Top Trauma Doc – Clifford B. Jones, M.D. – Joining CORE Institute // Remarkable Sound Wave Treatment Succeeds for Osteoid Osteoma // and More!

Clifford B. Jones, M.D. Joining CORE Institute

Dr. Clifford Jones, a world renowned orthopedic trauma surgeon, is joining The CORE Institute. Dr. Jones’ work has been widely recognized, from winning an Achievement Award from the American Academy of Orthopedic Surgeons to being named a Top U.S. Orthopedic Trauma Surgeon in 2012 in Orthopedics This Week.

“Dr. Jones has earned a national reputation as a leading traumatologist and we couldn’t be more excited that he chose to join our talented team at The CORE Institute, ” said Dr. Jason Scalise, vice chairman at The CORE Institute, in the June 4, 2015 news release. “While many orthopedic physicians know Dr. Jones for his research that has been recognized in several highly regarded medical journals or for the hundreds of lectures he has given, his patients know him for his personalized treatment plans to help each patient receive the best possible outcomes. It is with great excitement that we welcome him to the CORE team.”

Dr. Jones told OTW, “My first steps in this new role will be to specifically create an enhanced, well-functioning orthopedic trauma program at The CORE Institute in collaboration with Banner Healthcare concerning orthopedic trauma cases, education, treatment and prevention and improve upon the orthopedic trauma system for the state of Arizona. This will involve orthopedic trauma surgery but will also include a comprehensive, complete and consistent bone health program which will hopefully improve primary fracture healing and secondary or subsequent fracture prevention in both young and old patients.”

First in U.S.: Osteoid Osteoma Treated With MR Ultrasound Method

Two cancer patients are much healthier today thanks to sound wave energy. Doctors from the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Health System are the first in the United States to treat osteoid osteoma using an experimental magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) method.

According to the May 27, 2015 news release, the MR-HIFU method makes use of “focused sound wave energy to heat and destroy the targeted tumor under MRI guidance. This precise and controlled method does not require a scalpel or needle, greatly reducing the risk of complications like infections and bone fractures. It is also a faster treatment option, with expected total procedure time of an hour or less. In the U.S., MR-HIFU is used to treat uterine fibroids and painful bone metastases from several types of cancer in adults, but it has not been used in children.”

Asked what has prevented this kind of surgery from being more widely used, Karun Sharma, M.D., Ph.D., director of Interventional Radiology at Children’s National and principal investigator for the osteoid osteoma trial, told OTW, “MR-HIFU is a relatively new technology that is not yet widely available. It is currently used in adults for painful bone metastases and uterine fibroids. It is also being investigated and developed for many other diseases, including cancer and epilepsy. This is a very promising non-invasive treatment option but more clinical trials are still needed before it becomes more widely used.”

“Both participants were evaluated by our multidisciplinary team and found to be suitable for MR-HIFU ablation. Our team includes members from interventional radiology, oncology, surgery, and orthopedics as well as biomedical engineers specializing in MR-HIFU. In both cases, the osteoid osteoma lesions were accessible to the MR-HIFU beam and far enough from critical structures like nerves to be safely treated.”

“Patients who are unable to have an MRI are not appropriate for this treatment option. For example, patients who have a prosthesis, pacemaker or another non-MRI compatible device. Also, the location and size of the tumor are important considerations. For example, patients who have very large tumors or tumors which are very close to large nerves may not be appropriate for this treatment at this time.”

Looking forward, Dr. Sharma noted, “As part of our current research study using MR-HIFU to ablate osteoid osteoma, we will follow the participants for one year after their treatment. Other projects our team in the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National are working on include exploring the use of MR-HIFU as a noninvasive technique for ablating growth plates and malignant solid tumors. We have an open clinical trial for children and young adults with refractory soft tissue tumors, which is being performed in collaboration with Dr. Bradford Wood’s team at the NIH [National Institutes of Health]. We are also exploring the use of MR-HIFU to enhance delivery of local chemotherapy to tumors.”

FORCE-TJR Certified as Qualified Clinical Data Registry

Since 2010 the details of 30, 000 total joint patients have been tracked by FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement). Now, FORCE-TJR has been certified as a Qualified Clinical Data Registry (QCDR).

As part of this certification, says the June 4, 2015 news release, FORCE-TJR has developed new measures that are not related to The Physician Quality Reporting System (PQRS). These include:

• Pain and functional status assessment for hip and knee replacements
• Improvement in pain and function after hip and knee replacements
• Mental health assessment for patients who undergo hip and knee replacements
• Assessment and improvement on patients with osteoarthritis in the hip or knee

“The new QCDR designation allows FORCE-TJR to define new quality measures, including patient-reported outcomes, and to submit these data to CMS on behalf of our members—without any additional data collection. The data serve both their internal quality monitoring and meet the CMS mandate, ” said Patricia Franklin, M.D., FORCE-TJR’s registry director.

David Ayers, M.D., co-lead of FORCE-TJR and chair of the Department of Orthopedics and Physical Rehabilitation at UMass Medical School, told OTW, “Our biggest opportunity is that we are transitioning away from a federally funded grant program which was funded by the Agency for Healthcare Research and Quality (AHRQ) for the first four years, and AHRQ defined the number of hospitals and surgeons who were able to participate in first cohort. We are transitioning to a public/private partnership that allows FORCE-TJR to accept an unlimited number of new members, and as a result, we are expanding rapidly.”

“Our other challenge is that 40% of surgeons and physicians are not participating in the PQRS program. Because the healthcare system is transitioning from a volume-based reimbursement system to a value-based reimbursement system, clinicians are becoming frustrated that they cannot build their own infrastructure needed to collect data. They often don’t realize a program such as FORCE can facilitate collecting what they need to participate in the PQRS program, and can also collect information needed for bundled payment programs, and to explicitly show the value of the care that they provide their patients. Surgeons and physicians need to know that by joining FORCE-TJR, our method will make the entire process exceedingly easy because we collect information for them.”

“FORCE-TJR is expanding more rapidly than ever because more and more surgeons are recognizing the benefits of our program and want to join.”