Westinghouse Scientific Lecture 2016

Dr. Freddie H. Fu Distinguished Service Professor David Silver Professor and Chairman Department of Orthopaedic Surgery University of Head Team Physician University of Pittsburgh Athletic Department

Medicine is an Art Based on Principle Historical South Side

Work with Nature 1920 1940

1975

UPMC

Recognized for excellence. Sports Performance Complex

! #1 in Pennsylvania, #1 in Pittsburgh ! $10 Billion Global Health Enterprise ! >20 Hospitals; 400 Doctors’ Offices/Outpatient Sites ! 55,000 Employees; 3,600 Physicians UPMC UPMC Rooney Sports Performance Complex Lemieux Sports Performance Complex

How Do You Tear The ACL?

“Just do the right thing”

“Take good care of your patients and they will take good care of you”

Prof. Albert B. Ferguson, M.D. Chairman: 1953-1986 How Do You Tear The ACL? How Do You Tear The ACL? Examination of a Torn ACL What Does the ACL Look Like?

90º PL AM

Arthroscopy Torn ACL “Lucy” – 3.2 million years old Form Follows Function

Bony Morphology " ACL

Dr. Owen Lovejoy

Human knee Gorilla knee

Lucy Modern Human

Lovejoy, Fu, et al

Say what? you have 3 bundles? Variation in Range of Motion Between Species

Lion Polar bear

Cotton top Tiger Mandrill

! 12 yr old male ! Biting and pinching on left knee for several months ! Showing left knee to the zookeeper multiple times

Physical Examination After the Surgery

■ Johnny is doing well

■ No more biting and pinching of knee

■ Good motion Ice Hockey Football

2012 NFL Hall of Fame

Dan Marino Sydney Crosby

Gordon Fu

Curtis Martin

Medical Staff

Soccer

Roberto Baggio

Charles Smith

Pelé Dejuan Blair Suzie McConnell The Movie

Concussion

The Hit Symptoms of Concussion

Steelers vs Bengals AFC Wildcard Game ImPACT Program to Evaluate Concussion ImPACT Immediate Post-Concussion Assessment and Cognitive Testing Computerized Neurocognitive Testing

24-72 Concussion Hours Day 5-10 Beyond if necessary 4 days later 20 days later

No Return to Sports Until ImPACT is Normal!

Concussion Recovery

Genetics

Adequate Previous Treatment Concussions

Innovation Is Good

Rehabilitation Migraine

Lazy Eyes Is More Always Better? The Victorian Revolution in Surgery Connor, Science, 2004 Oxygen is Abundant in our Atmosphere Important Clinical Innovations in Surgery

■ Anesthesia

■ Antisepsis Michael Jackson ■ X-rays Is Increased Oxygen Beneficial?

Evidence Based Triad Orthopaedic Triad

Famous Famous Athlete Individual Patient or Clinical Values and Surgeon Wounded Warrior Expertise Improved Expectations Patient Outcomes

New Best Available Clinical Evidence Treatment Dr. John Bergfeld Health Expenditure in USA Health Care Delivery?

“We are making the same mistake in global health care that we make in the American system, believing that better diagnostics and therapeutic tools will solve all problems. They won’t. They haven’t. We don’t measure results well enough” Dartmouth for Health Care delivery Science

Jim Yong Kim (President, World Bank; Former President, Dartmouth College)

White Coat White Coat 1. Do what you love 11. Is the greatest always Ceremony Ceremony 2. Mentors the greatest? 3. You’ve got friends 12. Do the right thing Freddie H. Fu, MD, DSc (Hon), Freddie H. Fu, MD, DSc (Hon), 4. Talking without speaking: 13. Credibility and Integrity DPs(Hon) MED '77 Thoughts for DPs(Hon) DC’74, MED ’75 14. Patients come first Distinguished Service Professor, Distinguished Service Professor, hearing without listening University of Pittsburgh University of Pittsburgh 15. Be a dreamer Young Doctors 5. Focus versus multi-task

16. Don’t be a dinosaur David Silver Professor and Chairman, David Silver Professor and Chairman, Department of Orthopaedic Surgery, 6. IQ vs EQ Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine 17. The world is flat University of Pittsburgh School of Medicine From 7. Face time 18. Terrible towel

Freddie H. Fu, Md 8. For better or for worse 19. Home sweet home 9. Does no difference really 20. “I never dared to be radical Mean no difference? When young for fear it would 10. Is evidence based really Make me conservative when School of Medicine evidence based? Old” – Robert Frost The Terrible Towel Myron Cope

“Voice of the Steelers”

The Terrible Towel The Terrible Towel & Giving Back ! Each one of us can give back

! Own initiative and effort are more important than money

THINGS WE ALL CAN DO IN OUR EVERYDAY LIFE Learning Forever

University of Pittsburgh Cathedral of Learning