Winter 2010 RESEARCH INSTITUTE

News Winter 2010 RESEARCH INSTITUTE

Photo: John Kelly INSIDE Institute Focus u Page 3 Steven Read Uses Experience, We Have an Important Energy, and Passion to Support the Institute Announcement u Page 4 Winter Olympians Benefit from By Mike Egan, Chief Executive Officer, Steadman Philippon Research Institute Institute Research

u Page 5 he Steadman Hawkins Research Foundation Board voted The Steadman Clinic Tunanimously at its meeting in December 2009 to change its u Page 8 name to the Steadman Philippon Research Institute (SPRI). Meet Our Visiting Scholars: Dr. Marc Philippon joined the Vail Clinic in 2005, and Dr. Jean-Yves Schoenahl and already he is a well-known expert in the treatment and Dr. Leandro Ejnisman rehabilitation of sports-related hip injuries and disorders. Dr. u Page 9 Philippon’s contributions to our research efforts have been Research Shows Benefit of Hip Arthroscopy in Injured considerable, to say the least. Thus far, he has produced more Professional Hockey Players than 54 articles and 300 presentations under our auspices. His u Page 10 integrity and leadership capabilities, coupled with his technical Can Specific Footwear Reduce innovations in the field of hip arthroscopy, make him an ideal Injuries? addition to the marquee of our research organization. His u Page12 dedication to the principles of joint preservation and keeping Baseball Research for people active matches Dr. Steadman’s philosophy exactly. Most Prevention, Treatment, and Care u importantly, these physicians’ emphasis on the importance of Page 12 Leading You Down the Road to evidence-based medicine is paramount in their approach to Recovery research. u Page 13 The Steadman Sports Medicine Research Foundation was Powerful Prevention created in California by Dr. Richard Steadman in 1988 as a from Vitamin D STEADMAN PHILIPPON nonprofit organization to investigate causes and remedies for u Page 19 Save the Dates: (continued on page 2) Darius Rucker in Concert, July 8 August 19, Steadman Philippon Golf Classic

An International Center for Research and Education—Keeping People Active STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

(continued from page1) Science department is conducting exciting research using stem cells and platelet-rich knee injuries and disorders. It became the plasma. In Education, the current group Steadman Hawkins Sports Medicine Founda- of Fellows is outstanding, and next year’s tion in 1994, four years after Drs. Steadman candidates are exceptional. Guided by our and Hawkins founded the Clinic in Vail. distinguished Scientific Advisory Committee Then, in 2004, the name was changed to the and our commitment to conducting meticu- Steadman Hawkins Research Foundation. lous research, we expect to produce valuable Since Dr. Hawkins went to South new data in the coming years. Carolina in 2004 to start a clinic there, our on behalf of our board members, focus on knee and shoulder research has researchers and staff, thank you for your widened to include other areas of sports interest and past support. Our success — medicine. The Institute’s departments of indeed, all of our work — is funded by Education, Biomechanics, Basic Science, and friends like you who step forward to make Imaging have grown exponentially. Our certain our research continues. We are Clinical Research database (under the direc- counting on your continued support of tion of Karen Briggs, M.P.H.) has expanded the Steadman Philippon Research Institute to become the largest in the world for (SPRI). We will keep you updated on our knees and shoulders. All our departments work throughout the year. Please refer to are staffed by talented professionals our Fall Newsletter (of which we are very dedicated to helping conduct research that proud) for more information on recent will improve the practice of orthopaedics research projects. Our Web site address is over time. now www.sprivail.org. In 2009, the Biomechanics department uuuu earned international recognition for its work in biplane fluoroscopy. At present, our Basic

A Year of Uncertainty

So far, 2010 has been a year of uncertainty when it comes to retire- • Charitable Giving Through Your Traditional IRA: ment accounts, the charitable income tax deduction, traditional Congress has not yet extended last year’s law allowing people to IRAs and Roth IRAs. One thing is certain…conditions will continue give up to $100,000 to charity from a traditional, tax-deferred IRA. to change, but as of press time, here are highlights of current items However, it very well may do so given the popularity of that law. being impacted. If Congress reinstates the same policy, one benefit for individu- als with already significant income is that charitable gifts from • Charitable Giving and the Charitable Income Tax Deduction: retirement accounts can count toward the required minimum With President Obama’s effort to limit the federal income tax annual withdrawals for those 70 ½ or older. Directing the required charitable deduction to 28 percent, some taxpayers in higher tax minimum distribution to charity allows the distribution requirement brackets could be taxed more for their gift. For example, currently to be fulfilled and at the same time does not increase reportable a couple at the 35 percent tax bracket is able to claim itemized taxable income. deductions at this rate. If a fully deductible gift of $100,000 were made today, their income taxes would be reduced $35,000. By • Roth IRAs: reducing income taxes by $35,000, the $100,000 gift effectively If you have a traditional IRA but would prefer the income-tax-free “cost” only $65,000. In this same example under the Obama plan, benefit of a Roth IRA, you can now convert your traditional IRA the 28 percent limit would reduce their taxes only $28,000. This into a Roth IRA. But there is a tax-catch: You will have to pay would raise the “cost of the gift” to $72,000 and in essence result taxes on the funds transferred from your traditional IRA into your in increased income tax liability on $7,000 (the difference between Roth IRA. $65,000 and $72,000). Why? To transfer a traditional IRA account to a Roth, “equilibrium” You may want to speed up gifts planned in future years to this year has to be established. If you have a traditional IRA, you funded it and take advantage of a full tax deduction available in 2010. with “pre-tax” dollars. This allowed you to reduce your taxable income the year you made a contribution so when you withdraw

Patients in the News Steven Read Uses His Experience, Energy, and Passion to Support the Mission of the Institute.

By Jim Brown, Executive Editor, SPRI News

ere is the prototype of a Steadman HPhilippon Research Institute Board Member: (1) a person who exemplifies the Institute’s mission of keeping active people active; (2) a successful, innovative leader; (3) an individual who is willing to commit time, energy, and resources to building the pre- mier independent sports medicine institute in the world. One more thing: This person estate development corporation in Berkeley, Steven Read driving at the 24 hours of Le Mans. would be even more valuable if he or she California, and Co-Owner/Co-Chairman of could bring years of experience on similar Grocery Outlet, Inc., a retail food store boards. chain in the western states, Hawaii, Texas, Steven Read, a member of the SPRI and Louisiana. He sits on six boards, all Board of Directors for more than a decade, nonprofit, including the University of not only represents the prototype, he may San Francisco, the United States Ski and well be the prototype. He is Founding Part- Snowboard Foundation, and the Steadman ner of Read Investments, a commercial real (continued on page 4)

the income you will have to report it as taxable income. will only be $1,000,000. Congress is expected to take action on the Conversely, Roth IRAs are funded with after-tax dollars. estate tax this year, although the outcome is unclear. Since taxes have already been paid, funds withdrawn from Roth IRAs are tax-free. Paying taxes on previously tax-deferred Honoring Your Philanthropy funds from your traditional IRA equalizes the tax status of the money that will go into a Roth. In the midst of all this, how do you decide the best way to honor your philanthropic objectives and meet your financial goals? If you You have the option of spreading these taxes over two years if are hesitant while the picture remains unclear, we encourage you to you make this transfer. We do encourage you to consult your consider combining different giving plans. tax advisor to navigate the tax liabilities from this transaction. • You can make an outright gift of cash or appreciated assets that An offset to the tax liability is charitable giving. If you are convert- supports our programs immediately and gives you income and ing to a Roth IRA, consider combining that with a charitable gift to capital gain tax advantages. the Institute. You can take advantage of the charitable income tax • You can fund a gift that will provide a lifetime income along with deduction to offset some of the tax liability from the conversion. income and capital gain tax savings. • You can give through a bequest in your will or beneficiary des- • Estate Tax: ignation on your IRA account to continue your support beyond Under a 2001 tax law signed by President Bush, the estate tax your lifetime. falls to zero in 2010. Under the Bush law, there was a progressive • You can also combine these different giving plans to optimize increase in the dollar amount of an estate that was exempt from income and tax benefits. estate tax – $3,500,000 was exempt in 2009. In 2010, the estate tax falls to zero. On January 1, 2011, however, the estate tax returns Please contact John McMurtry, Vice President, Program Advance- and the dollar amount exempted before imposition of estate taxes ment, at [email protected] or 970-479-9797 with any questions.

STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

STEADMAN PHILIPPON UPDATE (continued from page 3) Philippon Research Institute, which he U.S. Olympic Skiers Set Record for refers to as his most stimulating and one Medals Won whose fellow members are, he says, over- whelmingly qualified. Athletes Benefit from Institute Research Injury Led to Involvement February brought us the 2010 Winter Olympics, where three great Like many of those who support the Americans who have directly benefited from Institute research claimed mission of the Institute, Steven first came seven out of eight Olympic medals for the U.S. in alpine skiing. into contact with the Steadman Clinic, and Two orthopaedic specialists from SPRI, Drs. Bill Sterett and Tom later, the Steadman Philippon Research Hackett, were volunteering as team physicians when Lindsey Vonn, a Institute, because of an injury. “I had three former patient of Dr. Sterett’s, won a gold in women’s Downhill and a knee injuries over a period of 15 years,” he bronze in women’s Super G. explains, “and I was fortunate enough to Julia Mancuso, who has been treated by pioneering hip specialist be able to see Richard Steadman the day Dr. Philippon, brought home silver medals in both women’s Downhill after my first ski accident. I was one of those and women’s Super Combined. aggressive recreational athletes who was And Bode Miller, whose career was saved by Dr. Steadman in 2001 able to take advantage of Dr. Steadman’s when his torn ACL underwent “healing response,” captured gold in approach to sports medicine before many men’s Super Combined, silver in men’s Super G, and bronze in men’s others. His ‘healing response’ technique Downhill. gave Dr. Steadman a competitive advantage (Update continues on page 15) because it was putting highly paid athletes back into competition three to five months faster than knee reconstruction procedures. “Later, when I was asked to serve on the Board, accepting the invitation was an easy decision and an honor,” he says. “The approach of the Institute was something with which I was very familiar, that is, using evidence-based medicine to maintain wellness, extend the length of a person’s physically active life, and enhance physical and mental performance.”

A Good Fit Steven is a near-perfect match for the work of the Board in many other ways.

Bode Miller of the United States competes in the slalom portion of the men’s Super- He began skiing as a toddler and he was a combined at the Vancouver 2010 Olympics in Whistler, British Columbia, Canada, Sunday, scholarship athlete on three NCAA champi- Feb. 21, 2010. (AP Photo/Alessandro Trovati) onship ski teams at the University of Utah. He also participates in road biking, he races vintage cars, he plays golf, and he enjoys fly-fishing. Did we mention that he believes in staying active? “I grew up in a family that encouraged athletics,” he says. “Sports taught me the values of self-discipline and preparation — make that over-preparation.” Read embraces the theme described in Malcolm Gladwell’s Outliers: 10,000 Hours, and he applies it to his work and to the work of the Institute. “It takes 10,000 hours of preparation and experience for one hour

Lindsey Vonn of the United States, the gold medal winner, center, celebrates with her — or sometimes, one minute — of execu- compatriot Julia Mancuso, silver, left, and Austria’s bronze medalist Elisabeth Goergl tion,” says Read. “That level of dedication during the medal ceremony for the women’s Downhill at the Vancouver 2010 Olympics in and mastery of intuitive skills are what Whistler, British Columbia, Wednesday, Feb. 17, 2010. (AP Photo/Alessandro Trovati) Steadman Philippon doctors and researchers going in the same direction. He calls it must possess to develop creative and ground- alignment — like-minded people sharing the breaking solutions to orthopaedic care.” same vision, making the same commitment, His family apparently also taught him and working together to help people main- the values of long-term commitment and tain a level of physical and mental perform- priorities. He has been married to his ance ingrained into their lifestyle. “kindergarten sweetheart,” Mary Ann, for uuuu 40 years, has three children and six grandchildren. You can ask him about his business, but he would prefer to tell you a story about Steadman Hawkins someone in his family. Foundation Becomes The Business Part of Building Steadman Philippon Although his business and sports back- ground are impressive, perhaps his most Research Institute important contribution to the Institute comes from his experience as a board Steadman Hawkins member at other institutions. At Duke University, he was instrumental in identify- Clinic Becomes the ing and funding more than $900,000,000 Steadman Clinic of building projects. In a similar capacity on the board of Fine Arts Museums of San Fran- wo associated organizations of interna- cisco, he was in charge of a $200,000,000 Ttional renown, dedicated to the advance- project that resulted in the 2005 re-building ment of orthopaedics and keeping people of the M. H. de Young Memorial Museum. active, have changed their names. Founded The museum is now considered one of the in 1990 and formerly the Steadman Hawkins most unique architectural structures in Clinic, The Steadman Clinic will continue its the world. seminal work in the diagnosis and treatment of orthopaedic injuries and disorders. Give Before You Get In addition, the Steadman Hawkins Research “Life needs to honor those who ‘give’ Foundation becomes the Steadman Philip- before they ‘get.’ The Institute promotes this pon Research Institute (SPRI), and will carry philosophy of giving,” says Read. “This belief forward its 22-year history of investigating is reflected through its practices, research, the causes, prevention, and treatment of publications, and especially by sharing orthopaedic disorders. its knowledge with the world’s medical (continued on page 6) community. “Once you are executing,” says Read, “a lot of things in life have to be intuitive. Preparation and experience allow you to make quick, well-informed decisions. At the end of the day, you are steering with your accelerator, not looking into the rear view mirror. “The Board is encouraged to in the same way to contribute its work and wisdom to advise the Institute through its many years of diverse cumulative experience to maintain the Institute’s leadership in research-based orthopaedics.”

Alignment is the Key Steven Read is an example — perhaps a prototype — of a fast-moving, give- before-you-get leader who shares his talent and passion with a research organization Photo: John Kelly

STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

(continued from page 5) recovery process. Many of the best athletes Knee surgeon Dr. Richard Steadman in the world, from the U.S. Ski Team to established the Steadman Sports Medicine players from every team in the NFL and Foundation in 1988 after recognizing the most major league baseball and soccer need for an official research entity to prove teams, have chosen Dr. Steadman as their theories about surgery, healing, and the knee doctor. rehabilitation of knee injuries and disorders. Now Steadman has taken an important The Institute’s focus has widened to include step to ensure the continuity of his mission, all areas pertaining to orthopaedics in the “Keeping People Active,” by naming human body in four areas of research: basic Steadman Clinic hip expert and managing science, clinical, biomechanics, and imaging. partner Dr. Marc J. Philippon to the marquee Notably, this organization has established of the new Steadman Philippon Research one of the largest knee, shoulder, and hip Institute (SPRI). databases in the world and has published “Marc Philippon has a well-deserved over 150 articles and research papers in peer- international reputation for his work in reviewed journals. “Everyone can relate to the treatment of sports-related hip injuries. Dr. Steadman’s original vision of keeping He has treated numerous Olympic and people active, and this mission has attracted professional athletes, returning them to accomplished board members, scientists, full competition. Some of these athletes researchers, and business people who have have gone on to break records in their sports taken a personal interest in the success of following recovery from hip surgery. We are the Steadman Philippon Research Institute,” very fortunate to have Dr. Philippon in Vail,” added J. Michael Egan, president and CEO commented Dr. Steadman. “He is a talented of SPRI. surgical innovator in the treatment of dis- Dr. Steadman invented the microfrac- orders and injuries of the hip and a pioneer ture procedure in the early 1980s, and today in the development of arthroscopic instru- this technique — a combination of surgery ments for hip surgery. He is especially skilled and specific rehabilitation — is widely used at addressing complex mechanical problems throughout the world. He was also one of in the hip. This, coupled with his integrity the first to design rehabilitation that intro- and leadership qualities, makes him an ideal duced the concept of moving the joint after addition to our research organization. Thus surgery. The standard treatment at that time far, he has produced more than 54 articles was immobilized ligaments and joints during and 300 presentations under our auspices.” recuperation, a practice that has since been “I am honored and pleased to be associ- abandoned in favor of more active rehabili- ated with Dr. Steadman in such a dynamic tation, which has been proven to speed the and productive organization. His precedent- setting work in the field of orthopaedics and the Institute’s research are held in high regard by the people and organizations I admire,” said Dr. Philippon. Dr. Philippon created a hip fellowship program at the University of Pittsburgh Medical Center in 2001. After joining the Vail Clinic, he integrated his fellowship program into the Institute’s existing sports medicine fellowship. Since then, Dr. Philippon developed a novel reconstructive technique to treat athletes with deficient labrums. This procedure has allowed professional athletes to return to their sports and its use has been expanded to include other appropriate patients. It has been validated through the Institute’s clinical database on outcomes. Three of Dr. Philippon’s former Fellows are now team physicians with NFL,

Photo: John Kelly NBA, and MLB teams.

Dr. Tom Clanton joined the staff of the clinic in August of 2009. He is a talented surgeon who has a worldwide reputation in the treatment of foot and ankle disorders and injuries. This spring, Dr. Rob LaPrade, an accomplished knee surgeon and researcher from Minnesota, will also join the Steadman Clinic. The Steadman Clinic is pleased to announce that former co-director of the shoulder service at Harvard, Dr. Peter Millett, has recently been named Chief of the shoulder service for the clinic.

The Steadman Clinic Physicians • Dr. Richard Steadman – knee injuries and disorders • Dr. Marc Philippon – sports-related injuries and disorders of the hip • Dr. Thomas O. Clanton – foot and ankle injuries and disorders and sports medicine

• Dr. William I. Sterett – sports medicine, Photo: John Kelly trauma, and injuries of the knee and leg; Team Physician for the U.S. Women’s Ski niques that have promoted faster and more Team successful healing of injured joints. Its focus • Dr. Peter J. Millett – shoulder surgery and is as much about helping grandparents stay sports medicine active with their grandchildren in the sports • Dr. Randy W. Viola – hand, wrist and elbow they enjoy, such as skiing, as it is about injuries, sports medicine, limb reattachment extending the careers of scores of Olympians • Dr. Donald S. Corenman – spine injuries and professional athletes, by helping them and disorders get back in the game. Founded in 1990, its • Dr. David C. Karli – physical medicine and physicians are among the best trained and rehabilitation, non-operative spine and most experienced in sports medicine and sports injuries, and regenerative medicine orthopaedic surgery. At the Steadman Clinic, • Dr. Tom Hackett – sports medicine, injuries the physician, patient, and therapist work of the shoulder, elbow and knee; Team as a team, from diagnosis to rehabilitation, Physician for the U.S. Snowboard Team to achieve the best possible outcome. The • Dr. Sanjitpal (Sonny) Gill – spine injuries Steadman Clinic works closely with Vail’s and disorders and sports spine injuries Steadman Philippon Research Institute (SPRI) When asked why the Clinic name has by sharing its clinical data with the Institute. been changed to the Steadman Clinic, Dr. Twitter: @SteadmanClinic Steadman replied, “We want to empha- size the fact that we now treat all areas in Steadman Philippon Research Institute orthopaedics, not just knees and shoulders. The Steadman Philippon Research Institute In addition, when Dr. Hawkins relocated (SPRI) (www.sprivail.org) is dedicated to to South Carolina in 2004, our paths natu- keeping people of all ages physically rally diverged, and it is appropriate for Vail active through orthopaedic research and to now choose the brand ‘The Steadman education in arthritis, healing, rehabilitation, Clinic.’” and injury prevention. Founded in 1988 by orthopaedic surgeon Dr. Richard Steadman The Steadman Clinic as the Steadman Sports Medicine Founda- The Steadman Clinic (www.steadman tion, the 501(c) (3) charitable organization clinic.net) in Vail, Colorado — with one has influenced the practice of orthopae- additional clinic in Frisco, Colorado — is dics throughout the world. Based in Vail, internationally recognized for developing Colorado, it has become one of the most and refining surgical and rehabilitation tech- published organizations in sports medicine research and education. uuuu STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

EDUCATION Europe. The European component of the Scholars program was developed in conjunc- tion with Arthrex, Inc., an orthopaedic Visiting Scholars medical device company founded by its Program Brings French president, Reinhold Schmieding. and Brazilian Physicians Getting the Call to the Institute “I first learned about the Steadman Clinic and the Steadman Philippon Research Dr. Jean-Yves Schoenahl and Institute when I read that some professional soccer players in Europe had gone to Vail Dr. Leandro Ejnisman will spend to be treated for their injuries,” recalls Dr. a year observing, assisting, Schoenahl. “Of course, I also knew about researching, and writing before Dr. Richard Steadman because of his world- taking their knowledge and skills wide reputation in sports medicine and his microfracture procedure. One of the doctors to Europe and South America. in France had worked with Dr. Peter Millett By Jim Brown, Ph.D., Executive Editor when he was in Boston, and he encouraged me to apply for the Visiting Scholars pro- wo orthopaedic surgeons, Dr. Jean-Yves gram. He told me that Steadman Philippon TSchoenahl of Strasbourg, France, and Dr. would be the best place for me to improve Leandro Ejnisman of Sao Paulo, Brazil, are my surgical skills and to conduct research.” spending a year at the Steadman Philippon “Jorge Paulo Lemann (one of the most Research Institute as participants in the SPRI important business leaders in Brazil) sup- Visiting Scholars program. ports SPRI’s Visiting Scholar program and is The physician-scholars will work with also a major sponsor of the Brazil Institute Steadman Philippon surgeons and scientists of Health Technologies, which pays for my to learn new surgical techniques, observe scholarship,” explains Dr. Ejnisman, who clinical practices, attend professional meet- was awarded his scholarship over a field of ings, conduct research, and submit the 20 applicants. results of their research to orthopaedic Dr. Ejnisman recently completed his journals. formal medical education at the University Dr. Schoenahl received his medical train- of Sao Paulo and will focus on hip surgery. ing at the University of Strasbourg (formerly “I knew about the international reputation Louis Pasteur University), where he will of Dr. Marc Philippon, and my brother, who return later this year to continue post-gradu- is also a physician in Brazil, had spoken ate studies. He was invited to participate with him. I applied for the Visiting Scholars in the SPRI Visiting Scholars program after position, sent them my credentials, and was being selected from candidates throughout interviewed in Rio de Janeiro. When I got Photos: Joe Kania Dr. Leandro Ejnisman Dr. Jean-Yves Schoenahl, left, with Dr. Peter J. Millett. the news that I had been accepted into the “To be such a famous guy, he is a really open program, it was a very happy day.” person. He knows everybody and speaks to everybody. In the operating room, what Making the Transition he does isn’t easy, but he is a very skilled For Drs. Schoenahl and Ejnisman, the and experienced physician who makes it transition to the U.S. has been smooth. “Vail look easy.” is a very pleasant place,” says Jean-Yves. “The people in the town and at Steadman What’s Next Philippon are very open-minded and eager At the end of their year at SPRI, Dr. to help. The city has an international feel Schoenahl and Dr. Ejnisman will return to and it is easy for people from other countries their countries. Dr. Schoenahl will resume his to meet others. This is true; I’m not saying it studies in Strasbourg and Dr. Ejnisman will just to be nice.” begin his practice in Sao Paulo. Both would Both also had the advantage of com- eventually like to continue as orthopaedic municating with their predecessors in the surgeons, teach medical students, and Visiting Scholars program. Dr. Schoenahl conduct research. got advice of Dr. Florian Elser of Germany, “There are still many questions yet to and Dr. Ejnisman was helped by Dr. Bruno be answered regarding hip arthroscopy,” Goncalves Souza. says Dr. Ejnisman. “I’d like to do research to “He told about his experience and what answer some of those questions.” to expect when I arrived in Vail and began “The Visiting Scholars program has my work at the Institute,” says Dr. Ejnisman. given us a great opportunity to improve “I was even able to move into the same ourselves and to discover a new culture,” apartment where Dr. Goncalves lived.” says Dr. Schoenahl. “It is very important for Language, which is a major adjustment us to spread the knowledge of orthopaedic for many people, has not been an issue for surgery and sports medicine at the Steadman Leandro, probably because he speaks five Philippon Research Institute to the rest of languages. Although Dr. Schoenahl did not the world.” have conversational English experience uuuu when he arrived in November of 2009, his language skills are very impressive. He says research update he still has problems with understanding slang, but so do many Americans. Institute Research Daily Routines Shows Benefit of Hip Now that both men have settled into their routines at the Institute, their schedules are Arthroscopy in Injured filled with spending time in the operating Professional Hockey room, attending to clinical duties, going to in-house education sessions, reading about Players research conducted at the Institute, and By Karen Briggs, M.B.A., M.P.H., Director, Clinical Research working on their own research projects. Dr. Ejnisman, whose focus at the Insti- ockey is one of the top four professional tute is hip arthroscopy, observed more than sports played in the United States. The 20 procedures performed by Dr. Philippon H National Hockey League is made up of many in just his first two weeks at the Institute. players from Canada, where hockey is the Dr. Schoenahl, whose research will center on official winter sport. The NHL, however, is management of the shoulder joint, spends an international league with players coming much of his time observing, assisting, and from more than nine countries. working with Dr. Millett. Approximately 1.4 million people “What I notice here is that the surgeons around the world play hockey, with just un- are very involved in current research,” says der 570,000 in the United States. Ice hockey Dr. Schoenahl, “and it shows in their proce- requires repetitive motion and high impact. dures. They want to do what is best for their Ice hockey is a full-contact sport and carries patients.” a high risk of injury. Not only are the players “What surprised me about Dr. Philippon is how friendly he is,” says Dr. Ejnisman. (continued on page 10) STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

(continued from page 9) The study concluded that arthroscopic moving at around 20–30 miles an hour treatment of the professional hockey player (32-48 kilometers per hour), quite a bit (NHL) for debilitating hip pain allowed of the game revolves around the physical for return to sport accompanied with high contact between the players. Skate blades, patient satisfaction. This study highlighted hockey sticks, shoulders, hips, and hockey the need for early intervention after injury. pucks all contribute. The number of injuries The earlier the players were treated, the is quite high. less chondral damage and the earlier they Goaltenders experience extreme hip returned to the ice without sacrificing a motion due to their use of the butterfly posi- decline in long-term function. tion. The hockey stride also places the hip in Arthroscopic hip surgery does not flexion, abduction and external rotation. Hip require as much surgical trauma as does injuries are common in hockey and are con- open hip surgery. Another recent study sidered a cause of significant disability and demonstrated the long rehabilitation are a potential cause of early retirement. required in hockey players following open A study recently published in the American hip surgery. The study showed that hockey Journal of Sports Medicine, authored by Dr. players returned to hockey in seven months. Philippon, reported the outcomes and return In the study by Dr. Philippon, the players to sport in NHL hockey players who were returned to hockey in three months. This treated with hip arthroscopy for labral tears study demonstrated that arthroscopic hip and femoroacetabular impingement. surgery allows for shorter rehabilitation The study included nine defensemen, and quicker return to sport. This is one of 12 offensive players, and seven goaltenders the few sports in which results have been who had hip arthroscopy. The average age published in both open and arthroscopic at the time of surgery was 27 years. The surgery. average time to return to skating/hockey uuuu drills was three months. Players completed a follow-up questionnaire at an average of Research to Determine 24 months after arthroscopy. The Modified Harris Hip Score, which is a patient-derived Whether Specific Foot- outcome score used to measure function, im- wear Will Reduce Low- proved from 70 preoperatively to an average of 95 at follow-up. The players were very er Extremity Injuries satisfied with the outcome of the surgery. By Michael R. Torry, Ph.D., Director, Biomechanics An important result of the study showed Research Laboratory; Jake Krong, M.S., Research Intern that players who delayed surgery had more chondral damage. ver 30 million Americans are classified as Orecreational runners. Despite advances in footwear technology, over half of these runners will miss time each year due to injuries such as plantar fasciitis, Achilles tendinitis, and knee pain. These injuries are associated with overpronation, or excess eversion motion of the rearfoot, and therefore running shoe companies have designed footwear with the goal of reducing this motion. Traditional motion-capture methods have not allowed us to see how the bones of the foot move within a shoe, and how the foot interacts with the materials in a shoe. Biplane fluoroscopy, however, allows mea- surement of individual bone motion within the foot to sub-millimeter accuracy. Such levels of precision have never been achieved in quantifying foot motion during walking and running.

10 Figure 1: Biplane fluoroscopy images are taken of a subject’s neutral foot alignment

Figure 2: A three-dimensional model of the foot reconstruct- ed from a CT scan

Figure 3: Bone models matched to fluoroscopy images during a running trial

Figure 1 Figure 2 Figure 3

In a collaborative study sponsored by that included the crash pad were both very Saucony, five runners were tested in the effective in reducing peak eversion angle. biplane fluoroscopy system. Saucony created Therefore, Saucony’s consumer (shelf) model four pairs of shoes with and without differ- is most effective at reducing excess rearfoot ent types of technology. The base shoe was motion. This is the first dataset that de- a basic cushioned running shoe that did not scribes how running shoe technology affects contain any of the technology that Saucony foot motion with the accuracy and precision uses in their footwear to reduce rearfoot of biplane fluoroscopy. motion. The medial post model contains a In addition to running, subjects also higher density cushioning material on the walked and ran barefoot through the inside of the shoe, which is meant to prevent biplane fluoroscopy system, and images the foot from rolling inwards (pronating) were also collected after a treadmill fatigue too much. The crash pad model contains protocol. This additional barefoot data, a heel insert that is designed to align the which is currently being analyzed, will give foot on a neutral, forward path while it is us important information about the normal touching the ground. The shelf model is the ranges of motions of the small bones in the shoe that Saucony sells to consumers, and it foot. The fatigued running data will help contains both the medial post and crash pad. us understand how shoe technology affects The overall eversion range of motion was motions when the muscles of a runner are lowest in the shelf model. The two models tired, which would be the case at the end of a longer run or race. We hope to use this information to understand how specific footwear types may reduce lower extremity injury prevalence. We recommend that you visit a specialty running store when purchasing a new pair of running shoes. It is difficult to generalize among people who may exhibit variation Figure 4 in running mechanics, arch type, weekly Saucony running shoes with medial post and crash mileage, and many other factors. In general, pad identified however, a runner with a flat foot (low arch) who tends to over-pronate will most likely need a motion control shoe with stability features such as medial posting. A runner with a moderate arch height whose foot follows a more neutral path (does not roll inward as much) might only need a lighter- weight cushioned shoe without as much stability. Even in that case, features such as the crash pad will optimize a neutral path Figure 5 while the foot is in contact with the ground. Comparing two different important rearfoot motion uuuu variables (range of motion and peak eversion angle, both measured in degrees) across four different shoe models. 11 STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

and then used to calculate various biomechanical parameters. These pitchers were then followed over an extended period of time to look for incidence of injury. one study showed a significant relationship between pitch velocity and elbow injury, with higher velocity correlating with a higher incidence of injury. An additional study showed a significant relationship between increased elbow valgus torque/ shoulder internal rotation torque and elbow injury. This will be presented at the American Academy of Orthopedic Surgeons/ American Shoulder and Elbow Society Colorado Rockies Combined Meeting in Miami, Florida, in pitcher Aaron Cook. April 2010. These studies are significant in that Ongoing Research in they prove causal relationships between Baseball Medicine certain biomechanical parameters and injury in baseball. In the past, these relationships Provides Further Clarity had been speculated but not proven. With for Treatment and Care scientific evidence of these relationships, care delivered to these athletes can improve, By: Thomas Noonan, M.D. Dr. Noonan is an orthopaedic surgeon and principal in not only at the professional level but also the Steadman-Hawkins Denver Clinic at the amateur and youth levels. We will continue to strive to better understand these njury has been a part of baseball as long injury mechanisms and prolong the careers Ias the game has existed. For decades, of these athletes. many injuries were essentially untreatable uuuu and ended many promising careers. More

recently, baseball medicine has advanced SPORTS AND WELLNESS and prolonged the careers of many players. The cause of injury, however, has remained somewhat clouded. Our ongoing research Leading You Down the has provided clarity as we have established Road to Recovery the relationship between certain throwing parameters and clinically significant injury. By Steve Stalzer, M.S.P.T., S.C.S. Through our relationship with the Managing Partner, Howard Head Sports Medicine Centers Colorado Rockies Major League Baseball Club, we recently showed that a lack of hances are if you are reading this news- shoulder strength (specifically external Cletter, you have had exposure to the rotation and elevation) correlates with an Steadman Clinic by seeking the best avail- increased risk of injury requiring shoulder able medical care for an injury or pain. For or elbow surgery. These findings were pre- those who have had surgery or treatment sented at the American Orthopedic Society with one of the physicians at the clinic, your for Sports Medicine annual meeting in July initial exposure to therapy likely seemed to 2009. Armed with this information, we can be just a part of the experience. Your thera- hopefully design better training programs pist may have appeared as an extension of for our pitchers to improve their strength your physician’s team. The purpose of this and decrease their risk of injury. article is to ensure that you receive the most Additional biomechanical studies have out of any therapy experience you may need been performed with Dr. Michael Torry, the for future bumps, bruises, or surgeries. Use director of the biomechanics department at the tips below as a roadmap for finding a the Steadman Philippon Research Institute. rehabilitation specialist. Complex video analysis of major league First, select a therapist who works pitchers was performed at spring training closely with your physician. At Howard Head Sports Medicine, we have had the privilege 12 of working with the Steadman physicians for over 25 years. Supporters of therapy, the Steadman Clinic physicians believe, is an inte- gral and valuable part of the healing process. Before Dr. Clanton joined the clinic, two therapists from our team traveled to Texas to learn about his surgical procedures and rehabilitation that accompany the advanced surgical techniques being provided by this world-renowned physician. The Steadman Clinic physicians and Howard Head Sports Medicine therapists than good customer service. These form a have partnered to develop protocols that foundation of a relationship that will help match rehabilitation with surgical tech- you meet your goals on the road to recov- niques, ensuring that you are provided with ery. Your therapist should provide you with the most appropriate and effective care. the motivation and inspiration to help you At home, make sure your therapist through the rough days. understands your physician’s rehabilitation By selecting a therapist who is a great fit guidelines and philosophy. Close communi- for you and committing yourself to a proper cation between your therapist and physician rehabilitation program, you are taking a will help you progress at the right pace. Your great step in the right direction on the road therapist can also help identify if things are to recovery. not on track and may require follow-up with uuuu your physician. Choose a specialist. Like physicians, therapists complete general training in all Powerful Prevention areas. Some remain generalists, while others from Vitamin D specialize in areas such as pediatrics, hand therapy, orthopaedics, and sports medi- By Melanie Hendershott, R.D., C.S.O. cine. Just as you would not want a general Editor’s Note: Melanie is the outpatient dietitian for the surgeon operating on your knee, you also Shaw Regional Cancer Center in Edwards, Colorado would not choose a general therapist to provide therapy following a meniscus repair or What is Vitamin D? ACL reconstruction. Find a therapist who has Vitamin D is more like a hormone than a completed a residency or holds an advanced vitamin. Our bodies manufacture vitamin D certification such as OCS (orthopaedics), SCS when sunlight hits our skin. The risk of vita- (sports), or CHT (hand therapy). min D deficiency increases during the winter Visit a clinic that practices evidence- season. The rays of the sun are inadequate based medicine. Therapists who are involved during the winter months if you live north of in research and modify treatment techniques the 37 north latitude, as we are here in Eagle and therapy programs based upon research County (see Figure 1). A lighter skin person will provide you with the best rehabilita- needs approximately 6-8 minutes with 25 tion possible. By collaborating with physi- percent of body exposure (arms and legs) to cians at the Steadman Clinic and researchers make 1,000 IU Vitamin D at noon on June 21. at Steadman Philippon Research Institute, For those with darker skin, the need increases Howard Head Sports Medicine has been able 18 minutes without sunscreen. to validate exercises through EMG studies Unfortunately, there are only a few and modify rehabilitation protocols based foods that naturally contain vitamin D, upon clinical research data. Rehabilitation making it very difficult to obtain enough should continue to be modified according to from the diet. Milk is fortified and natu- advances in surgical procedures as we learn ral sources primarily come from seafood. more through clinical outcomes. Because of our long winter months and low Finally, choose a therapist with whom dietary intake of vitamin D, supplementa- you enjoy working. You will know in the tion is often necessary to maintain first five minutes of your first session if you proper levels. are on the right track. Presence in conversa- (continued on page 14) tion and establishing a connection are more 13 STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

Risks of Vitamin D Deficiency checked. Ask your doctor to add the test to Risk factors for vitamin D deficiency your regular blood work. Another option is include age older than 65 years, exclusively to get a $40 home test kit from Grassroots breast-fed infants, dark skin, low sunlight Health (www.grassrootshealth.org), a non- exposure, sedentary lifestyle, and obesity. profit organization that focuses on vitamin According to a recent article from Harvard D. Vitamin D deficiency is defined as levels Medical School, approximately one-third of less than 20 ng/ml and insufficiency at 20 to adults are either in the deficient or insuf- less than 30 ng/ml. Normal levels are 30-100 ficient vitamin D categories. Also, 75 percent ng/ml (see Table 2). Repletion guidelines for of those with cardiovascular disease are deficient and insufficient levels are to take low in Vitamin D. In fact, having adequate 50,000 IU per week for eight weeks, then vitamin D levels between 30 and 60 ng/ml recheck and repeat as necessary until normal can result in a 35 percent decreased risk levels are reached. of cancer; up to 80 percent reduced risk of breast cancer; up to 60 percent reduced risk Supplementation Recommendations of colon cancer; decreased risk of cancers of The American Academy of Pediatrics the pancreas, advanced prostate, ovary, non- recommends that infants and children have Hodgkin’s lymphoma, kidney, leukemia, and 400 IU/day within the first few days of life endometrial cancer; 49 percent decreased with supplementation, the formula, or risk of fractures; 72 percent decreased risk milk (1 liter). For adults, the Harvard article of falls, 13 percent reduction in blood recommends 800 to 1,000 IU vitamin D pressure; and even a 77 percent reduced supplementation as the easiest way to risk of influenza. Vitamin D deficiency is obtain adequate amounts. also associated with increased risk of More Research autoimmune deficiencies such as multiple A new study funded by the National sclerosis, type 1 diabetes and lupus. There- Institutes of Health is looking for partici- fore, eliminating vitamin D deficiency could pants. The study is called The VITamin D and be one of the most important public health Omega-3 TriaL (VITAL) and will be investigat- advances of our time. ing men and women taking 2000 IU vitamin Know Your Level D and 1 gram Omega-3 daily for reduced risk Like knowing your cholesterol, it is of heart disease, stroke, and cancer. If you important to have your vitamin D level are interested in participating or want more information, visit their website at www. Table 1 A Partial List of Foods that Naturally Contain Vitamin D vitalstudy.org.

Main Message Vitamin D can be a large factor in chronic disease prevention, but only if you know your levels are adequate. Please ask your doctor to check not only your level, but to consider checking the levels of all their Figure 1. patients. It could be lifesaving. uuuu

Table 2. Blood Levels of Vitamin D 25(OH)D3 Health Implications Ng/ml Deficiency, high risk of various conditions- <20 Requires repletion Insufficiency, mild risk of various conditions 20-29 – Requires Repletion Sufficiency, decreased risk of various 30-100 conditions >100 Possible unsafe level Toxic levels, impossible to achieve with sun >150 exposure alone

14 (Steadman Philippon Update, continued from page 4) 2010 Arthroscopy Association of North America, May 20-23, Hollywood, Florida Publications, Presentations, The Arthroscopy Association of North America (AANA) is an accreditation council for continuing medical and Research education. AANA exists to promote, encourage, support, Institute Research Leads the and foster the development and dissemination of knowledge of arthroscopic surgery in order to improve upon World. the diagnosis and treatment of diseases and injuries of the musculoskeletal system. Karen Briggs, M.B.A., M.P.H., Director of Clinical Re- search, reports that 2010 will be another prolific year for AANA accepted the following presentations: the Institute as numerous papers have been accepted by Optimization of Magnetic Resonance Imaging of the prestigious medical and scientific societies and journals. Anterior Bundle of the Ulnar Collateral Ligament: A Randomized Controlled Trial of 3 Patient Positions. 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons Subcoracoid Impingement: Factors Associated With the The 77th Annual Meeting of the American Academy Size and Location of the Coracohumeral Interval. of Orthopaedic Surgeons (AAOS), New Orleans, March 9-13, accepted four podium and four poster presentations The following research will be presented at AANA as highlighting Institute research. e-posters: The Academy provides education and practice management services for orthopaedic surgeons and allied Hip Arthroscopy in The Patient 50 Years and Older. health professionals. The Academy also serves as an advocate for improved patient care and informs the New Method To Assess CAM Impingement and the Risk public about the science of orthopaedics. Founded as of Chondral Damage Using AP Pelvis Radiographs. a not-for-profit organization in 1933, the Academy has grown from a small organization serving less than 500 Subcoracoid Impingement: Factors Associated With a members to the world’s largest medical association of Narrow Coracohumeral Interval in Patients Who Under- musculoskeletal specialists. The Academy now serves went Coracoidplasty. more than 34,000 members internationally. Comprehensive Arthroscopic Management (CAM) of Shoulder Osteoarthritis in Young Active Patients. Podium Presentations 2010 European Society of Sports Traumatology, Use of an Unloader Brace for Medial or Lateral Knee Surgery and Arthroscopy Annual Meeting, Compartment Osteoarthritis of the Knee. June 9-12, Oslo, Norway The European Society of Sports Traumatology, Knee Tegner Index and Lysholm Scores Assess Activity and Surgery and Arthroscopy (ESSKA) promotes the exchange Function 6 Years Post Collagen Meniscus Implants. of information data covering research into the scientific and practical aspects of knee ailments. Outcomes Following Arthroscopic Labral Repair in the Hip: Prospective Minimum 2-Year Follow-Up. ESSKA has accepted the following five podium and two poster presentations for the annual meeting. Relationship Between the FABER Test and the Radiographic Alpha-Angle in Patients With FAI. Podium Presentations: Knee Outcomes Data Collection in a Sports Medicine Poster Presentations Practice With a One-Page Form. Analysis of Scores To Document Outcome Following Hip Outcomes Following Hip Arthroscopy With Microfracture. Arthroscopy Meniscus Tear Types and Patterns Correlate With Function and Activity Levels at Least Two Years Decreased Femoral Head-Neck Offset Maybe a Possible After Partial Meniscectomy. Risk Factor for ACL Injury. Function and Return to Activity Outcomes Six Years After Outcomes of Displaced Clavicle Fractures: Non-Operative Partial Meniscectomy Vs. Collagen Meniscus Implants Vs. Intramedullary Fixation. Assessed With Lysholm Scores and Tegner Index.

Decision-Making in Treating Diaphyseal Clavicle Fractures: Hip Arthroscopy in the Patient 50 Years and Older. Is There Agreement Among Surgeons? (continued on page 16) 15 STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

(continued from page 15) Method for Determining Scapulo Thoracic Motion Poster Presentations: In The Lat Pulldown in Healthy Subjects Using Bi-Plane Viscosupplementation Injections Augmented with Fluoroscopy. Anker CR, Shelburne KB, Hackett TR, Corticosteroid for Knee Osteoarthritis: Patient Duffy P, Peterson DS, Krong J, Hageman L, North A, Expectations and Clinical Outcomes. Torry MR, Giphart JE.

Use of an Unloader Brace for Medial or Lateral Tibio-Femoral Kinematics of Soft and Stiff Landings: A Compartment Osteoarthritis of the Knee. Bi-Plane Fluoroscopic Study. Peterson DS, Shelburne KB, Giphart JE, Krong J, Steadman JR, Torry MR. Mike Torry, Ph.D., Director of the Biomechanics Research Laboratory, reports that 19 abstracts have been The Relationship of Lower Extremity Alignments, Knee accepted by the Orthopaedic Research Society for its 2010 Laxity and Anterior Tibial Translation During Drop Land- annual meeting and one abstract was accepted by the ings: A Bi-Plane Fluoroscopic Study. Torry MR, Peterson Society of Military Orthopaedic Surgeons for its annual DS, Shelburne KB, Krong J, Giphart JE, Steadman JR, meeting. Woo S L-Y. 2010 Annual Meeting of the Society of Military Hip Rotation Function of the Pectineus Muscle. Decker Orthopaedic Surgeons (SOMOS) Annual Meeting, MJ, Krong J, Hageman LR, Torry MR, Philippon MJ (2010), December 13-17, 2010, Vail, Colorado Torry MR, Peterson DS, Shelburne KB, Krong J, Giphart JE, The purpose of the Society of Military Orthopaedic Steadman JR, Woo S L-Y. Surgeons is to provide a forum for the interchange of medical knowledge as it relates to the practice of Ortho- Thigh Strength Does Not Correlate With Anterior Tibial paedic surgery in the military. SOMOS shall hold at least Translation During Drop Landings: A Bi-Plane Fluo- one general meeting each year. The annual meeting is roscopic Study. Torry MR, Peterson DS, Shelburne KB, primarily of a scientific nature. Previous conferences have Krong J, Giphart JE, Steadman JR, Woo S L-Y. generated over 500 in attendance.

SOMOS accepted the following abstract for presentation: A Comparison of Muscle Contributions to Belly Press and Does Biceps Tenodesis Alter Shoulder Kinematics? A Lift Off Tests With Simulated Obesity. Yanagawa T, Torry Novel Approach In Vivo Biplane Fluoroscopy Study. C. MR, Shelburne KB, Hackett TR, Pandy MG. Dewing, M.D., M.C., U.S.N.; F. Elser, M.D.; JE Giphart, Ph.D., J. Krong, M.S.; D. Peterson, M.S.; MR Torry, Ph.D.; Comparison of Two Normalization Schemes For Knee PJ Millett, Ms.C., M.D. Kinematics Derived from Bi-Plane Fluoroscopy. Peterson DS, Shelburne KB, Giphart JE, Krong J, Steadman JR, 56th Annual Meeting of the Orthopaedic Research Torry MR. Society, March 6-9, New Orleans The Orthopaedic Research Society (ORS) is dedicated In Vivo Tibia-Femoral Contact Patterns in the Natural to the advancement of orthopaedic research and to Knee During Jump Landing. Clary CW, Laz PJ, Giphart JE, the translation of basic and clinical research to clinical Torry MR, Rullkoetter PJ, Shelburne KB. practice. The ORS carries out this mission primarily by disseminating knowledge and by promoting the develop- A Musculoskeletal Model of the Hip for the Calculation ment of basic and clinical scientists. The ORS also advo- of Muscle and Joint Loads During Physical Activity. cates for increased resources for research, and increases Shelburne KB, Decker MJ, Philippon MJ, Torry MR. public awareness of the impact of orthopaedic research. Hip Joint Forces During Squatting Exercise Predicted ORS has accepted the following 19 abstracts for With Subject Specific Modeling.Shelburne KB, Decker presentation: MJ, Philippon MJ, Torry MR. Deep Hip Muscle Function During Gait. Decker MJ, Krong J, Peterson DS, Torry MR, Philippon MJ. Muscle Forces at the Hip During Squatting Exercise. Shel- Temporal Predictors of Anterior Tibial Translation In burne KB, Decker MJ, Philippon MJ, Torry MR. Healthy Adults. Peterson DS, Shelburne KB, Giphart JE, Krong J, Steadman JR, Torry MR. Anterior Hip Muscle Forces During Ice Hockey Sprint Starts. Shelburne KB, Torry MR, Krong J, Decker MJ, In Vivo Knee Kinematics Under Increasing Demand Of Philippon MJ. Functional Activities: A Bi-Plane Fluoroscopic Assessment. Torry MR, Shelburne KB, Peterson DS, Krong J, Giphart JE, Steadman, JR.

16 Effect of Long Head Biceps Tenodesis on In Vivo Glenohumeral Translations During Loaded Forward Flexion Using Biplane Fluoroscopy. Giphart JE, Millett PJ, Dewing CB, Elser F, Peterson DS, Krong J, Hageman E, North A, Torry MR.

Effect of Clavicle Shortening on In Vivo Acromioclavicular Rotations During Lat Pull Downs Using Bi-Plane Fluoros- copy. Giphart JE, Shelburne KB, Hackett TR, Duffy P, King J, Peterson DS, Krong J, Hageman E, North A, Torry MR.

Muscle And Joint Loading At The Shoulder During The Forward Punch Rehabilitation Exercise. Yanagawa T, Torry MR, Shelburne KB, Hackett TR, Pandy MG.

Comparison of Six Degrees of Freedom Glenohumeral Kinematics During Abduction, Scaption and Forward Flexion In Healthy Subjects Using Biplane Fluoroscopy. Giphart JE, Millett PJ, Anstett T, Brunkhorst JP, Peterson DS, Krong J, Shelburne KB, Torry MR. Photo: John Kelly

joint-preservation techniques through arthroscopic hip American Academy of Orthopaedic Surgeons surgery. His patients have included Alex Rodriguez, Greg (AAOS) Recognizes Dr. Peter Millett Norman, Mario Lemieux, and Kurt Warner. Congratulations to Dr. Millett for being the inaugural In addition, researchers at the Steadman Philippon recipient of the AAOS Achievement Award. The spirit of Research Institute in Vail, Colo., recently have concluded this new recognition program is to encourage and cele- a study on the effects of stem cells on cartilage regen- brate active volunteer involvement by our membership. eration. In a letter to Dr. Millett, Dr. Joseph Zuckerman, AAOS president, wrote, “It is indeed an honor for me to The January 13 and 14 issues of the New York recognize Academy members like yourself whose volun- Times covered the story of New York Mets center teer efforts support our colleagues, the Academy and fielder Carlos Beltran, who underwent arthroscopic the orthopaedic profession. You and the other Academy knee surgery by Dr. Steadman, In the January 13 Fellows who give of yourselves are the reason for the article, Surgery for Beltran Means He’s Likely Out Until strength of the Academy in all of its endeavors, as well as May, journalist Ben Shpigel writes, The Mets said that it the world of orthopaedics.” was Beltran’s decision and that his “personal physician,”

Dr. Richard Steadman, a noted orthopedist, performed In the Media the surgery in Colorado.

USA Today featured the Institute, Dr. Marc J. During the Winter Olympics, The Wall Street Jour- Philippon, and Dr. Richard Steadman in the nal journalist Matthew Futterman cited Institute February 22 article, Athletes Embrace Cutting- VP for Program Advancement and former US Ski Edge Doctors, Methods To Speed Recovery, by Team coach John McMurtry in articles February 13, Jorge L. Ortiz. The Old Men on the Mountains, and February 18, Both doctors and the Institute were prominently The Americans Win Another Rodeo. featured throughout the article and in the side-bar, In an event such as the Olympics, with so much at Doctors Athletes Rely On: stake, the mental aspect can and usually is the deciding Knees: Richard Steadman. A pioneer in microfracture factor, said former U.S. Alpine Coach John McMurtry. surgery and the co-founder of the renowned Steadman Very often the favorites in the Olympics falter and a dark Hawkins Clinic in Vail, Colo. Much sought-after by skiers horse breaks through. The favorites carry the burden of and soccer players. Patients have included Joe Montana, expectations which can factor into the final result. Lind- Bruce Smith, Kobe Bryant, and Carlos Beltran. sey (Vonn) is a tremendous athlete and is physically and Hips: Marc Philippon. A consultant to teams in the mentally dominant. She radiates confidence. four major sports, Philippon has advanced the use of uuuu

17 STEADMAN PHILIPP O N RESEARCH INSTITUTE WINTER 2010

than animals) periodically and correlate those images with Basic Science findings. In Clinical Research, we’re already collecting data that enable us to correlate imaging results with our long-term studies of clinical outcomes. In Biomechanics, our researchers will be able to incorporate images into their computer models of shoulders, hips, and knees.

Over the past 20 years, what is the most significant development in terms of the Institute’s Photo: John Kelly organization? Dr. Rodkey: It is the fact that the Insti- FREQUENTLY ASKED QUESTIONS tute has evolved from an idea — the brain- child of Dr. Steadman — into a structured What are the most significant organization with four distinct divisions. The breakthroughs or accomplish- organization and the physicians and scien- ments in terms of research of the tists it has attracted have allowed the Insti- Institute? tute to become one of the world leaders in Dr. William G. Rodkey, chief scientific orthopaedic research. That position is based officer, answers: In Basic Science we’ve been on our peer-reviewed publications, national able to define the underlying molecular and and international presentations, and clinical cellular biological events that occur within outcomes. the healing response for ACL injuries. Also, the work we’ve done on microfracture was What are the implications of a major event, especially in identifying the Imaging Research for research importance of removing calcified cartilage being conducted by the Institute? as part of the process and of being able to Dr. Charles Ho, director of Imaging quantify molecular and cellular events at Research, comments: Until now, imaging has two, four, six, and eight weeks following not been included in the Institute’s already the microfracture procedure. In doing so, massive database. By incorporating the we’ve been able to validate the rehabilita- results of imaging into that database, there tion protocol. will be a stronger tie to what happens in The most important event in Clinical the clinic. In fact, what happens in the Clinic Research has been the development of a is the database. Now we will be able to see comprehensive patient database that is how imaging has influenced treatment and almost unique in the world. It is significant outcomes. because we were doing evidence-based We are now knocking on the door of a medicine (EBM) before there was even such whole new area of treatment. With our new a term. Now it’s one of the hottest buzz imaging capabilities contributing to patient words in the medical and medical research evaluation and treatment, we may be able communities. to stabilize, arrest, or reverse the degenera- In Biomechanical Research, probably the tion of tissue before a tear or defect in a most important milestone is our advance in joint occurs. We hope we can contribute to computer modeling of various areas of the understanding, developing, and validating body, and manipulating those models based the type of diagnosis and treatment that no on actual human images. one has been able to do previously. our newest department, Imaging Re- uuuu search, will allow us to do things that will impact the other three divisions. For example, we might be able to image patients (rather

18 SAVE THE DATES Golf Digest listed Sanctuary as the best Habervision new private course in 1997. Gary McCord, CBS golf analyst and senior PGA tour profes- Is Here! Darius Rucker in sional, has said, “Sanctuary is simply the Concert most spectacular golf course I have ever The Steadman Philippon seen.” Research Institute would like to offer all our sup- uly 8 is the The Steadman Philippon Research porters and their families date for our Institute is grateful to Dave and Gail Liniger, J and friends the opportunity annual summer owners and co-founders of RE/MAX Interna- to purchase the new and fundraiser. Darius tional, who created this unique opportunity exciting line of Habervi- Rucker, the for the Institute to develop and enhance sion Polarized Eyewear Country Music relationships with those who support our products and accessories Association 2009 mission. Sponsorship opportunities and team at a 50 percent savings! Horizon Award slots are available now. More information A portion of the proceeds winner and nomi- can be obtained by visiting our website from each sale goes to the nee for 2010, will (sprivail.org) under “Upcoming Events,” Institute. perform at the Gerald Ford Amphitheater or by calling the Development office at in Vail, Colorado. The evening will also (970) 479-5781. To request an invitation or The sunglasses and ski include a sit-down dinner with live and for more information on other upcoming goggles incorporate the silent auction. events, please contact John McMurtry. very best polarized tech- uuuu uuuu nology available. There is something for everyone. Steadman Philippon Go to www.habervision. on the Links com and enter Affinity Member Code: FOUNDA- The 2010 Steadman Philippon TION. There is no expira- Research Institute Golf Classic, tion date. Share the code! presented by RE/MAX International, Shop and enjoy. set for August 19, 2010

roceeds from the seventh annual tourna- Pment will support the development of new procedures and methodology to battle degenerative arthritis. The team event will include a shotgun start with a modified scramble. The tournament is open to the public. Sanctuary organizes and hosts charitable events to support organizations devoted to the arts, children, health care, and crisis management. Through 2009, more than 260 charities have raised more than 47 million dollars to benefit the constituents they serve. Renowned course architect Jim Engh, Golf Digest’s first-ever “Architect of the Year” in 2003, designed the course that protects a private oasis of 220 acres, effectively comple- menting the 40,000 surrounding acres of dedicated open space.

Photo: John Kelly

19 STEADMAN PHILIPPON RESEARCH INSTITUTE Non-profit Org. U.S. Postage Paid 181 West Meadow Drive Suite 1000 Ft. Collins, CO Vail, Colorado 81657 Permit #266 970-479-9797 970-479-9753 FAX http://www.shsmf.org

Steadman Philippon Research Institute is a tax-exempt 501 (c) (3) charitable organization dedicated to keeping people active.

The Steadman Philippon Research Institute is dedicated to keeping people of Mark Your Calendar: all ages physically active through orthopaedic research and education in the areas of arthritis, healing, rehabilitation, and injury prevention. JULY 8, 2010 ADMINISTRATION CLINICAL RESEARCH Darius Rucker, in concert. J. Michael Egan Karen K. Briggs, M.B.A., M.P.H. President and Chief Executive Officer Director The evening includes a sit-down dinner Marc Prisant Kira Barclay with live and silent auction. Executive Vice President and Chief Financial Officer Research Associate Vail, Colorado William G. Rodkey, D.V.M. Leandro Ejnisman, M.D. Chief Scientific Officer Brazilian Visiting Scholar Amy Ruther Marilee Horan, M.P.H. For more information, please contact Human Resources and Accounting Manager Research Associate Sheri Wharton at 970.479.5788 DEVELOPMENT Lauren Matheny or [email protected]. John G. McMurtry, M.A., M.B.A. Research Associate and Bioskills Coordinator Vice President for Program Advancement Christopher Pizzo Sheri Wharton Research Associate AUGUST 19, 2010 Director of Special Events Jessica Corenman 2010 Steadman Philippon Research Institute Maricela Pinela Intern Development Associate Alyson Guillet Golf Classic, presented by RE/MAX International Intern BASIC SCIENCE at Sanctuary, Sedalia, Colo. William G. Rodkey, D.V.M. Mackenzie Herzog Director Intern Ryan Kunkel For more information, contact John McMurtry BIOMECHANICS RESEARCH LABORATORY Intern at [email protected], Michael Torry, Ph.D. Director Brian Maxwell Intern (970) 479-5781. J. Erik Giphart, Ph.D. Senior Staff Scientist IMAGING RESEARCH Jacob Krong Charles P. Ho, Ph.D., M.D. Intern Director Casey Myers EDUCATION Intern Greta Campanale Wes Pennington Coordinator Intern OFFICE OF INFORMATION SERVICES Jean-Yves Schoenahl, M.D. Joe Kania European Visiting Scholar Coordinator Barry Eckhaus Coordinator Executive Editor: Your Legacy, Our Future. Please remember Steadman Philippon Jim Brown, Ph.D. Research Institute in your will, trust, or other estate plan.