Components of the program will include exposure to multiple surgeons and exposure techniques, direct patient care in offices and clinic, and the opportunity to participate in clinical and basic science research projects. The adult fellow will be credentialed as junior faculty and have independent OR and clinical privileges for cases that are appropriate for his/her level of expertise. The fellow will meet for constructive performance evaluation with the program director directly on a monthly basis. The fellow will be credentialed and function as a junior attending with senior staff/faculty back up. Moonlighting opportunities will be considered subject to approval by the program director and risk management.  

The adult fellow will directly participate in the mentoring and training of both residents and medical students. The fellow will lead the weekly indications conference and coordinate resident presentations at the monthly adult conference. He/She will also lead the journal club presentations and discussions.

Required educational conferences will include:

• Monthly resident adult reconstructive conference
• Adult Reconstruction Journal Club
• Attendance at Annual AAHKS and/or AAOS meeting
• Hands-on cadaver course (once per year)
• Weekly indications conference with faculty
• Weekly Grand rounds
• Monthly QA at RIH and TMH
• Research meeting
• Monthly Reconstruction Clinic

The Brown University Adult Reconstruction Fellowship is truly comprehensive, covering every aspect of primary and revision total hip and knee arthroplasty. There is a broad exposure to different surgical approaches and philosophies. The faculty utilizes direct anterior, anterolateral, and posterior approaches for total hip arthroplasty and there is exposure to gap balancing and measured resection for total knee arthroplasty. Faculty members are excited to include the fellow in all of their interesting and complex cases, which as a result provides an extraordinary revision hip and knee arthroplasty experience. Brown University is the tertiary referral center for Rhode Island and there is no shortage of revision cases, peri-prosthetic fractures and infection cases.

The fellowship curriculum emphasizes the fellow’s learning experience and allows flexibility in rotation schedules to be apart of the unique cases, conduct influential research, and attend courses and conference. This fellowship is everything I am looking for in a fellowship, congenial faculty, broad exposure to different surgical approaches, complicated primary and revision arthroplasty, and the freedom and encouragement to grow and learn as a young arthroplasty surgeon. After this fellowship, I have no doubt that I will be comfortable handling any complex adult reconstruction problem.

Alumni

The Brown University Comprehensive Adult Reconstruction Fellowship offers opportunities to become involved in a wide variety of basic, clinical, and translational research.  For maximum value, the research plan should be tightly integrated with the clinical program and be methodologically sound.  Therefore, it should be discussed in advance with the fellowship director, research mentor, and fellowship research director.

The research opportunities are broadly grouped into two formats.  (1.) Our Total Joint Center is participating in the Function and Outcomes Research for Comparative Effectiveness in TJR (FORCE-TJR) program, a national joint replacement registry developed at UMass.  The registry offers the opportunity to use the FORCE-TJR national database of over 40,000 joint replacements to answer research questions requiring large databases. (2.) Investigator-initiated research is ongoing into a wide variety of issues relative to arthritis, joint replacement, and associated health care delivery. A non-exclusive list of ongoing projects includes the creation of a risk-adjusted model of TJR outcomes, characterizing limb and bone blood flow in arthritis with advanced imaging, randomized controlled trial of a pulsed electromagnetic field for the treatment of osteoarthritis of the knee, systematic review of venous thromboembolism in joint replacement, effects of body composition in total knee arthroplasty, impact of non-English speaking on length of stay and other outcome variables, evaluation of trunnionosis as a failure modality of THA, and the impact of combined tranexamic acid  administration on blood loss in TJA.

Many collaborations and facilities have been established to extend the range of capabilities available and facilitate the ability to pose a broad range of research questions.  Collaborations exist with the Dartmouth Biomedical Engineering Center: Implant Retrieval Lab, the Citigroup Biomedical Imaging Center and the Memorial Hospital for advanced joint imaging, the Center for Evidence-Based Medicine at the Brown School of Public Health, UMass FORCE-TJR, and RI Blue Cross.  Among the facilities available are advanced bone, cartilage, and joint imaging with DEXA for bone density and body composition analysis, pQCT of the knee, contrast-enhanced MRI for measuring bone blood flow, articular cartilage imaging including T2 mapping and T1r imaging, biomotion studies with orthogonal fluoroscopy and virtual reality-based pathway geometry.  For those interested in basic research, extensive biochemical, cell and molecular biological, and biomechanical laboratories are available.

Instruction and consultation are available in experimental design, regulatory compliance, professional writing, data management, statistics, and presentation through the department’s Clinical/Translational Research Program.

You must apply through SF Match, a third-party application service. The fellowship participates in the match set forth by the American Association of Hip and Knee Surgeons.
The application form and all supporting documentation must be submitted by the end of October, approximately two years preceding the appointment date. The academic year begins in late July or early August. Exact deadlines for the current year can be found on the SF Match website.

• To apply to the program, visit the SF Match website. 
• Applicants considered for an appointment will be invited to visit for a personal interview with the program director and selected faculty. Interviews will be held in February 2025 for two fellowship spots.

Audrey Bell
Adult Reconstruction Fellowship Coordinator
The Warren Alpert Medical School of Brown University
Phone: (401) 457-1567
Fax: (401) 457-2198
Email: abell@universityorthopedics.com