Starting in October 2009, HealthpointCapital initiated a one-year Research Scholarship at the Hospital for Special Surgery (HSS) for a select oprthopedic surgeon from China. This month, we checked in with our Research Scholar, Dr. Xiaodong Ju, to see how he was getting along at HSS and what he was learning from his clinical and research experiences here in America.
Can you provide our readers with a brief overview of your training? What is your principal area of clinical practice? What are your primary areas of research?
Dr. Ju:I obtained my MD and PhD degrees from Peking University Health Center in 2004. Since 2001, I have been training in special orthopedic surgery at Peking University Third Hospital where my major clinical focus has been in sports injury and joint surgery. I have taken a keen interest in knee and shoulder arthroscopy, total knee arthroplasty and other sports medicine and large joint operations. In terms of clinical research, I work as an assistant researcher on ligament and cartilage repair research and also on the pathogenesis of osteoarthritis with support from the National Natural Science Foundation of China.
Tell us about your hospital in China.
Dr. Ju: Peking University Third Hospital is a famous, large and comprehensive hospital that integrates medical services with teaching, research and preventive medicine. Founded in 1958, our hospital established these forward-thinking and now leading centers of excellence: the Institute of Sports Medicine, Reproductive Medicine Center and Spine Surgery in China. We are also in the leading position among neurology, cardiology, urinary surgery and ophthalmology specialties. Peking University Third Hospital has 34 clinical departments, 10 technological departments and 1,260 sickbeds. Over 9,000 outpatients are treated in our hospital per day, and over 20,000 operations are completed per year.
The Institute of Sports Medicine is, in our view, the best multi-disciplinary sports medicine facility in China. Founded in 1959, it has 4 divisions: sports injury, sports nutrition, medical supervision and rehabilitation. The facility is responsible for medical service, education and research as well as treatment on-site for sports teams. With more than 60,000 outpatients and 3,200 operations annually, we are the busiest department in the hospital.
Why were you interested in a US fellowship?
Dr. Ju: Hospital for Special Surgery (HSS) is the best hospital for orthopedics in US, and I have the privilege of working with Dr. Scott Rodeo, who is one of the most famous professors at HSS. His outstanding research is of particular interest to me. I believe that if I have an opportunity to study and research at HSS as a fellow, the experience can improve my research capacity and enlarge my knowledge in this field, which will greatly benefit me as a clinician as well as patients in China.
How is your experience so far at HSS?
Dr. Ju: Aside from HSS being one of the most famous hospitals specialized in orthopedics in the world, the basic research is also strong and advanced. First, I am learning a great deal and acquiring advanced experiences through attending orthopedics surgeries and following Dr. Rodeo's ward rounds. Secondly, I am doing some molecular biological experiments on patella tendon-bone-healing and biomechanics experiments on ligament and tendon repair, such as enzyme linked immunosorbent assay and reverse transcription polymerase chain reaction.
Is there anyone elso you have enjoyed working with?
Dr. Ju: I am also working with Dr. Xianghua Deng, who is an Assistant Scientist at the Laboratory for Soft Tissue Research. The Lab is dedicated to performing basic and applied research on the various soft tissue structures of the musculoskeletal system.
What are the most distinct differences between practices in China and America that you have observed so far?
Dr. Ju: Orthopedic surgical volume at HHS is much larger than that of Peking University Third Hospital (22,600 VS 6,800 procedures pet year). Perhaps the largest distinction is that the majority of surgeries at HSS are ambulatory, whereas most of operations in our hospital are inpatient surgeries. In China, I perform operations by myself and I am in charge of applying for grants for research. Here in the U.S., I mainly watch and act as an assistant during operations and do some experiments in person at HSS.
What are the most important lessons you expect to apply in China when you return next year?
Dr. Ju: In the day-to-day clinical field, I am reinforcing my abilities in foot, ankle and wrist arthroscopy. In the research field, I expect to bring back insights relating sports medicine biomechanics.
Where do new technologies typically originate in China (companies, surgeons, government sponsored research)?
Dr. Ju: In the field of orthopedics in China, most new technologies originate from visiting surgeons and learning abroad by Chinese surgeons. We also see new technologies coming from well-known overseas companies that are importing into China.
What are some of the exciting orthopedic technologies currently being developed in China?
Dr. Ju: Most technology development is coming in the form of joint prosthesis, internal fixation devices for spine and bone (e.g. trauma implants), as well as arthroscopic devices and implants.
What is in store for the future of sports medicine surgery?
Dr. Ju: Minimally invasive surgery and arthroscopy are the directions in which sports medicine surgery are developing. Advanced knee surgery techniques including arthroscopy have become fundamental techniques for all surgeons across the world. It is now at a point where there is no significant difference in knee surgery techniques between US and China. Shoulder and elbow arthroscopy also have developed well and made a huge progress over the past ten years or so.
There is nevertheless still plenty to be worked in the areas of foot, ankle and wrist surgery and arthroscopy. A good example of this is total ankle replacement. Although this technique has been performed for several decades, the results have not begun to approach satisfaction rates of widely performed procedures such as total knee replacement until only recently. It seems there is a great deal of improvement potential in these areas.
