osu orthopaedics accomplishments report 2010

2010 ACCOMPLISHMENTS REPORT

Advances in Patient Care, Research and Education

THE OHIO STATE UNIVERSITY DEPARTMENT OF ORTHOPAEDICS

1 Welcome from Jason H. Calhoun, MD, FACS3 Mission and Vision4 The Orthopaedic Program at Ohio State9 Clinical Highlights16 Educational Programs21 Orthopaedics Research22 Orthopaedics Research Collaborations24 Department of Orthopaedics

table ofcontents

Dear Colleagues and Friends,

These are exciting times to be part of Orthopaedics at The Ohio State University Medical Center. Things are changing, growing and moving fast, fueled by a shared vision for orthopaedic excellence and a commitment from the leaders of our vast University and Medical Center to make it happen. That commitment has been backed up with investments – and sizeable ones, too, in added faculty, facility space and technology. In response, our talented teams have pushed boundaries, inspired change and practiced medicine on the cutting edge in every area of orthopaedics.

The revolution is apparent in many ways. Our Orthopaedics staff has more than doubled from just two years ago, significantly increasing our capacity to serve patients with all kinds of orthopaedic needs. We have added all-new dedicated programs in six clinical specialty areas. Long a leader in the orthopaedic specialties of trauma, sports medicine and oncology, Ohio State now advances medicine in every area of orthopaedics, making ours the most comprehensive program in the region. Dedicated new facility space, highlighted by the opening of the Hand and Upper Extremity Center and the new CarePoint East clinic. Investments in advanced new technologies such as MAKOplasty® have made where we practice as exciting as what and how we practice.

Also key to orthopaedic excellence is a commitment to groundbreaking research and education. Both are bigger priorities than ever at Ohio State, and new staff and supports have been added to build the outcomes of these programs. The results have been immediate and dramatic. This year, the number of research papers published in orthopaedic peer-reviewed publications increased five-fold over 2009. Funded research tripled in the same period. Our residents are benefiting from an improved and expanded curriculum and more training opportunities and mentorships in every specialty area.

We are pleased to share with you the exciting and rapid advancements that have been made this year in orthopaedic treatment, research and education at Ohio State. We have a vision of becoming one of the top 10 orthopaedic programs in the country in the next five years – and, I think you will agree, we have the momentum to achieve it.

Thank you for your interest, and I hope you enjoy reading this first report of accomplishments for the Department of Orthopaedics at Ohio State.

Sincerely,

Jason H. Calhoun, MD, FACS Frank J. Kloenne Chair in Orthopaedic Surgery Professor and Chair, Department of Orthopaedics

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T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

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Division leads including: (back row left to right) Jeffrey Granger, MD, Thomas Ellis, MD, Andrew Glassman,

MD, Ian Alexander, MD and Julie Bishop, MD (front row left to right) Laura Phieffer, MD, Joel

Mayerson, MD, Christopher Kaeding, MD and Erik Monson, DPM

O R T H O PA E D I C S A C C O M P L I S H M E N T S R E P O R T

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In the words of Steven G. Gabbe, MD, CEO of The Ohio State University Medical Center, Ohio State is “dedicated to eminence” in medicine – and orthopaedics is a big part of that vision. These are not empty words, but rather a commitment that is being backed up with significant investments.

Already, these investments are bearing fruit. In all key measures, orthopaedic programs at Ohio State have improved – in patient care, research and education. The most well-known measure – the U.S.News & World Report annual hospital rankings – says it all: In 2010, Ohio State’s orthopaedics program jumped 13 places to number 28 – up from 41 the year before.

Our goal is to become one of the top 10 orthopaedic programs in the country within the next five years. Ohio State is aggressively pursuing a strategy of growth and development in key areas to achieve this goal. But, ultimately, what will get us there has everything to do with something we already have: a breadth and depth of resources. “What is remarkable about Ohio State’s orthopaedics program is what is remarkable about Ohio State itself – scope,” says Jason Calhoun, MD, chair of the Department of Orthopaedics.

Ohio State is one of the largest universities in the country. We have a leading oncology program in the Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, a Level 1 trauma center and one of the best sports medicine programs in the country. Orthopaedics faculty are the physicians for the Ohio State Buckeyes. Ohio State’s Orthopaedics physicians and residents also have access to a busy children’s hospital, conducting rotations at the nationally recognized Nationwide Children’s Hospital in Columbus.

The scope of Ohio State’s resources is a major benefit to orthopaedic research and training programs, too. Faculty and residents routinely collaborate with colleagues at the University’s leading dental, veterinary, engineering and business schools. “Every one of these schools is conducting research that they want to collaborate with us on,” Dr. Calhoun says. “The University is a leader in so many different areas of academics – that influences our ability to conduct research, education and patient care in so many ways.”

“Ohio State has all of the pieces it needs to be a top-tier orthopaedics program,” he says. “Now, it’s about bringing all of those pieces together.”

“What is remarkable about Ohio State’s orthopaedics program is what is remarkable about Ohio State itself – scope.”

Jason Calhoun, MD, FACS Chair, Department of Orthopaedics

MISSION AND VISION


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Growth was the hallmark of 2010 for Orthopaedics at Ohio State. In every way, it grew – in the number of faculty, the number of patients served, funding for research studies, number of papers published, class size of residents and the size and number of clinical divisions.

A banner year for faculty recruitment

OSU Medical Center leaders made a very deliberate effort to recruit the best physicians to become division directors and faculty at Ohio State. It wasn’t a hard sell. Physicians want to be part of the exciting potential and growth at the Medical Center, so they came on board en masse. In 2010, the number of total Orthopaedics faculty increased to 41, up from 17 just two years earlier. These physicians are leaders in their fields. They now lead dedicated service lines in 10 orthopaedic specialty areas, of which eight are new: foot and ankle, shoulder, hand and upper extremity, adult reconstruction/total joint replacement, spine, hip arthroscopy, general and musculoskeletal infection. The addition of talented surgeons to the existing orthopaedic oncology and trauma divisions has significantly benefited the program as well.

These physicians, researchers and educators have transformed what was a small but advanced and highly specialized orthopaedic practice into a fully comprehensive program serving patients with every kind of orthopaedic need.

The Orthopaedics faculty at OSU Medical Center has served thousands of patients. Through years of experience, these physicians have perfected the most advanced techniques. But it isn’t just quantity that sets them apart – it’s the complexity of the cases they see, and their expertise in designing the newest and most advanced techniques that are improving outcomes for patients.

“We can do everything from microsurgery to treatments for the most extensive infections and injuries,” Dr. Calhoun says. “On any given day, we could have one surgeon conducting a 14-hour pelvic osteosarcoma, a sports medicine physician treating the program’s 3,000th ACL, and a surgeon at the Hand and Upper Extremity Center taking care of a patient with a crushed hand. We routinely treat patients with the most complex issues.”

ORTHOPAEDICS AT OHIO STATE

Right: O-H-I-O

“Physicians from Neurosurgery and Spine, Plastic Surgery and Hand Surgery, General Surgery and Trauma, Pediatrics and Pediatric Orthopaedics – we all work together often, and we work together well.”

Jason Calhoun, MD, FACS Chair of the Department of Orthopaedics


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Working in close proximity with physicians from the other specialty areas promotes the collaborative approach to patient care and research that is unique to Ohio State. A multidisciplinary approach to treatment, research and education isn’t just a tenet of the program, it’s a daily reality.

“Physicians from Neurosurgery and Spine, Plastic Surgery and Hand Surgery, General Surgery and Trauma, Pediatrics and Pediatric Orthopaedis – we all work together often, and we work together well,” Dr. Calhoun says.

More robust educational programs

“Our faculty is excited and passionate about teaching.” Dr. Calhoun says. “Education is as core to what we do as taking care of patients and conducting research.”

Along with the growth in faculty has come an increase in the number of orthopaedic residents and a more robust educational program. In 2005, the orthopaedic residency program at Ohio State consisted of 20 residents, and many ended up going elsewhere to conduct their rotations because Ohio State did not employ faculty in all areas of orthopaedics. All of that changed in the past five years. In 2010, the total number of residents increased to 37. A new fellowship in hand surgery was added to the previously existing fellowship in sports medicine, and plans are in the works to add fellows to almost every other division, as well.

This change has been led by two new residency program directors: Joel Mayerson, MD, director of Musculoskeletal Oncology, and Erik Monson, DPM, director of Podiatry. Supported by new assistant program directors Julie Bishop, MD, Shoulder and Sports Medicine, and David

Flanigan, MD, Sports Medicine, this team has completely revamped the educational program, bringing new vision, structure, guidelines and learning opportunities to residents.

As assistant director of resident research, Dr. Flanigan has put a curriculum in place to get residents the experience and support they need to investigate, write and publish research papers. This includes an assigned research mentor for every resident. The clinical education program includes a completely overhauled, comprehensive curriculum. Dr. Bishop has structured the program so residents have a clear understanding of the expectations for their clinical studies, access to a variety of learning mediums and innovative means of getting the hands-on learning they need. Faculty are closely integrated into the program, ensuring residents get personalized attention from the leaders in each field.

Expansion of programs and facility space

The University has invested heavily in the Orthopaedics program over the past several years, in salaries, technology and facilities. This tangible sign of commitment was punctuated in 2010 by the opening of the new Hand and Upper Extremity Center, a designated Level 1 trauma center by the American College of Surgeons. Uniquely designed to bring surgeons and physicians from multiple specialties and

“Our faculty is excited and passionate about teaching.”

Jason Calhoun, MD, FACS Chair of the Department of Orthopaedics


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fields together in a single setting, the state-of-the-art facility delivers the highest standard of orthopaedic care for both inpatients and outpatients. The patient-centric design promotes a small, community hospital-like setting for patient comfort and convenience.

The Hand and Upper Extremity Center has become a model for orthopaedic excellence at Ohio State, and plans are underway to open a similar center for Sports Medicine.

“We’re able to take care of every orthopaedic problem – which we weren’t able to do three

years ago – but now we need to be able to do it at a greater volume and in the kinds of facilities that promote the highest standards of care,” Dr. Calhoun shares.

A worthwhile investment

The Medical Center has made a heavy investment in Orthopaedics over the past two years, and already these investments are paying off. Revenue measures are up across the board as a result of dramatically increased patient visits and greater practice efficiencies. In 2010, patient revenues increased by 21 percent over fiscal year 2008.

Below: Grant Jones, MD. Ohio State’s sports medicine program offers a comprehensive array of services including ACL injury prevention, performance arts medicine and concussion services


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Foot and Ankle and Podiatry

At The Ohio State University Medical Center, patient care, research and education are conducted in a truly multidisciplinary manner. One of the best examples of how this approach is applied in practice is at Ohio State’s Foot and Ankle Center.

At the Foot and Ankle Center, physicians from three different specialties – orthopaedics, infection and podiatry – collaborate daily on a wide variety of foot and lower extremity conditions, including complex issues resulting from diabetes, infection, injury or persistent foot pain. Residents in podiatry and orthopaedics conduct rotations at the Center, where they are exposed to many different aspects of patient care.

“Sometimes, there can be animosity between orthopaedic MDs and podiatry DPMs,” says Jason Calhoun, MD. “Our doctors work very well together, all under one roof. This is the standard for patient care, education and research at Ohio State.”

Ohio State’s division of Foot and Ankle Surgery is one of several new orthopaedic service lines added in just the past two years. Two new faculty members, Erik Monson, DPM, director, Podiatry, and Ian Alexander, MD, director, Foot and Ankle Surgery, together run the new Foot and Ankle Center. The Center’s physicians are frequently consulted by referring physicians who have tried, without success, to relieve patient pain after foot surgery or prolonged treatment.

“Just because a patient has ongoing pain after foot surgery or treatment does not mean there is no hope,” Dr. Alexander says. “We commonly treat and help patients who have been in this predicament. But we’d rather see them earlier in the process so that earlier interventions can help prevent more serious conditions.”

CLINICAL HIGHLIGHTS

Right: Joel Mayerson, MD (pictured) and Thomas Scharschmidt, MD are the only fellowship-trained physicians in central Ohio treating patients with sarcoma.

At The Ohio State University Medical Center, patient care, research and education is conducted in a truly multidisciplinary manner.


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Shoulder

With the 2005 arrival and 2010 appointment of Julie Bishop, MD, as director of the division of Shoulder Surgery, another new orthopaedic service line at OSU Medical Center was born.

Dr. Bishop and Dr. Grant Jones, who are also sports medicine specialists, are shaping new standards for patient care in shoulder surgery with her leadership in several clinical studies

They were recently joined by Dr. R. Bryan Butler, a fellowship-trained surgeon who will focus on treatments for shoulder and elbow injuries. This recruitment will enable OSU to establish a fellowship in shoulder surgery in the near future.

Hand and Upper Extremity

One of the best examples of Ohio State’s rapidly emerging excellence in orthopaedics is the Hand and Upper Extremity division. In the period of just one year, the division has doubled in faculty and more than quadrupled the number of patients served with conditions ranging from routine to extremely complex – including severed hands and nerves, crush injuries, arthritic fingers, carpal tunnel syndrome, distal radioulnar conditions, joint replacement, fractures, tendon lacerations, trigger finger, thumb joint pain and dislocations.

Specialists from across the campus come together at Ohio State’s dedicated facility, the Hand and Upper Extremity Center, to collaborate on patient treatment in a truly multidisciplinary manner. A designated Level 1 trauma center by the American College of Surgeons, the Hand and Upper Extremity Center is uniquely designed to provide multidisciplinary care in a single location for patient convenience. The Center opened in 2010.

Led by Michael Ruff, MD, the comprehensive team of the Hand and Upper Extremity Center includes physicians, surgeons and clinicians associated with orthopaedic and plastic surgery, physical medicine and rehabilitation, anesthesiology, sports medicine and outpatient rehabilitation services. Surgeons are fellowship-trained in hand and upper extremity surgery and microsurgery.

Sports Medicine

OSU Medical Center has a long legacy of excellence in sports medicine practice. Together with their colleagues in family medicine, physical medicine, rehabilitation, physical therapy, athletic training, sports psychology and sports nutrition, orthopaedic physicians comprise one of the leading sports medicine treatment and rehabilitation programs in the country.

The Sports Medicine division provides the highest standard of patient care using the most advanced surgical techniques, evidence-based medicine and research available. The practice continued its rapid growth in 2010, with more than 11,500 patient visits, up more than 15 percent over the past three years. The division also continues to attract major talent, including the recent recruitment of Timothy Hewett, PhD, director of research.

Sports Medicine physicians at Ohio State are involved in many important research studies, including the first National Institutes of Health-funded, multi-center study of functional outcomes following ACL reconstruction. Christopher Kaeding, MD, co-director, Sports Medicine, is co-investigator of this $1.3 million study.

OSU Medical Center has a long legacy of excellence in sports medicine, and orthopaedic surgeons play leading roles in this comprehensive practice.


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Adult Reconstruction/ Total Joint Replacement

Surgeons at Ohio State are making strides in the advancement of adult reconstruction of joint damage as part of the fully comprehensive Adult Reconstruction and Total Joint Replacement division. Directed by Andrew Glassman, MD, the division receives referrals from all over the region for patients in need of joint replacement or reconstruction for severe osteoarthritis, post-traumatic arthritis and avascular necrosis, among other conditions.

The Adult Reconstruction and Total Joint Replacement division has, literally, gone from zero to 60 in no time flat. Two years ago, the program did not exist; the university had no total joint surgeons. Today there are three, including

Dr. Glassman, who has performed several thousand hip replacements and several thousand knee replacements, and Thomas Ellis, MD, who has performed over 600 hip arthroscopies, more than any other surgeon in Ohio.

The Adult Reconstruction and Total Joint Replacement division does more than perform surgeries; faculty also participate in the design of major surgeries and approaches. Dr. Glassman, who practiced with Charles Engh, MD, one of the most prominent total joint replacement surgeons in the world, has designed two total hip prostheses and more than a dozen partial knee replacements. Matt Beal, MD recently joined the division after finishing an adult reconstruction fellowship at Massachusetts General Hospital. Surgeons also are perfecting an approach to arthroscopic total joint replacement for morbidly

Right: The Ohio State University is pleased to now offer MAKOplasty® knee replacement surgery–an innovative treatment option for people with early to mid-stage osteoarthritis of the knee. MAKOplasty® patients can benefit from quicker recovery, less impact on healthy bone and tissue and a more natural feeling knee after surgery.


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obese patients. “Our goal is to thoroughly evaluate these patients who have a high rate of complications and help them become healthy enough to have successful surgery,” says Dr. Glassman.

Routine to the practice at Ohio State is the application of advanced techniques and technologies, such as minimal incision arthroscopy for cartilage and joint repair and robotics for partial joint replacement, which reduce recovery times to a few days, versus several weeks.

“Our program is multidisciplinary, which has significant benefits for patients,” Dr. Glassman says. “Many patients have comorbidities, including systemic arthritis, lupus and joint destruction due to renal failure or immunosuppression. Patients are better cared for in a setting with disciplines to address all of those conditions.”

Musculoskeletal Infection

Ohio State is home to a specialized program dedicated to the treatment of infections that damage bone and surrounding tissues. The Musculoskeletal Infection division is led by Jason Calhoun, MD, chair of the Department of Orthopaedics at Ohio State and an internationally recognized expert in the prevention and treatment of infection and osteomyelitis research.

The Musculoskeletal Infection program is one of only a handful of such programs in the country. It is a field of study that has been a passion of Dr. Calhoun’s for more than 30 years. He has published more than 140 papers on the subject,

three books and has received numerous awards and grants, including most recently a $1.7 million Department of Defense grant on the study of resistant organisms in terrorism.

What sets Ohio State’s program apart is its foundation in multidisciplinary instruction, research and treatment, which allows for greater collaboration among colleagues, not only from the Medical Center, but across the University campus, as well.

Below: Matthew Beal, MD is part of OSU’s growing adult reconstruction program.


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“We’re working very closely with the Infectious Disease Group, the Comprehensive Wound Center and colleagues across the campus in a truly multidisciplinary process,” Dr. Calhoun says. “So what we have is all the different aspects that are necessary for the research, teaching and education of musculoskeletal infections, right here together at Ohio State.”

Trauma

The orthopaedic surgeons at OSU Medical Center’s Orthopaedic service are leaders in the latest surgical options for patients with complex fractures and post-traumatic conditions, as well as chronic conditions such as shortened or crooked legs from previous surgeries that are anywhere from a few months to many years old. Physicians from all over the country consult with Ohio State surgeons on cases where orthopaedic surgery has not been successful in correcting these problems.

The Orthopaedic trauma division is an integral part of the Level 1 multispecialty trauma services at Ohio State. The trauma team provides comprehensive 24-hour service specializing in patients with multiple system injuries as well as fractures of the long bones of the upper and lower extremities and the pelvis and acetabulum. The team also specializes in the treatment of elderly patients for whom bone fragility is a major cause of fractures.

Through its Fragility Fracture Program, the orthopaedic specialists at Ohio State have created specialized care protocols for patients with fractures due to osteoporosis. Patients receive priority evaluation and are moved to the operating room expeditiously, lessening risk of complications including pneumonia and infections and ensuring early mobility post-surgery to facilitate rehabilitation and recovery.

Involved in care are orthopaedic surgeons, medical physicians, physical therapists, physician assistants, occupational therapists, nurses, nutritionists and case managers.

“Fragility fracture patients whose surgery is expedited have decreased morbidity, decreased mortality, shorter lengths of stay in the hospital and an increased likelihood of returning to their pre-injury status,” says Laura Phieffer, MD, director, Orthopaedic Trauma. “Traditionally, few fracture patients receive evaluation and treatment of osteoporosis. Our program strives to prevent future fractures, with comprehensive patient education and discharge planning.”

Oncology

The Division of Musculoskeletal Oncology stands at the forefront of research and patient care in this rapidly changing field. Until last year, Joel Mayerson, MD, director, Musculoskeletal Oncology, was the only fellowship-trained orthopaedic surgeon in central Ohio who specialized in treating sarcomas. Now, the team has grown to two, with the addition of Thomas Scharschmidt, MD.

Drs. Mayerson and Scharschmidt are part of a multidisciplinary team of medical oncologists, radiation oncologists, plastic surgeons and pathologists focused on early detection and treatment of musculoskeletal oncology. Since

Routine to the practice at Ohio State is the application of advanced techniques and technologies, such as minimal incision arthroscopy for cartilage and joint repair and robotics for partial joint replacement, which reduce recovery times to a few days, versus several weeks.


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primary bone cancers most commonly occur in children and adolescents, the surgeons work closely with Nationwide Children’s Hospital of Columbus to ensure the best possible treatment for young patients battling the disease. These surgeons are leading advancements in the field; for example, Dr. Mayerson has pioneered the application of devices to keep up with pediatric patients’ bone growth. By fitting a 10-year-old boy with an expandable total femur prosthesis, which lengthens without surgery as the bone grows, Dr. Mayerson saved the child’s leg and became the first surgeon in the U.S. to use the device.

The most common form of bone sarcoma in adults is chondrosarcoma, which usually occurs after age 60. Ohio State’s orthopaedic oncology surgeons are the only physicians in central Ohio

who are experts in the management of this rare disease, which is not responsive to radiation or chemotherapy.

Spine

Spine is yet another division of the Department of Orthopaedics at Ohio State that has experienced dramatic growth. Two years ago, there were no physicians at Ohio State who specialized in surgery of the spine; today, there are two: Ronald Wisneski, MD, who leads the program and Ronald Lakatos, MD. These surgeons collaborate routinely with their colleagues in Neurological Surgery in the care of patients with complex fractures or tumors.

“This is another area where it is very, very unusual for surgeons in two different specialties

Left: Christopher Kaeding, MD


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– orthopaedics and neurosurgery – to work together,” says Dr. Calhoun. “But sometimes, patients need more than brain surgery or bone surgery. Collaboration between these surgeons means patients receive the most outstanding care possible.”

Spine surgery at Ohio State includes traditional and minimally invasive procedures for cervical, thoracic and lumbar spinal diseases, including adult degenerative, inflammatory, congenital, metabolic, neoplastic and traumatic spinal disorders. Surgeons specialize in operative and non-operative solutions including disectomy and fusion, pharmaceutical therapy and rehabilitation.

Spine surgeons at Ohio State exercise a conservative approach to surgery. “Only about five percent of patients who have back pain need an interventional procedure,” says Ronald Wisneski, MD, director of Spine. “Spine surgery certainly is appropriate for conditions that require reconstruction, but many conditions benefit from less invasive treatment. When we determine that a patient would benefit from surgery, you can be assured we’ve evaluated every possible alternative.”

Below: Ajit Chaudhari, PhD, leads Ohio State’s biomechanics laboratory.

Right: Alan Litsky, MD, ScD, BioMaterials laboratory


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Advancing Education for the Future Leaders of the Field

With the growth of Orthopaedics at Ohio State, education has become a major focus and priority. A newly designed and innovative curriculum is structured to significantly increased faculty participation and now offers a host of advanced learning opportunities unmatched by orthopaedic education programs at other hospitals and medical centers.

“We are doing some extremely novel things to advance orthopaedic education,” says Joel Mayerson, MD, program director of orthopaedic residency. “We are providing residents with a depth and breadth of educational opportunities immediately at their disposal, which has taken a lot of the burden of instruction off of them. It has been a major undertaking, which has been possible only because of the institutional support we have received to create this program.”

The transformation of the Orthopaedics education program has been led by Dr. Mayerson and his team of assistant program directors: Julie Bishop, MD, Shoulder and Sports Medicine, who designed and is implementing the clinical education curriculum, and David Flanigan, MD, Sports Medicine, who designed and implemented the orthopaedic research education protocol. Dr. Flanigan also directs the new OSU Cartilage Restoration Program which is one of only a few such programs in the country.

Training in All Orthopaedic Subspecialties

The new orthopaedic curriculum includes clinical training in each of the 10 subspecialties available at Ohio State. Few other hospitals or academic programs offer formal education in so many orthopaedic subspecialties, including the rarer ones like oncology and musculoskeletal infection. The pediatrics rotation is a collaborative effort with Nationwide Children’s Hospital. All this is a big part of Ohio State’s appeal.

“This specialized training is very important,” Dr. Mayerson says. “Every doctor who performs surgery is going to need to understand how to manage infections. Every general orthopaedic physician is going to experience patients with tumors – they need to know how to refer them appropriately.”

EDUCATIONAL PROGRAMS

“We are doing some extremely novel things to advance orthopaedic education. We are providing residents with a depth and breadth of educational opportunities immediately at their disposal.

Joel Mayerson, MD Director, Muskuloskeletal Oncology and Orthopaedic Residency Program


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In each subspecialty, residents receive instruction on 12 topics related to that area. The orthopaedic education team identifies the corresponding peer-reviewed articles and work with faculty on lecture materials. Lectures are regularly attended by faculty – often as many as 30 at a time.

“Medical students and residents are very excited about the renewed educational commitment of our faculty,” says Julia Panzo, orthopaedics residency program manager. “Residents are getting more interaction with faculty than ever before – quality interaction – so they really look forward to attending lectures and conferences.”

Innovating Basic Training: The Objective Structured Clinical Examination There are many innovative components to Ohio State’s orthopaedics curriculum, one of which is the Objective Structured Clinical Examination (OSCE) program. This course, used in many medical fields to teach students how to conduct proper patient histories and physicals, has not been widely incorporated into orthopaedics curricula. It was introduced in the Ohio State orthopaedics education program last year, with great success.

The course places residents in real-life situations with professional actors trained as patients with a variety of common orthopaedic problems, including orthopaedic trauma, spine, shoulder and knee problems. The sessions are conducted in OSU’s Clinical Skills Laboratory – a high-tech training center with “real” patient examination rooms and reception areas connected to observation rooms where faculty and students view and record the interactions.

The actors, who are experienced in OSCE “performances” in many medical specialties, come with realistic-looking moulage “injuries” and are trained by Dr. Bishop in their condition and how to behave with the resident. The residents are tested on the questions they ask, physical exam skills, maneuvers and interpersonal skills with the patients.

“With the pressure on attending physicians, there isn’t always time for them to observe residents conducting patient exams. Programs like this are incredibly important.”

Currently, Dr. Bishop and her team are conducting a survey of orthopaedics programs across the country to understand how others provide core competency training.

More Interactive Instruction in Anatomy

Another area of innovation in orthopaedic education at Ohio State has been in the instruction of musculoskeletal anatomy.

To encourage greater participation and learning, students are now divided into four “stations,” where an attending physician teaches five to six residents on a different part of the anatomy with specific learning objectives for each group. The result is a much more interactive experience. “Residents are completely involved and participating, so they prepare more and the learning is much greater,” Dr. Bishop says.

To encourage greater participation and learning, students are now divided into four “stations,” where an attending physician teaches five to six residents on a different part of the anatomy with specific learning objectives for each group.


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New Dedicated Lab Space for Arthroscopic Training

Ohio State recently received a grant to instruct students in arthroscopy in a dedicated laboratory. The grant has allowed students to learn how to conduct arthroscopic procedures with advanced and basic knee, shoulder and hip problems, instructed by attending physicians in each subspecialty.

Expansion of Training in Core Competencies

There is growing awareness of the importance of more structured resident training in orthopaedics. Last year, Ohio State received the honor of being awarded a grant from the American Orthopaedic Association to continue

and expand its innovative core competency program. Orthopaedic residents at Ohio State were involved in identifying and submitting the grant for the program.

A new lecture series was established by Mike O’Brien, administrator for the department, on business and management topics. The series focuses on financial management and resources as well as coding and compliance. The entire Orthopaedic faculty at Ohio State has jumped on board to help make the curriculum a success.

“The culture of residency education in orthopaedics is changing,” Dr. Bishop says. “We’ve put a lot of emphasis on it, so the entire department has pitched in. They see that it really is making a difference.”

Last year, Ohio State received the honor of being awarded a grant from the American Orthopaedic Association to continue and expand its innovative core competency program.


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Building a Foundation for Advanced Research

Another essential component of the orthopaedic curriculum at Ohio State is research. Drs. Mayerson and Flanigan have restructured the approach to instructing residents in research best practices.

There is an entire course on research education covering how to read a research paper, write an Internal Review Board application, execute the study, write the manuscript and submit it for publication.

Residents have two systematic reviews during the residency – one in which they work together with another resident to review an article on a specific topic, and another in which they create their own manuscript. Junior residents are paired with senior residents, and each is assigned a faculty mentor – one clinical and one from the basic sciences – with whom they meet periodically to ensure they are keeping up with their goals. There also are progress reports along the way.

Due to the University’s size and leadership in many different academic fields – not only medicine – residents have unlimited opportunities for research. They have unparalleled access to faculty and resources, including busy hospitals in oncology, trauma and pediatrics, and top-notch research programs in veterinary medicine, engineering and many other fields.

Already, this emphasis on resident research has yielded results, with residents publishing at least half of the more than 100 articles by orthopaedic faculty last year.

“Having access to faculty from all of the different schools at Ohio State allows residents to do research in many different fields of study. That is an amazing opportunity,” Dr. Mayerson says. “The amount of effort we have gone through to make sure we’re providing our students with so many opportunities to learn, and so many resources and support to be successful, is what makes this curriculum superior.”

Below: University Hospital East, a key site for OSU orthopaedic services


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ORTHOPAEDIC RESEARCH

One of the most important facets of an academic medical program is its commitment to research that translates into improvements in patient outcomes. As The Ohio State University Medical Center’s Department of Orthopaedics expands its clinical services, it has also experienced rapid growth in its research programs, particularly when measured by sponsored funding and scholarly publications.

“Becoming a top program means serving more patients, not just in the clinic and operating room, but in the laboratory and in collaboration with other specialists to find improvements in delivering care,” explains Jason Calhoun, MD, chair of the Department of Orthopaedics. “We see research as an integral part of our efforts to improve our patients’ lives by solving real-world problems, not as something separate from our daily work with patients.”

This approach is demonstrated by the acceleration of research programs over the past two years. Since fiscal year 2008, the Department’s sponsored research funding has grown from $218,488 to $1.2 million annually. The Department has added a grants specialist, Lisa Durham, PhD, to work with faculty in identifying opportunities for funding and preparing applications.

“Many of our longtime faculty have significant experience in conducting research programs, which means not only coming up with a plan for how to improve care, but in developing a proposal, finding funding, managing the work and reporting the results,” says Dr. Durham. “But as we grow, newer faculty and residents can really take advantage of the resources offered by Ohio State to create a research program that leads to long-term professional achievements. That’s what we are aiming to accomplish.”

Established research programs in oncology, sports medicine and trauma have expanded, and the Department has grown to add investigations in areas such as musculoskeletal infection, joint replacement, hand surgery and spine surgery. In many cases, collaboration with specialists from veterinary medicine, family medicine, engineering and other OSU Medical Center departments is key to the program’s success.

Established research programs in oncology, sports medicine and trauma have expanded, and the Department has grown to add investigations in areas such as musculoskeletal infection, joint replacement, hand surgery and spine surgery. In many cases, collaboration with specialists from veterinary medicine, family medicine, engineering and other OSU Medical Center departments is key to the program’s success.


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ORTHOPAEDIC RESEARCH COLLABORATIONS

Other large-scale research efforts involve collaboration with industry and military experts. Jason Calhoun, MD, and co-investigator Li-Yan Yin, MD, are completing the third year of a four-year, $1.7-million project sponsored by the U.S. Department of Defense to determine which antibiotic or combination of antibiotics is best suited to treat extremity infections from blast wounds, a major source of morbidity and mortality among U.S. soldiers in Iraq and Afghanistan.

“Back in 2003, we began to hear from military physicians about the problems wounded soldiers were facing from persistent infections with unexpected patterns of resistance,” shares Dr. Calhoun. “A number of orthopaedic and infection specialists from around the country have put their heads together and worked with the U.S. military to find ways to respond to this problem rapidly, and I believe we are making a difference. I’m proud to be part of it.”

• The OSU Movement Analysis and Performance (MAP) Program is co-directed by Ajit Chaudhari, PhD, and Laura Schmitt, PT, PhD. Housed in a 4,500-square-foot, state-of-the-art laboratory adjacent to the Martha Morehouse Medical Plaza, this program focuses on biomechanics, functional motion assessment and rehabilitation. Investigators simulate real-life environments such as a pitching mound and running track to study how the body moves during athletic activity, and how to treat and prevent injuries to joints caused by motion.

• Orthopaedic researchers also work closely with veterinary colleagues at the Orthopaedic Molecular Medicine Suite and Applied Research Laboratory, directed by Alicia Bertone, DVM, PhD. A multidisciplinary team investigates musculoskeletal biology and molecular medical therapies that are associated with musculoskeletal disease in both animals and humans. The laboratory primarily focuses on healing articular cartilage, accelerating bone repair, genetic markers of orthopaedic diseases, and medications for joint disease and gene therapy.

• The Orthopaedics Ergonomic Laboratory, directed by Steven Lavender, PhD, studies how the body responds to real-world working conditions and creates biomechanical models to provide information on how joints react during exertion. Researchers work to improve our understanding of the risks human joints are exposed to during work and to quantify risk factors for injury.

• The Orthopaedic BioMaterials Laboratory, under the direction of Alan Litsky, MD, ScD, is a multifunctional materials testing facility where a variety of basic and applied biomaterials research is conducted, including static, fatigue and viscoelastic materials evaluation; implant stability testing; bone and ligament strength determinations; and fracture fixation rigidity testing. Projects include the development and evaluation of reduced-modulus bone cement, quantification of the mechanical degradation of bioabsorbable implants and implant micromotion measurements.


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The Department of Defense grant is one of the first of many expected federally sponsored orthopaedic research programs at Ohio State. Efforts are currently focused on gaining National Institutes of Health funding.

“Traditionally, orthopaedic research has been funded largely by industry, private foundations or the investigators themselves,” Dr. Calhoun says. “That’s not the problem; that’s part of the solution. But a bigger part of the solution is in broadening our horizons and looking at some of the big challenges facing American medicine, such as hospital-acquired infections, rehabilitation, antibiotic resistance and limb regeneration, to name a few. Orthopaedic specialists can play a major role in creating advances in those areas, particularly in collaboration with the kinds of experts one finds at a large research university.”

A further measure of the Department’s success is its expanding presence in published academic research. Typically, the faculty would produce about 25 to 30 peer-reviewed manuscripts a year. One of Dr. Calhoun’s goals is to increase that dramatically by placing a greater emphasis on not only producing but also reporting the results of research. He recruited an experienced medical editor, Maurice Manring, PhD, to lead efforts for increased productivity in peer-reviewed journals.

“You can put a lot of work into a very good idea, but ultimately, if you don’t publish, it’s not going to be known, discussed or make much of a difference,” says Dr. Manring. “Our faculty are dedicated, talented and have good ideas. In

many cases, the only thing keeping them from seeing their work published is the process of polishing the work, preparing it for submission, responding to reviews, making revisions and proofing it. We work to make sure those things are done correctly and expeditiously.”

So far, that work has roughly tripled the number of peer-reviewed manuscripts produced by

Orthopaedics. In 2010 the Department had more than 100 manuscripts published or accepted for publication.

“It is gratifying to see these results, and I take them as an indicator that we are on the right track,” Dr. Calhoun says. “We’ve been able to build on a solid foundation of existing programs as well. But when I look at the people who have joined us over just the past year, and talk with them about what they’re planning and working on, I’m confident that we not only can sustain this level of growth but greatly expand upon it.”

“It is gratifying to see these results, and I take them as an indicator that we are on the right track. We’ve been able to build on a solid foundation of existing programs as well. But when I look at the people who have joined us over just the past year, and talk with them about what they’re planning and working on, I’m confident that we not only can sustain this level of growth but greatly expand upon it.”

Jason Calhoun, MD, FACS Chair, Department of Orthopaedics


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Andrew Glassman Matthew Beal Thomas Ellis

We perform hip and knee surgeries at University Hospital East and University Hospital. Many difficult cases are referred to us by other surgeons, including revision surgeries and co-morbidities. Our total joint service division is staffed by physicians Andrew Glassman, MD, director of the Total Joint and Adult Reconstruction Center; Matthew Beal, MD, and Thomas Ellis, MD, who directs the hip preservation service.

Laura Phieffer Michael Quackenbush

Corey Van Hoff

Our orthopaedic trauma team is a key service at many central Ohio hospitals and serves patients from across the region. Laura Phieffer, MD, directs our orthopaedic trauma program. She is joined by Michael Quackenbush, DO, and Corey Van Hoff, MD. Other department specialists also are called upon to evaluate and treat emergencies and help heal traumatic orthopaedic injuries.

Adult Reconstruction/Total Joint

Trauma

The Department of Orthopaedics at The Ohio State University Medical Center is dedicated to providing both innovative services for patients with musculoskeletal disorders and superior education for future orthopaedic surgeons. We serve hospitals and clinics across the region. Our surgeons are fellowship-trained.

DEPARTMENT OF ORTHOPAEDICS


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Jeffrey Granger John Roberts

Jeffrey Granger, MD, John Roberts, MD, and John Sharkey, MD, cover a wide array of common problems within the musculoskeletal system, and can help determine if patients need referral to one of our subspecialists.

General

Joel Mayerson Thomas Scharschmidt

Our oncology physicians serve patients from across the region at the Comprehensive Cancer Center- James Cancer Hospital and Solove Research Institute and also Nationwide Children’s Hospital. Joel Mayerson, MD, directs orthopaedic oncology and works with Thomas Scharschmidt, MD, as well as a multidisciplinary team of medical oncologists, radiation oncologists, plastic surgeons and pathologists focused on early detection and treatment of cancer.

Oncology

Julie Bishop R. Bryan Butler

Our shoulder specialists treat common upper extremity joint problems such as fractures and damage to soft tissue. We also perform joint replacements. Julie Bishop, MD, is director of our shoulder division. She is joined by Grant Jones, MD and R. Bryan Butler, MD.

Shoulder

John Sharkey

Grant Jones


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Jason Calhoun Chair, Department

of Orthopaedics

Meredith Deutscher

Jason Calhoun, MD, Chair, Department of Orthopaedics, works alongside internal medicine infection specialist Meredith Deutscher, MD, and surgeon Jeffrey Granger, MD, to prevent and treat musculoskeletal infections. They often consult with specialists in other areas to address the most challenging cases. They perform research to develop new antibiotics and methods aimed at preventing orthopaedic infection.

Infection

Jeffrey Granger

Christopher Kaeding

Julie Bishop Thomas Ellis

Our physicians provide care for The Ohio State University Buckeyes athletic teams as well as for area colleges, high schools and other organizations. We are a full-service sports medicine department, with certified athletic trainers, and provide services in areas such as radiology, casting and pharmacy. We also work closely with specialists in other medical departments, such as family medicine and rehabilitation. OSU Sports Medicine’s orthopaedics are led by Christopher Kaeding, MD, the co-director of Sports Medicine for OSU. He is joined by specialists David Flanigan, MD; Julie Bishop, MD; Grant Jones, MD; Thomas Ellis, MD; Robert Najarian, MD, and John Sharkey, MD.

Sports Medicine

David Flanigan Grant Jones

Robert Najarian John Sharkey


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Michael Ruff Hisham Awan R. Bryan Butler

Our Hand Center team is led by Michael Ruff, MD. He is joined by Hisham Awan, MD; R. Bryan Butler, MD; Dick Coleman, MD; plastic surgeon Brian Janz, MD; and Ryan Klinefelter, MD.

Hand and Upper Extremity

Dick Coleman Brian Janz

Ryan Klinefelter

Ronald Wisneski Ronald Lakatos

Our physicians specialize in operative and nonoperative solutions, including disectomy and fusion, pharmaceutical therapy and rehabilitation. The division is led by Ronald Wisneski, MD. He is joined by Ronald Lakatos, MD.

Spine


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Ian Alexander

Ian Alexander, MD, directs this service, which treats deformity, arthritis and painful soft tissue conditions of the foot and ankle as well as problems associated with diabetes. Jason Calhoun, MD, leads our infectious service and also serves as chairman of the department. He is an internationally recognized expert and researcher in orthopaedic infections and in the use of external fixation devices to treat fractures and other injuries to the lower extremities. They are joined by podiatrists Said Atway, DPM; Alan Block, DPM, MS; and Erik Monson, DPM.

Foot and Ankle

Said Atway Alan Block Jason Calhoun

Research

Ajit Chaudhari Lisa Durham Timothy Hewett M.M. Manring Li-Yan Yin

Alicia Bertone Steve Lavender Alan Litsky Robert Siston

The Department of Orthopaedics conducts both clinical and basic science research focused on prevention and treatment of musculoskeletal injuries and infections. Our programs include investigations into new antibiotics, new implants designed to facilitate healing, treatments for osteoarthritis, biomechanical testing, and many others.

Erik Monson

Dear Friend of OSU Orthopaedics:

Our vision is to become one of the top 10 orthopaedic programs, which requires a strong endowment. Any financial support to help develop OSU Orthopaedics is greatly appreciated.

Thank you,

Jason H. Calhoun

Featured funds include:

To give to one of the featured funds listed above, use the enclosed envelope or visit giveto.osu.edu. For more information, please call the OSU Medical Center Department of Development at 614-293-3752.

301839 Ortho Residents Fund309177 Ortho Library311899 MSKS Book Fund310925 Ortho Special Initiative302456 Ortho Develop-Research313649 Musculoskeletal Infections313648 Foot and Ankle Research313388 Hand and Upper Extremity303412 Ortho Joint Replacement313647 Hip Preservation

310715 Ortho Sarcoma Research311930 Ortho Spine312728 Ortho Trauma Research & Education Fund313446 Shoulder Research & Education313470 Cartilage Restoration307966 Sports Medicine313399 Sports Medicine Athletic Injuries312409 Sports Biomechanics Research312843 Orthopaedic Ergonomic Research

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osu orthopaedics accomplishments report 2010

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