New Certification Requirements…Breakthrough Approach to Stimulate Bone Formation and Repair…Preventing Joint Replacement Surgery…First-of-Its-Kind Global Trauma Database Effort Launched…and more.
New Certification Requirements
Greg Mencio, M.D. is chair of the AAOS Board of Specialty Societies (BOS), an entity comprised of the leaders of 22 North American musculoskeletal specialty societies. How are they helping your “average” orthopedist? Dr. Mencio tells OTW, “One of the major things our fellows are dealing with now is maintenance of certification. There are a number of new mandates that have been put forth by the American Board of Medical Specialties (ABMS) and the American Board of Orthopaedic Surgery (ABOS) around this issue. Among the latest additions to the process of recertification are performance improvement modules that track how effectively physicians are performing in caring for patients. The BOS is working with the AAOS to develop the appropriate educational modules to meet these new requirements. We are trying to ‘mine’ the critical content expertise that exists within the specialty societies to develop testing processes that are educational for surgeons and relevant to patient care. The fact is that surgical techniques have changed and will continue to change…what many of us do now is different from what we did in training. We have got to be ‘fluid’ in keeping pace with best practices—and the public wants to know that physicians are up to speed on the latest skills and training.”
“The other ‘hot button’ issue now is advocacy. Legislatively, we are in favor of policies that focus on quality of care, access to specialty care, and patient safety. We work with the AAOS Council on Advocacy, Board of Councilors and State Orthopaedic Societies through our Office of Government Relations to deliver our messages on a continual basis. We recently co-hosted the 2012 National Orthopedic Leadership Conference (NOLC), in Washington, DC, that drew more than 200 orthopedic surgeons. These physicians attended educational symposia and participated in visits to Capitol Hill to engage their federal representatives in support of legislation to reduce the burden of professional liability insurance and to amend anti-trust laws to allow equitable negotiations between health care providers and health insurance plans to ensure continued access to quality care for our patients.”
Anjan R. Shah, M.D. Joins Florida Orthopaedic Institute
If there is trauma, the folks at the Florida Orthopaedic Insitute (FOI) have a new specialist to help out…Dr. Anjan R. Shah is now on board as an orthopedic trauma specialist. Prior to joining FOI, Dr. Shah assisted in the development of Lawnwood Regional Medical Center’s orthopedic trauma service in Fort Pierce, Florida, and was an orthopedic trauma surgeon throughout his tenure there. Dr. Shah initiated the orthopedic trauma protocols, oversaw all complex orthopedic cases that were presented in the emergency room, handled referrals and transfers from tertiary centers in the surrounding area and participated in multiple seminars on the topics of orthopedic trauma. Dr. Shah is a board-certified and fellowship-trained orthopedic trauma surgeon and received his medical degree from Boston University School of Medicine. He did a residency in orthopedic surgery at Drexel University in Philadelphia, then went on to receive fellowship training in orthopedic trauma surgery at Florida Orthopaedic Institute.
Engineering the Bone Surface
It’s sort of a ‘Why didn’t anyone think of this before?’ situation. Well, S. Adam Hacking, Ph.D., Director of the Laboratory for Musculoskeletal Research and Innovation in the department of Orthopaedics at the Massachusetts General Hospital and Harvard Medical School, did think of it: Enhanced Bone Formation and Repair by Modification of Allograft Surfaces. Dr. Hacking, who was awarded the Orthopaedic Research and Education Foundation (OREF)/Synthes Research Grant in Trauma, tells OTW, “This is an entirely new approach to stimulate bone formation and repair…I call it, ‘bone surface engineering’ The incorporation of specific nanosize features on the surface of bone stimulates osteoblast differentiation and recruitment, which ultimately leads to increased bone formation. This is very exciting because by simply manipulating the morphology of the bone surface, we have demonstrated about a twofold enhancement in bone formation in segmental defect and allograft treated defect models. With this grant from the OREF, more comprehensive trials are underway and we are looking forward to having enough data to begin clinical work.”
“This entirely new approach is significant for a number of reasons. First, there are many situations where enhanced bone formation is required; second, it has the potential to integrate with and compliment a number of existing approaches and finally, bone surface engineering offers a low cost approach that may one day provide benefit to those in less developed nations—where the incidence of trauma is high but the cost of therapeutics can be prohibitive.”
“We are still investigating how the bone surface engineering approach works. We believe that texturing the bone surface leads to the release of cytokines and intercellular messengers beneficial for bone healing. Instead of exogenously delivering growth factors, texturing the bone surface may stimulate the body to release them when and where needed…it’s like braille for guiding the formation of new bone.”
Gary Kraus, M.D. Honored as Top Doc
For the sixth year in a row, H Texas Magazine has chosen Gary Kraus, M.D., FAANS, a Houston spine and brain surgery expert, as a Top Doctor. Dr. Kraus treats a wide variety of brain and spine disorders, but has a special interest in non-surgical as well as surgical treatment of lower back pain and neck pain. He has patents pending on minimally invasive devices for the spine, and he has produced several websites: spinesurgery.com; spinehealth.com; neurosurgerypa.com. Dr. Kraus started and directed a Gamma Knife program in Ohio in 1999, and has been director of a Gamma Knife Center in Houston for seven years. Dr. Kraus is Chairman of Neurosurgery at Memorial Hermann Memorial City Hospital, Houston, Texas. He is Director of Neuroscience and Gamma Knife at West Houston Medical Center. He is Assistant Clinical Professor, Department of Neurosurgery at the University of Texas Medical School at Houston.
Preventing Joint Replacement Surgery
How to put the brakes on joint degeneration? A resident at the Hospital of the University of Pennsylvania—Mara L. Schenker, M.D.—is hot on the trail of an answer to that question. Dr. Schenker, who received a 2010 Orthopaedic Research and Education Foundation (OREF) Resident Clinician Scientist Training Grant, tells OTW, “Researchers at the Penn’s McKay Orthopaedic Research Laboratory have developed a nanofibrous scaffold that mimics the scale of the meniscal extracellular matrix, as well as its anisotropic (direction-dependent) architecture. My colleagues and I have been doing electrospinning, where we pull two types of polymers into an electrical field, collect them and are left with a sheet of dual polymer. We then fold that into three-dimensional structures for implants.”
“This is a novel therapy that has the potential to prevent knee patients from having to undergo joint replacement down the line. We are beginning a large animal study and have already worked out some of the ‘kinks’ such as getting the implants secured in the joint (using a three dimensional model). We are looking at a new way to thread the structures and ways to secure them in the joint, as well as ways to recreate the curved fibers of the meniscus.”
First-of-Its-Kind Global Trauma Database Effort Launched
A novel effort is underway at the Institute for Global Orthopaedics & Traumatology (IGOT) at the University of California San Francisco (UCSF). Amber Caldwell, Director of Outreach Development for IGOT, tells OTW, “We are developing a global trauma database in partnership with Mohit Bhandari, M.D. at McMaster University. While there are many estimates, we don’t know the actual global burden of trauma…those who show up at a hospital and those who don’t make it to the hospital. Some of those participating in this effort are six surgeons from Africa who recently visited IGOT through our Global Knowledge Exchange. When reviewing one of our major projects, INORMUS, an international trauma registry project, our visitors emphasized the need for a database, even locally, to better advocate for and defend resources needed to meet the ever growing demand of orthopedic trauma. The visiting surgeons’ role is to be on-the-ground investigators and lead study directors at their respective centers. They will supervise and facilitate in data collection and growth of the research infrastructure.”
Ted Miclau, M.D., professor and vice chair of Orthopaedics at UCSF and Director of the UCSF/San Francisco General Hospital Orthopaedic Trauma Institute (OTI) tells OTW, “The three surgeons from Tanzania—Dr. Edmund Eliezer, Dr. Billy Haonga and Professor Musera—and three from Kenya—Dr. Anthony Nduati, Dr. Geofrey Koech and Dr. Nedford Ongaro—began their visit with the IGOT by attending the SF Orthopaedic Trauma Course. They mixed with the 450 other attendees, and were able to have one-on-one meetings with national trauma experts. Some of our visitors participated in a clinical research workshop and others did a clinical case study symposium. The six visiting surgeons all come from two academic centers that were already in partnership with IGOT. While here, they spent time in educational and research meetings and one-on-one research mentoring, which was extremely popular. We see these relationships as fundamental in improving the care of orthopedic trauma globally, and we hope that these projects will be the foundation for future research on regionally-important questions.”
For more information, please visit: http://orthosurg.ucsf.edu/oti/outreach/programs/igot.
