Interview with Dr. Jeanne Franzone & Dr. Richard Kruse,
Nemours Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA

Soon after the initiation of the COVID pandemic, in June of 2020, Dr. Jeanne Franzone c (Nemours Alfred I. duPont Hospital for Children, Wilmington, DE), Dr. Maegen Wallace (Children’s Hospital and Medical Center Omaha, NE) and Dr. Jill Flanagan (Children’s Healthcare of Atlanta, Atlanta, GA) initiated an OI Surgeon Quarterly Case Review: A Virtual Forum.

The forum was developed to facilitate a virtual discussion among surgeons with an interest in OI surgery, to meet to discuss challenges related to OI surgeries. Drs. Franzone, Wallace and Flanagan all specialize in the orthopaedic care for patients with OI as part of multidisciplinary OI programs and sought to gather surgeons with an interest in and a passion for improving the surgical care for patients with OI.

What kind of case discussions do you have?

We meet on a quarterly basis by Zoom and we discuss OI-cases submitted by the participating surgeons – these may be completed surgeries or upcoming surgeries that demonstrate a learning point. Surgeons may submit cases to seek advice. We discuss both broad topics as well as the detailed aspects of OI surgery. We also place importance on follow-up discussion of prior cases so that we all continue to learn.

Who can join?

We aim for this to be an inclusive environment, and given time constraints, each surgeon may not be able to attend every meeting. We currently include 33 surgeons from 22 institutions in the US. We emphasize that it is a respected environment in which challenges and complications may be discussed.

How do you deal with anonymization and privacy?

It is very important for patient privacy to be respected. We ask for the cases to be deidentified of patient names and identifying information. We emphasize that it be a respected environment.

Have there been any challenges?

Absolutely! In addition to the usual technical challenges, a challenge in gathering a group of busy orthopaedic surgeons is finding the time and finding a time of day that works across different time zones. For this North American based group we currently meet in the evening hours to try to steer clear of morning conferences, patient clinics and planned surgeries.

What are the lessons learned so far?

We have had many interesting discussions regarding surgical indications, techniques and implant considerations. As noted above, the follow-up provided regarding the cases discussed greatly enhances the learning opportunities.

Would you recommend other countries or regions to establish similar projects?

Yes. We have found this type of virtual discussions to be a valuable way to bring together surgeons from different institutions to share ideas and learn from case-based discussions. There is benefit to collegial discussion among surgeons specializing in OI, to incorporate care within their specific healthcare system.

Do you ever publish some of these cases as case studies?

The US-based OI Quarterly Case Review has been a clinical discussion, more case-specific.

How could we make sure that knowledge benefits orthopedic surgeons in less developed countries?

By sharing this information here, we hope to encourage similar discussions in different healthcare systems around the world. We (Dr. Kruse and Dr. Franzone) have also initiated an international forum to include different healthcare systems and resources. We also encourage similar forums among other specialties and care disciplines.

Please tell us more about the international forum!

We have organized an International OI Surgeons Work Group. This is an international gathering of specialized OI surgeons including surgeons from 7 countries and 3 continents. The initial meeting took place in May 2022. It was an exciting gathering, very dynamic and interactive and set the stage nicely for international collaboration of OI surgeons regarding challenging topics such as acetabular protrusion. Although also a case-based discussion, the aim for this group is to discuss surgical care in a way that spans different healthcare systems and available resources. This international perspective will be used as a springboard to facilitate international research collaboration and knowledge dissemination. People who have questions about this forum can contact office@oife.org