted of simulating pelvic osteotomies on Sawbones models.   We encountered several technical challenges in carrying this out. Most salient was the brittle nature of the models and their tendency to split or break inadvertently.  In addition, complete reorientation osteotomies (e.g. PAO or Triple type) were challenging to demonstrate given the complete acetabular disassociation.  Furthermore, osteotomies that rely on plastic deformation (e.g. Dega type) were difficult to demonstrate with the brittle models.  One solution we devised was to apply modeling clay to the models.  In doing so, we were able to provide mechanical integrity to the model while allowing for plastic deformation. 
Ultimately, we were somewhat unsatisfied with the supporting footage we obtained with our Sawbones models.  This led us to create additional visual material in the form of computer animation.  Thankfully, we found a computer animation package that is available for free as open-source software.  While we were very happy with the end quality of the computer animation sequences, these productions required a significant amount of time and computer resources. Ultimately this increased the time course of our project.
Was the primary outcome measure of success reached?
Yes. Our goal was to create a video that demonstrates the indications, osteology, anatomy, and technical aspects of common osteotomies used for DDH.  We completed this and have since uploaded the video to the POSNA academy website where it currently awaits peer review. As such, our metric of success (the number of views on POSNA academy) is not yet available.  
The 10 minute video is available here in the interim, https://drive.google.com/open?id=1izn9cJ8pX__z6Hg7w5ZDicMBTHKEzlVx
We also produced a video that describes the technique for a triple pelvic osteotomy in detail.  This awaits peer review on POSNA academy as well and is available at the following location in the interim.
https://drive.google.com/open?id=1DEOv49q7xFS6IA3CGH0Q6_oXw5sm7teT
Future plans, presentations or publications as a result of this grant.
In the future, we plan to create a video that describes the technique for a Dega osteotomy in detail with the idea that this could be submitted to POSNA academy or to the POSNA Video Theater. 
Final expense report for the project.
 
Date of Expense Item (s) Cost ($)
6/14/2017 Sawbones models and dry-erase pelvis 875.18
6/14/2017 Tripod stand (used during filming of Sawbones osteotomies) 24.9
7/19/2017 Modeling clay (used to simulate plastic deformation on Sawbones models) 14.75
7/26/2017 Encrypted External Hard Drive (used to store video footage from cases / Sawbones) 116.55
     
  Total 1031.38