DEPARTMENT OF ORTHOPAEDICS

DEPARTMENT OF

ORTHOPAEDICS

UHhospitals.org/Ortho • DEPARTMENT OF ORTHOPAEDICS _| 3 2 _| UNIVERSITY HOSPITALS CASE MEDICAL CENTER • 216-844-7200

The Department of Orthopaedics at UH Case Medical Center and Case Western Reserve University School of Medicine is one of the oldest and most respected in the nation, and it continues to be at the forefront of clinical orthopaedic research, innovation and treatment. Its establishment in 1907 occurred decades before the creation of the American Academy of Orthopaedic Surgeons and the American Board of Orthopaedic Surgery. To say it has a long-standing tradition of excellence would be an understatement. The department has trained some of the top orthopaedic surgeons in the world, and leaders of many of the major spine programs in the U.S. and throughout the world have trained at UH Case Medical Center. The department’s excellence in clinical activities is consistently recognized by U.S. News & World Report, which ranks it as one of the top orthopaedic departments in the country. National leadership in musculoskeletal research is confirmed by its continued ranking, recently at No. 15, in the top-funded orthopaedic departments in the U.S. by the National Institutes of Health.

Our board-certified and fellowship-trained orthopaedic surgeons have expertise in specific subspecialties, including total joint reconstruction, spine, musculoskeletal oncology, foot and ankle, hand and upper extremity, pediatric orthopaedics, shoulder and elbow, sports medicine and trauma.

To contact the department directly, email OrthoInfo@UHhospitals.org.

DEPARTMENT OF

ORTHOPAEDICS

Among the nation’s leading academic medical centers, UH Case Medical Center is the primary affiliate of Case Western Reserve University School of Medicine. With more than 1,000 registered beds, UH Case Medical Center provides primary, specialty and subspecialty medical and surgical care. Located in the heart of Cleveland’s University Circle on a beautiful 35-acre campus, UH Case Medical Center includes general medical, intensive care and surgical units as well as three major hospitals:

UNIVERSITY HOSPITALS SEIDMAN CANCER CENTER UNIVERSITY HOSPITALS MACDONALD WOMEN’S HOSPITAL UNIVERSITY HOSPITALS

RAINBOW BABIES & CHILDREN’S HOSPITAL

Our physicians and researchers – who also serve as faculty at Case Western Reserve University School of Medicine – are leaders in their respective fields, and their ongoing clinical research programs push the boundaries of medical progress. To learn more, visit UHhospitals.org

UH CASE MEDICAL CENTER

ACCELERATING BREAKTHROUGH DISCOVERIES INTO MEDICINES The Harrington Discovery Institute at University Hospitals is the nonprofit arm of The Harrington Project for Discovery & Development, a national initiative supporting breakthrough research by physician-scientists. The Harrington Project is a new and powerful approach to address the challenges of advancing discoveries into medicines.

To learn more, visit HarringtonDiscovery.org

HARRINGTON DISCOVERY INSTITUTE

Randall E. Marcus, MD Chair, Department of Orthopaedics

UH Case Medical Center and Case Western Reserve University School of Medicine Charles H. Herndon Professor Department of Orthopaedics Case Western Reserve University School of Medicine

All National Institutes of Health (NIH) funding for basic and clinical research is awarded to the School of Medicine at Case Western Reserve University.

2014 marks the first of a 10-year commitment

for University Hospitals to serve as the

official health care partner to the Cleveland

Browns. University Hospitals physicians

will care for every aspect of team members’

health, from injury prevention to strategies

to optimize athletic performance.

Both the Cleveland Browns and University Hospitals share the same vision of how the athlete of the future will experience medical care. “We really want to be able to care for the entire player both on and off the field for his overall wellness, and I think that’s what spurred this initial partnership, that goal of being the sports medicine program of the future,” says James Voos, MD, Head Team Physician, the Cleveland Browns, UH Case Medical Center; and Clinical Associate Professor of Orthopaedics, Case Western Reserve University School of Medicine.

All of the sports medicine experts at University Hospitals are fellowship-trained sports medicine surgeons who are active as both clinicians and researchers. This combination allows experts to provide the Cleveland Browns with the highest level of care.

The athletes’ orthopaedic care is provided by two dedicated team orthopaedic surgeons, Dr. Voos and

Michael J. Salata, MD, Associate Orthopaedist Team Physician, the Cleveland Browns, UH Case Medical Center; and Assistant Professor of Orthopaedics, School of Medicine. They visit the Browns training facilities several times per week, and attend every home

and away game. This affords athletes streamlined access to fellowship-trained orthopaedic specialists who evaluate and treat acute injuries as quickly as possible. University Hospitals is spearheading an optimal health model for the athletes, which involves caring for athletes in a way that goes beyond injuries and return to play. Primary support is for the orthopaedic needs for acute and chronic musculoskeletal injuries, but experts also provide all of the team’s medical care. That includes physicals and specialist care, all the way down to day-to-day medical issues. Whether an athlete has a torn ACL, appendicitis or a bad cold, he will be treated by the leading experts at University Hospitals.

Specialists from numerous disciplines, including sleep medicine, nutrition, cardiology, dermatology, infectious diseases, orthopaedics and sports psychology, are consulting with athletes to improve total player health. Athletes present with a wide range of health concerns, all of which affect performance and recovery time. For example, an athlete who is not sleeping well may have slowed reaction times and poorer physical performance during practices. The specialists working with the Cleveland Browns aim not only to

address problems, but also to optimize every aspect of a player’s health so that he is in peak performance condition. The comprehensive concussion program at University Hospitals also plays an integral role in player care. The team neurologists are neurosurgeons for concussion management, which is especially important given mounting evidence on the lasting impact of head injuries.

The practices established with the Cleveland Browns will influence how experts care for athletes from all walks of life. “We’re trying to develop a model that is applicable across many different subsets of patients,” says Dr. Salata. Coinciding with and building on the partnership with the Cleveland Browns, University Hospitals is currently developing the interdisciplinary UH Sports Medicine Institute. It will bring an extremely diverse group of departments under one roof to open the door for collaboration – a novel concept in sports medicine care. The institute will enhance specialists’ ability to exchange ideas and information with each other and with other team physicians.

The UH Sports Medicine Institute will offer exciting opportunities for researchers, basic scientists and

physicians to collaborate. The institute’s clinical research focus will ensure that all athletes receive the most advanced care. Discoveries that begin in the laboratory will be tested on the field, undergo trials and evaluation, and may eventually be adapted into the community.

“ It’s our goal to change the

landscape of sports medicine,”

Dr. Salata says. “Having a

partner like the Cleveland

Browns who are committed to

athleticism at such a high level

is really instrumental. Their goal

as well as ours is to push the

forefront of what we can do in

that arena.”

CLEVELAND BROWNS AND

UNIVERSITY HOSPITALS

PARTNER TO CHANGE THE

FUTURE OF SPORTS MEDICINE

Visit UHhospitals.org/CME for the latest in live, webinar and on-demand Continuing Medical Education events.

UHhospitals.org/Ortho • DEPARTMENT OF ORTHOPAEDICS _| 7 6 _| UNIVERSITY HOSPITALS CASE MEDICAL CENTER • 216-844-7200

CLINICAL ADVANCES

in what is essentially a permanent injury. The cartilage cells have difficulty

communicating because articular cartilage has poor blood supply. The body does not begin the healing process because it does not realize it is injured. Current treatments are limited because technologies are not able to consistently make normal articular cartilage. Dr. Michael Salata and co-investigator Eben Alsberg, PhD, Associate Professor of Biomedical Engineering and Orthopaedic Surgery, Case Western Reserve University, are researching a method to turn mesenchymal stem cells (hMSC) into cartilage cells via chondrogenic induction. These cells can self-assemble into sheets, and when given bioactive factors from biomaterials within the sheets, they can be guided into becoming cartilage-forming cells to make articular cartilage. This tissue-engineered approach is being pursued to fill in and treat defects. The research is currently moving into animal trials.

Surgeons have many options to choose from when creating implants to correct deformed spines in children. But evidence has not established which options result in the best outcomes. To this end, Christina K. Hardesty, MD, orthopaedist, UH Case Medical Center; and Assistant Professor, Orthopaedics, and Adjunct Professor, Pediatrics, School of Medicine, is studying implant usage in different types of scoliosis, such as how many screws are necessary to adequately correct a deformity. Dr. Hardesty is also studying Risser casting for early onset scoliosis and Scheuermann’s kyphosis. Risser casts are applied with the patient in a corrected position and extend from the breast tissue down to the upper portion of the pelvis. Dr. Hardesty’s research is studying what patient characteristics need to be present for Risser casting to be most effective.

Reducing blood loss after shoulder surgery can decrease the risk for transfusions, infection and other complications. Robert Gillespie, MD,

orthopaedist, UH Case Medical Center, and Assistant Professor, Orthopaedics, School of Medicine, recently conducted a prospective, randomized, double-blind study to determine if the medication tranexamic acid would affect blood loss. The study involved 110 shoulder surgery patients. Patients received either saline or tranexamic acid in the wound just prior to closure. The results showed that blood loss was significantly reduced in patients given the medicine compared with those who received saline. The procedure could be a relatively inexpensive way to decrease risk for complications following shoulder surgery.

The Institutional Review Board-approved Pediatric Orthopaedic Spinal Deformity Database is the largest pediatric orthopaedic spine database in a single institution in the world, containing data on more than 2,350 patients and 15,000 evaluations. It includes all pediatric patients with spinal deformity involved in treatment, including bracing, casting and surgery, since 1992. Nontreatment or observation patients are not included. The database records retrospective and prospective nonoperative and operative clinical and radiographic data, length of stay, instrumentation and fusion levels, neurological monitoring data, perioperative blood loss, length of surgery and complications. It provides an effective and efficient way to obtain aggregate information on patient outcomes, quality control, complications and long-term results, says George Thompson, MD, Division Chief, Orthopaedic Surgery, UH Rainbow Babies & Children’s Hospital; and Professor of Orthopaedics, School of Medicine. It is also used as an efficient way to review clinical problems and to perform research. Because of research collaboration with other hospitals, departments, divisions and databases nationally and internationally, there were 15 articles published in peer-reviewed journals by orthopaedics faculty from 2013 to 2014 and 36 national and international presentations given by our pediatric orthopaedic faculty.

Dr. George Thompson

Dr. Edward Greenfield

Dr. Matthew Kraay

Rotator cuff injuries are extremely hard to heal, with research citing a failure rate between 20 and 90 percent.

Dr. Robert Gillespie and Ozan Akkus, PhD, clinical researcher, Musculoskeletal Mechanics and Materials, Department of Orthopaedics; and Professor of Mechanical and Aerospace Engineering, Case Western Reserve University, are developing a novel way to strengthen tendons. They use electric currents to create collagen threads, which are then woven into fabric. The fabric is used as a scaffold for adult stem cells that develop into new tendon tissue. The collagen fabric will strengthen the

All National Institutes of Health (NIH) funding for basic and clinical research is awarded to the School of Medicine at Case Western Reserve University.

The commitment to exceptional patient care begins with revolutionary discovery. University Hospitals Case Medical Center is the primary affiliate of Case Western Reserve University School of Medicine, a national leader in medical research and education and consistently ranked among the top research medical schools in the country by U.S. News & World Report. Through their faculty appointments at Case Western Reserve University School of Medicine, physicians at UH Case Medical Center are advancing

TOMORROW’S CURES TODAY.

UH Case Medical Center’s physicians, surgeons and scientists –

all members of the faculty of Case Western Reserve University

School of Medicine – are leaders in their respective fields,

and their ongoing research programs are at the leading edge

of medical progress. A strong emphasis on translational, or

“bench-to-bedside,” research means that new and innovative

treatments and technologies transfer more rapidly from the

research laboratory to actual patient care.

Osteogenic sarcoma is a rare form of bone cancer with a high mortality rate. Treatment involves surgery to remove the primary tumor from the bone. However, most patients also have tiny metastasis in their lungs. Molecules that may contribute to tumor formation are currently being studied by Edward Greenfield, PhD, Director of Orthopaedic Research, UH Case Medical Center, and Harry E. Figgie III, MD, Professor of Orthopaedics, School of Medicine; and Patrick Getty, MD,

Medical Director, Musculoskeletal Oncology, UH Seidman Cancer Center; Barbara Peterson Ruhlman Chair in Orthopaedics, UH Case Medical Center; and Program Director, Orthopaedic Surgery Residency, and Associate Professor, Orthopaedics, School of Medicine. Their work has identified four receptor tyrosine kinases molecules that play a role in cancer cell biology. Animal studies are under way to explore how drugs can block the expression of one of these molecules, AXL, to prevent tumor growth.

Research from the Department of Orthopaedics and the Department of Mechanical and Aerospace Engineering of the Case School of Engineering centers around improving joint replacement devices and outcomes. Experts have been improving the materials used in joint replacement devices and measuring wear in hip replacement devices. They have also been studying why implants do not improve surgical outcomes. The research is under the direction of Clare Rimnac, PhD, Wilbert J. Austin Professor of Engineering, Case Western Reserve University, and Matthew J. Kraay, MD,

Director, Center for Joint Replacement & Preservation, UH Case Medical Center; Director, Joint Reconstruction & Arthritis Surgery, UH Case Medical Center; Kingsbury G. Heiple and Fred A. Lennon Chair in Orthopaedics, UH Case Medical Center; and Professor of Orthopaedics, School of Medicine.

Dr. Clare Rimnac

tendon while the stem cells and growth factors encourage healing. The National Institutes of Health recently awarded the doctors a five-year, $1.7 million grant to develop and study the process and material.

Evidence has not established clear guidelines for when limb deformities in children are severe enough to warrant surgery. To find out, Raymond Liu, MD,

orthopaedist, UH Case Medical Center, and Assistant Professor of Orthopaedics and Pediatrics, School of Medicine, has spent the past year studying a collection of 100-year-old skeletons at the

Cleveland Museum of Natural History. Dr. Liu was looking at the relationship between the severity of bow legs, knock knees or limb length discrepancies and the severity of arthritis development. He found that limb discrepancies up to 20 millimeters weren’t associated with an obvious difference in the amount of arthritis. He also discovered that just a small amount of angular deformity resulting in bow legs increased the risk of arthritis. These insights will help surgeons identify which patients will benefit from surgery.

10 _| UNIVERSITY HOSPITALS CASE MEDICAL CENTER • 216-844-7200 UHhospitals.org/Ortho • DEPARTMENT OF ORTHOPAEDICS _| 11

LEADERSHIP

Randall E. Marcus, MD

Charles H. Herndon Professor and Chair Department of Orthopaedics

Christopher G. Furey, MD

Henry H. Bohlman, MD Chair in Spine Surgery Associate Professor

Patrick J. Getty, MD

Barbara H. Ruhlman Professor in Orthopaedic Surgery Associate Professor

Edward M. Greenfield, PhD

Harry Figgie III Professor

Director of Research, Department of Orthopaedics

Matthew J. Kraay, MD

Kingsbury G. Heiple and Fred A. Lennon Professor of Orthopaedics

Clare M. Rimnac, PhD

Wilbert J. Austin Professor of Engineering and Orthopaedics Director, Orthopaedics Materials and Mechanics Laboratory

George H. Thompson, MD

Chief, Pediatric Orthopaedics,

UH Rainbow Babies & Children’s Hospital Professor

James E. Voos, MD

Director, Sports Medicine

Head Team Physician, Cleveland Browns Associate Professor

FOOT & ANKLE

Randall E. Marcus, MD

Charles H. Herndon Professor

Shana N. Miskovsky, MD

Assistant Professor

HAND & UPPER EXTREMITY SURGERY

J. Robert Anderson, MD Assistant Professor Stephen H. Lacey, MD Associate Professor John W. Shaffer, MD Professor

JOINT PRESERVATION & CARTILAGE RESTORATION Michael J. Salata, MD Assistant Professor Donald B. Goodfellow, MD Associate Professor Shana N. Miskovsky, MD Assistant Professor Brian N. Victoroff, MD Associate Professor James E. Voos, MD Associate Professor Roger G. Wilber, MD Assistant Professor

HIP & KNEE REPLACEMENT

Matthew J. Kraay, MD

Kingsbury G. Heiple and Fred A. Lennon Professor of Orthopaedics Steven J. Fitzgerald, MD Assistant Professor Victor M. Goldberg, MD Professor Randall E. Marcus, MD

Charles H. Herndon Professor

William J. Petersilge, MD Assistant Professor Glenn D. Wera, MD Assistant Professor Roger G. Wilber, MD Assistant Professor

MEDICAL SPORTS MEDICINE

Sean A. Cupp, MD Associate Professor Susannah Briskin, MD Associate Professor Mary Solomon, MD Assistant Professor Amanda Weiss-Kelly, MD Associate Professor ONCOLOGY & MUSCULOSKELETAL TUMORS Patrick J. Getty, MD

Barbara H. Ruhlman Professor in Orthopaedic Surgery Associate Professor

John T. Makley, MD

Professor

CLINICIANS AND SCIENTISTS

at UH Case Medical Center and

Case Western Reserve University School of Medicine

DEPARTMENT OF ORTHOPAEDICS

SHOULDER & ELBOW

Robert J. Gillespie, MD

Director, Division of Shoulder & Elbow Surgery

Assistant Professor Michael J. Salata, MD Assistant Professor John W. Shaffer, MD Professor Brian N. Victoroff, MD Associate Professor James E. Voos, MD Associate Professor SPINE Christopher G. Furey, MD

Henry H. Bohlman, MD Chair in Spine Surgery Associate Professor Nicholas U. Ahn, MD Associate Professor Jason D. Eubanks, MD Assistant Professor Zachary L. Gordon Assistant Professor E. Byron Marsolais, MD Professor SPORTS MEDICINE James E. Voos, MD Associate Professor Sean A. Cupp, MD Assistant Professor Allison Gilmore, MD Assistant Professor Donald B. Goodfellow, MD Associate Professor Thomas C. McLaughlin, MD Associate Professor Shana N. Miskovsky, MD Assistant Professor Michael J. Salata, MD Assistant Professor Brian N. Victoroff, MD Associate Professor

CELLULAR & MOLECULAR BIOLOGY LAB

Edward M. Greenfield, PhD

Harry Figgie III Professor Director of Research, Department of Orthopaedics Shunichi Murakami, MD, PhD Assistant Professor Guang Zhou, PhD Assistant Professor

MUSCULOSKELETAL MECHANICS AND MATERIALS LAB Ozan Akkus, PhD Associate Professor Eben Alsberg, PhD Associate Professor Dwight Davy, PhD Professor Umut A. Gurkan, PhD Assistant Professor Joseph Mansour, PhD Professor Clare M. Rimnac, PhD

Wilbert J. Austin Professor of Engineering and Orthopaedics

FUNCTIONAL ELECTRICAL STIMULATION LAB

Kath Bogie, DPhil

Adjunct Assistant Professor

P. Hunter Peckham, PhD Professor Ronald Triolo, PhD Professor Mary Anthony, DO Robert J. Berkowitz, MD Trevor Bullock, DO Robert Corn, MD John Feighan, MD Richard Gittinger, MD Reuben Gobezie, MD Daniel Karns, MD John K. Krebs, MD Jared S. Levin, MD Matthew Levy, MD Larry Gene Lika, DO Charles LoPresti, MD Michael A. LoPresti, MD David G. Marsh Jr., MD

Blane McCoy, MD Brett William McCoy, MD Alan L. Panteck, MD William Petersilge, MD Michael Retino, MD Harkeet Sandu, MD Scott G. Schnell, MD J. Britten Shroyer, MD William B. Stanfield, MD D. Philip Stickney, MD Andre Wolanin, MD Daniel J. Zanotti, MD Robert M. Zanotti, MD Scott Zimmer, MD

To refer a patient or learn more about UH Case Medical Center Department of Orthopaedics, call 216-844-7200 or visit