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Thesis title: Reactogenicity of Synthetic Calcium Phosphate Bioceramics in Osteoporotic Fracture Area. Experimental and Clinical Study

Scientific supervisors: Prof. Māra Pilmane, Prof. Andrejs Skaģers

WHO?

"Loads of work add colour to my life and prevent me from getting into a rut. It is not easy to juggle the multiple roles that I have: surgeon, head of department and university teacher. However, in spite of the heavy workload, inspired by professor Skaģers, five years ago I decided to commence doctoral studies. After work with brief moments of rest I am finally approaching the finish line. Looking back at this time, I would say that it contributed to the development of my personality.

Similarly to the children of actors, who spend their childhood behind the scenes and occasionally stay there, my father [chair of the board of Riga Hospital No.2 traumatologist-orthopaedist Jānis Petronis] had a great impact on my career and the decision to become a doctor came naturally. I may say that I spent my childhood in my current work place – I was sitting here and doing my homework. To my mind, being a doctor is the best job. Though, the sweet is never as sweet without the sour. Still, job satisfaction is worth the sweat."

WHAT?

"Osteoporosis leads to the loss of calcium and bone fractures. A bone itself is a perfect substitute for the bone. It means that this material has to be taken from the human body that is associated with additional surgery and an even greater chance of getting trauma. Thus, studies of various biomaterials have been undertaken for decades worldwide. Rudolfs Cimdins Riga Biomaterials Innovations and Development Centre of Riga Technical University (RTU) is the leading institution in Latvia in this field. Both universities – RTU and RSU – have a long-standing successful cooperation. Professor Skaģers is a coryphaeus of this field from the perspective of medicine. The topic of my thesis – the use of bioceramics in long bones of the body, such as femoral bones – has not been studied in Latvia yet. Therefore, I decided to focus on the use of calcium phosphate bioceramics in large bone fractures."

"Doctoral studies enrich me as a doctor, as on a daily basis I perform surgery, whereas while writing my thesis I analyse my surgery results and look at my work from a different perspective. My patients and I benefit from it," says 3rd year doctoral student and traumatologist and orthopaedist Sandris Petronis.

HOW?

"An experimental part is included in the study. It took place at the RSU Experimental Animal Laboratory. Professor Skaģers and I performed experimental surgery on rabbits, occasionally a residency student came to assist us. The study also consisted of a clinical part with the participation of patients of Riga Hospital No.2. It was exciting to go back to the beginning of medical studies and recall analysing microscopic bone structures under the supervision of professor Māra Pilmane at the Anatomical Theatre and evaluating the recovery potential of the bone after implantation of bioceramic granules after immunohistochemical reaction. A surgeon’s daily routine that involves evaluating surgery results from a clinical perspective is one thing, whereas, viewing these results with the naked eye under a microscope and analysing them is a totally different thing.

The majority of my patients suffer from femoral fractures that require routine surgery. The thesis allowed me to look at health issues of my patients from a different perspective trying to figure out improvement opportunities. I’ve recently arrived from a conference that was held in USA and there I became aware of the world tendency, namely, in the future, besides reading current medical literature, surgeons will have to analyse their performance in the operating room, collect and analyse data obtained by themselves. Patients benefit from doctors engaged in research."

CONCLUSIONS

"It is typical for humans to strive for improvements and alternative bone substitutes have been studied for decades. To date bioceramic materials have been studied and used in maxillofacial surgery in Latvia, whereas, results of my study lead to the conclusion that this material is well tolerated by the patients suffering from long bone fractures and contributes to the healing of large bone fractures.”

I see doctoral studies as a process rather than a result. Owing to my doctoral studies, I crossed paths with knowledgeable and dedicated people, who I would most likely not meet under other circumstances. I benefited from working with professor Līga Bērziņa-Cimdiņa, Dagnija and Jānis Loči from RTU Rudolfs Cimdins Riga Biomaterials Innovations and Development Centre, veterinary surgeons and zoologists from the RSU Experimental Animal Laboratory. It was essential to return to the Anatomical Theatre headed by professor Māra Pilmane and work as a teacher at RSU Department of Orthopaedics under the supervision of professor Andris Jumtiņš. I am grateful to RSU professor Sandra Lejniece and professor Aigars Pētersons for inspiring me."