Westinghouse Scientific Lecture 2016
Dr. Freddie H. Fu Distinguished Service Professor David Silver Professor and Chairman Department of Orthopaedic Surgery University of Pittsburgh 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 Basketball
Roberto Baggio
Charles Smith
Pelé Pittsburgh Panthers 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 Center 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