AO Recon Comes to North America

Daniel J. Berry, MD is a professor and director of the Core Center for Clinical Research in Total Joint Arthroplasty at the Mayo Clinic in Rochester, Minnesota, where he was formerly chief of orthopedic surgery. He is currently a member of the AO Recon Steering Board. He has made extensive contributions to peer-reviewed research on hip and knee replacement as well as authoring and editing several textbooks on the subject.

Dr. Berry has served as director of the American Board of Orthopaedic Surgery, chairman of the Maurice E. Müller Foundation, president of the Mid-America Orthopaedic Association, president of the American Association of Hip and Knee Surgeons, and president of the American Academy of Orthopaedic Surgeons. 

Introducing a formal teaching mechanism for arthroplasty and reconstruction

Most people are familiar with AO Trauma, AO Recon is also an organization run under the aegis of the AO foundation. AO Trauma, as everyone knows, has been instrumental in teaching basic trauma skills to both residents and young physicians in orthopedics. The goal of the Recon group is to do the same but with arthroplasty and reconstructive procedures. 

One of the things that I think we do very well in North America is eventually give people outstanding skills in arthroplasty. That said, along the way, as people are developing their skills there’s not typically been a national resource for people to learn how to do arthroplasty well. It’s been delegated of course to individual residency programs, and often times—at the sort of mid-level resident time when you’re just starting to learn arthroplasty skills and acquire them—there’s not a formal teaching mechanism to learn how to do that, both with respect to the concept and the essentials but also with respect to the technical elements of it. 

One of the great things about the AO Recon course curriculum that’s been put together is that it provides an outstanding opportunity for people to acquire the conceptual elements of joint arthroplasty that they’ll need going forward and some of the practical skills as well. 

Developing skills for a mature practice

The goal for AO Recon NA is to have participants that are interested in learning to improve their skills in arthroplasty. You have to be open to learning new skills, you have to be excited for the opportunity to acquire those skills. Many of those people are people who will go on to have a career in one of many different specialties in orthopedics, one of which might be arthroplasty, but not necessarily. 

This isn’t meant for the super specialist, this is meant for someone in the middle of their training or early on in their practice who wants to acquire good skills in arthroplasty but needs an opportunity to do that on a practical basis.

Everyone knows that the AO foundation has been a blue-chip organization in terms of the quality of education that’s provided—absolutely superb. We all know that from our experience with the basic trauma course, which almost every resident in the country took at some point or another. 

The organization is one that when they do something, they do it extraordinarily well, they do it on a first-class basis, and that’s the intent with the AO Recon side of the AO Foundation. I have a lot of confidence based on our experience internationally up to now, and also based on my knowledge of the organization, that the courses put together for AO Recon are going to be first class, outstanding in every way, have the best faculty, have the best facilities, and have the best curriculum to try to make sure somebody acquires the skills they need as they start to mature their practice and go into more details of arthroplasty later on.

AO Recon NA’s first-ever course will be conceptual and practical

Principles of Total Hip and Knee Arthroplasty is a two-day course. The idea is to have people gain a number of different facets of excellence in arthroplasty. 

First, conceptual: we go through a lot of the concepts of primary hip replacement and primary knee replacement. What are the indications, what are the key decisions with respect to, for example, the hip surgical approaches—bearing surfaces, implant fixation, and avoidance of complications. In the knee, similarly: indications, key surgical steps of the technique, methods of balancing the knee, how to manage the knee with or without cruciate retention, management of complications, and avoidance of complications. 

And then we have a practical element. On the hip side, we have practical elements related to acetabular preparation—which is one of the trickier parts of hip replacement—implant position, and implant fixation. On the knee side, we have practical exercises on one of the technically more difficult things which is cutting the tibia properly with hand instruments and doing it in a way that provides you with a proper implant alignment regularly in every single case.

Intimate forum for engaging with expert faculty

We also have case discussion sections and small group discussions to go over some of the peri-operative management questions and surgical nuances that are worth talking about in a discussion section. It’s a nice forum because the size of the course is small. It’s limited in this case to forty people. 

It will be a very one-on-one, intimate experience with our faculty. We will have ten faculty members, so it will be a ratio to one faculty member to four participants. You will have a lot of time to spend with national caliber faculty members whom we’ve recruited for this course.

We’ve run these courses internationally now for several years. They’ve been very popular. They‘ve appealed both to fellows and residents internationally but also to people who may have been early into their practice but not have had any real formal training in arthroplasty. Of course, the situation in North America is different, almost everyone gets arthroplasty training during their residency, but the difference is as a mid-level resident you often don’t get formal arthroplasty training it’s a little bit of on-the-job stuff. 

This is an opportunity to formally understand a lot of details about arthroplasty, have a strong basis of knowledge going into your more senior years, and also get some really essential, key skills in arthroplasty so when you’re actually doing those procedures as a more senior resident you have the skillset to do them and do them well.

The things that will make it special, in addition to being the first one, is that there’s going to be an opportunity for every participant to spend a lot of time with national caliber surgeons on a one-to-one basis. Number one, talking to them, number two, getting to know them, and number three, learning from them both in a conceptual as well as practical manner. That’s something you’re not going to get at any other course in the United States.

The residents or fellows that end up coming, I think they’re going to have a great experience. I think that they’ll find out on a practical basis that what I’ve just mentioned is both something that they’ll learn a lot from as well as enjoy. We aim to have both a very education series but also an enjoyable series of days.