Orthopaedic Surgery and Rehabilitation

Breaking News for alumni and friends of the University of Nebraska Medical Center Department of Orthopaedic Surgery and Rehabilitation

OAKVIEW MEDICAL BUILDINGUNMC Physicians Orthopaedics is currently scheduling appointments in our beautifully renovated clinic at the Oakview Medical Building.

Our new clinic features modern, state-of-the-art facilities, including in-suite radiology services and convenient first floor access.

The Oakview Medical Building offers patient-friendly, one-stop accomodations! Our West Omaha patients can now schedule clinic visits, radiology, physical therapy, and complete follow-up care at one location.

NEBRASKA ORTHOPAEDIC HOSPITALUNMC Physicians Orthopaedics has teamed up with the Nebraska Orthopaedic Hospital! We are now offering the convenient option to have surgical treatment with our orthopaedic surgeons right next door at the Nebraska Orthopaedic Hospital.

UNMC Physicians Orthopaedics expansion at the Oakview Medical Building is unveiled!

The highly anticipated renovation of our Oakview Medical clinic is complete! Our beautiful new clinic space is open and we are now offering convenient one-stop services for our West Omaha patients.

ORTHOPAEDICS IN WEST OMAHA JUST GOT BIGGER AND BETTER

Dr. Kevin Garvin, ChairmanHip & Knee Replacement

Dr. Chris CornettSpine Surgery

Dr. Mark DietrichSports Medicine

Dr. Curtis HartmanHip & Knee Replacement

Dr. Beau KonigsbergHip & Knee Replacement

NEWLY RENOVATED CLINIC - SAME GREAT LOCATION!2727 South 144th Street, Suite 140 (across from Oakview Mall)

BREAKING NEWS | FALL 2013

Dr. Lori ReedFoot and Ankle

Dr. Matthew TeusinkShoulder & Elbow

UNMC PHYSICIANS ORTHOPAEDIC SURGEONS CURRENTLY PRACTICING AT THE OAKVIEW MEDICAL BUILDING

• Convenient West Omaha location• Beautifully renovated clinic space• Modern, state-of-the-art facilities• In-suite basic radiology• Convenient 1st floor access• Orthopaedic clinic, radiology,

physical therapy, and follow-up care at one location

• Surgical treatment available at the Nebraska Orthopaedic Hospital

• Hip and knee replacement• Foot and ankle• Shoulder and elbow• Sports medicine• Spine

CALL 402-559-8000 TO SCHEDULE AN APPOINTMENT!

OAKVIEW ORTHOPAEDIC CLINIC EXPANSION AT-A-GLANCE:

Message from the chair

BREAKING NEWS | 2

BREAKING NEWS | FALL 2013

Breaking News is published three times a year for alumni and friends of the UNMC Department of Orthopaedic Surgery and Rehabilitation.

Chair:Kevin L. Garvin, M.D.

Administrator:David Staiert

Newsletter: Dana Meyer

For additional printed copies, please contact: Dana Meyerdmeyer@unmc.edu402-559-4380

UNMC Department of Orthopaedic Surgery981080 Nebraska Medical Center Omaha, NE 68198-1080www.unmc.edu/orthosurgery

This publication is available online.

Over the past few years, there has been one request we’ve heard repeatedly from our patients and referring physicians in the West Omaha area . . . “When are you going to expand your presence out West?”

We heard you, and we’ve been working hard to make it happen. In the last two issues of Breaking News we began dropping hints about the our plan for the department’s expansion at the Oakview Medical Building and Nebraska Orthopaedic Hospital. We are excited to announce that this transformation is complete! Our newly renovated, state-of-the-art clinic space is now open and we are taking referrals and appointments.

As you may know, an expansion project is no easy task. It involves a lot of hard work and planning, collaboration amongst many parties, and most of all it requires time. It doesn’t happen overnight, but the investment is well worth it. This new clinic space will allow us to better serve our patient base in the West Omaha area, with an increased physician prescence and increased number of clinics being held at the Oakview Medical Building. Our redesigned, modern facilities offer many new benefits, including in-house radiology and convienent first floor access, just to name a few.

In addition, our surgeons have teamed up with the Nebraska Orthopaedic Hospital (NOH). We are very excited about this new partnership and the ability to offer our patients the convenient option of having surgical treatment at NOH, right next door to the Oakview Medical Building.

Other important announcements include the newest addition to our full-time faculty, Dr. Matthew Teusink, a fellowship-trained shoulder and elbow surgeon. Learn more about Dr. Teusink on page 7. We would also like to introduce the Class of 2018, featured on page 11.

Everything we do in our department is focused on providing quality healthcare to our patients. We work hard at all aspects of our clinical and academic practice to ensure that everyone who comes to our clinic receives the absolute best in orthopaedic care, and will continue to receive that quality of care for generations to come.

Recently, we were pleased to learn that our hard work has again been recognized. U.S. News & World Report ranked The Nebraska Medical Center the Best Regional Hospital in Eastern Nebraska for Orthopaedics, 2013-2014. We are proud of this recognition and we hope you are also.

Look for the Winter 2013 edition of our department newsletter to be out in just a few months, as we are now publishing three times per year! We enjoy bringing you news and updates about the department, and we hope you enjoy learning about the changes taking place. In turn, we encourage alumni and friends of the department to email news and photos for inclusion in future issues of Breaking News to dmeyer@unmc.edu.

We look forward to hearing from you!

Kevin L. Garvin, M.D.L. Thomas Hood, M.D., ProfessorshipProfessor and ChairOrthopaedic Surgery and Rehabilitation

You asked for it. We listened.

In 2010, I had the honor of being one of two American orthopaedic surgeons chosen to travel to Austria, Switzerland, and Germany on a month-long scientific and cultural exchange. This year, we had the privilege of hosting the corresponding European fellows (two from Germany, one from Austria, and one from Switzerland) on a visit to Omaha as part of their six-week tour of England, the U.S., and Canada. The Austrian-

Swiss-German (ASG) fellowship started in 1978 when two German orthopaedists traveled to the U.S. The fellowship became formalized as a program of the American Orthopaedic Association in 1984, and in 1998 the first tour of Europe by North American fellows was initiated. Since that time, in even years, two Americans, a Canadian, and a British orthopaedist travel to Europe; in odd years, the European fellows visit Britain, Canada and the U.S. The four 2013 fellows are: Drs. Andreas Niemeier, an arthroplasty surgeon from Hamburg, Germany; Tobias Renkawitz, an arthroplasty surgeon from Regensburg, Germany; Rainer Biedermann, a pediatric orthopaedist from Innsbruck, Austria; and Fabian von Knoch, an arthroplasty surgeon from Zurich, Switzerland.

I met the fellows at the midpoint of their trip, at the American Orthopaedic Association (AOA) Annual Meeting in Denver, CO. On Wednesday, June 12, Dr. Kevin Garvin and I attended a dinner to introduce the current fellows to former American ASG fellows. After two more days at the AOA meeting, the fellows and

I traveled back to Omaha on Saturday, June 16, and had dinner at The Grey Plume. The next morning, Drs. Niemeier and Biedermann went on a long run with Dr. Garvin (from Midtown Crossing to the Old Market and back), then we all went for a lovely brunch at the Garvins’ home. That afternoon, we attended the 3rd game of the College World Series, between the University of North Carolina and North Carolina State. It was the first time any of the fellows except Dr. Renkawitz had ever seen a baseball game, and they all enjoyed it. Luckily, I have seen just enough baseball to be able to explain the basic rules to them. That night, Dr. Layne Jenson joined us for dinner at my house, where I served a typical middle European meal (asparagus pizza, wiener schnitzel, red cabbage, potato salad, and apple cake). The fellows were grateful for a home-cooked meal and familiar food.

On Monday, June 17, the fellows presented their research, and a little bit of information about their hometowns, during orthopaedic Grand Rounds. Dr. Niemeier presented “Bone Preserving Implants in

The 2013 Austrian-Swiss-German Traveling Fellows visit Omaha

BREAKING NEWS | FALL 2013

Dinner at M’s Pub with the 2013 ASG Traveling Fellows and orthopaedic department faculty: (left to right) Drs. Fabian von Knoch, Susan Scherl, Tobias Renkawitz, Brian Hasley, Rainer Biedermann, Andreas Niemeier, and Sean McGarry.

Author, Dr. Susan Scherl

see ASG pg 4

Here is an e-mail and photo the fellows sent after their visit:

Susan, The travel went smoothly and we arrived well in Iowa City. We did enjoy our stay with you in Omaha very much and thank you for having us with you!

There's always a variety of things that impress us at each single stop of the tour, but you made sure that we all will never forget Omaha by taking us to the baseball game, which was really special. We thank you for all you efforts, hospitality, great food and your commitment to the cause of the mutual ASG fellowship.

Please let us know when you come to Europe and visit our places!

We'll forward you some fotos from our stay in Nebraska soon, Kind regards,Your 4 ASG fellows.

BREAKING NEWS | 4

Dr. Esposito, Children’s hosted U.S. Bone and Joint Initiative

Dr. Paul Esposito served as the host of this year’s United States Bone and Joint Initiative (USBJI) annual board meeting, June 9 through 11, along with Children’s Hospital & Medical Center. Dr. Esposito is the American Academy of Pediatrics liason of the USBJI, and a professor of orthopaedic surgery at UNMC.

The three-day agenda included meetings at both the Sheraton and Children’s, a first-hand view of the Clinical Simulation Laboratory (CSL), located in the UNMC Michael F. Sorrell Center for Health Science Education, and a tour of the rare book room in the UNMC McGoogan Library Special Collections Department.

The USBJI is the U.S. National Action Network of the worldwide Bone and Joint Decade, a multi-disciplinary initiative targeting the care of people with musculoskeletal conditions--bone and joint disorders. Its mission is to improve the quality of life for people with musculoskeletal conditions and to advance the understanding, prevention, and treatment of these conditions.

Learn more about the USBJI at www.usbji.org.

United States Bone and Joint Initiative (USBJI) board members during a visit to Children’s Hospital & Medical Center during the group’s annual board meeting held in Omaha June 9-11.

Shoulder Arthroplasty,” Dr. Renkawitz presented “Computer Assisted Total Joint Replacement,” Dr. Biedermann presented “Cost Effectiveness of Universal Ultrasound Screening for Developmental Dysplasia of the Hip,” and Dr. von Knoch presented “Combined Unicompartmental Knee Arthroplasty and High Tibial Osteotomy.”

After Grand Rounds, Dr. Biedermann accompanied me to Children’s Hospital & Medical Center to observe in clinic,

and the rest of the fellows went to the OR at UNMC to observe joint replacement procedures. We all met for lunch in Dundee at The French Bulldog, accompanied by Dr. Curtis Hartman.

Then it was time for a guided tour of the biomechanics lab with Dr. Hani Haider. The fellows were very impressed with the innovative research being performed by Dr. Haider and his team. Finally, that evening we returned to the Old Market,

where we did some people-watching at La Buvette (the fellows said the bread there was “almost as good as European bread”) before heading to M’s Pub for dinner with Drs. Lori Reed, Sean McGarry, and Brian Hasley. The next day, the fellows left Omaha to continue on to Iowa City, and then the Canadian portion of the tour.

ASG (continued from pg 3)

BREAKING NEWS | FALL 2013

Continuing education and Grand RoundsThe following continuing education seminars and Grand Rounds presentations by department faculty, current residents, and guest speakers are open to any interested participants. Please call the department at (402) 559-4533 to check on possible updates to this schedule. Orthopaedic Grand Rounds are held Mondays at 6:30 a.m. in Room 1005 of the Sorrell Center.

SEPTEMBER 2013

2 Labor Day – No Grand Rounds

9 “Hand Embryology and Overview of Congenital Deformities of the Hand and Fingers” (Dr. Gaddie)

16 “The Young Arthritic Knee” (Dr. Lindgren)

23 “Pediatric Femoral Fractures” (Dr. Jenson)

30 “Rotator Cuff Tears” (Dr. Dammann)

OCTOBER 2013

7 Morbidity and Mortality, Summer Quarter

14 “Fractures of the Cervical Spine” (Dr. Minges)

21 “How Does Reverse Shoulder Arthroplasty Work?” (Dr. Teusink)

28 “Traumatic Elbow Injuries” (Dr. Siebler)

NOVEMBER 2013

4 “Graft Selection in ACL Reconstruction: Pros and Cons” (Dr. Dietrich)

11 “Osteotomies for Sagittal Plane Deformities” (Dr. Cornett)

18 “Direct Anterior Approach to THA” (Dr. Konigsberg)

25 “Radiographic Evaluation of Wear in THA” (Dr. Azzam)

DECEMBER 2013

2 “Regional Blocks for Upper and Lower Extremity Surgery: What Does the Literature Say?” (Dr. Jennifer Ahlers, UNMC Anesthesiology)

9 “Dupuytren’s Contracture” (Dr. Taiber)

16 “Role of a Statewide Trauma System in the Management of the Polytrauma Patient” (Dr. Paul Schenarts, UNMC General Surgery”

23 No Grand Rounds

30 No Grand Rounds

The Nebraska Medical Center ranked Best Regional Hospital in Eastern Nebraska for Orthopaedics

U.S. News and World Report surveyed the nation’s roughly 5,000 hospitals to come up with this year’s list of Best Hospitals. Fewer than 150 of those hospitals are nationally ranked. Of the 16 specialties studied by U.S. News and World Report, The Nebraska Medical Center was recognized in 9. The Nebraska Medical Center is ranked 45th nationally for its cancer care. This places the hospital in the top three percent of the 4,806 analyzed for the latest Best Hospitals rankings.

ADDITIONAL “HIGH PERFORMING” RANKINGS IN EIGHT SPECIALTIES

The Nebraska Medical Center was also “high-performing” in eight other specialties (listed below) and ranked the Best Regional Hospital in Eastern Nebraska for Orthopaedics.

• Ear, Nose & Throat • Gastroenterology • Geriatrics

• Nephrology • Neurology & Neurosurgery • Orthopaedics

• Pulmonology • Urology

MEDICAL CENTER NAMED TOP HOSPITAL IN NEBRASKA, AGAIN

At the orthopaedic residency program in Nebraska, we believe in providing superior education and mentorship to each and every resident in our program. Every year, we work hard to conceive new and innovative ways to inspire our residents, and create in them the desire to be exceptional surgeons, researchers, and educators, so that they can in turn mentor the orthopaedic residents of future generations.

That’s why we created the John F. Connolly Resident Excellence Fund and established a goal to raise $150,000 in honor of the late Dr. John Connolly (chair of Orthopaedic Surgery 1974-1990). Dr. Connolly created a legacy in education through his leadership, elevating the standard of orthopaedic residency training in Nebraska. Through this legacy, he led the way for many amazing educators that have followed in his footsteps. Was one of those educators your mentor?

PLEASE CONSIDER MAKING A PLEDGE TO THE JOHN F. CONNOLLY

RESIDENT EXCELLENCE FUND IN SUPPORT OF THE DEPARTMENT OF ORTHOPAEDIC SURGERY AND REHABILITATION.

The purpose of this fund is to provide financial support for resident projects during their years in training, in an effort to continue the legacy of resident research and education that Dr. Connolly fostered. In order to achieve this goal, we need the help of department alumni and friends within the community who share our vision of making Nebraska the place for orthopaedic residency education.

WE WOULD LIKE TO RECOGNIZE ALL INDIVIDUALS WHO HAVE DONATED TO THIS FUND SINCE ITS INCEPTION. THANK YOU FOR YOUR CONTINUED SUPPORT.

BREAKING NEWS | 6

John F. Connolly resident fund update

If you would like to make a donation or pledge to the John F. Connolly Resident Excellence Fund, please use the enclosed remittance envelope, or contact Meg Johnson with the University of Nebraska Foundation at (402) 502-4107, or via email at mjohnson@nufoundation.org.

Mrs. Elizabeth BerentsonMrs. Anne Connolly Dr. & Mrs. Jeffrey P. DavickDr. & Mrs. James P. DevneyDr. & Mrs. Paul J. DuweliusDr. Jeffrey M. FarberDr. & Mrs. Timothy C. Fitzgibbons

Dr. and Mrs. Roy GuseDr. and Mrs. James M. HillDr. and Mrs. F. Stig JacobsenDr. & Mrs. R. Michael MendlickDr. and Mrs. Jeffrey S. MooreOrthopaedic & Spine Specialists, P.C.OSS Health

Drs. Lewis H. & Cynthia A. OsterDr. David A. & DuAnn PetersonDr. & Mrs. Michael J. SicuranzaSignificance FoundationDr. & Mrs. Samuel E. SmithDr. & Mrs. Wayne O. SouthwickAnonymousC

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BREAKING NEWS | FALL 2013

John F. Connolly resident fund update

Dr. Matthew Teusink, assistant professor, joined the orthopaedic department’s full-time faculty in August. Learn more about Dr. Teusink below, and help us welcome him to our team!

Specialty: Shoulder and Elbow

Birthplace & hometown: Fremont, MI

Education: •Medical degree: University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, August 2003-May 2007

•Residency: University of Iowa Hospitals and Clinics, Iowa City, IA, July 2007- June 2012

•Fellowship: Florida Orthopaedic Institute, Tampa, FL, Shoulder and Elbow Fellowship, August 2012-July 2013

Clinic locations: •Durham Outpatient Center•Oakview Medical Building

Areas of interest: Dr. Teusink’s special interests are in shoulder and elbow arthroplasty, trauma, and arthroscopy.

Family: Wife, Mrs. Jennifer Teusink, and son, Justin Teusink

Personal interests: Triathlon, golf

FOR REFERRALS OR APPOINTMENTS CALL 402-559-8000.

NEW FACULTY PROFILE: MEET DR. MATTHEW TEUSINK

The spine surgery, knee and hip replacement programs at The Nebraska Medical Center have earned Blue Distinction Centers+ from the Blue Cross and Blue Shield of Nebraska in 2013.

The Blue Distinction Centers for Specialty Care® program awards medical facilities that have demonstrated expertise in delivering quality specialty care. Research confirms that the newly designated Blue Distinction Centers+ (the highest Blue Distinction recognition) demonstrate better quality and improved outcomes for patients, with lower rates of complications and readmissions than their peers. Blue Distinction Centers+ also are more than 20 percent more cost efficient.

The selection criteria used to evaluate facilities was developed with input from the medical community and includes general quality and safety metrics plus program specific metrics.

The physicians at the Spine Center, which include both neurosurgeons and orthopaedic surgeons, provide comprehensive care for the treatment of acute and chronic conditions of the spine including congenital, degenerative, and traumatic conditions of the cervical, thoracic, and lumbar spine. Some of the conditions treated include neck and back pain, degenerative disc disease, spinal stenosis, herniated discs, sciatica, and trauma.

The hip and knee replacement surgeons at the Department of Orthopaedic Surgery and Rehabilitation are skilled in the prevention, diagnosis and treatment of musculoskeletal disorders, ranging from minor injuries to the most complex surgical procedures, including revision arthroplasty and osteotomies.

“Receiving this recognition is a result of the experience, skills, depth of expertise and the commitment to high quality care that our staff provides to our patients,” said Kevin L. Garvin, M.D., orthopaedic department chairman. “Our team works diligently every day to make the proper diagnosis and prescribe an appropriate and comprehensive course of treatment.

Blue Cross Blue Shield awards top honorSPINE, KNEE AND HIP REPLACEMENT EARN HIGH QUALITY OF CARE

BREAKING NEWS | 8

The department’s 2013 graduation presentations were held June 21-22 at the Michael F. Sorrell Center for Health Science Education. Featured guests included visiting professor Dr. Bernard Morrey of the Mayo Clinic, and retired astronaut Clayton Anderson, who was the 2nd Annual Andersen Lecturer.

The schedule of events was as follows:

FRIDAY, JUNE 21, 2013Graduating Resident Presentations“Short, Locked Humeral Nailing via Neviaser’s Portal: An Anatomic Study” Annie Knierim, M.D.

“Less than 100% Bone Support May Not Be Associated with Radiolucencies with a Partially Cemented Glenoid Component” Nolan May, M.D.

“Cost-Effectiveness Analysis of Autologous Chondrocyte Implantation: A Comparison of Periosteal versus Type I/III Collagen Patch” Eric Samuelson, M.D.

“Evaluation of Functional Outcomes of Mini Open Rotator Cuff Repair without Acromioplasty” Jeremy Toomey, M.D.

Alumni UpdatesClass of 2003: Kristoffer Breien, M.D.Class of 1993: J. Eric Gordon, M.D. Musculoskeletal Infection Presentations“Early Detection of Particle-Induced Peri-Implant Inflammation using Macromolecular Imaging Probe” Dong Wang, Ph.D.

“Post-Arthroplasty Staphylococcus aureus Biofilm Infections Elicit Immune Deviation” Tammy Kielian, Ph.D.

“Preoperative Infection Risk Evaluation in Patients Undergoing Total Joint Arthroplasty” Angela Hewlett, M.D.

Guest Speaker Presentations“Total Elbow Arthroplasty – It Isn’t Rocket Science” Bernard Morrey, M.D.

“The Dream of a Lifetime” Clayton C. Anderson, NASA Astronaut, Retired

Presentations were followed by a lunch break and a tour of the Rare Book Collection featuring the H.W. Orr Collection at the College of Medicine’s McGoogan Library.

Afternoon activities included a College World Series tailgate at the Hilton Omaha, Liberty Tavern Patio.

Class of 2013 honored during annual graduation celebration

SATURDAY, JUNE 22, 2013CHALLENGING ORTHOPAEDIC PROBLEMS OF THE UPPER EXTREMITY SYMPOSIUM

Session I: Shoulder and Upper Extremity: Diagnosis and Treatment Moderator: Bernard Morrey, M.D.

Case Presentation and Panel DiscussionPanel members: Ian Crabb, M.D., Jack McCarthy, M.D., Nicholas Bruggeman, M.D., Michael Gross, M.D., Charles Rosipal, M.D.

“Current Concepts in Managing Complex Fracture Dislocation at the Elbow” Bernard Morrey, M.D.

Session II: Upper Extremity Fractures and FixationModerator: Matthew Mormino, M.D.

“Radiolucencies Surrounding a Smooth-Stemmed Radial Head Component may not Correlate with Forearm Pain or Poor Elbow Function” Annie Knierim, M.D.

“Single Column Plating of the Distal Humerus” Todd Gaddie, M.D. “Outcomes Following Distal Humeral Fracture Fixation with an Extensor Mechanism” Matthew Mormino, M.D.

“A Biomechanical Evaluation of Clavicle Fracture Fixation Constructs” Curtis Hartman, M.D.

“Outcome of THA after Acetabular Fracture using an Uncemented Acetabular Component” Beau Konigsberg, M.D.

“Sonication for Enhanced Diagnosis of Prosthetic Joint Infection” Curtis Hartman, M.D.

Evening activities included a banquet at the Hilton Omaha, Blackstone A Ballroom.

Left to right: Volunteer Associate Professor Dr. Timothy Fitzgibbons (GIKK), Visiting Professor Dr. Bernard Morrey (Mayo Clinic), retired astronaut Clayton Anderson (2nd Annual Andersen Lecturer), Volunteer Instructor Dr. Michael Gross (GIKK), and Department Chairman Dr. Kevin Garvin during the 2013 Nebraska Orthopaedic Residency Graduation Ceremonies.

2013 HOUSE OFFICER OF THE YEAR

Fellowship: University of Massachusetts Medical Center, Hand & Upper Extremity Surgery Fellowship, Worcester, MA College: Montreat CollegeMedical school: University of Nevada School of Medicine Spouse: Devon ToomeyChildren: Heath, Brooks, & Bowen Toomey

JEREMY TOOMEY, M.D.

ERIC SAMUELSON, M.D.

Fellowship: OrthoCarolina, Shoulder & Elbow/Sports Medicine Fellowship, Charlotte, NC College: University of Nebraska–LincolnMedical school: UNMC College of MedicineSpouse: Brandy SamuelsonChildren: Taylor & Ethan Samuelson

ANNIE KNIERIM, M.D.

Fellowship: Reno Orthopaedic Clinic, Trauma Fellowship, Reno, NV College: Concordia College, Moorhead, MNMedical school: Creighton University School of Medicine

NOLAN MAY, M.D.

Fellowship: Southern California Orthopedic Institute, Sports Medicine Fellowship, Los Angeles, CA College: Nebraska Wesleyan UniversityMedical school: UNMC College of MedicineSpouse: Dr. Erin MayChildren: Blaire & Eli May

CONGRATULATIONS TO THE 2013 GRADUATES

BREAKING NEWS | FALL 2013

Frank P. Stone, M.D., Award for Resident Academic Excellence Nolan May, M.D.

John F. Connolly, M.D., Award for Outstanding Resident Research Eric Samuelson, M.D.

Award for Outstanding Junior Resident Scott Vincent, M.D.

Award for Faculty Excellence in Teaching Matthew Mormino, M.D.

2013 ORTHOPAEDIC GRADUATION AWARDS

2013 HOUSE OFFICER OF THE YEAR

Of special mention this year: Nolan May, M.D., received the House Officer of the Year award

from the University of Nebraska College of Medicine for his “outstanding qualities as a physician, teacher and scholar.”

Congratulations to Nolan on receiving a well-deserved honor!

CLASS OF 2012: POST-FELLOWSHIP UPDATE

Although it’s hard to believe, it has already been a year since the Class of 2012 embarked on their fellowships! Here is an update on where they are now, and the orthopaedic practices they have joined.

Ryan W. Hess, M.D. University of South Carolina Department of Orthopaedic Surgery

and Sports Medicine, Columbia, SC

Nicholas S. Aberle II, M.D. Boulder Orthopedics, Boulder, CO

Brian A. Vernon, M.D. Intermountain Healthcare, Logan Regional Orthopaedics,

Logan UT

Lucas J. Burton, M.D.Premier Orthopaedics and Sports Medicine, Nashville, TN

BREAKING NEWS | 10

Visiting Speakers expand resident education

APRIL 201329 Dr. John Yee, Professor and Chair, Department of Biomedical Science, CUMC “Cellular and Biologic Mechanisms in Osteolysis and Bone Loss”

MAY 201310 Chris Fugman & Joe Cuda, Northwestern Mutual, Glendale, WI “Financial planning, Debt, and Disability Insurance”

13 Dr. Phillipp Streubel, Assistant Professor Mayo Clinic, Rochester, MN “Proximal Humerus Fractures”

22 Eric Rose, Director, HCA Physician Services, Mountain Division. Arranged by OREF/HCA. “Finding the Right Practice” Focusing on Practice Types, Employment Contracts, Negotiation Strategies, & Legal/ Financial Considerations.

JUNE 2013 17 AUSTRIA, SWITZERLAND & GERMANY (ASG) TRAVELING FELLOWS LECTURES

Dr. Andreas Niemeier, University Medical Center Hamburg- Eppendorf, Hamburg, Germany “Bone Preserving Implants in Shoulder Arthroplasty”

Dr. Tobias Renkawitz, Regensburg University Medical Center, Bad Abbach, Germany “Computer Assisted Total Joint Replacement”

Dr. Rainer Biederman, Medical University of Innsbruck, Innsbruck, Austria “Cost Effectiveness of Universal Ultrasound Screening for Developmental Dysplasia of the Hip”

Dr. Fabian von Knoch, Schulthess Clinic Zurich, Switzerland “Combined Unicompartmental Knee Arthroplasty and High Tibial Osteotomy”

21-22 GRADUATION CEREMONIES

21 Dr. Bernard Morrey, Professor of Orthopedics at the Mayo Clinic and the University of Texas Health Science Center in San Antonio “Total Elbow Arthroplasty – It Isn’t Rocket Science”. Clayton C. Anderson, NASA Astronaut, Retired “The Dream of a Lifetime”

Dr. Dong Wang, Associate Professor, COP Pharmaceutical Science, UNMC “Early Detection of Particle-Induced Peri- Implant Inflammation using Macromolecular Imaging Probe”

Dr. Tammy Kielian, Professor, Pathology/ Microbiology, UNMC “Post-Arthroplasty Staphylococcus aureus Biofilm Infections Elicit Immune Deviation”

Dr. Angela Hewlett, Assistant Professor, Infectious Diseases, UNMC “Preoperative Infection Risk Evaluation in Patients Undergoing Total Joint Arthroplasty”

22 Dr. Bernard Morrey, Professor of Orthopedics at the Mayo Clinic and the University of Texas Health Science Center in San Antonio “Current Concepts in Managing Complex Fracture Dislocation at the Elbow”

24 Dr. Lance Warhold, Associate Professor, Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center Lebanon, NJ “Carpal Instability-What Every Orthopaedic Resident Needs to Know” AUGUST 2013 5 Rhonda S Frans, CPC, CEMC, Compliance Auditor, UNMC Physicians “Documentation and Billing Compliance”

Providing a well-rounded educational experience for our residents means bringing in visiting speakers who can share their expertise on a variety of topics. Annual contributions to the department’s Development Fund allow us to continue to bring guest speakers who offer new and innovative ideas in surgical techniques, research topics, and patient care.

LISTED BELOW ARE THE VISITING SPEAKERS THAT PRESENTED IN THE DEPARTMENT OF ORTHOPAEDIC SURGERY FROM APRIL TO AUGUST 2013.

SAVE THE DATE!2013 RESIDENT RESEARCH SYMPOSIUM TO BE HELD FRIDAY NOVEMBER 22ND

The guest speaker for this year’s resident research symposium will be Dr. Ivan Tarkin, Associate Professor of Orthopaedic Surgery; Chief, Division of Orthopaedic Traumatology from the University of Pittsburgh. Dr. Tarkin is an alumnus of the Nebraska Orthopaedic Residency Program, Class of 2005.

To request more information contact Geri Miller, residency coordinator, at 402-559-2258.

BREAKING NEWS | FALL 2013

WE WOULD ALSO LIKE TO WELCOME GREG DAMMANN, M.D., WHO JOINED OUR PROGRAM ON JULY 1, 2013, AS A HOUSE OFFICER IV.

GREGORY DAMMANN, M.D.Hometown: Lena, IL

Education: •Medical: University of Illinois College of Medicine, Rockford, IL•Undergraduate: Monmouth College, Monmouth, IL

SAYFE JASSIM, M.D.Hometown: Sioux Falls, SD

Education: •Medical: Sanford School of Medicine at the University of South Dakota•Undergraduate: University of Minnesota

BENJAMIN OGDEN, M.D.Hometown: Ogden, Utah

Education: •Medical: University of Virginia •Undergraduate: Weber State University

LEONID GROSSMAN, M.D.Hometown: St. Louis, MO

Education: •Medical: Creighton University School of Medicine•Graduate: Saint Louis University•Undergraduate: Saint Louis University

NOAH PORTER, M.D.Hometown: Omaha, NE

Education: •Medical: Creighton University School of Medicine•Undergraduate: Nebraska Wesleyan University

Meet our new residents: Class of 2018

BREAKING NEWS | 12

Publications, Presentations and Honors

Department faculty members present many lectures, seminars, and courses at both local and regional, as well as national and international meetings. They also serve in leadership positions and offices for local, state, national and international organizations. Here are some of our faculty and staff’s presentations and publications, awards and achievements, offices held, and other professional activities from April 2013 - July 2013.

PUBLICATIONS: (Peer reviewed)Moll, S.; Zhang, Y.; Zhu, Z.; Edmondson, P.; Namavar, F.; and Weber, W.: Comparison Between Simulated and Experimental Au-ion Profiles Implanted in Nanocrystalline Ceria. Nuclear Instruments and Methods in Physics Research Section B: Beam Interactions with Materials and Atoms, 307: 93-97, http://dx.doi.org/10.1016/j.nimb.2012.12.119, July 15, 2013.

Garvin, K.; Konigsberg, B.; Ommen, N.; and Lyden, E.: Erratum to: What is the Long-term Survival of Impaction Allografting of the Femur? Clinical Orthopaedics and Related Research, 471(7): 2411, 10.1007/s11999-013-2954-2, July 2013.

Konigsberg, B.; Hess, R.; Hartman, C.; Smith, L.; and Garvin, K.: Inter- and Intraobserver Reliability of Two-dimensional CT Scan for Total Knee Arthroplasty Component Malrotation (2013 Knee Society Proceedings). Clinical Orthopaedics and Related Research (Knee), online June 2013.

Sybil Biermann, J; Adkins, DR; Agulnik, M; Benjamin, RS; Brigman, B; Butrynski, JE; Cheong, D; Chow, W; Curry, WT; Frassica, DA; Frassica, FJ; Hande, KR; Hornicek, FJ; Jones, RL; Mayerson, J; McGarry, SV; et al.: Bone Cancer: Clinical practice guidelines in oncology. JNCCN Journal of the National Comprehensive Cancer Network, 11(6): 688-723, June 1, 2013.

Baykal, D.; Siskey, R.; Haider, H.; Saikko, V.; Ahlroos, T.; and Kurtz, S.: Advances in Tribological Testing of Artificial Joint Biomaterials Using Multidirectional Pin-on-disk Testers. J Mech Behav Biomed Mater: pii: S1751-6161(13)00185-9, doi: 10.1016/j.jmbbm.2013.05.020., [epub ahead of print] May 29, 2013.

Edmondson, P.; Young, N.; Parish, C.; Namavar, F.; Weber, W.; and Zhang, Y.: Irradiation Induced Effects at Interfaces in a Nanocrystalline Ceria Thin Film on a Si Substrate. MRS Online Proceedings Library, 1516, Published online by Cambridge University Press, May 13, 2013.

Namavar, F.; Sabirianiov, R.; Zhang, J.; Cheung, C.; Blatchley, C.; Miralami, R.; Sharp, G.; and Garvin,

K.: Nanostructurally Designed Ultra-hydrophilic Hard Ceramic Oxide Coatings for Orthopaedic Application. Mater. Res. Soc. Symp. Proc. © 2013 Materials Research Society, 1578, DOI:10.1557/opl.2013. 880, 2013.

Miralami, R.; Koepsell, L.; Premaraj, T.; Kim, B.; Thiele, G.; Sharp, G.; Garvin, K.; and Namavar, F.: Comparing Biocompatibility of Nanocrystalline Titanium and Titanium-Oxide with Microcrystalline Titanium. Mater. Res. Soc. Symp. Proc. Vol. 1569 © Materials Research Society, 2013.

BOOK CHAPTERS AND REVIEWS: Scherl, S.: Pediatric Femoral Shaft Fractures. In Orthopaedic Trauma Call for the Attending Surgeon, 45: 369-378. Hak DJ, Ipaktchi KR, Morgan SJ, eds., Thorofare, NJ, Slack, Inc., March 15, 2013.

Cornett, C.; Grabowski, G.; and Kang, J.: Posterior Cervical Fusion and Lateral Mass Screw Fixation. In Surgical Atlas of Spinal Operations, 1st Edition, 23: 176-186. Eds. Enk, J; Vaccaro, A; New Dehli, India, Jaypee Brothers Medical Publishers (P) LTD, March 2013.

AWARDS AND ACHIEVEMENTS:McGarry, S.: Promoted to Associate Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery and Rehabilitation, July 1, 2013.

Reed, L.: Promoted to Associate Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery and Rehabilitation, July 1, 2013.

May, N.: House Officer of the Year Award, University of Nebraska College of Medicine, June 30, 2013.

May, N.: Frank P. Stone, M.D., Award for Resident Academic Excellence, Nebraska Orthopaedic Surgery Residency Graduation, June 22, 2013.

Samuelson, E.: John F. Connolly, M.D., Award for Outstanding Resident Research, Nebraska Orthopaedic Surgery Residency Graduation, June 22, 2013.

Vincent, S.: Award for Outstanding Junior Resident, Nebraska Orthopaedic Surgery Residency Graduation, June 22, 2013.

Mormino, M.: Award for Faculty Excellence in Teaching, Nebraska Orthopaedic Surgery Residency Graduation, June 22, 2013.

Garvin, K.: 2012 Compassionate Doctor recognition, American Registry, LLC, April 22, 2013.

Dietrich, M.: 5 Years of Service, University of Nebraska Medical Center, April 2013.

Scherl, S.: 10 Years of Service, University of Nebraska Medical Center, April 2013.

Garvin, K: Castle Connolly America’s Top Doctors 2013.

Mormino, M.: Castle Connolly Regional Top Doctors 2013.

Samuelson, E.: Recipient of the Mid-America Orthopaedic Association’s (MAOA) educational grant to attend the 2013 MAOA Annual Meeting. MEMBERSHIPS AND OFFICES HELD: Daccarett, M.: Trauma Committee Member, University of Nebraska Medical Center, Omaha, NE, 2008–present.

Translator, Journal of Arthroplasty, 2008–present.

Dietrich, M.: American Orthopaedic Society for Sports Medicine Council of Delegates, August 1, 2012–July 31, 2015.

Esposito, P.: Board of Directors, Physician Director, Children’s Specialty Physicians, February 2012-2015.

Osteogenesis Imperfecta Foundation •Medical Advisory Council, July 2011- 2014 •Scientific Meeting Committee, 2010- present

One World Health Center •Executive Committee, March 2013- present •Board of Directors, March 2008-present

Children’s Hospital & Medical Center•Board of Directors, Advisory Board 2010-present •Quality and Patient Safety Committee, 2008-present •Medical Staff Committees *Ethics Committee, Omaha, NE, Children’s Hospital, 2010-present *Clinical Service Chief, Orthopaedic Surgery 2009-present *Information Technology Oversight Committee, 2009-present *Allied Health Committee, 2008- present *Bylaws Committee, 2008-present *Credentials Committee, 2008- present (Chair, 2011-present) *Surgical Services Committee, 2008- present *Focused Peer Review Committee, 2008-present *Quality Safety Leadership Team, 2006-present

Metro Omaha Medical Society Founda-tion, Member, Board of Directors, 2010-present.

Reviewer, Clinical Orthopedics and Clinical Research, 2010-present.

U.S. Bone and Joint Initiative•Liaison representative of the American Academy of Pediatrics, 2009-present•Chairman, Pediatric Specialty Group, 2013-present

Consultant Reviewer, Journal of Pediatric Orthopaedics, 2008-present.

Consultant Reviewer, PEDIATRICS, 2005-present.

Garvin, K.: The Hip Society•Chair, Education Committee, 2013-2014.•Program Chair, 2013-2014

Member, Chancellor Search Committee, University of Nebraska Medical Center, 2013

Chair, Research Committee, The Knee Society, 2012-2015.

Member, Adult Reconstruction Hip Pro-gram Subcommittee, American Academy of Orthopaedic Surgeons, 2012-2014.

Member, Board of Directors (2nd term), Omaha Sports Commission, 2011-2014.

Member, Antibiotic Prophylaxis for Dental Procedures Committee, American Academy of Orthopaedic Surgeons/American Dental Association, 2011-2013.

Haider, H.: Reviews Editor, Journal of Engineering in Medicine, IMechE Part H, March 2012-present.

International Society of Technology in Arthroplasty (ISTA)•Director, Scientific Review and Information Technology, September 2011-present.•Member, Board of Directors, 2005- present.

Biomedical Engineering Committee, The American Academy of Orthopaedic Surgeons; Member and Official Representative of the Orthopaedic Research Society, February 2011-present.

Basic Science Education Committee (BSEC), The Orthopaedic Research Society, 2011-present.

Reviewer, Journal of Clinical Orthopaedics and Related Research (CORR), July 2010-present.

Appointed to the Editorial Board for the Journal Advances in Orthopedics, June 2010-present.

Reviewer of abstracts (Re-appointment), Orthopaedic Research Society, August 2009-present.

Chairman/Coordinator, Biotechnology and Biomedical Engineering Committee, Iraqi American Academic and Pro-

BREAKING NEWS | FALL 2013

fessional Community Program, “Together for Iraq” project, Iraqi Cultural Center, Washington, D.C., 2009-present.

Editorial Board Member, Journal of Engineering in Medicine, IMechE Part H, 2009-present.

Reviewer, Journal of Orthopaedic Research, 2007-present.

Reviewer, Journal of Engineering in Medicine, 2007-present.

International Standards Organization (ISO) •Chair, Expert Group revising knee wear testing standards, 2002-present •Member, United States Delegation to Committee SC 150 (Medical Devices), 2002-present

American Society of Testing and Materials (ASTM) •Co-Chair, Knee Wear Testing Standards Committee, ASTM International, 2002- present •Chair, Ankle Replacement Testing Standards Committee, ASTM Inter- national, 2000-present

Hartman, C.: Member, UNMC Graduate Faculty, May 2013-present.

Member, Membership Committee, Metro Omaha Medical Society, April 2012-present.

Orthopaedic Basic Science Subcommittee, American Academy of Orthopaedic Surgeons, 2012-2016.

UNMC College of Medicine•M2 ICE Course Instructor, September 2009-present.•M3 Course Instructor September 2009- present.

Hasley, B.: Medical Director of the Pediatric Orthopaedic Clinics of the Children’s Specialty Physicians, Children’s Hospital & Medical Center, Omaha, NE, May 2013-present.

Konigsberg, B.: UNMC College of Medicine •Member, Medical Student Admissions Committee, June 2011–December 2014.•Instructor, M1 ICE Course, August 2010-present.

Member, Membership Committee, Metro Omaha Medical Society, April 2012-present.

McGarry, S.:University of Nebraska Medical Center •Elected to UNMC Faculty Senate, June 2013-May 2014.•Continuing Education Committee, Member, October 2012-present.•Tissue Bank Review Committee, Member, 2006-present.

Musculoskeletal Transplant Foundation (MTF) •Memberships/Nominations Committee Member, February 2012-present •Medical Board of Trustees, April 2006- present

Consultant Reviewer, Clinical Ortho-paedics and Related Research, March 2011-present.

Consultant Reviewer, Orthopaedics, February 2011-present.

Tumor Module Editor, Orthopedics Hyperguide, February 2011-present.

Children’s Hospital of Omaha Bylaws Committee, Member, January 2008-present.

National Comprehensive Cancer Network (NCCN) •Soft Tissue Sarcoma Panel, July 2007- present •Bone Cancer Panel, May 2006-present

Mormino, M.: AO North America •Fellowship Advisory Board, 2011-present •Faculty, 1997-present

At-large Member to the UNMC Physicians Board of Directors, UNMC Physicians, July 2010-2013.

Consultant Reviewer, Journal of Surgical Education, 2010-present.

Consultant Reviewer, Journal of the American Academy of Orthopaedic Surgeons, 1999-present.

Reed, L.: Member, Public Relations Committee for the Orthopaedic Trauma Association, 2009-present.

Scherl, S.: American Orthopaedic Association •Member, Traveling Fellowship Committee, June 2012-present •Chair, ASEAN Traveling Fellowship Subcommittee, June 2011-present

Pediatric Orthopaedic Society of North America•Editorial Board, ‘Resident Review,’ June 2009-present•Advocacy Committee, May 2013-present•Program Committee, May 2013-present

Children’s Hospital & Medical Center•Member, Omaha Transfusion Committee, January 2010-Present•Member, Omaha Trauma Performance Improvement and Patient Safety Committee, 2009-present•Member, Omaha Education Committee, January 2011-present•Member, Omaha Surgical Services Interdisciplinary Committee, January 2012-present

•Member, Omaha Emergency Department Interdisciplinary Committee, January 2013-present

CURRENT GRANTS:Hasley, B.: CSSG Multi-Center Retrospective and Observational Data Registry for Clinical and Radiographic Outcomes of Spinal Surgery Comparing Instrumentation and Procedures (K2M CSSG Data Collection Project Agreement), Clinical Trial. Principle Investigator, May 25, 2011-May 25, 2014.

Hartman, C.: Smith & Nephew: A Multicenter, Randomized, Clinical Outcome of Visionaire Patient Matched Technology vs Standard Surgical Instrumentation in Total Knee Arthroplasty, Clinical Trial. Principal Investigator, February 18, 2011-February 17, 2014.

Haider, H.: Simplified Orthopedic Surgery, A Four-year Federally Funded Study Sponsored by the United States Naval Health Research Center. Principal Investigator, October 2010-2014.

Haider, H.: Wear Characterization of Metal-on-metal Total Hip Replacement Components with Differing Carbon Content, Tohoku Univ. Principal Investigator, November 2012–November 2013.

Haider, H.: A Battery of Tests to Characterize the Arthrex TKR System - Contact Area & Stress, Constraint and Range of Motion, and Modular Interlock Strength, Arthrex, Inc. Principal Investigator, November 2012–November 2013.

Haider, H.: Wear Tests for the Arthrex CR, CR-CS and PS TKR Components, Arthrex, Inc., Principal Investigator, November 2012–November 2013.

Namavar, F.: Material Science Smart Coatings, Department of Energy. Principal Investigator, September 2010-September 2013.

Esposito, P.: Support for Research Assistant, Awarded by James Roberts, December 2010-present.

Esposito, P.: Tiny Bones Program, Wm. Patrick Foundation, December 2010-present.

PRESENTATIONS, INTERNATIONAL AND NATIONAL: Reed, L.: Advances in Femoral Nailing. Depuy Synthes Women’s Leadership Initiative, West Chester, PA, June 2013.

Reed, L.: Ankle Fractures. AO North America Basic Principles and Techniques of Operative Fracture Management Course for Residents, Kansas City, MO, April 2013.

Reed, L.: Advances in Femoral Nailing. AO North America Advanced Principles Course, Pittsburgh, PA, June 2013.

Reed, L.: Mangled Extremity: Decision Making; Salvage vs Amputation. AO North America Advanced Principles Course, Pittsburgh, PA, June 2013.

Reed, L.: Talus Fractures. AO North America Advanced Principles and Techniques of Operative Fracture Management Course, Pittsburgh, PA, June 2013.

Namavar, F.; Sabirianiov, R.; Rubenstein, A.; Miralami, R.; Geoffrey, M.; Thiele, G.; Sharp, G.; and Garvin, K.: Engineering Nanostructured Cubic Zirconia Coating for Enhanced Biointegration of Orthopaedic Implants. International Conference on Metallurgical Coatings and Thin Films, San Diego, CA, April 29-May 3, 2013.

Namavar, F.; Chakkalakal, D.; Sabirianiov, R.; Miralami, R.; Thiele, G.; Sharp, G.; and Garvin, K.: Smart Nano-crystalline Coatings for Orthopaedic Implant Devices. International Conference on Metallurgical Coatings and Thin Films, San Diego, CA, April 29-May 3, 2013.

Garvin, K.: Inter and Intra Observer Reliability of CT Scan for Total Knee Arthroplasty Component Malrotation. Annual Meeting of the National Ortho-paedic Educational Society, Turnberry, Scotland, April 28-May 4, 2013.

Scherl, S.: Supracondylar Humerus Fractures: Can I Fix These and Stay Out of Trouble? 13th Annual AAOS/OTA Orthopaedic Trauma Update, San Diego, CA, April 25-27, 2013.

Scherl, S.: Pediatric Tibia Fractures. 13th Annual AAOS/OTA Orthopaedic Trauma Update, San Diego, CA, April 25-27, 2013.

Scherl, S.: Pediatric Case Presentation. 13th Annual AAOS/OTA Orthopaedic Trauma Update, San Diego, CA, April 25-27, 2013.

Garvin, K.: Inter and Intra Observer Reliability of CT Scan for Total Knee Arthroplasty Component Malrotation. Annual Meeting of the Association of Bone and Joint Surgeons, Istanbul, Turkey, April 24-26, 2013.

Haider, H.: Hip Biomechanics and Total Hip Replacement. Innovation & Methods in Preclinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

see PUBLICATIONS pg 15

BREAKING NEWS | 14

Mary Peterson, R.N., has a long history at UNMC. Twenty-two years long, in fact. Of those 22 years, 15 have been with the orthopaedic clinic.

After spending seven years as a staff nurse in UNMC inpatient services, Mary joined the orthopaedic department as a research nurse in 1998. Her early position not only encompassed research, but also included being clinical support for Dr. Kevin Garvin, professor and chair, and an adult reconstructive surgeon in the department. In 2001, Mary became a specialty nurse. This year marks not only her 15-year anniversary with the deparment, but also of supporting Dr. Garvin. It’s no surprise that to the many patients, physicians, and clinical staff that have come in contact with Mary over those 15 years, she’s become virtually synonymous with “orthopaedics” at UNMC.

“Mary is the first face and voice of my patients,” said Dr. Kevin Garvin, who nominated Mary for the Chancellor’s Silver ‘U’ Award, received in April of this year. “She has the incredible ability to change direction on the fly and works with our clinical staff, surgery scheduling, and patient floor staff, to ensure the patient

has the best surgical experience possible. Mary is truly deserving of this long-overdue award.”

Some of Mary’s day-to-day responsibilities include facilitating the coordination of multiple complex patient care activities to ensure an effective overall plan of care. She is an integral part of patient and family pre- and post-operative education. She clinically manages patients with complex health needs, coordinating with nursing staff and other multi-disciplinary team members to assure continuity of care. Mary also assists patients post-operatively, scheduling follow-up clinic visits, radiology, physical therapy, and home health visits.

“Many of my patients are elderly with multiple medical conditions,” said Dr. Garvin. “She listens to them, carefully explains the surgical process, and answers their questions. She is also at the front of my patient’s discharge planning and coordinates this feature of their stay.”

Congratulations to Mary Peterson on receiving the Silver ‘U’ Award!

SILVER ‘U’ AWARD: The Chancellor’s Silver ‘U’ Award is a UNMC program that “recognizes strong consistent performers, whose daily contributions or special achievements help meet UNMC’s mission.”

YEA

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OF

SER

VIC

E A

WA

RD

SEMPLOYEE AWARDS

LINDA KRAUT, BAOffice Associate I

15 YEARS OF SERVICEUNMC April 2013

DANA SCHWARZ, BS, MS, ASNClinical Research Coordinator

15 YEARS OF SERVICEUNMC (6 years, Orthopaedics) January 2013

EILEEN ROONEY, BAAccounting/Office Associate

5 YEARS OF SERVICEUNMCSeptember 2013

UNMC WELLNESS ADVOCATE AWARD: Received April 2013 for her efforts to maintain a healthy lifestyle and promote wellness among others.

MARY CHADWELLMedical Assistant

5 YEARS OF SERVICE UNMC PhysiciansApril 2013

MARY PETERSON, R.N.Specialty Care Nurse, UNMC

Mary Peterson: Silver ‘U’ Recipient

BREAKING NEWS | FALL 2013

How you can help: You can contribute to Operation Walk or Operation Walk USA by making a donation using the enclosed remittance envelope, or by contacting Meg Johnson at the University of Nebraska Foundation via phone (402-502-4107) or e-mail (mjohnson@nufoundation.org).

Thank you for your support.

SAVE THE DATE! OPERATION WALK USA 2013 • DECEMBER 2-7, 2013

EMPLOYEE AWARDS

Mary Peterson: Silver ‘U’ RecipientHaider, H.: Knee Biomechanics and Total Knee Replacement. Innovation and Methods in Preclinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Haider, H.: Roadmap for Preclinical Implant Evaluation. Innovation and Methods in Preclinical Testing of Ortho-pedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Haider, H.: Testing Standards: How to Read Them; What Standards are Applicable. Innovation and Methods in Preclinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Haider, H.: Total Hip Replacement Wear Testing (In-vitro). Innovation and Methods in Preclinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Haider, H.: Total Knee Replacement Wear Testing. Innovation and Methods in Preclinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Haider, H.: Why Perform Evaluation Testing? Innovation and Methods in Pre-clinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Haider, H., and D’Lima, D.: Effects of Implant Wear Debris, Especially Metal-on-metal Hips. Innovation and Methods in Preclinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Haider, H., and D’Lima, D.: How ASTM Works, and Invitation of Researchers and Practitioners in China to Participate (from China!). Innovation and Methods in Preclinical Testing of Orthopedic Implants Science & Technology Seminar, Beijing, China, sponsored by AMTI (Advanced Mechanical Technology, Inc.) and One Measurement Group, Ltd, April 24-25, 2013.

Samuelson, E., and Brown, D.: Poster presentation: Cost-Effectiveness Analysis of ACI: A Comparison of Periosteal Patch Versus Type I/III Collagen Membrane. Mid-America Orthopaedic Association Annual Meeting, Amelia Island, FL, April 17-21, 2013.

Scherl, S.: Module Leader: Pediatrics; Presenter: Pediatric Fracture Module. Orthopaedic Trauma Association Residents Comprehensive Fracture Course 2.0, Lombard, IL, April 10-13, 2013.

Garvin, K.: Femoral Component Revision with Emphasis on Impaction Grafting. Hospital for Special Surgery, New York, NY, April 11-12, 2013.

Garvin, K.: Prosthetic Joint Infection of the Hip: Are We Making Progress? Hospital for Special Surgery, New York, NY, April 11-12, 2013.

Minges, D.; McClellan, J.; Burd, T.; McClellan, M.; Carson, N.; and Tverdik, J.: Podium Presentation A175: Can Preoperative Electromyography Predict Relief of Leg Pain after Spinal Surgery? Global Spine Congress, Hong Kong, China, April 4-6, 2013.

Namavar, F.; Sabirianiov, R.; Zhang, J.; Cheung, C.; and Blatchley, C.:

Nanostructurally Designed Ultra-hydrophilic Hard Ceramic Oxide Coatings. 2013 MRS Spring Meeting & Exhibit, San Francisco, CA, April 1-5, 2013.

Miralami, R.; Koepsell, L.; Premaraj, T.; Kim, B.; Thiele, G.; Sharp, G.; Garvin, K.; and Namavar, F.: Comparing Bio-compatibility of Nano-crystalline Titanium and Titanium-oxide with Microcrystalline Titanium. 2013 Materials Research Society Spring Meeting, San Francisco, CA April 1-5, 2013.

PRESENTATIONS, REGIONAL AND LOCAL: Esposito, E.: The Limping Child. Lecture – Pediatric Department, Penn State University, Hershey, PA, July 9, 2013.

Esposito, E.: Medical and Surgical Treatment of Osteogenesis Imperfecta. Pediatric Grand Rounds, Penn State University, Hershey, PA, July 9, 2013.

Esposito, E.: Osteogenesis Imperfecta: Surgical Treatment, Techniques and Tricks. Orthopaedic Grand Rounds, Penn State University, Hershey, PA, July 9, 2013.

Cornett, C.: Decision Making in SpineSurgery. Nebraska Self-insurers Assoc-iation Luncheon, Omaha, NE, June 12, 2013.

Scherl, SA: Common Pediatric Fractures. EMS Rounds, Children’s Hospital & Medical Center, Omaha, NE, April 16, 2013.

Esposito, E.: Neonatal Orthopaedics. New Frontiers in Neonatal Care, La Vista, NE, April 5, 2013.

Cornett, C.: Back Pain: What You Need to Know. UNMC, Family Medicine Board Review Course. Omaha, NE, April 2013.

Cornett, C.: Treatment Options for Common Spine Conditions. Community outreach talk/education, Lincoln, NE, April 2013.

Miralami, R.; Thiele, G.; Sharp, G.; Garvin, K.; and Namavar, F.: Biocompatibility of Ion Beam Assisted

Deposition (IBAD) Nano-crystalline Titanium and Titanium-oxide. The 44th Annual Midwest Student Biomedical Research Forum (MSBRF), Omaha, NE, February 23, 2013.

PUBLICATIONS (continued from pg 13)

BREAKING NEWS | FALL 2013

981080 Nebraska Medical Center Omaha, NE 68198-1080

ADDRESS SERVICE REQUESTED

ORTHOPAEDIC SURGERY

Visit us online at www.unmc.edu/orthosurgery

in this issue

OrthOpaedics in West Omaha just gOt bigger and better Our newly renovated clinic at the Oakview Medical Building is open and taking appointments!

austrian-sWiss-german (asg) traveling fellOWs visit Omaha The 2013 ASG fellows were able to experience both science and fun during their recent stop in Omaha. Between lectures and observing surgeries, they were able to take in a College World Series baseball game.

blue crOss blue shield aWards tOp hOnOr..... The spine surgery, knee and hip replacement programs at The Nebraska Medical Center have earned Blue Distinction Centers+ from the Blue Cross and Blue Shield of Nebraska in 2013.

NonprofitOrganizationU.S. Postage

PAIDPermit No. 454

Omaha, NE

Breaking Newsfor alumni and friends of the University of Nebraska Medical Center Department of Orthopaedic Surgery and Rehabilitation

Help us GO GREEN! To receive Breaking News

electronically, simply e-mail dmeyer@unmc.edu.

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DEPARTMENT OF ORTHOPAEDIC SURGERY & REHABILITATION | CASE REPORT | FALL 2013

BACKGROUND Reconstruction of the distal femur after resection for osteosarcoma in a young child is challenging. The distal femur represents the most common skeletal location for osteosarcoma. Not coincidentally, the distal femoral physis is the site of greatest growth of any of the long bones in the lower extremity. Nearly all cases of osteosarcoma in the distal femur involve the distal femoral growth plate. The distal femur grows at a rate of 1 centimeter (cm) per year through childhood and slightly more during puberty.

Osteosarcoma occurs most frequently in the second decade of life in children and young adults, with varying potentials for continued growth. In a teenager that has reached or is nearing the skeletal maturity, this is not a significant issue. However, in younger children, loss of this growth center with resection of a tumor presents a potential for significant limb length discrepancy.

Traditionally in these younger patients, surgeons performed either an above-knee amputation or rotationplasty (Jacobs, 1984; Merkel, Gebhardt, & Springfield, 1991). More recently, expandable prostheses have become popular. Some of the earlier generations of these prostheses had significant durability issues and mechanical problems. A study by Saghieh et al. showed mechanical failure in 35%, reoperation in 40%, and complications in 70%. Success in achieving limb length equality was more reliable (Saghieh et al., 2010).

A second major concern with regards to reconstruction, if the child survives their cancer diagnosis, is durability of the implant. Revision of these prostheses becomes more and more difficult. Five- and ten-year survival for distal femoral megaprostheses range from 85% (5-year) to 55% (10-year) (Biau et al., 2006), respectively. A recent multicenter review looked at mode of failure in specific anatomic locations and found 27% failure in reconstruction of the distal femur, 23% if tumor progression is not included. The most common modes of failure were: infection, aseptic loosening, and mechanical failure (Henderson et al., 2011). In general, implant failure due to mechanical issues has decreased over the last 30 years. Infection and aseptic loosening remain problematic.

A novel method of fixation has shown promise in reconstruction of the distal femur. A recent paper showed 5- and 10-year survival rates of 85% and 80%, respectively (Healey, Morris, Athanasian, & Boland, 2013). This novel prosthesis also allows for expansion to compensate for the loss of distal femoral physis with resection of the tumor.

THE CASE A 12-year-old male presented to clinic with a 3- to 4-week history of increasing pain in the left knee. The patient and the patient’s family recalled no antecedent injury, accident, or trauma to the area. He had no prior surgery or problems with the knee. He complained of pain at night, pain at rest and pain exacerbated with activity. His past medical and surgical history was unremarkable. There was no specific family history of any cancers.

On physical examination, he was awake, alert and oriented, and in no acute distress. He had no obvious mood or affect disorders. He had normal stance, gait and coordination. Examination of the left lower extremity demonstrated some tenderness about the lateral side of the distal femur with a firm expansile mass of the distal femur. There were no overlying skin changes. He had full motion about the hip, knee, ankle and foot, as well as pain with full flexion about the knee. Otherwise, motor sensation and reflexes were intact. No peripheral swelling, lymphedema, or adenopathy was noted.

AP and lateral radiographs showed a mixed radiolucent-radiodense lesion of the distal femur located at the metaphysis and growth plate (see figures 1 and 2). MRI scans of the distal femur demonstrated a large lesion in the distal femoral physis with associated soft tissue mass that extended laterally, destroyed the bony cortex, and involved the growth plate (see figures 3 and 4).

A biopsy confirmed the diagnosis of osteosarcoma. Further staging studies, including a 3-phase whole body bone scan and CT scan of the chest, showed no evidence of metastatic disease.

The patient underwent consultation with Pediatric Oncology and was started on neoadjuvant chemo-therapy. After the completion of approximately 10

Reconstruction of the distal femur with an expandable prosthesisSean McGarry, M.D., Associate Professor, Musculoskeletal Oncology, Department of Orthopaedic Surgery and Rehabilitation Case Report

Figure 1. (Above, left) AP radiograph left knee at presentation. Top arrow demonstrates a “Codman’s triangle”. Bottom arrow demonstrates a “sunburst” of reactive bone.

Figure 2. (Above) Lateral radiograph left knee at presentation.

(continued on back)

Figure 3. MRI image, coronal T1 left knee at presentation. Top arrow shows extensive soft tissue component of the tumor. Bottom arrow shows tumor involvement of the physis.

Figure 4. MRI image, axial T2 left knee at presentation. Arrow again demonstrates extensive soft tissue component of the tumor posterior and lateral.

weeks of preoperative chemotherapy, thepatient was again staged and noted to have good consolidation of his tumor mass. The tumor mass was again noted to involve the distal femoral physis.

We had a lengthy discussion with the family and felt as if a limb salvage procedure could be performed. Consideration was made for a rotationplasty versus a distal femoral mega-prosthesis. The patient was a prepubescent child who was approximately 5’4” tall. His mother was 5’7” tall and his father was 6’5” tall. Therefore, we knew there was going to be a significant issue with limb length discrepancy using a traditional distal femoral megaprosthesis. We discussed, with the patient and his family, the placement

of an expandable prosthesis with a potential to equalize the leg lengths as he went through puberty. The patient underwent a distal femoral resection and reconstruction, with an expandable megaprosthesis (see figures 5 and 6). The patient went on to complete 6 months of postoperative chemotherapy.

The patient was recently seen in follow-up 18 months after his index procedure, doing well with no evidence of disease. A scanogram demonstrated an approximate 1 cm leg length discrepancy, right greater than left. The patient was taken to the operating room for a lengthening procedure. The leg was prepped and draped; a 1 cm incision was made in the patellar tendon just inferior to the patella. The lengthening

maneuver involved turning a screw located in the intracondylar notch that incrementally disengaged the inner and outer components of the prosthesis. Ten full turns of the screwdriver lengthened the prosthesis by 12.5 millimeters (mm) (see figures 7 and 8). He was discharged to home with physical therapy for range-of-motion. He had normal peroneal nerve function and approximate limb length equality at that point.

Future plans include periodic CT scanograms for limb length discrepancy. We will proceed with further lengthenings as necessary, with a goal of limb length equality at the end of skeletal maturity. The prosthesis still has about 5 cm of lengthening available.

DEPARTMENT OF ORTHOPAEDIC SURGERY & REHABILITATION | CASE REPORTS | FALL 2013

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Figure 5. AP radiograph left knee immediately post-operative.

Figure 6. Lateral radiograph left knee immediately post-operative.

Figure 7. AP radiograph left knee pre-lengthening. Bracket demonstrates distraction between the telescoping inner and outer components of the prosthesis (this is neutral or zero distraction).

Figure 8. AP radiograph left knee post-lengthening. Bracket demonstrates increased distraction of about 1 cm between the telescoping inner and outer components of the prosthesis (compared to figure 7).