SPORT Data Durable Over Eight Years
Todd Albert, M.D. is a spine surgeon and is president of the Rothman Institute in Philadelphia. He is also chair of the Department of Orthopaedic Surgery at Thomas Jefferson University. Musing on the recent release of the Spine Patient Outcomes Research Trial (SPORT) data, Dr. Albert told OTW, “The data showed that the results were durable over eight years and didn’t degrade at all. While this was not especially surprising, as is often the case, we needed the data to act as proof for insurers and policymakers. The standout piece of information was the finding that all three interventions—decompression for radiculopathy caused by a herniated lumbar disc, laminectomy for spinal stenosis, and laminectomy and fusion for degenerative spondylolisthesis—were cost effective. This should assure that from now on insurers will cover these procedures because there is little argument that they are cost effective.”
“Also important is that we now have a model for how these studies have to be done. This is important because we need to address the issue of how these patients fare at 10 and 15 years. We have a rich database that has been created as part of the SPORT study, and we hope to address other questions surrounding those procedures. One example is how patients over 80 years old do compared to younger people. Also, it is critical that we be able to determine the appropriate timing of these interventions. For certain injuries is it better to have these procedures done more acutely than even waiting three months? We will find out.”
“Rare” Shoulder Problem NOT Rare After All
Jon J.P. Warner, M.D. is chief of the Shoulder Service at Massachusetts General Hospital and co-director of the Boston Shoulder Institute Fellowship. A former president of the American Shoulder and Elbow Society (ASES), Dr. Warner told OTW, “My colleagues and I are observing that a condition previously thought to be uncommon—suprascapular neuropathy is responsible for shoulder pain otherwise unexplained by other causes. This condition, which involves an irritation of a nerve in the shoulder, is often unrecognized or overlooked by orthopedic surgeons. We often have patients come to my office from all over the U.S. and after several surgeries they continue to have pain.”
“These patients complain of pain over the top and back of the shoulder; they may also complain of weakness. The surgeon often mistakes the pain for a rotator cuff tear or a problem emanating from the neck. The suprascapular nerve is deep in the shoulder, comes from the neck, and can be compressed in several ways. It is usually a diagnosis of exclusion; the good news is that it is curable with nerve decompression that is performed arthroscopically. If the person’s pain is relieved by a fluoroscopic-guided injection into the suprascapular notch then they are candidates for this procedure. Our team is conducting an ongoing study on this, looking at the predictive value of giving injections, patients feeling relief, and then having the surgery. If this condition is diagnosed, the person receives the injection and feels better, then the likelihood of surgery giving lasting relief is 90%.”
Protecting Time for Research by Residents – HSS Leads the Way
No research, no progress. With this in mind, at Hospital for Special Surgery (HSS) Laura Robbins is senior vice president for education and academic affairs. She tells OTW, “All residents are required to conduct research as part of their training, yet given their significant clinical responsibilities finding time for research is difficult. We have designed a research curriculum for our residents, and we engage our scientists who examine what we expect out of the curriculum and what exactly we are teaching. We recognized the need to put administrative resources into the curriculum so we hired a research coordinator to help guide and work with the residents. In the PGY 2 [post graduate year two] each resident must meet with his or her mentor, develop research ideas, and then present those to the faculty. The mentoring continues in PGY 3, at which time they must apply for a grant from an outside organization.”
“While not every institution has the resources to put toward this curriculum, they can likely implement portions of it. Probably the most important thing we have done is to protect time for research in the rotation schedule. For other institutions the easiest way to implement a similar research program for residents would be to protect and carve out mentoring time early on in the residency program. In addition, institutions should require residents to go through certain research milestones. For example, in PGY 2 they must learn how to critique a research study; in PGY 3 they must learn more about methodology from their mentors and implement the methodology to address their research question. We have demonstrated that when we implemented the curriculum, we went from $8, 000 in awarded resident research grants in 2005 to $380, 000 in 2010; in 2005 residents published 16 papers, but in 2010 they published 84 papers. Taking the time and effort to invest in this structured program has been a real success.”
Steve H. Yoon, M.D. Joins Kerlan-Jobe
Steve H. Yoon, M.D. has joined the Kerlan-Jobe Orthopaedic Clinic in Los Angeles as a shareholder. Dr. Yoon is a board certified physiatrist and specializes in advanced non-surgical biologic treatments for sports injuries as well as interventional treatments for back and neck pain. Currently, he serves as a consultant to several professional and collegiate teams including the Los Angeles Lakers, Los Angeles Dodgers, Los Angeles Angels of Anaheim, Los Angeles Kings, Anaheim Ducks, Los Angeles Sparks and Loyola Marymount University.
Dr. Yoon joined Kerlan-Jobe in 2010 after completing his fellowship in Pain Medicine at the University of California, Los Angeles and Veterans Affairs Greater Los Angeles Health Care System where he acquired skills using a multidisciplinary approach in the treatment of both acute and chronic pain including the use of medication and image-guided interventional techniques.
Dr. Yoon completed his residency in Physical Medicine and Rehabilitation at NYU Medical Center and the Hospital for Joint Diseases where he was elected and served as Chief Resident. Dr. Yoon began his studies at the University of Alabama at Birmingham where he graduated with a bachelor of science degree in biology. He continued his academic pursuits at the University of Alabama at Birmingham School of Public Health where he earned a master of public health degree followed by a doctor of medicine degree at the University of Alabama School of Medicine. Dr. Yoon completed his internship in Internal Medicine at the University of Massachusetts Medical Center.
Dr. Yoon told OTW, “During my three years at Kerlan-Jobe Orthopaedic Clinic, I have made an asserted effort to utilize biologic treatments as part of the non-surgical management of sports injuries for our patients. The results have been promising and the science continues to evolve. The goal will be to continue to offer these types of non-surgical treatment options along with other innovative minimally-invasive techniques to address our patients’ orthopedic needs.”
UCF Medical Student Wins Ruth Jackson Award
Casey deDeugd, a fourth year student at the University of Central Florida (UCF) College of Medicine has received a national award from the Ruth Jackson Orthopaedic Society, which promotes professional growth and leadership for women orthopedic surgeons.
deDeugd received a Medical Student Achievement Award and will be honored at the society’s annual meeting March 11-12 in New Orleans. The award, given this year to six female medical students across the county, honors achievements in academics, research, leadership, mentoring, athletics and community service. Ruth Jackson was America’s first female orthopedic surgeon.
deDeugd has received numerous honors during her four years at the College of Medicine. She is a charter member of the college’s Alpha Omega Alpha Honor Society, the National Honor Society for medical students. A second lieutenant in the U.S. Air Force, she participates in the Health Professions Scholarship Program, which provides scholarship help to students who spend time with the military while in school and apply for a military service residency upon graduation.
From my first searches for a Doctor to perform cervical fusion surgery on me, Dr. Albert’s name kept surfacing . Reading authored/coauthored research articles plus his willingness to be involved in continued holistic research, led me to request him as my doctor The above article just confirms how right i was. Lucky to have found him.
When he looks you in the eye and promises to take care of you; count on it!
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