The University of Pennsylvania Orthopaedic Journal Volume 28 June 2018 The University of Pennsylvania Orthopaedic Journal Volume 28, June 2018 Editorial Board Editors-in-Chief Adnan Cheema, MD Michael Eby, MD Faculty Advisors Jaimo Ahn, MD, PhD Samir Mehta, MD Section Editors Blair Ashley, MD Ryan Charette, MD Agnes Dardas, MD, MSc Rikesh Ghandi, MD Daniel Gittings, MD Mark Hasenauer, MD Cody Hillin, MD Liane Miller, MD Matthew Sloan, MD, MS Matthew Webb, MD Nicole Zelenski, MD VOLUME 28, JUNE 2018 iii The University of Pennsylvania Orthopaedic Journal Volume 28 June 2018 Table of Contents Letter from the Editors 1 Michael Eby, MD and Adnan Cheema, MD Dedication: Marvin Steinberg, MD 4 David Steinberg, MD Letter from the Chair 7 L. Scott Levin, M, FACS Letter from the Program Director 10 Craig Israelite, MD In Memoriam: Dean Lorich, MD 11 David Helfet, MD Editorials My Executive Masters in Business Administration Experience 15 Derek Donegan, MD, MBA(c) Opportunities Abound for Innovation 17 Mark Turco, MD, FACC Pride in Leadership: Penn Orthopaedics 19 Joshua Rozell, MD and John Kelly IV, MD Hip and Knee Arthroplasty Care Pathways: Process Improvement Methods Increase Quality and Lower Care Cost 20 Eric Hume, MD, Hannah Lacko and Joanne Piscitello Faculty Updates Faculty Awards and Appointments 25 Michael Eby, MD and Adnan Cheema, MD Update: Penn Center for Musculoskeletal Disorders 29 Louis Soslowsky, PhD 2017 Penn Orthopaedics Cartilage Repair Symposium 30 Mackenzie Sennett Division Updates Orthoplastics Division Update 31 Stephen Kovach III, MD Orthopaedic Trauma Division Update 32 Samir Mehta, MD Spine Division Update 33 Vincent Arlet, MD Sports Medicine Division Update 34 Brian Sennett, MD Hand Division Update 35 David Bozentka, MD Shoulder and Elbow Division Update 36 David Glaser, MD Arthroplasty Division Update 37 Charles Nelson, MD Foot and Ankle Update 38 Daniel Farber, MD Oncology Division Update 39 Kristy Weber, MD Children’s Hospital of Philadelphia Update 40 John Flynn, MD and Divya Talwar, PhD, MPH Resident and Fellow Updates Chief’s Corner: Academic Chief Update 44 Joshua Rozell, MD, Joshua Steere, MD and Zachary Zimmer, MD VOLUME 28, JUNE 2018 v VI TABLE OF CONTENTS Recent Changes in the University of Pennsylvania Orthopaedic Residency Program 45 Nicole Zelenski, MD and L. Scott Levin, M, FACS Visiting Professor Lectureship Series: 2017-2018 46 Adnan Cheema, MD Shoulder and Elbow: University of Pennsylvania-Princess Grace Traveling Fellowship 50 Chad Myeroff, MD Alumni Residents: Where are they now? 51 Adnan Cheema, MD Current Residents 53 Current Fellows 58 Hospital System Updates Corporal Michael J. Crescenz VA Medical Center Update 60 Marlene DeMaio, MD Pennsylvania Hospital Update 62 Neil Sheth, MD McKay Orthopaedic Research Laboratory Update 63 Robert Mauck, PhD and Louis Soslowsky, PhD What’s New at the PVAMC Translational Musculoskeletal Research Center 64 George Dodge, PhD and Robert Mauck, PhD Biedermann Lab for Orthopaedic Research Update 66 Michael Hast, PhD Human Motion Lab Update 67 Josh Baxter, PhD Clinical Research Update 68 Annamarie Horan, PhD Penn Orthopaedics: Advancing Care through Network Development 71 Rachel Kleinman, MHSA Penn Orthopaedics: Continued Growth and Expansion 72 Neil Ravitz, MBA Clinical Research Orthoplastics Tips & Tricks: Soft Tissue Reconstruction of the Complicated Knee Arthroplasty: Principles and Predictors of Salvage 74 David Colen, MD, Martin Carney, BS, Valeriy Shubinets, MD, Michael Lanni, MD, Tiffany Liu, BS, L. Scott Levin, MD, Gwo-Chin Lee, MD and Stephen Kovach, MD All Hope is Not Lost: Saving Limbs with the Orthoplastic Approach 78 Shaun Mendenhall, MD, Oded Ben-Amotz, MD, Joshua Mirrer, MD, Samir Mehta, MD, David Glaser, MD and L. Scott Levin, MD, FACS Hand Transplantation in the Rat: Technical Refinements of the Rat Forelimb Vascularized Composite Allotransplantation Model 81 Shaoqing Feng, MD, PhD, Shaun Mendenhall, MD, Oded Ben-Amotz, MD, Joshua Mirrer, MD, Ivan J. Zapolsky, MD, MS and L. Scott Levin, MD, FACS Arthroplasty Tips & Tricks: Preoperative Planning and Templating for Total Hip Arthroplasty 83 Matthew Sloan, MS, MD and Charles Nelson, MD Increasing Rates of Obesity, Diabetes, and Depression Prevalence Among Primary and Revision Total Joint Arthroplasty from 2002-2014 86 Mark Hasenauer, MD, Matthew Sloan, MS, MD, Amanda Warkow and Neil P Sheth, MD Prophylactic Tibial Stem Fixation in the Obese: Comparative Early Results in Primary Total Knee Arthroplasty 90 Joshua Steere, MD, Michael Sobieraj, MD, PhD, Christopher DeFrancesco, BS, Craig Israelite, MD, Charles Nelson, MD and Atul Kamath, MD A Computational Modeling Approach to Optimize Cup Coverage and Minimize Impingement Risk Using Subject-Specific Activities of Daily Living 91 Josh Baxter, PhD, Jenna Bernstein, MD, Neza Stefanic and Michael Hast, PhD Clinically relevant knee motion is accurately measured with a self-calibrated wearable sensor 93 Todd Hullfish, BSME, Annelise Slater, Brendan Stoeckl, Peter Gebhard, MS, Feini Qu, PhD and Josh Baxter, PhD UNIVERSITY OF PENNSYLVANIA ORTHOPAEDIC JOURNAL TABLE OF CONTENTS VII Foot & Ankle Tips & Tricks: The Scandinavian Total Ankle Replacement (STAR): Design Evolution and Clinical Results 95 Ryan Charette, MD and Kathryn O’Connor, MD Chronic Nicotine Exposure Alters Tendon Vascularity and Viscoelasticity 99 Daniel Gittings, MD; Corinne Riggin; James Boorman-Padgett, MS; Stephanie Weiss; George Fryhofer, MD; Daniel Farber, MD; David Steinberg, MD and Louis Soslowsky, PhD Effect of Pulsed Electromagnetic Field Therapy on Healing in a Rat Achilles Tendon Partial Tear Model 101 James Boorman-Padgett, Julianne Huegel, Courtney Nuss, Molly Minnig, Andrew Kuntz, MD, E. Waldorff, N. Zhang, J. Ryaby and Louis Soslowsky, PhD Modulation of Vascular Response after Injury in the Rat Achilles Tendon Alters Healing Capacity 103 Corinne Riggin, Ashley Rodriguez, Stephanie Weiss, Harina Raja, Mengcun Chen, Susan Schultz, Chandra Sehgal and Louis Soslowsky, PhD Achilles Tendon Structure in Distance Runners does not Change Following a Competitive Season 105 Todd Hullfish, BSME, Kenton Hagan, Ellen Casey and Josh Baxter, PhD Hand Surgery Tips & Tricks: Local Anesthetic Techniques for the Hand 107 Rikesh Gandhi, MD, Ivan Zapolsky, MD, and Benjamin Gray, MD CT Scans Oriented Along the Longitudinal Scaphoid Axis Do Not Change Surgical Management of Scaphoid Fractures 110 Adnan Cheema, MD, Paul Niziolek, David Steinberg, MD, Bruce Kneeland, MD, Nikolas Kazmers, MD, and David Bozentka, MD The Porcine Accessory Carpal as a Model for Biologic Joint Replacement for Trapeziometacarpal Osteoarthritis 112 Brendan Stoeckl, Michael Hast, PhD, Mackenzie Sennett, Minwook Kim, PhD, Michael Eby, MD, Thomas Schaer, BS, VMD, Robert Mauck, PhD and David Steinberg, MD Orthopaedic Oncology Tips & Tricks: Determinant and Indeterminate Lesions: When is Biopsy Necessary? 114 Nicole Zelenski, MD and Kristy Weber, MD Pediatric Orthopaedics Tips & Tricks: Atraumatic foot drop: A case report of an intraneural peroneal ganglion cyst 116 Liane Miller, MD, Amirhossein Misaghi, Apurva Shah, MD and Alexandre Arkader, MD Preliminary Mechanical and Ultrastructural Characterization of Pediatric Anterior Cruciate Ligaments and Tendons Used for Reconstruction 119 Elaine Schmidt, Theodore Ganley MD, Kevin Shea and Michael Hast, PhD Trends in the Surgical Management of Osteochondritis Dissecans of the Knee at a High-Volume Pediatric Hospital Network 122 Scott LaValva, Eileen P. Storey, James Carey, MD, Kevin G. Shea, John Polousky and Theodore Ganley, MD Type IV Tibial Spine Fractures Revisited: Arthroscopic Treatment and Outcomes for an Uncommon Injury 125 Alexander Adams, Taylor Jackson, Itai Gans, Julien Aoyama, Theodore Ganley, MD Evidence-Based Orthopaedics: Current Concepts, Principles, and Practice 129 Jigar Gandhi, Julien Aoyama and Theodore Ganley, MD IM Nails vs. Plate and Screws in Radial/Ulnar Fractures 130 Jermonte Lowe, Julien Aoyama, Tyrell Young-Hamilton and Lawrence Wells, MD Shoulder & Elbow Tips & Tricks: The Saline Load Test is Effective in Detecting Traumatic Arthrotomies of the Shoulder 132 Daniel Gittings, MD, Jonathan Dattilo, MD, George Fryhofer, MD, Michael Hast, PhD and Samir Mehta, MD Rotator Cuff Repair: An Opportunity for Improved Efficiency, Cost-Effectiveness and Ultimately, Cost Savings 134 Zachary Zimmer, MD, Deepak Chona, MD, Andrew Kuntz, MD, Russell Huffman, MD and David Glaser, MD Assessing the Contribution of the Central Screw to Glenoid Baseplate Fixation in the Presence of Osteopenic Bone 136 Michael Hast, PhD, Matthew Chin, PhD, Elaine Schmidt, Anthony Cresap and Andrew Kuntz, MD VOLUME 28, JUNE 2018 VIII TABLE OF CONTENTS Aging Related Degenerative Mechanical Changes Manifest Earlier in Supraspinatus Tendons 138 Joseph Newton, George Fryhofer, MD, Snehal Shetye, PhD Ashley Rodriguez, A ndrew Kuntz, MD and Louis Soslowsky, PhD Biceps Detachment Alters Joint Function and Tendon Mechanical Properties in a Chronic Massive Rotator Cuff Tear Rat Model 140 Mengcun Chen, Snehal Shetye, PhD, Julianne Huegel, Daniel Gittings, MD, Courtney Nuss, Stephanie Weiss, Andrew Kuntz, MD and Louis Soslowsky, PhD Spine Indirect Decompression Progresses Substantially after Immediate Postoperative Period following Lateral Lumbar Interbody Fusion 142 Matthew Webb, MD, Michael Eby, MD and Michael Murray, MD Risk Factors for Surgical Site Infections after Posterior Spinal Fusion in Neuromuscular and Cerebral Palsy Scoliosis Patients: A Retrospective ACS NSQIP Pediatric Database Analysis