The Knee module was held from the 21st March to 2 April 2026 at the TTM Hospital in Apia, Samoa and was attended by nine (9) PIOA Trainees namely: Dickson Wak from Papua New Guinea, Steven Kutukana from Solomon Islands, Tzun Rafael from Palau, Vanua Ilo from Vanuatu, Taukoriri Tibriano from Kiribati , Manoa Valeniyasana and Paul Lomavatu from Fiji and Robert Fa’ataga and Michael Leota from Samoa.
This module was successfully facilitated with lectures, saw bone practicals and arthroscopy practical on Virtamed knee arthroscopy simulator by Dr. David Rovinsky from Hawaii, Dr Kaushik Hazratwala from Australia, Dr Desmond Soares from Australia and Dr Shaun Mauiliu and Areta Samuelu from Samoa.
Each morning would start off at 8:00 am with a ward round with a Trainee leading the case presentation. The Trainees present the relevant history and clinical examination findings as elicited with further discussions on the current investigations and management being done. Trainees are then asked to demonstrate how they would do clinical examinations to elicit certain signs and on the rationale for the patient management and treatment being done. Suggestions for further investigations and treatment improvement are then being put forward to the Trainees and the local team. This exercise is very helpful for Trainees in developing their clinical skills and to try and elucidate clinical reasoning which would be helpful in decision making.
At the Knee Module lectures Trainees were taught a systematic approach to history taking, clinical examination and investigation with a focus on common Knee orthopedic and trauma conditions. Most of the topics are also covered in the weekly zoom sessions prior to the modules, hence emphasis are put on the common and core pathologies.
Practical sessions were done in the afternoons with Trainees in 3 rotations practicing clinical examinations with live patients with clinical signs, sawbones exercises which covered the common Knee Orthopaedic and trauma case management and an arthroscopy rotation using the Virtamed simulator. The sawbones rotations included: common fractures like patella fracture fixation with tension band wiring, tibial plateau fracture stabilization with spanning external fixation and definitive treatments, ACL and MCL, and LCL graft positioning using rope and screws and high tibial osteotomy, distal femur osteotomy. The arthroscopy station provided guided instruction in triangulation, diagnostic arthroscopy and then simulated arthroscopic knee conditions. The simulator provides a realistic opportunity to develop skills in arthroscopic techniques and triangulation before commencing clinical arthroscopy.
The module was then concluded with a Knee Anatomy, Biomechanics and clinical scenario Quiz and practice Computer viva – 5 cases after which feedback was given to each Trainee.
During the module Dr. Kaushik Hazratwala was able to demonstrate for Dr Samuelu the technique for 1 patient with patella instability and 3 patients needing ACL reconstruction. This will assist the surgeons in Samoa to continue developing the skills to continue providing this this procedure in future.
