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Area of Science:

  • Orthopaedic Surgery
  • Arthroplasty Research
  • Surgical Education

Background:

  • The John N. Insall Knee Society Traveling Fellowship facilitates knowledge exchange among orthopaedic surgeons.
  • The impact of such fellowships on surgeon practice patterns remains under-investigated.
  • Understanding practice evolution post-fellowship is crucial for surgical education and patient outcomes.

Purpose of the Study:

  • To investigate the effect of the John N. Insall Knee Society Traveling Fellowship on orthopaedic surgeons' practice preferences and implementation of changes.
  • To assess the anticipated versus actual changes in total knee arthroplasty (TKA) techniques and protocols.
  • To evaluate the long-term impact of traveling fellowships on surgical practice.

Main Methods:

  • A 59-question survey was administered to four 2018 Insall Traveling Fellows before, immediately after, and 4 years post-fellowship.
  • The survey assessed anticipated practice changes in TKA patient selection, planning, intraoperative techniques, and postoperative protocols.
  • Responses were analyzed to compare initial excitement for change with long-term implementation.

Main Results:

  • Immediately after the fellowship, fellows anticipated significant changes in both consensus and controversial TKA topics.
  • Four years later, the implementation rate of these anticipated changes was substantially lower than the initial excitement.
  • A statistically significant decline was observed in the implementation of both consensus and controversial practice changes over time.

Conclusions:

  • The John N. Insall Knee Society Traveling Fellowship generates initial enthusiasm for adopting new practices in total knee arthroplasty.
  • Long-term follow-up reveals limited actual implementation of these changes, suggesting significant practice inertia.
  • Factors such as time, ingrained habits, and institutional barriers may impede the translation of fellowship-inspired learning into routine surgical practice.