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FOCUS and Oheneba Boachie-Adjei, M.D.

Humanitarian Award Winner Oheneba Boachie-Adjei Goes Home to Ghana // New Study: Faster Recovery, Less Pain Knee Revisions // and More!

Elizabeth Hofheinz, M.P.H., M.Ed. • Mon, August 4th, 2014

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Orthopedic Humanitarian Oheneba Boachie-Adjei, M.D. Goes Home to Ghana

On November 1, 2014 Hospital for Special Surgery (HSS) will bid adieu to Dr. Oheneba Boachie-Adjei, M.D., who has served as chief of the Scoliosis Service since 1994. Dr. Boachie, who was awarded the Humanitarian Award from the Academy of Orthopaedic Surgeons (AAOS) in 2004, is returning to his native Ghana where he will oversee orthopedic care at a hospital that he established. He tells OTW, “My return to Ghana has been in the making for many years. In 1972 I came to the U.S. for a purpose and I have achieved that. I have trained at the finest orthopedic hospital in the country, and have given back what I could. I am 63 years old and if I want to train more surgeons in Ghana, now is the time.”

It was in 1998 that Dr. Boachie established the Foundation of Orthopedics and Complex Spine (FOCOS) in order to provide care to patients with spinal deformities and other orthopedic problems in developing countries. “Working with many generous people from the U.S. and Ghana, we have treated more than 27, 000 patients and have performed more than 1, 000 surgeries. As I move forward, I will have all of the excellent training from HSS to accompany me, in particular the professional standards. My goal is to practice orthopedics like I practiced it in New York.”

“Specifically, this means instituting universal standards and perioperative protocols. You typically would not have spinal cord monitoring in the OR in Ghana, but I could not deviate from this excellence, so I have made sure that our patients will indeed have this. I engaged professionals in the U.S. and trained local nurses who are now experts in spinal cord monitoring.

In addition, we have treated approximately 200 patients at the new hospital with arthroplasty and to date have had zero infections. This has only been achieved by adhering to the standards to which I am accustomed, such as sterility, monitoring equipment, and protocols.”

Dr. Boachie earned a bachelor of science summa cum laude from Brooklyn College in 1976 and received a doctor of medicine degree from Columbia University College of Physicians and Surgeons in 1980. He completed his orthopedic residency at HSS and went on to pursue advanced training in spine deformity at the University of Minnesota.

Dr. Boachie, who has recently been honored with the HSS Lifetime Achievement Award, says that fundraising from afar will be more of a challenge. “In the past we have held events here, including a gala that helped pay for the activities of the FOCOS Hospital. Going forward, if we can keep the hospital at the same level of quality as it is now, we will be able to attract paying patients. The radiology department, as well as the lab and rehabilitation services, can generate some revenue. If we become known for our services then patients from all over Africa may seek out our hospital and assist with funding. For those patients who cannot pay we will find sponsors as we have been doing.”

His first steps when he hits the ground in Ghana this November? “I will round up my local staff, as well as the medical and foundation boards to develop a strategic plan for the next 2-5 years. We will review our protocols as well. We have a humanitarian affiliation with HSS to assist us as far as education, research, administration, and volunteerism. In a sense, we will be taking it one day at a time.”

“One year from now I hope to have three or four full time orthopedic surgeons; up until now we have depended on volunteers. I would also like to have a full time anesthesiologist, EMS, an electronic medical record system, and the beginnings of an orthopedic residency rotation program.”

“I completed all of my academic duties at HSS last week, but I will continue to do cases part time. I am grateful for the HSS experience, which has taught me the importance of committing to a purpose…the opportunities are out there for the taking, but you must do your part…and you must stay focused and be patient.”

Faster Recovery, Less Pain in Knee Revision

Wayne G. Paprosky, M.D. is a hip and knee surgeon at Midwest Orthopaedics at Rush who is on the hunt for a ‘more perfect’ way to do knee revision surgery…and he may have found it. He told OTW, “My colleagues and I noticed that the results of cemented revision knee surgery leave a lot to be desired. We developed the idea of using cones to enable us to avoid the use of bone cement for long term fixation and Zimmer crafted the implant.”

“When you remove the cement from the top of the tibia it usually leaves hole. If you fill it with cement it loosens up and results in shin pain. You can avoid this if you put a cone in the upper part of the tibia or the lower part of the femur, put the implant inside of that, and then attach it to metal. The cones, made of trabecular metal, are very porous (like pumice). You hammer it into the top of the bone and it sticks to the inside of the bone and bone grows into that. You then cement the metal shank of the prosthetic to the inside of the metal.

“We were surprised to find that patients feel better so much faster than with cement. It was also surprising that they did not have as much shin pain. Additionally, after two years there were no lines around the cement that suggested preliminary loosening. Thus far, we have done about 60 of these surgeries and there are no downsides thus far. In my opinion using these cones in revision knee surgery is the wave of future. We will soon be submitting these results for publication."

UCSF Tapped by NSF to Fix What’s Ailing Innovation

The orthopedic surgery department at the University of California, San Francisco (UCSF) has a new mission from the National Science Foundation (NSF): find out what is not working and find solutions. Through a new entity, the Center for Disruptive Musculoskeletal Innovations (CDMI), the UCSF orthopedics department will take advantage of the clinical and bioengineering resources at UCSF and The University of Toledo (UT), as well as that of industry leaders.

The CDMI is the only Industry/University Cooperative Research Center (I/UCRC) in the U.S. that is dedicated to musculoskeletal device, material and diagnostic innovation.

Dr. Lotz told OTW, “The CDMI brings faculty from UCSF and UT together with industry leaders to form a single center focused on increasing value in musculoskeletal care. The NSF I/UCRC model is an ideal means to bridge academia to industry in a manner consistent with each group’s inherent organizational structure and purpose. In an era of healthcare reform and reduced government spending on biomedical research, the CDMI fosters a symbiotic relationship where university faculty help industry build value through technological innovation and industry supports graduate education through sponsored research. Ultimately, the CDMI is more about jointly defining the problem, than finding specific solutions.”

Commenting on the public-private partnerships, Dr. Lotz noted, “We’re following the NSF I/UCRC model, where our industry partners form an advisory board and jointly oversee all aspects of the center. They collaborate with faculty to define pre-competitive research themes that meet industry needs and build upon center faculty expertise. Research projects manned by graduate student trainees are supported by leveraged IAB [Industry Advisory Board] membership funds (collected with low campus overhead). NSF contributions to the center help cover other administrative costs.”

“At our Center Planning meeting that was held last July, the IAB and faculty focused the center research activities on areas that can improve value in musculoskeletal care by identifying cost drivers, and improving outcome durability through technological innovation. We defined areas of shared interest that include multi-center clinical outcomes and cost data, quantitative measures of functional outcome that can be used to assess treatment value, techniques to reduce surgical site infections, predictors of proximal junctional kyphosis, and sensors, materials, and screening models for bone healing.”

“The CDMI is an ecosystem for innovation where center faculty learn about industry unmet needs through open discussion. These conversations frame a priority list of industry-inspired fundamental research questions that serve as targets for center faculty platform technologies. In this fashion, the center becomes a conduit between industry needs and the academic research base, and a support mechanism for fundamental research that industry can’t do in-house.”

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