Depression and psychiatric disease associated with outcomes after anterior cruciate ligament reconstruction

While most patients with an anterior cruciate ligament(ACL) injury indicate satisfaction with surgical intervention, a significant proportion still do not return to pre-injury level of function or sport. Psychiatric comorbidities, such as depression, have recently been associated with poor clinical outcomes after ACL reconstruction(ACLR). To date, no article has yet examined how depression affects ACLR outcomes and how potential screening and intervention for psychological distress may affect postoperative activity level. The purpose of this review is to delineate potential relationships between depression and ACLR outcome, discuss clinical implications and identify future directions for research.

Evaluation of an interactive virtual surgical rotation during the COVID-19 pandemic

Objective:To evaluate medical student and attending surgeon experiences with a novel interactive virtual Otolaryngology-Head and Neck Surgery(OHNS)medical student elective during the COVID-19 pandemic.Study Design:A virtual OHNS elective was created,with three components:(1)interactive virtual operating room(OR)experience using live-stream video-conferencing,(2)telehealth clinic,(3)virtual didactics.Setting:OHNS Department at the University of Pennsylvania(May 2020 to June 2020).Methods:Six medical students from the University of Pennsylvania;five attending otolaryngologists.Two surveys were designed and distributed to participating medical students and attending surgeons.Surveys included 5-point Likert scale items,with 1 indicating"not at all"and 5 indicating"very much so".Results:Response rate was 100%for both surveys.Students on average rated the educational value of the telehealth experience as 4.2±1.2,and the virtual OR experience as 4.0±0.6.Most students(n=5,83%)indicated that they had enough exposure to faculty they met on this rotation to ask for a letter of recommendation(LOR)for residency if needed,while attending surgeons had an average response of 3.0±1.0 when asked how comfortable they would feel writing a LOR for a student they met through the rotation.A majority of students(n=4,67%)felt they connected enough with faculty during the rotation to ask for mentorship.Half the students(n=5,50%)indicated that the rotation allowed them to evaluate the department's culture either"extremely well"or"somewhat well".Conclusions:Overall,participating students described this innovative virtual surgical rotation as an educationally and professionally valuable experience.With the continued suspension of visiting student rotations due to the COVID-19 pandemic,this virtual model may have continued relevance to medical education.