Smith M, West S, Malanga G, Hager N, Hulsopple C, Yuan X

Abstract submitted to Association of Military Surgeons of the United States 2022

The Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) organization, based out of the Department of Physical Medicine and Rehabilitation (PM&R) at the Uniformed Services University (USU), is dedicated to advancing musculoskeletal injury rehabilitative care within the Military Healthcare System (MHS) to reduce the burden of musculoskeletal injuries on operational readiness. Through its core infrastructure and inter-service collaborations, MIRROR facilitates training programs for medical education to expand and optimize treatments. Knee injuries are one of the most common musculoskeletal complaints among Active Duty military personnel. Autologous micro-fragmented adipose tissue (MFAT) has shown promise as a regenerative therapy for meniscal tears in the civilian population. MIRROR supports a randomized controlled trial (RCT) at multiple military treatment facilities (MTFs), with the objective to investigate the safety and efficacy of intrameniscal injection with autologous MFAT for symptomatic meniscal injuries in a military population. With the assistance of a peer-to-peer, two-day training program incorporating didactic cadaveric training and hands-on patient cases, clinicians at three MTFs garnered the procedural skills required to safely administer this novel intervention prior to the launch of this multi-site study.

Smith M, West S, Persinger J, Hager N, Smith J, Miller M, Yuan X, Reece D

Abstract submitted to Association of Military Surgeons of the United States 2022

The COVID-19 pandemic has taken a significant toll on global medical education and research since March 2020, prompting a surge of virtual learning. Like other research entities, the Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) organization, based out of the Department of Physical Medicine and Rehabilitation (PM&R) at the Uniformed Services University (USU), was not spared from the pandemic’s impact on research operations and adapted to persevere, despite setbacks. At the heart of the organization’s mission, MIRROR provides clinicians and researchers with the support and infrastructure to advance musculoskeletal injury rehabilitative care by facilitating training programs for medical education. According to the Defense Medical Epidemiology Database, nearly 17,000 Active Duty service members were diagnosed with carpal tunnel syndrome (CTS) in 2016, the most common peripheral entrapment neuropathy. MIRROR currently supports a study at multiple military treatment facilities (MTFs) comparing Ultrasound-Guided Carpal Tunnel Release (USCTR) to the current standard-of-care surgical release with respect to return to duty and clinical outcomes in the military population with CTS. With the aid of an innovative virtual platform, training for this enhanced intervention continued during the pandemic, propelling MIRROR’s mission to advance military medicine.

Persinger J, Benbassat D

Abstract submitted to Association of Military Surgeons of the United States 2022

The Department of Physical Medicine and Rehabilitation (PM&R) at the Uniformed Services University (USU) started offering a musculoskeletal (MSK) ultrasound (US) clerkship to USU medical students in 2019. It included resident didactic instruction on the fundamental principles of ultrasonography and hands-on clinical instruction using the ultrasound machine and transducers. Despite the clerkship’s tangible benefits to undergraduate medical students, it was discontinued following the 2020 pandemic’s stay-at-home orders. To ensure continued delivery of the course, the department transformed its traditional clerkship training using innovative distributed technologies.