SPRI News Winter 2013 INSTITUTE
Photo: John Kelly
RESEARCH INSTITUTE INSIGHT INSIDE
U Page 3 Productivity, Efficiency, and Dr. J. Richard Steadman receives the Support Highlight 2012 for SPRI Richard O’Connor Research Award U Page 3 By Stan Pappelbaum, M.D., M.B.A., Interim Chief Executive Officer, Robert F. LaPrade M.D., Ph.D. Awarded Steadman Philippon Research Institute “Orthopaedic Nobel Prize” U Page 4 e will look back at the year 2012 as one of significant Earl Graves, Sr., Presented With Wchange, enormous productivity, increased efficiency, Lifetime Achievement Award and exciting promise for the Steadman Philippon U Page 6 Research Institute. None of these achievements would Kenneth and Anne Griffin Foundation have happened without the generous support of indi- Supports Visiting Scholar Program viduals like you and our corporate sponsors. U Page 8 Patients in the News: INCREASED PRODUCTIVITY Brandt Snedeker: From Hip Surgery The newly named department of BioMedical Engi- to the Top of Professional Golf PHILIPPON neering and the Center for Outcomes-Based Orthopaedic U Page 10 Research, as well as the Center for Translational and Research Update: Regenerative Medicine Research and department of Ten Year Survivorship Following Knee Arthroscopy in Patients with Imaging Research, have initiated and completed a record Moderate to Severe Osteoarthritis number of research studies. These studies have produced of the Knee scholarly articles published in peer-reviewed journals, U Page 13 presentations made at national and international confer- Sports and Wellness: ences, and recognition for the physicians and scientists at Dr. Peter Millett Offers Tips For Maintaining Healthy Joints SPRI at unparalleled rates. In 2012, BioMedical Engineering alone produced 11 U Page 18 Coen Wijdicks, Ph.D., Named high-impact publications, another 10 papers have been “Outstanding Reviewer of the Year” accepted for future publication, and 13 papers are in the U Page 19 review process. SPRI Reports Record Year in
STEADMAN The Center for Outcomes-Based Orthopaedic Publication of Peer-Reviewed Research Research converted to a new digitized method of collect- U Page 22 ing data that has dramatically reduced costs, produced Save the Date: better quality data, and made that information avail- Edwin McCain to Perform for Summer Benefit Concert (continued on page 2)
An International Center for Research and Education—Keeping People Active SM BOARD OF DIRECTORS J. Richard Steadman, M.D. In Memoriam: Founder and Chairman Co-Chief Scientific Officer J. Michael Egan The Steadman Philippon Research Institute President and Chief Executive Officer SPRI NEWS WINTER 2013 Vail, Colo. The Steadman Philippon Research Institute Vail, Colo. Marc J. Philippon, M.D. Co-Chief Scientific Officer The Honorable Jack Kemp The Steadman Philippon Research Institute Chairman and Founder Vail, Colo. Kemp Partners Washington, D.C. (continued from page 1) H.M. King Juan Carlos I of Spain Honorary Trustee Emeritus: Harris Barton able to our researchers at a faster pace Adam Aron Managing Member Chief Executive Officer HRJ Capital than ever before. The SPRI database now Philadelphia 76ers. Woodside, Calif. Philadelphia, Pa. Jack Ferguson includes more than 3,000 knee surgeries, Howard Berkowitz Founder and President Chairman and Chief Executive Officer Jack Ferguson Associates more than 2,000 shoulder procedures, BlackRock HPB Washington, D.C. New York, N.Y. and almost 1,000 foot and ankle sur- H. Michael Immel Robert A. Bourne Executive Director (retired) geries—and the database continues to Vice Chairman Alabama Sports Medicine and CNL Financial Group, Inc. Orthopaedic Center grow. Orlando, Fla. Lafayette, La. Lodewijk J.R. de Vink Arch J. McGill Blackstone Healthcare Partners President (retired) Avon, Colo. AIS American Bell INTERNATIONAL RECOGNITION Julie Esrey Scottsdale, Ariz. Our physicians and scientists contin- Trustee Emeritus Betsy Nagelsen-McCormack Duke University Professional Tennis Player (retired) ue to be recognized by some of the most Vail, Colo. Orlando, Fla. prestigious professional organizations in Stephanie Flinn Hobe Sound, Fla. the world. Dr. J. Richard Steadman, al- George Gillett Chairman ready one of this nation’s most honored Booth Creek Management Corporation Vail, Colo. Earl G. Graves, Sr. Chairman and Publisher Earl G. Graves, Ltd A Good Idea New York, N.Y. Ted Hartley Chairman and Chief Executive Officer RKO Pictures, Inc. It’s a good idea for everyone reading this or someone dear to you has battled the life- Los Angeles, Calif. article to have a will. Through years of your constraining effects of an orthopaedic disorder. Frank Krauser President and CEO hard work, you have accumulated a lifetime Thanks to leading-edge research and treatment, NFL Alumni (retired) and Pro Legends, Inc. Ft. Lauderdale, Fla. of assets, and a properly drawn will allows that person may have returned to an active, high- Greg Lewis President the distribution of those assets to reflect your quality life. What a good idea to review your will Greg Lewis Communications Basalt, Colo. wishes. To help you accomplish exactly that, and include a bequest to the Steadman Philippon Thomas A. Mars here are some good ideas! Research Institute to continue the advancement Executive Vice President and Chief Administrative Officer of life-changing care, education, and scientific Walmart 1. Have a Will Rogers, Ark. investigation. John G. McMillian It sounds simple, but without a will you may Chairman and Chief Executive Officer (retired) Allegheny & Western Energy Corporation as well give all you’ve worked for to the state 3. It’s 10:00 PM. Do You Know Where Coral Gables, Fla. Peter Millett, M.D., M.Sc. to give away for you. If you die without a will, Your Will Is? The Steadman Clinic Vail, Colo. the state must follow very specific rules for Quick, where is the original of your will? Who Larry Mullen, Jr. distributing your assets, and it may not be else knows where it is? How fast can it be Founder, Partner U2 what or who you had in mind. located? If your will can’t be found, it’s as if you Dublin, Ireland Cynthia L. Nelson never had one. Wherever you keep your will, Cindy Nelson LTD 2. Reflect What You Value Today Vail, Colo. make certain those most likely to be contacted The emphasis is on today. Suppose you wrote Mary K. Noyes in the event of death are fully informed and can Freeport, Me. a will ten years ago, and since that time you Al Perkins locate your will. Chairman Emeritus Rev Gen Partners Denver, Colo. Senenne Philippon Vail, Colo. Cynthia S. Piper Estate Tax Changes on the Horizon for 2013? Trustee Hazelden Foundation Long Lake, Minn. Steven Read Under current law, the estate tax exemption is scheduled to drop significantly from $5,120,000 in Co-Chairman Read Investments 2012 to $1,000,000 in 2013, and the estate tax rate is scheduled to increase from 35 to 55 percent. Lafayette, Calif. Kenneth Schanzer On January 1, 2013, the exemption and rate are scheduled to return to levels that were in effect in President NBC Sports (retired) 2001/2002: a $1,000,000 estate tax exemption and 55 percent estate tax rate. Avon, Colo. Damaris Skouras Global Reach Management Company There was an effort to avoid this increase by the House, which on August 1, 2012, passed the Job New York, N.Y. Gay L. Steadman Protection and Recession Prevention Act (JPRPA). The Act included a one year extension of the Vail, Colo. 2012 estate tax rules; however, Congress adjourned shortly thereafter and the session calendar Stewart Turley Chairman and Chief Executive Officer (retired) through the end of the year presents a challenging schedule to address this issue, leaving the future Jack Eckerd Drugs Bellaire, Fla. of the federal estate tax in 2013 and beyond in question. Norm Waite Vice President Booth Creek Management Corporation Vail, Colo. 2 (continued from page 1) orthopaedic surgeons, was presented the STEADMAN PHILIPPON UPDATE Richard O’Connor Research Award for his research paper on 10-year survivorship following knee arthroscopy in patients Institute Research Leads the World with osteoarthritis. Dr. Steadman’s co-authors were Karen Briggs, Lauren Matheny, and Dr. Henry Ellis. Richard O’Connor Award
PLANS Dr. J. Richard Steadman, Earlier this year, SPRI engaged the founder and chairman of the services of The Greenwood Company, a Board for the Steadman Philip- professional fundraising management pon Research Institute, was in group, for the purpose of helping the 2012 honored with the Richard Institute increase its productivity as a O’Connor Research Award. Dr. Steadman, internationally known (continued on page 4) for his work as an orthopae- dic knee surgeon, received the award for the research paper titled “Ten Year Survivorship Following Knee Arthroscopy in 4. Call Us to Let Us Know Patients with Moderate to Severe Jonathan B. Ticker, M.D., chair of the Research Committee for the We would like to thank you personally for your Osteoarthritis of the Knee.” Dr Arthroscopy Association of North generosity in including the Institute in your Steadman developed this ar- America, presents the Richard O’Connor Research Award to Dr. plans. We would also like to welcome you into throscopic treatment package for Richard Steadman. our Founders Society—a cherished group of patients who have osteoarthritis friends and supporters who, through their be- but are not ready to change their activity level or proceed quests, support our work and a future of healthy to total knee replacement. and active lifestyles. This paper showed that a large number of patients could delay total knee replacement for 10 years. His co- There are other ways to remember the Institute authors on the award-winning paper are Karen Briggs, in your plans. You can simply name the Institute Lauren Matheny, and Dr. Henry Ellis. Dr. Steadman’s presen- as a beneficiary of your retirement accounts or tation and many others were highlighted at the Arthroscopy as beneficiary/owner of a life insurance policy Association of North America’s 31st Annual Meeting in you no longer need. If we can answer any Orlando, Florida, May 17-18. questions, please contact John McMurtry, Vice UUUU President, Program Advancement, at mcmur- [email protected] or (970)-479-9797. Robert F. LaPrade, M.D., Ph.D. Awarded “Orthopaedic Nobel Prize”
Historical and Future Federal Estate The American Academy of Tax Exemptions and Rates Orthopaedic Surgeons and the YEAR ESTATE TAX TOP ESTATE Orthopaedic Research and Educa- EXEMPTION TAX RATE tion Foundation announced in 2000 $675,000 55% November that Robert F. LaPrade 2001 $675,000 55% M.D., Ph.D. has been awarded 2002 $1,000,000 50% the highly competitive and 2003 $1,000,000 49% 2004 $1,500,000 48% prestigious 2013 OREF Clinical 2005 $1,500,000 47% Research Award for his submitted 2006 $2,000,000 46% paper on “Improving Outcomes 2007 $2,000,000 45% for Posterolateral Knee Injuries.” 2008 $2,000,000 45% Dr. LaPrade will be presenting his 2009 $3,500,000 45% 2010 $0 0% (continued on page 18) Robert F. LaPrade, M.D., Ph.D 2011 $5,000,000 35% 2012 $5,120,000 35% 2013 $1,000,000 55% 3 SPRI NEWS WINTER 2013
(continued from page 3) grateful to Dave and Gail Liniger, own- revenue source. As a result of the study, ers and co-founders of RE/MAX, LLC, and the Greenwood group made recommen- to the Vail Valley Medical Center, a title dations involving, among other things, sponsor for the third consecutive year. the name and structure of the Institute, Let me reiterate something I men- governance and oversight of SPRI’s fund tioned at the beginning of this column. development program, a SPRI fellows The Steadman Philippon Research Insti- alumni association, increased philan- tute is productive, efficient, and good at thropic support, a 36-month fundraising what is does because of you. World-class campaign, and communications with physicians and scientists, cutting-edge donors. The recommendations are now facilities, and life-changing research being processed by the leadership of wouldn’t be possible without your sup- SPRI and will be incorporated into our port. We know that, and we want you to institutional planning program. know how much we appreciate every- SPRI is already moving forward with thing you do for SPRI. the goal of establishing a department UUUU of Orthopaedic Rehabilitation Research, which will be the first of its kind in the Earl Graves, Sr., world. We are in the process of finding Presented With Life- and recruiting an internationally known director, and our hope is to make a for- time Achievement mal announcement regarding the new Award by the department early in 2013. Steadman Philippon SPECIAL EVENTS Research Institute Finally, on behalf of the staff at By Jim Brown, Executive Editor, SPRI News SPRI, I want to thank you for supporting SPRI’s three special events this sum- n July 5, 2012, the Steadman Philip- mer. The events—Darius Rucker’s “Rock pon Research Institute and its Board the Research” concert, the dinner/gala O of Directors presented the first ever Life- that followed the concert and honored time Achievement Award to Earl Graves, Earl Graves (Pg 4), and the Golf Classic brought in donations of more than $1 Sr. His youngest son, Michael, accepted million. The events produced the highest the award on behalf of Earl and his re- amount ever generated for our com- cently deceased wife, Barbara. bined summer fundraising activities. The Earl is one of the nation’s most suc- money will go directly into ongoing and cessful and distinguished business lead- new orthopaedic injury prevention, and ers. He serves on the Institute’s Board treatment research. and has raised hundreds of thousands The Darius Rucker concert, presented of dollars for the Institute during his 15- by Vail Valley Pharmacy and the Yates year tenure. The Board also named Earl a and Nisonoff Families, took place July Lifetime Trustee of the Institute. 5 at the Gerald R. Ford Amphitheater Speaking for SPRI and the Board, Dr. in Vail. A sold-out audience of 2,700 Richard Steadman and Dr. Marc Philip- people attended the event, and the 450 pon said, “We at the Steadman Philippon attendees who purchased VIP tickets Research Institute are proud to recognize enjoyed pre-concert hors d’oeuvres and a Earl Graves as the first recipient of the sit-down dinner in the Betty Ford Garden Steadman Philippon Research Institute’s immediately following the concert. Lifetime Achievement Award. We are The SPRI Golf Classic presented honored to have this association. He has by RE/MAX, LLC, was held August 16 been an active member, and we hold at Sanctuary, one of the world’s most him in the highest esteem.” beautiful courses. One hundred golfers Earl is chairman and chief executive participated in the event, and SPRI is officer of Earl G. Graves, Ltd, the parent
4 serve as chairman of Pepsi’s Customer Advisory and Ethnic Marketing Committee.
THE GRAVES-STEADMAN CONNECTION “I had a series of knee injuries over a long period of time,” says Earl, who had been going to Colorado with his family to ski for many years. “Someone men- tioned to me that there was an ortho- paedic group in Vail called the Steadman Clinic and a doctor named Richard Steadman. I looked him up, got an evaluation and later, treatment, and the rest is history.” Earl’s son, Earl Graves, Jr., says about his father, “Our father has always been the kind of person who wanted to ‘give back’ and work in the not-for-profit busi- ness sector. He loved Dr. Steadman, liked what the Institute was doing and how it helped people, and he loved skiing. It was a perfect storm.” Earl G. Graves, Sr. Earl Graves, Sr., was a close friend of corporation for the Earl G. Graves Pub- the late Secretary of Housing and Urban lishing Company. His company publishes Development Jack Kemp, who encour- BLACK ENTERPRISE, a business-service aged him to get involved with SPRI and magazine targeted to black profession- its Board of Directors. Secretary Kemp als, executives, entrepreneurs, and policy served on the SPRI Board of Directors makers in the public and private sector. until his death in 2009. BLACK ENTERPRISE has a circulation of (continued on page 6) over 425,000 and a readership of more than 3.8 million.
FROM BROOKLYN TO MORGAN STATE TO THE GREEN BERETS AND BEYOND Born in Brooklyn, Earl was a ROTC graduate with a degree in econom- ics from Morgan State University. He attended Airborne and Ranger School and finished his Army service with the rank of captain as a member of the 19th Special Forces Group—the Green Berets. Earl began his career as an adminis- trative assistant to the late Senator Robert F. Kennedy from 1965 to 1968. After Senator Kennedy’s assassination, Earl formed his own management con- sulting firm to advise corporations on urban affairs and economic development. He served as chairman and CEO of Pepsi-Cola of Washington, the largest Photo: Barry Eckhaus minority-controlled Pepsi-Cola franchise Michael Graves, center, accepts the Lifetime Achievement Award and honorary in the United States, and he continues to “lab coat” on behalf of his father from Drs. Steadman and Philippon.
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(continued from page 5) and Management to the Earl G. Graves In addition to his contributions School of Business and Management. to SPRI, Earl served as a director of Earl is a member of the National Aetna Life and Casualty Company, The Black College Hall of Fame and has Schomburg Center for Research in Black lectured at Yale University. He has been Culture, AMR Corporation (American Air- awarded honorary degrees from 51 lines), DaimlerChrysler AG Corporation, universities, including his alma mater. Federated Department Stores, Inc., and Earl currently resides in Westchester Rohm & Haas Corporation. He also serves County, New York. He and his late wife, as a volunteer on boards of TransAfrica Barbara, have three married sons, Forum and the American Museum of Earl, Johnny, and Michael, and eight Natural History and Planetarium. grandchildren. UUUU LIFE-CHANGING EXPERIENCE “Being treated by Dr. Steadman was Kenneth and Anne a life-changing event for me because it Griffin Foundation helped to heal a lifetime problem, just as Grants $200,000 to it has for people in all walks of life,” says Earl. “There is something to be said for a Support Visiting person who is at the top of the medical Scholar Program profession for all the right reasons.” “The Clinic and the Research Institute for Clinical Sports have been on the cutting edge of medi- Medicine MRI cal science,” he continues. “When I had my first knee surgery decades ago (long he Steadman Philippon Research before I met Dr. Steadman), surgeons TInstitute is pleased to announce a had to open up the entire knee with $200,000 grant award from the Ken and very invasive surgery. Because of the Anne Griffin Foundation to support the work they’ve done here, surgical pro- Griffin Visiting Scholar Program for cedures are now much less invasive and Clinical Sports Medicine MRI. the recovery time is much quicker. The Mr. Griffin, a former Steadman Clinic fact that people from all over the world patient and long-time supporter of SPRI’s come here for treatment is a testimony research efforts, is the founder and chief to the research that has been conducted executive officer of Citadel LLC, a fran- at SPRI.” chise that includes both Citadel Asset Speaking of the SPRI Fellows, Earl Management and Citadel Securities. says, “It’s clear that it is an honor to be Citadel is one of the most successful selected to come and work at the financial institutions in the world. Steadman Clinic and the Steadman Mr. Griffin is a graduate of Harvard Philippon Research Institute. SPRI has and an active supporter of educational, world-renowned facilities and physicians civic, cultural, and evidence-based medi- who train these young doctors to care cine initiatives. He serves on the board for and help people. The success that of trustees for both the Art Institute of SPRI has had should not be a surprise. Chicago and the Museum of Contempo- It attracts the best and brightest rary Art, as well as the board of directors medical minds.” of the Chicago Public Educational Fund. Within the business community, he is HIGHER EDUCATION, EQUAL a member of numerous organizations, OPPORTUNITY including the World Economic Forum, Earl is a staunch advocate of higher G100, and the Economic Club of Chicago. education and equal opportunity. In “Ken Griffin has always been a sup- recognition of his support of entrepre- porter of the Institute, and he has taken neurial education, Morgan State Uni- a special interest in imaging research,” versity renamed its School of Business says Charles Ho, M.D., Ph.D., director of 6 gin his or her work in 2013. That person will read and review clinical patient MRI exams, assist in developing and validat- ing sports medicine MRI protocols and scoring systems, and collect imaging data to be incorporated into SPRI’s existing clinical and operative database. “In addition to evaluating and ana- lyzing the imaging database and cor- relating it with the clinical database and outcomes, the Visiting Scholar will also write and submit articles to be consid- ered for publication in peer-reviewed journals,” adds Dr. Ho. “The Visiting Scholar will have the unique opportunity of correlating the results of imaging, Kenneth G. Griffin clinical exams, arthroscopy and operative results, and outcomes. Following patients Imaging Research at SPRI. “He has fol- from day one to final outcomes is an lowed the progress of Imaging Research experience that would be difficult get and its collaboration with Siemens anywhere else.” Medical Solutions USA as the department “On behalf of the Steadman Philip- expanded in areas of imaging biomark- pon Research Institute and the depart- ers, mapping, and the clinical imaging ment of Imaging Research,” concludes database. When the Institute’s Imag- Dr. Ho, “I want to express our apprecia- ing Research Fellowship sponsorship by tion to the Kenneth and Anne Griffin Siemens was scheduled to expire, Ken Foundation for making this Visiting took up the challenge and committed to Scholar Program possible. Their philan- sponsoring the Visiting Scholar Program thropic generosity will greatly enhance for the next two years.” our research and education mission, The process of identifying and re- and this award will undoubtedly help us cruiting the first Griffin Visiting Scholar advance evidence-based medicine and has already begun, and the physician science.” who is selected for the position will be- UUUU Photo: John Kelly
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PATIENTS IN THE NEWS SURGERY Actually, there have been two surgeries, one on the left hip in 2010 Brandt Snedeker: From and a similar procedure on the right Hip Surgery to the Top of hip last November. “In 2010, my left hip Professional Golf in Less started to hurt during the U.S. Open,” recalls Brandt. “I thought it might have Than a Year been just a fluke thing and tried to get through the rest of the season, but it re- By Jim Brown, Executive Editor, SPRI News ally never got better. I had a sharp stab- bing pain when I walked, and it was very ow many career changing events sore at night and early every morning.” can you have in one year? Four and H “I had heard about Dr. Marc counting, if you are professional golf star Philippon from other golfers and knew Brandt Snedeker. Brandt had hip surgery that he had treated Greg Norman for a at the Steadman Clinic in November of hip problem. Every golfer I talked with 2011; won a PGA tournament 90 days had nothing but good things to say later at Torrey Pines; was named to the about their experience with Dr. Philippon U.S. Ryder Cup team early in September; and his colleagues at the Steadman Clinic and won the Tour Championship and the and the Steadman Philippon Research FedExCup on September 23 in Atlanta. Institute.” Other than that, the past year or so “I sat down with Dr. Philippon on has been business as usual for Brandt, a Monday, and after looking at MRI who joined the PGA after graduating results, he told me that he could get me from Vanderbilt and playing two years back to 100 percent in eight weeks— on the Nationwide Tour. In 2007, he was playing tournaments in 12 weeks. He named PGA Rookie of the Year. was completely confident that it was an
Brandt Snedeker
141st Open Championship, July 20, 2012, at Royal Lytham & St Annes golf course, Lancashire, England. Round 2 - Brandt Snedeker shoots 64 to tie the lowest round at the course and -10 under par total after 36 holes.
© AP Images Photo: Stuart Robinson, AP Images
8 issue that could be resolved, and he was “He called and asked me if I wanted right. I had the operation two days later to represent the United States on the Ry- and was playing golf right on schedule.” der Cup team,” says Brandt. “I couldn’t The hip disorders causing Brandt’s say ‘yes’ fast enough. It’s a huge thing pain were, among other things, a torn for my career.” labrum and a condition called femoro- Brandt was also one of four Ryder acetabular impingement (FAI). FAI is a Cup rookies named to the team. Love common cause of hip pain and osteoar- wanted “hot” putters on the team and thritis that involves too much friction in Brandt has been one of the best putters the hip joint during extreme range of on the tour. The Ryder Cup was played in motion movements. late September at Medinah Country Club “As my left hip got better,” says near Chicago, a club that has hosted two Brandt, “I noticed a growing problem in PGA Championships since 1999. my right hip. It wasn’t as bad as the left hip, but it was causing pain, and nothing TOUR CHAMPIONSHIP AND FEDEXCUP I tried could calm it down. I knew I had Brandt already had the year of a the same bone problem as in my right lifetime when the Tour Championship hip and that it wasn’t going to get any tournament began. In addition to the better, so I went back to Vail for pretty Farmers Insurance Open, he recorded six much the same procedure done in 2010.” top ten finishes and more than $3.5 mil- lion in season earnings. A WIN AT TORREY PINES By winning the Tour Championship, The second surgery was on Novem- he added $1.44 million in prize money, ber 1, 2011. After three weeks of physical plus a $10 million bonus from FedEx for therapy in Vail with therapists at Howard accumulating the most points during the Head Sports Medicine, Brandt returned season. to Nashville and continued rehabbing “This is what you work your whole with his physical therapists there. life for; all those balls you hit,” Brandt “Having the surgery was the best told the press after the tournament. health-related decision I’ve ever made,” he says. “Just the knowledge Dr. Philip- LOOKING BACK, LOOKING FORWARD pon has about what he does and work- What would Brandt tell someone ing with the physical therapists 4-6 hours with a hip problem similar to his? “I’ve a day was a huge bonus in getting me heard too many horror stories of what back to 100 percent.” happened to people who didn’t take this By mid-January, Brandt was back on kind of condition seriously. It can affect the course and ready for the PGA tour you for the rest of your life. It’s worth again. In only his second tournament the effort to get the best medical advice, after surgery, the Farmers Insurance and there is no question that Dr. Open at Torrey Pines, he came from Philippon and the people at Steadman seven shots back in the final round and Philippon are the best at what they do.” defeated Kyle Stanley in a playoff. It was For those who might consider sup- Brandt’s third PGA title, but not his last. porting SPRI, Brandt says, “Every dol- lar you donate will go toward helping RYDER CUP people recover from orthopaedic condi- On September 4, 2012, the Ryder tions and injuries. And everything they Cup team was announced, and Brandt are doing at SPRI is on the forefront of was one of four wildcard selections helping people return to good health as made by team captain Davis Love III. fast as possible. They did it twice for me.” UUUU
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RESEARCH UPDATE Not only are we unsure how long the knee replacement will last in a 45-year- Ten Year Survivorship old patient, these increasing numbers may be reducing the activity level of Following Knee a significant number of people, and Arthroscopy in Patients decreased physical activity complicates many other diseases such as diabetes and with Moderate to heart disease. Severe Osteoarthritis In this study, we wanted to see if total knee replacement could be delayed of the Knee with arthroscopic treatment of the knee. In the past, knee arthroscopy was re- rthritis continues to be the leading served for patients without high-grade Acause of disability in the U.S., and the osteoarthritis. However, new studies prevalence is rising in most nations. In examining results of the procedure in the face of severe osteoarthritis of the older patient populations, as well as in knee, total knee replacement has histori- patients with established osteoarthritic cally been shown to be a reasonable and joints, have shown moderate success effective surgical treatment. over the short term. Data regarding The procedure is not without long- long-term results of arthroscopic surgery term drawbacks, however. In particular, on patients with severe osteoarthritis are the inability to participate in high impact limited, however. The purpose of this sports such as jogging, climbing, soccer, study was to see how long patients who and tennis have made it a less desirable received arthroscopic treatment delayed option for a younger patient who wishes total knee replacement. to remain active. It was recently reported From August 2000 to November that the U.S. spent $9 billion on knee re- 2001, 865 knee arthroscopies were per- placement in 2008. The number of knee formed by Dr. Steadman. Among those replacements in adults ages 45 to 65 has procedures, 81 knees (73 patients) were tripled during the last 10 years in the U.S. identified that had severe symptomatic arthritis prior to the procedure and were included in the study for analysis. Pa- tients were included in the study if they had failed non-operative (conservative) management for their arthritis, which included modification of daily activities, physical therapy, anti-inflammatory med- ications, and weight loss or joint lubricat- ing injections. All patients in the study were considered appropriate candidates for total knee replacement by common standards, but were referred to our institution for arthroscopic consideration in order to retain an active lifestyle. The average age of the patients was only 57 years. The arthroscopic treatment “pack- age” focuses on pain generators. These include stiffness, synovitis, meniscus tears, and closed space due to scarring. In the degenerative knee, volume in the knee is especially important to allow
Photo: John Kelly
10 for painless movement. The “package” At 10 years postoperatively, patients addresses each area if needed. First, the were contacted to determine if they had joint is filled with saline to inflate the undergone total knee replacement. If capsule around the joint. This may break they had not, they were sent a question- up small scar tissue, but it also gives naire that documented symptoms and the doctor an indication of how much overall satisfaction with the knee. volume the knee has before surgery. All Of the 81 knees originally operated unstable tissue that may cause catching on, several were deceased or did not is removed. Synovitis is removed to de- want to participate. Of the 69 knees re- crease pain, and all spaces are opened to maining, 43 received total knee replace- restore the normal volume and normal ment at an average of 4.4 years after biomechanics of the knee. Bone spurs original knee arthroscopy. Patients who are also removed if they are limiting the required total knee replacement were motion of the knee. older (60 years old) compared to those A strict postoperative rehabilitation who did not require it (53 years old). program is vital to the success of the Overall, survival rates of the original ar- procedure. The goal of this rehabilitation throscopic procedure were 60 percent at is to prevent scar formation within the five years, 47 percent at seven years, and joint, as well as to maintain appropriate 40 percent at 10 years. Survivorship was joint fluid volume, which prevents fur- defined as not having a total knee re- ther friction between the bones of the placement procedure performed. Twen- knee joint. ty-six patients did not require total knee The secondary goal of rehabilitation replacement by 10 years, and reported a is to regain strength in the leg. We use a mean satisfaction of eight on a scale of 1 three-phase rehabilitation program on to 10. these patients. The first phase focuses This study demonstrated that the on re-establishing range of motion, arthroscopic surgical technique devised stretching, and overall joint mobility. by Dr. Steadman was able to delay the Patients limit weight bearing on the need for total knee replacement on limb for one to two weeks after surgery. average by five to 10 years. This allowed Continuous range of motion exercises for patients to continue the more active are used during the first week immedi- lifestyle that had prompted them to seek ately after surgery. Greater mobility of out treatment at our institution in the the knee gives the knee the best chance first place. We believe that following a to be as good as it can be. strict and comprehensive rehabilitation Patella mobility exercises are critical program postoperatively was critical to to this program. If the correct environ- the overall success of the procedure. ment is created with the knee, then In summary, we found that ap- strength usually returns. In the first six proximately 40 percent of patients who weeks, the patient works to achieve mus- were originally candidates for total knee cle activity without joint strain. Excessive replacement were able to delay the pro- strengthening may increase stiffness by cedure for 10 years. Arthroscopic surgery placing strain on the work done inside is not a cure for knee arthritis, but in the knee. the right patient who wishes to remain After six weeks, patients began to active, we believe it is a viable option in work on strength training by means order to delay the need for a total joint of walking uphill on a treadmill and replacement. This study shows that there increased intensity on the bike. The el- is no reason not to do arthroscopy in the liptical can be used if no pain is felt. The degenerative knee. This study won the physical therapist emphasized closed prestigious Richard O’Connor award by chain exercises. At four months, weight the Arthroscopy Association of North training exercises and a return to full America for 2012. activity was allowed. UUUU
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SPORT.DR Data The old system required patients, physicians, and SPRI’s research scientists Collection Software to fill out paper forms, having a person is Game-Changer for process the forms using a scanner, and utilizing another person to indepen- SPRI’s Center for dently verify that data for mistakes or Outcomes-Based omissions—all before actual research was Orthopaedic Research begun.
By Jim Brown, Executive Editor, SPRI News INSTANTANEOUS DATA CAPTURE The SPORT.DR. software allows SPRI ver the past months, the Center doctors to complete a form on a comput- Ofor Outcomes-Based Orthopaedic er tablet device after a clinical examina- Research at SPRI has quietly converted tion of a patient,” explains Briggs. “Our from a paper and scanning-based meth- software sends a PDF to the patient as a od of collecting data to one that uses backup to their medical record. We get paperless, tablet technology and soft- all of the data instantaneously.” ware. The new software is called SPORT. On the patient side of the process, a DR, which stands for Steadman Philippon person can fill out a form online before Outcomes Research Data Registry. It was ever arriving at SPRI or they can use an implemented with the help of Littleton, iPad in the waiting room once they’ve Colorado-based Clinical Trial Site Solu- arrived. Either way, time is saved. “One tions (CTSS). person coordinates all data questions,” The results, according to the Center’s adds Briggs. “Instead of scanning forms director, Karen Briggs, have been quick all day, our interns can do research all and dramatic. “The new software has day, and we can start research on a pa- been a game-changer for those of us in tient the minute he or she is done.” Orthopaedic Research. Our data capture One of the features of SPRI’s mas- costs have been reduced by more than sive database is that records have been 97 percent, our quality is better, and we kept on some patients for as long as 20 have information available much quicker.” years. “We’ve been keeping in touch with them by regular U.S. mail, sending follow-up questionnaires at least once a year. Now we can do it by email and not send out a thousand pieces of mail a month.”
TIME AND MONEY SAVED “The whole process represents a ma- jor saving in terms of time and money,” says Briggs. “We don’t have paper forms anymore, we don’t have to pay for mailing, and we don’t have to manu- ally verify data. The forms double-check themselves. Patients have to respond in certain ways. If they don’t, the program prompts them to correctly enter data. When the data collection is complete, Kelly it immediately goes into the database John and into what we call our Patient Report
Photo: Card.” Left to Right Front Row: Lauren Matheny, Karen K. Briggs, M.B.A., and Marilee Horan, The SPRI staff compared the cost of M.P.H. Left to Right Back: Ashley Darrough, MacKenzie Herzog, and Doug Gillard the old system to the SPORT.DR system and found a 97.33 percent reduction in
12 cost—$3.75 per patient encounter record then; $0.10 per patient record now. Briggs says that all of the existing data in SPRI’s database has been merged into the new system. “Implementation of the new system is about 98 percent complete, but it seems like we think of a new feature to add every day.” In terms of productivity, the results of SPORT.DR have been impressive. “We’ve already submitted five times more abstracts for publication or pre- sentation at professional meetings than we ever have before during a similar time period, and it’s because the SPORT. DR software gives us more time to do Illustration: Marty Bee research.” EXERCISE FOR FUN, TRAIN FOR HEALTH UUUU More than 3.5 million kids receive SPORTS AND WELLNESS medical treatment for sports injuries annually. While sports offer a fun way to Dr. Peter Millett Offers exercise, they can sometimes be taken too far. The mindset that the more you Tips For Maintaining train the more you gain, unfortunately, Healthy Joints leads to overuse and overtraining, which can cause irreversible damage. Keeping Up With The It’s important to train smart in order to Game of Life: Everyday avoid injury. This includes consistent and adequate rest between training periods, Tips For Maintaining implementing an effective stretching Healthy Joints protocol, and taking time off from sports when aches and pains arise. ports and everyday activities put Stremendous stress on joints. Dr. Peter MANAGE A HEALTHY BODY WEIGHT J. Millett, SPRI Board member and Maintaining a healthy body weight orthopaedic shoulder specialist, offers is crucial to long-term joint health. The this informative article on useful tips to knees and ankles tend to bear the big- maintain healthy joints to keep them gest brunt of the body’s weight, so every safe and active for life. extra pound that is packed on means Throughout childhood, everyone that your precious joints are having to experiences the occasional skinning of a work extra hard to carry the load. Obesi- knee or bruise from a fall. These com- ty is a risk factor for many health-related mon injuries heal quickly and cause little conditions, and it has been noted that it concern for worry. While the ailments speeds up the process of cartilage break- from life’s little stumbles can be nursed down. Maintaining a healthy weight by back to health, there are bigger, hidden eating right and staying active will help concerns that start early and sometimes ensure joint health for years to come. never return to normal. Joint health is something you can’t see with the naked MAINTAIN A BALANCE BETWEEN eye, making it a big reason why millions MOTION AND REST of Americans take it for granted. While staying active is necessary to Though everyday activities put a maintain a healthy body, there has to be great amount of mechanical stress on a balance between motion and rest. our joints, Dr. Millett, offers these tips for (continued on page 14) maintaining healthy joints: 13 SPRI NEWS WINTER 2013
(continued from page 13) EDUCATION Engaging in repetitive motions or the same activity day after day can put great Welcome 2012-2013 strain on the body. This overuse can wear down cartilage and loosen tendons lead- Fellows ing to injury. The key is to pay attention to your body. When you feel pain or dis- NINE NEW PHYSICIANS INTRODUCED comfort during or after certain activities such as household chores or exercise, it’s his year, nine young orthopaedic important to take a break and consider Tsurgeons were selected from a field eliminating the activity for a period of more than 160 to participate in 12 of time. months of vigorous training in the Stead- man Philippon Sports Medicine Fellow- STRENGTHEN AND STRETCH TO STABILIZE ship Program. Our goal is to prepare When your body is properly aligned, them to be leaders in the field of ortho- your muscles and joints work together paedic sports medicine for the remainder in harmony to stabilize and take the of their careers. Many go on to hold burden off of one specific body part. high-level faculty positions at top medical Just like when a car is out of alignment, schools. the body can get out of alignment too. In 2010, we added two Fellows to Building muscles through strength train- our program when we welcomed the ing exercises and maintaining a strong, Institute’s first Foot and Ankle Fellow healthy core will help stabilize, support, and the world’s first Sports Medicine and guide the muscles. A proper stretch- Imaging Research Fellow. In addition, ing regimen is equally important to help we now have three Visiting Scholars, enhance circulation and improve range who are in essence research fellows from of motion. overseas. All 11 (Fellows and Visiting Scholars) are being given a unique JOINT PRESERVATION IN LIEU OF JOINT opportunity to perform research in their REPLACEMENT respective areas of interest, including Regardless of your activity level, biomechanics research, clinical research, everyone will endure some natural wear imaging research, and basic science and tear of the joints. For some who ex- research. perience chronic joint pain, joint replace- Once every 18 months after that, ment surgery is an option. However, it they will return with other past Fellows is usually only recommended for older for further education and to exchange adults, or for those who have tried other the additional knowledge they have alternatives. Joint preservation to delay gained since completion of Fellowship joint replacement surgery offers indi- training. The Institute currently main- viduals the chance to restore their joints tains a network of more than 183 Fel- through the use of highly advanced lows in communities around the world techniques and procedures. While who serve in academic positions at lead- cartilage cannot be repaired, it can be ing universities and in private practices. preserved to avoid the future onset of rapid degeneration. 2012-2013 STEADMAN PHILIPPON Dr. Peter J. Millett is an orthopaedic SPORTS MEDICINE FELLOWS surgeon and member of the Board of Directors of SPRI and the SPRI Scientific Tyler C. Collins, M.D. Advisory Committee. For more tips for Dr. Collins grew up in Colorado, maintaining healthy joints, visit www. where he learned to ski at the age of drmillett.com. three. After high school, he attended the UUUU University of Virginia, where he played varsity baseball and was Academic All-
14 ACC. He graduated with high honors from the School of Engineering and Ap- plied Science with a Bachelor of Science in systems engineering. From Virginia, he switched coasts and attended medi- cal school at the University of Southern California, where he was a Deans Schol- ar. He remained at USC for his residency training and spent the majority of his time treating the underserved popula- tion in Los Angeles. His research interests include fixation of proximal humerus fractures, needle arthroscopy of the knee, reliability and reproducibility of shoulder fracture classification systems, and objective shoulder strength after fixation of clavicle fractures. After traveling throughout the coun- the board of directors and attained Front row: Peter Millet, M.D., try, Dr. Collins is thrilled to be back in M.Sc., Edmund Ganal, M.D., the rank of captain, specializing in Colorado and feels extremely fortunate Marc Philippon, M.D., technical and water rescue. Robert LaPrade, M.D., Ph.D. to train at the Steadman Clinic. 2nd Row: Christopher Espinoza- After graduation, he attended Ervin, M.D., Scott Faucett, M.D., Dartmouth Medical School, earn- Jared Lee, M.D., J. Richard Christopher Espinoza-Ervin, M.D. Steadman, M.D. ing a Master of Science degree in Dr. Espinoza-Ervin graduated from 3rd Row: Tyler Collins, M.D., health care policy and leadership as Jack Skendzel, M.D., Nicholas the University of Oklahoma with a Bach- Viens, M.D., Tom Hackett, M.D. he pursued his growing interest in elor of Science degree in microbiology. Back Row: Jeffrey Nepple, M.D., orthopaedic surgery and sports medi- Randy Viola, M.D., Tom Clanton, He completed his medical degree at the cine. Dr. Faucett chose to remain at M.D. University of Colorado School of Medi- Dartmouth Hitchcock Medical Center cine. While in medical school he was for the opportunity to focus on awarded a National Institutes of Health health policy and his other research grant to fund research focused on the interests: clinical epidemiology and treatment of orthopaedic trauma. cost effectiveness decision analysis. During the completion of his ortho- Throughout his residency, he pro- paedic surgery residency at the University vided physician coverage for the of Texas Southwestern, he assisted with Dartmouth Varsity athletes. team coverage of high school, collegiate, and professional sports. His research Edmund “Edton” A. Ganal, M.D. focused on the treatment of lower Dr. Ganal graduated magna cum extremity trauma, shoulder arthroscopy, laude with Revelle Provost honors and the pediatric knee. He was selected from University of California, San as a chief resident and honored with Diego, with a degree in biochemistry the Vert Mooney Award for Academic and cell biology. He was a member Achievement. of Phi Beta Kappa and played NCAA soccer. He volunteered on a medi- Scott C. Faucett, M.D., M.S. cal mission to the Philippines before Born and raised in Santa Monica, attending Tufts University School of California, Dr. Faucett matriculated at Medicine on a Health Professional Middlebury College in Vermont, where Scholarship. he studied economics and chemistry. As Dr. Ganal completed general an undergraduate, he also refined his surgery internship, then served as a skills as a telemark skier and began to battalion surgeon with the Marines. volunteer with the town’s rescue squad. He deployed to Iraq in support of By his fourth year, he was appointed to
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Thank You Operation Iraqi Freedom. After complet- elected team co-captain his senior year. ing orthopaedic residency at Naval Medi- He then attended Washington Univer- A special thank you to cal Center San Diego, he was stationed sity School of Medicine in St. Louis and our sponsors who make at Newport, Rhode Island, where he was awarded the Brookings and Carter the Fellowship program deployed to Afghanistan for Operation Research Award during his final year. Dr. possible. We’d like to Enduring Freedom and took care of com- Nepple completed his residency training recognize those individu- bat casualties. at Washington University in St. Louis. als and foundations that During his time in St. Louis, he was support the entire Fellow- Jared T. Lee, M.D. involved in team coverage of the St. ship class through the Dr. Lee attended Brigham Young Louis Rams football and Blues hockey. He sponsorship of Academic University as a student-athlete. He grad- also spent two weeks in Port-au-Prince, Chairs. uated magna cum laude with a Bachelor Haiti, as part of a medical mission group Chair sponsors of the of Art in history and was a member of treating orthopaedic conditions after 2012-2013 Steadman Phi Kappa Phi. As an undergraduate, Dr. the earthquake. While at Washington Philippon Fellowship Lee played football at Ricks Junior Col- University, his research focused on young Class are Mr. and Mrs. lege. He was team captain, All-American, adult hip disease and femoroacetabu- Lawrence Flinn, Mr. and and inducted into the Ricks College Ath- lar impingement. He also received the Mrs. Brian P. Simmons, letic Hall of Fame. Recruited to Brigham AOSSM NCAA Research Award in 2011 Mr. and Mrs. Peter Young University, he was named team for research on knee articular cartilage Kellogg, Mr. and Mrs. captain, all-conference safety, and first disease in football players at the NFL Al Perkins, and Mr. and team academic All-American, and re- Combine. His research resulted in numer- Mrs. Steven Read. ceived the prestigious National Football ous publications and presentations. After Fellowship Benefactors Foundation and College Football Hall of completing his training, Dr. Nepple will fund the research of one Fame post-graduate scholarship. Prior to return to Washington University in St. Fellow for one year. Each medical school he signed as a free agent Louis. Benefactor is assigned with the Cincinnati Bengals and later a Fellow, who provides worked for Forest Laboratories. Jack Skendzel, M.D. written reports and up- He received his medical degree from Dr. Skendzel graduated magna dates of his or her work. the University of Washington School of cum laude from the University of Notre We extend our gratitude Medicine, where he was elected a mem- Dame. While at Notre Dame, he spent six to the following individu- ber of Alpha Omega Alpha and gradu- months in London studying and travel- als and foundations for ated with honors. Dr. Lee completed resi- ing throughout Europe. After college, their generous support: dency training in the Harvard Combined he attended medical school at George- Mr. and Mrs. Milledge Orthopaedic Residency Program and town University in Washington, D.C. Dr. Hart, the Fred and Elli served as administrative chief resident Skendzel then returned to his native Iselin Foundation, Mr. for the Massachusetts General Hospital. Michigan and completed his orthopae- Tim McAdam, Mr. and He was recognized for the highest aver- dic surgery residency at the University Mrs. Jay Precourt, and age score on the orthopaedic in-training of Michigan. During his residency, he Mr. and Mrs. Stewart examination among the graduating completed several research projects and Turley. residents. His research interests include published in journals such as the Journal the biomechanics and traumatic injuries of Arthroplasty, the American Journal of the sternoclavicular joint, a topic on of Sports Medicine, and Arthroscopy. He which he has made numerous presenta- also served as an administrative chief tions. resident for the orthopaedic program and covered local high school football Jeffrey J. Nepple, M.D. teams, as well as collegiate basketball Dr. Nepple grew up in Templeton, and hockey. Iowa. He graduated summa cum laude from Truman State University in Kirks- FOOT AND ANKLE FELLOW ville, Missouri with a degree in math- ematics. While at Truman, he played Nicholas A. Viens, M.D. NCAA Division II basketball and was Dr. Viens graduated magna cum laude from Duke University, where he earned a Bachelor of Arts degree in his-
16 tory, as well as membership in Phi Beta ogy at the US Naval Hospital, Camp Kappa. He was awarded highest dis- Lester, in Okinawa, Japan. Upon return- tinction in his major and the William T. ing to the United States, he completed a Laprade Prize for the outstanding thesis combined Musculoskeletal Fellowship at in the Department of History. Dr. Viens the Armed Forces Institute of Pathology attended the Duke University School of and the University of Maryland. Medicine and furthered his interests in The next two years were spent in Au- clinical orthopaedics and research. He gusta, Georgia, where he is an assistant completed orthopaedic surgery residency professor of Radiology, and at the VA at Duke University Medical Center and Medical Center, where he was head of was very involved with the resident selec- the Department of Radiology. In 1997, tion and education processes. He was an he entered private practice with Charles- American Orthopaedic Foot and Ankle ton Radiologists in Charleston, South Society Resident Scholar, an Ameri- Carolina. While there, he worked closely can Orthopaedic Association Resident with the local orthopaedic surgeons, es- Leadership Forum Nominee, and a John pecially those who served the area’s high A. Feagin, Jr., M.D., Leadership Program school, college, and professional sports Medical Scholar. teams. Dr. Viens has co-authored publica- UUUU tions in the Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Foot and Ankle Inter- Where Are They Now. . ? national, the Journal of Arthroplasty, and the Journal of Surgical Orthopaedic The graduating class of 2011-2012 Steadman Philippon Fellows is Advances. His clinical and research inter- busy establishing new careers in orthopaedics. ests include foot and ankle athletic and traumatic injuries, as well as treatment Adam Anz, M.D. of arthritic conditions of the foot and Dr. Anz is practicing at the Andrews Orthopaedic and Sports Medicine ankle, including total ankle replacement. Center in Gulf Breeze, Florida. Having grown up in Waterville, Maine, where he earned his Eagle Scout Christian Balldin, M.D. and was active in sports and camping, Dr. Balldin is practicing with the San Antonio Orthopaedic Group in San Dr. Viens is looking forward to spending Antonio, Texas. a year in the mountains and enjoying the snow with his wife, Lindsey, and son, Robert Boykin, M.D. Henry. Dr. Boykin is establishing his practice at Blue Ridge Bone and Joint in Knoxville, Tennessee. SPORTS MEDICINE IMAGING FELLOW Mark Geyer, M.D. W. Sean Smith, M.D. Dr. Geyer has joined the practice at the Athletic Orthopedics and Knee Dr. Smith is a graduate of Xavier Uni- Center in Houston, Texas. versity and the University of Cincinnati College of Medicine, where he attended Jeffrey Padalecki, M.D. on a U.S. Navy Health Professions Schol- Dr. Padalecki has moved to Austin, Texas, and is practicing at the arship. His internship was at the Universi- Austin Regional Clinic. ty of Chicago Hospitals and Clinics, which was followed by three years active duty Benjamin Petre, M.D. in the medical clinic at Willow Grove Dr. Petre is now in Queen Ann, Maryland, practicing sports medicine at Naval Air Station in Willow Grove, Penn- the Orthopaedic and Sports Medicine Center. sylvania. He completed his radiology residency at the National Naval Medical Norman Waldrop, M.D. Center in Bethesda, Maryland, and then Dr. Waldrop is establishing his sports medicine practice at the Andrews spent three more years on active duty as Orthopaedic and Sports Medicine Center in Birmingham, Alabama. the head of the Department of Radiol-
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(Steadman Philippon Update, continued from page 3) The Orthopaedic Foundation winning paper at the Annual Meetings of the Ortho- for Active Lifestyles Honors paedic Research Society and the American Acad- emy of Orthopaedic Surgeons in 2013. “I am very Dr. Steadman humbled to have been chosen to receive this award. I am also very grateful to my family for their sup- The Orthopaedic Foundation for Active Lifestyles port and to my many colleagues who have been an recently honored Dr. Richard Steadman, M.D., with essential part of my research over the past 15 years. the Excellence in Sports Medicine award at their This award solidly validates our research strategy of eighth annual gala. The presentation of the award, defining the anatomy, developing improved means which took place took place November 13 at The of diagnosing a problem, redefining the clinically Harvard Club of New York City, was made by televi- relevant biomechanics, developing improved radio- sion icon Regis Philbin. Also honored was tennis graphic diagnostic measures, developing biomechan- legend, Billie Jean King, who received the Spirit of ically validated ligament reconstructions, and then Active Lifestyle award. validating these reconstructions in patient outcomes UUUU studies. In addition to the posterolateral knee for which this award was based, we have similar ongo- Coen Wijdicks, Ph.D., Named ing programs for the medial knee and MCL, anterior cruciate ligament, and posterior cruciate ligament,” “Outstanding Reviewer of the said Dr. LaPrade. Dr. LaPrade’s collaborators on this Year” by European Society paper included Lars Engebretsen, M.D., Ph.D. (Uni- versity of Oslo, Norway), Steinar Johansen, M.D. of Sports Traumatology Knee (University of Oslo), Chad Griffith, M.D. (University Surgery and Arthroscopy of Minnesota), Benjamin Coobs, M.D. (University of Minnesota) and Andrew Geeslin, M.D. (Western (ESSKA) Michigan University). Coen Wijdicks, Ph.D., director OREF CLINICAL RESEARCH AWARD of the department of BioMedi- In 1994, the Board of Trustees of the Orthopae- cal Engineering and senior staff dic Research and Education Foundation (OREF) scientist with the Steadman Philip- created the OREF Clinical Research Award to stimu- pon Research Institute in Vail, was late and recognize outstanding orthopaedic clini- recently named “Outstanding cal research. This award is considered the highest Reviewer of the Year” for 2012 by the European Society of Sports research award for orthopaedic surgeons and has Coen Wijdicks, Ph.D. been called the “Orthopaedic Nobel Prize.” The Traumatology Knee Surgery and Award is chosen by the Research Development Arthroscopy (ESSKA). Committee of the American Academy of Ortho- The announcement was made paedic Surgeons from manuscripts which represent in the journal, Knee Surgery, Sports a large body of cohesive and highly significant Traumatology, Arthroscopy (KSSTA) scientific work, reflecting years of investigation in - The Official Journal of ESSKA. orthopaedic surgery. Previous winners of this award Dr. Wijdicks has been an instru- read like a “Who’s Who” of high impact orthopaedic mental contributor towards many clinicians and researchers for whom clinical studies diverse research studies affiliated have resulted in numerous scientific breakthroughs with the Institute. His research focus is on transla- and for which significant numbers of patients have tional research for current clinical needs, with an benefitted from their research work. This award emphasis on a bench-to-bedside focus. Some of his represents researchers who have made most of the studies include novel methods to stimulate tissue leading orthopaedic advancements of the past regeneration via biologic growth factors to pro- 60 years. mote healing; radiographic quantification related to UUUU common injuries of the knee and shoulder; and the development of new ligament reconstructions with biomechanical validation to optimize surgical recon- structions of common ligament injuries. He has published over 50 peer-reviewed scien- tific articles in high-level journals, presented over
18 100 abstracts at national and international meetings, It is not only about the quantity, but and received over 10 awards for his and colleagues’ overall excellence in research. Most notably, in June also the quality of publications within of 2010 Dr. Wijdicks was awarded the prestigious Nicola’s Foundation Young Researcher Award, which SPRI that allow for high impact in our is given to the best scientific manuscript in the field of knee surgery at the bi-annual ESSKA congress. orthopaedic community. Our publica- The Institute extends its congratulations to Dr. Wijdicks for his extraordinary efforts. tions are accepted to the top journals. UUUU Dr. Marc Philippon, orthopaedic hip surgeon and SPRI Board Member, stated, “It is not only about the Steadman Philippon Research quantity, but also the quality of publications within Institute Reports Record SPRI that allow for high impact in our orthopaedic community. Our publications are accepted to the top Year in Publication of Peer- journals.” Reviewed Orthopaedic According to Dr. Coen Wijdicks, director of the department of BioMedical Engineering at SPRI, Research Studies “Peer-reviewed publications that incorporate rel- evant research studies provide a significant credible In the field of healthcare, peer review and publi- resource among peers. Because it is published in such cation of clinical and scientific studies certify that the a large forum, the result is high impact and captures absolute highest standards in the research process a large audience.” have been met. BioMedical Engineering scientists The Steadman Philippon Research Institute is from the Steadman Philippon Research Institute engaged in various orthopaedic research studies will have 33 studies completed by year-end. These throughout the year. In 2012, some of the published orthopaedic research studies include injury preven- studies included: tion, clinical observation, and assessment in all areas N The effects of arm elevation on the 3-dimensional of orthopaedic sports medicine. acromiohumeral distance: a biplane fluoroscopy The department of BioMedical Engineering at study with normative data SPRI, a world leader in orthopaedic and sports medi- N Anatomic suture anchor versus the brostrom tech- cine research, reports a record number of research nique for anterior talofibular ligament repair papers by PubMed. PubMed’s database is a service of N Femoroacetabular impingement treated with PRP the U.S. National Library of Medicine, and provides and bone marrow concentrate aspirate in a profes- access to peer-reviewed and accepted online collec- Coen Wijdicks, Ph.D. sional soccer player tions of research studies for the medical community. For 2012, the department of BioMedical Engineering (continued on page 20) will have 16 orthopaedic studies published, another seven papers accepted for publication, and 10 papers still in peer review. Independent, unbiased, critical assessment of medical conditions, treatments, and patient out- comes is integral to validating clinical research. SPRI’s orthopaedic research studies include injury prevention, clinical observation, and assessment in all areas of orthopaedic sports medicine. In the field of healthcare, these studies certify that the absolute highest standards in conducting, recording, and re- porting the research have been met. Once an ortho- paedic research study is submitted to a professional journal by a research team, a peer review committee Kelly scrutinizes it, and only the best papers are accepted for publication. John
The large number of SPRI studies published in Photo: a 12-month period is an extraordinary accomplish- Robert F. LaPrade, M.D., Ph.D., Coen A. Wijdcks, Ph.D., Kyle Jansson, Mary ment and the highest indicator of the quality of their Goldsmith, M.Sc. , and J. Erik Giphart, Ph.D. research.
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(Steadman Philippon Update, continued from page 19) This new study proposes a quantitative grading N Recruitment and activity of the pectineus and piri- system based on dorsiflexion stress radiographs. This formis muscles during hip rehabilitation exercises: will result in a predictable and reproducible test for an electromyography study evaluating the extent of injury to the first MTP joint. N The management of injuries to the medial side of The study was performed in the department the knee. of BioMedical Engineering (BME) at SPRI, and the “Without a peer review process for medi- results were submitted for publication this month. cal research, there would be very little validity to UUUU published studies. It is well recognized that peer- reviewed publications have gone through vigor- Dr. Marc Philippon Publishes ous peer review and represent the highest levels of scholarly work. It has always been our goal, and it Study on the Arthroscopic will continue to be our goal, to plan to publish our Treatment for Femoroacetab- orthopaedic research studies in the highest level journals starting from the point of initial design of ular Impingement in our works,” states Dr. Robert LaPrade, chief medical Adolescents research officer of the Institute.” In 2011, SPRI completed construction of its Peer-reviewed publications are considered the multi-million dollar, state-of-the-art laboratories and gold standard among medical professionals. They surgical skills facilities. The principal goal for these offer critical information about how to best to treat facilities is to understand the demands on joints for patients with certain medical problems. PubMed certain sports or motions, how injuries occur and represents independent, critical assessment of medi- how they can be best treated, and to offer physicians, cal conditions, treatments, and patient outcomes. SPRI Fellows, and International Research Scholars the These studies are an important part to validate one’s ability to practice current and new surgical tech- research, and researchers must include details about niques in a simulated operating room environment. the scientific progress used, as as well as insight into UUUU the investigation and outcomes. SPRI Board Member Dr. Marc Philippon is Dr. Thomas O. Clanton an expert in treating femoroacetabular hip impingement. His study on treating the condition Receives Research Grant for arthroscopically in adolescents (patients ranging in the Evaluation of Serious age from 11 to 16 years) was recently accepted and published on PubMed. Turf Toe Injuries The purpose of this particular study was to evalu- ate clinical outcomes after arthroscopic treatment The Orthopaedic Education Foundation of for femoroacetabular impingement in the adoles- the American Orthopaedic Foot and Ankle Society recently awarded Dr. Thomas O. Clanton, orthopae- dic surgeon and director of Foot and Ankle Sports Medicine for the Steadman Clinic in Vail, Colorado, a research grant concerning turf toe Injuries. This research initiative, which was conducted at the Steadman Philippon Research Institute, provides a detailed evaluation of turf toe injuries using a method of analysis that utilizes stress radiographs. Turf toe injuries occur when the big toe is hy- perextended or moved to a position that is beyond its normal range of motion, leading to a sprain to the ligaments and soft tissue that surround the big toe joint. It is an injury commonly seen in high-level athletes such as gymnasts, football players, and soccer players. Historically, there has been dispute Kelly on the best course of treatment to repair turf toe injuries because there is not a specific standardized John
approach. Photo: Dr. Marc Philippon
20 Lynda then moved to Phoenix, Arizona, where she worked in program- ming and operations for KUTP TV45. After three and a half years in the desert, Lynda realized that Colorado was home and relocated back to her hometown of Vail. Lynda Sampson After returning, Lynda joined the TV8 team in February 1991, dur- ing the station’s first year of operation. Her first Mechanical causes of FAI as seen on an axial view of the hip joint. job was as co-host and Beaver Creek Resort re- porter. In the fall of 1993, Lynda went on to work The reduced clearance leads to repetitive abutment between the femur and the acetabular rim. Top Left: Normal hip. Top Right: Reduced femoral head- as the executive producer and host of “Good neck offset (cam impingement). Bottom Left: Excessive over coverage of the Morning Vail,” where she stayed for 15 years. femoral head (pincer impingement). Bottom Right: Combination of cam and pincer types of impingement. Lynda served as Regional Development Of- ficer for Colorado Mountain College and helped cent and pediatric population with a minimum of two generate support for the Edwards campus, years follow-up. The mean age for the study (at the programs, and students. Lynda recently devel- time of surgery) was 15 years. Sixty-nine percent of the oped “Women in Philanthropy,” a member-based patients were girls and 31 percent were boys. program with the goal of increasing awareness The conclusions indicate that hip arthroscopy in and support for Colorado Mountain College. the pediatric and adolescent population is a safe pro- Prior to assuming her full-time duties at SPRI, cedure, with excellent clinical outcomes at two to five Lynda directed this past summer’s event “Rock the years. In this study, there was an association between Research,” featuring Darius Rucker. The concert alpha angle and age. Clinical scores showed a signifi- and gala broke all records for attendance and cant improvement after surgery; however, 13 percent revenue, with Rucker playing to a standing room of patients did require a second procedure for capsulo- only audience of 2,700. labral adhesions. Active in our community, Lynda has served UUUU on the board of the Breast Cancer Awareness Group for the past 16 years. She spent two years Lynda Sampson Named as the president of the Red Sandstone Elemen- tary School PTA, where she successfully headed Director of Special Events up the school’s campaign for a new playground. and Major Gifts She volunteers for Vail Mountain School’s Parent Partners, and is currently chairing the Vail Valley Lynda Sampson has been named director of Special Medical Center’s annual Hospital Dinner Dance. Events and Major Gifts at the Steadman Philippon Lynda has also agreed to sit on the Vail Valley Research Institute. Among her duties at SPRI, Lynda Foundation’s 2015 Youth Committee for the will work with donors and prospective donors, direct- World Alpine Ski Championships. ing them to projects and programs that match their When she is not working or volunteering, you interests. will find Lynda and her husband, Peter, chasing Lynda grew up in Vail and graduated from Colo- their two young boys, Cooper and Garrett, and rado State University at Fort Collins with a degree in their golden retriever, Brody. speech communications. From there she traveled the UUUU world with the performing group “Up With People” for two years. First performing as a student and cast member, she then was hired as part of the production/ dance team.
21 SPRI NEWS WINTER 2013
FREQUENTLY ASKED QUESTIONS school year. Medical and societal costs related to these injuries are substantial. WHAT NEW RESEARCH INITIATIVES ARE Sports injuries place a substantial burden UNDERWAY AT SPRI? on the healthcare system for both initial As our Institute looks forward to 2013 care and rehabilitation. They also result and its 25th year of keeping people active, in costs related to lost productivity and we want friends and supporters to know other economic factors. Anterior cruciate about plans for two exciting endeavors. ligament (ACL) knee injuries, for example, A new initiative is our Global Center are usually sports-related and can be for Excellence in Hip Preservation and debilitating enough to prevent continued Research. It will be the first of its kind any- physical activity. The related surgical and where. With 285,000 hip replacement sur- rehabilitative costs of ACL repair total ap- geries performed each year in the United proximately $646 million annually in the States, the Center’s objective will be to United States. delay or prevent these surgeries altogether. The scientifically validated deliver- Directed by Dr. Marc Philippon, the able will be the identification of injury Center will be unique in the world for risk factors, understanding the mecha- advancing the prevention, care, and nism of injury, and implementation of treatment of hip injuries and disease. The an injury prevention program to provide Center will fully integrate four labs within a decrease in the annual injury rates for SPRI’s department of BioMedical Engineer- participants in specific sports. Our ulti- ing: Biomechanics, Musculoskeletal mate goal is to have injury prevention Mechanics, BioMedical Imaging, and knowledge transferred from the specific Orthopaedic Engineering. sports participants to the general public. The objectives of the Center will focus Since 2007, the International Olympic on these areas: Committee has placed a high priority on N determine the causes of femoroacetabu- developing injury prevention programs lar impingement (FAI) and other hip in high-level and recreational sports. The pathologies IOC’s Medical and Scientific Department N advance joint preservation and restora- is currently developing research in injury tion techniques prevention, education, and implementa- N refine surgical techniques to treat FAI tion of new knowledge. As IOC President and other hip pathologies Dr. Jacques Rogge, who is a leader in this N refine and validate hip-rehabilitation effort, said, “The evidence suggests that, protocols although sports participation is benefi- N develop injury prevention measures in cial, injuries are a significant side effect. young active people. To promote physical activity effectively, And our second initiative is our new we have to deal professionally with the Sports Injury and Disease Prevention Initia- health problems of the active patient. tive. Projects already under way at SPRI in This involves not only providing effec- this broad area of research will impact mil- tive care for the injured patient but also lions of lives. In 2012, we began identifying developing and promoting injury preven- the mechanisms of injury. tion measures actively.” As we have reaped the rewards and UUUU benefits of sports and exercise, we are also seeing an epidemic rise in sports injuries SAVE THE DATE to children and adults. In our community, for example, we are conducting stud- Edwin McCain to ies on youth hockey players (ages 10-19 Perform for Summer years) and have seen a dramatic increase in the number of hip injuries in children. Benefit Concert In the United States, high school students participating in sports (football, soccer, e are excited to announce that Ameri- basketball, wrestling, baseball, volleyball, Wcan singer-songwriter Edwin McCain and softball) sustained an estimated 1.2 will show his support for the Steadman million injuries during the 2008–2009 Philippon Research Institute (SPRI) as the 22 Steadman Philippon Golf Tournament
THE VAIL VALLEY MEDICAL CENTER 2013 STEADMAN PHILIPPON RESEARCH INSTI- TUTE GOLF CLASSIC PRESENTED BY RE/MAX INTERNATIONAL SET FOR AUGUST 15, 2013
Proceeds will support the orthopaedic Edwin McCain research and educational programs headline performer for the Institute’s 2013 of the Steadman Philippon Research annual summer fundraising concert. “Rock Institute. the Research” is scheduled for Thursday, The team event held at Sanctuary Golf July 11, at the Gerald R. Ford Amphitheater Course, in Sedalia, Colorado, just south of in Vail, Colorado. Denver, will include a shotgun start with McCain is a well-known alternative a modified scramble. The tournament is rock singer-songwriter. While his albums open to the public. Sanctuary organizes are released under his name, he does have and hosts charitable events to support a permanent band, referred to as the organizations devoted to the arts, children, Edwin McCain Band. health care, and crisis management. Long-time touring friends with Hootie Since 2004, the Institute has raised and the Blowfish, the Edwin McCain Band more than $1.2 million from this golf tour- released their first major-label album, nament to support its research programs. “Honor Among Thieves,” in 1995. Mid- Renowned course architect Jim Engh, Golf 2004 saw the arrival of his first studio Digest’s first-ever “Architect of the Year,” album in three years, entitled “Scream & designed the course that protects a private Whisper,” which was released by label, DRT oasis of 220 acres, effectively complement- Entertainment. ing the 40,000 surrounding acres of dedi- Edwin McCain Band’s original material cated open space. CD, titled, “Lost in America,” was released The Steadman Philippon Research In- in, 2006, by Vanguard Records. This was stitute is grateful to Dave and Gail Liniger, a true “rock ‘n roll” collection. There owners and co-founders of RE/MAX Inter- were three single releases from this CD: national, who built this course and created “Gramercy Park Hotel,” “Truly Believe,” this unique fundraising opportunity for the and “The Kiss.” Institute to develop and enhance Edwin’s next release, a collection of relationships with those who sup- rhythm and blues cover songs entitled port our mission. “Nobody’s Fault But Mine,” was released Sponsorship opportunities June 24 2008 under the Saguaro Road and team slots are available Records label. now. More information can be In 2010 he released “The Best of Edwin obtained by visiting our website McCain,” a 20 career retrospective that (www.sprivail.org) under “Up- included a cross-section of material as well coming Events,” or by calling the as a new single, “Walk With You.” Development office at (970) 479- McCain’s tenth album, “Mercy Bound,” 5781. To request an invitation or was released August 30, 2011. for more information on other All proceeds from the concert will fund upcoming events, please contact new research for orthopaedic injuries and John McMurtry at the Steadman conditions. Last year’s event was extremely Philippon Research Institute, successful and we are looking forward to (970) 479-5781. another sellout crowd. For information UUUU on the dinner and auction, please call Lynda Sampson (970) 479-5809. UUUU
23 181 West Meadow Drive Suite 1000 Vail, Colorado 81657 970-479-9797 970-479-9753 FAX http://www.sprivail.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 all ages physically active through orthopaedic research and education in the areas of arthritis, healing, rehabilitation, and injury prevention. Mark Your Calendar: ADMINISTRATION Lauren Matheny Stanley Pappelbaum, M.D., M.B.A. Coordinator of Lower Extremity Research JULY 11, 2013 Chief Executive Officer Ryan Warth Coen A. Wijdicks, Ph.D. Research Assistant SPRI Presents Edwin McCain in Concert Chief Operating Officer BIOMEDICAL ENGINEERING Gerald R. Ford Amphitheater James Holland Coen A. Wijdicks, Ph.D. Chief Financial Officer Director For more information, contact Lynda Sampson Amy Ruther J. Erik Giphart, Ph.D. Manager, Business Administration BioMotion Laboratory Coordinator at (970) 479-5809 Tiffany Cook Mary Goldsmith, M.Sc. Administrative Assistant Senior Robotics Engineer DEVELOPMENT Kyle Jansson, B.S. AUGUST 15, 2013 John G. McMurtry, M.A., M.B.A. Senior Mechanical Engineer Vail Valley Medical Center 2013 Steadman Vice President for Program Advancement Sean Smith Lynda Sampson Research Engineer Philippon Research Institute Golf Classic, Director of Special Events, Major Gifts Lourenco Peixoto, M.D. CENTER FOR TRANSLATIONAL AND REGENERATIVE MEDICINE RESEARCH Visiting Research Scholar presented by RE/MAX, LLC at Sanctuary, William G. Rodkey, D.V.M. Kevin Campbell Sedalia, Colo. Director Research Assistant SURGICAL SKILLS LABORATORY Nicholas Kennedy For more information, contact John McMurtry Kelly Adair Research Assistant at (970) 479-5781 or [email protected] Surgical Skills Manager Max Michalski CENTER FOR OUTCOMES BASED ORTHOPAEDIC RESEARCH (COOR) Research Assistant Karen K. Briggs, M.B.A., M.P.H. Rachel Surowiec Director Research Scientist Ashley Darrough Katherine Wilson Data Collection Coordinator Research Engineer Grant Dornan IMAGING RESEARCH Statistician Charles P. Ho, Ph.D., M.D. Doug Gillard Director Spine Research Coordinator W. Sean Smith, M.D. Peter Goljan Imaging Fellow Executive Editor: Research Assistant EDUCATION Braden Hartline Kelly Stoycheff Jim Brown, Ph.D. Research Assistant Education & Fellowship Coordinator Marilee Horan, M.P.H. OFFICE OF INFORMATION SERVICES Coordinator of Upper Extremity Research Barry Eckhaus Joel Huleatt Manager, AudioVisual/Multimedia Research Assistant Angelica Wedell AV/Multimedia Technician SPRI has a Facebook page! Search for “Steadman Jason Gregg Manager, IT Philippon” on Facebook and click “like” on our page. Watch our wall for updates on our research as well as Your Legacy, Our Future. Please remember Steadman Philippon lecture series, orthopaedics in the news and more! Research Institute in your will, trust, or other estate plan.