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Orthopaedic Institute

About

The scientist/clinician partnership at Geisinger Orthopaedic Institute facilitates research in discovering the best applications of, improvements to and innovations for the latest orthopaedic technologies in development. The basic research and clinical trials aim to develop the best implants, finest biomaterials and cutting-edge pharmaceuticals for musculoskeletal patient care.

"We are a dynamic orthopaedic translational research center," says Michael Suk, MD, JD, MPH, FACS, chairman, department of orthopaedic surgery at Geisinger Health System. "Our affiliation with various groups prove that Geisinger is a major contributor to orthopaedic research."

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Leadership

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Investigators

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Funded Projects

  • Determination of Localized Bone Quality: Correlation of Bone-Screw Pullout and Bone Microindentation to Bone Mineral Density Background and Significance - PI, Thomas R. Bowen, MD - Overall objectives include collecting 30 proximal femoral head specimens from healthy (femoral neck fractures) and osteoporotic populations, perform matched screw-pullout and micro-indentation techniques on each bone specimen, correlate experimental measurements of screw-pullout and micro-indentation measurements with results from radiographic or experimental measurements of bone mineral density and identify a preliminary "health" threshold for screw-pullout and/or micro-indentation as compared to other quantified determinants of bone health.
  • Regenerex Tibial Tray Multi-Center Data Collection - PI, G. Dean Harter, MD - The purpose of this data-collection effort is to perform a five-year evaluation of the Regenerex Tibial Tray, which has been cleared by the FDA and has been on the market since 2004. This data collection effort will document the clinical outcomes of the Regenerex Tibial Tray. The data gathered will be collated and used to provide feedback to designing engineers; support marketing efforts, and answer potential questions from reimbursement agencies.
  • Prospective Multicenter Open Market Study of the Encore Reverse Shoulder Prosthesis - PI, G. Dean Harter, MD - Purpose of the study is to evaluate the use and efficacy of the Reverse Shoulder Prosthesis for treatment of rotator cuff deficiency in subjects who are candidates for a total shoulder replacement (primary and revision subjects).
  • FAITH - Fixation Using Alternative Implants for the Treatment of Hip fractures: A Multi-Centre Randomized Trial Comparing Sliding Hip Screws and Cancellous Screws on Revision Surgery Rates and Quality of Life in the Treatment of Femoral Neck Fractures. - PI, Daniel S. Horwitz, MD -This is a multi-centre trial involving surgeons across North America, South America, Europe, Australia, Asia and Africa. The primary objective of the study is to assess the impact of sliding hip screws vs. cancellous screw fixation on rates of revision surgery at two years in individuals with femoral neck fractures. The secondary objective is to evaluate the impact of sliding hip screw vs. cancellous screws on complications, including mortality, avascular necrosis, nonunion, implant breakage or failure, and infection.
  • Use of a Registry on Infection to Improve Subject Outcomes and Research Efforts - PI, Michael Suk, MD - Infection remains a serious clinical problem in orthopaedic surgery. The emergence of infections resistant to multiple drugs has altered the treatment and reduced the success rates of joint prosthesis and fracture-fixation devices following treatment of infection. While the infection rates over the past decade have been only two percent and five percent, greater than 80 percent of these infections are caused by Staphylococcus. The purpose of this study is to create an international registry on musculoskeletal infection cases. The registry will collect information and specimens that will be used in future studies looking at trends in infection rates and treatments as well as the effectiveness of different treatments.
  • Orthopaedics Trauma Registry - PI, Daniel S. Horwitz, MD -Establish a database of all orthopaedic trauma patients at Geisinger Health System and follow the health information for the lifetime of the patient. The database is used for future IRB approved research protocols and QI/QA projects.
  • Pediatric ATV Injuries: Incidence and Cost in the State of Pennsylvania - PI, Thomas R. Bowen, MD -To analyze the severity and incidence of ATV related pediatric injuries in the state of Pennsylvania and correlate these with a cost model generated from admission to Geisinger Medical Center.
  • Total Joint Replacement in the Obese: The BMI a Threshold A Collaborative Research Project between Geisinger Health System and FORCE-TJR - PI, Thomas R. Bowen, MD - Purpose of this study is to establish a threshold by which the risk of elective total joint arthroplasty outweighs the benefit in the obese patient population, and to risk stratify patients based upon their medical comorbidities and compare it to their functional outcomes.
  • Redefining the Mechanical Alignment "Safe Zone" in Total Knee Arthroplasty - PI, Michael Suk, MD - The goal of primary total knee arthroplasty is to achieve a postoperative limb alignment in the neutral mechanical axis. Previous investigations have observed less favorable outcomes associated with increased deviation from a neutral mechanical alignment. At present there is not a well established target range for postoperative coronal alignment, or "safe zone." The purpose of this study is to investigate the relationship, if any, in a relatively large patient group, between post-operative coronal alignment, or "safe zone," and clinical outcomes in patients undergoing total knee arthroplasty.
  • Evaluation of Ankle Fracture Results using a Novel Fracture Fixation Method: Sidewinder Plate - PI, Gerard Cush, MD - There are several approved surgical fixation techniques for displaced malleolar fractures. New techniques in plate and screw design have recently emerged. Many specific to the treatment of displaced malleolar fractures. The Sidewinder plate (TriMed, Valencia CA) is on of these novel plate designs. The purpose of this retrospective chart review is to analyze the clinical and radiographic outcomes of this novel plating system.
  • Gender Differences in Periprosthetic - PI, Elie Ghanem, MD - The purpose of this retrospective cohort study is to determine whether gender is an independent risk factor for developing a prosthetic joint infection (PJI) after primary or revision total joint arthroplasty (TJA) and to determine if there is a genetic predisposition for developing PJI after TJA that is either related or independent of gender.
  • Evaluating Perioperative Management of Blood Thinners and Antiplatet Medication When Undergoing Total Joint Replacement Surgery - PI, Elie Ghanem, MD - The purpose of this retrospective review is to evaluate the postoperative outcomes of patients having total joint replacement/revisions of the hip and knee and evaluate the rate of infection, cardiac and mortality risk associated with the procedure based on the perioperative use of Aspirin, Plavix and Coumadin as deep vein thrombosis (DVT) and pulmonary embolism (PE) prophylaxis.
  • Diagnosing Persistent Infection in Hip and Knee Spacers - PI, Elie Ghanem, MD - The purpose of this retrospective study is to define cut-off values for fluid cell count and differential obtained from hip or knee spacer aspirate that will aid in detecting a persistently infected spacer.
  • Reverse Total Shoulder Arthroplasty in Morbidly Obese Patients - PI, G. Dean Harter, MD - Retrospective review of patients who underwent reverse total shoulder arthroplasty over a 6-year period to determine if morbidly obese patients have a significantly greater rate of complications following reverse total shoulder arthroplasty.
  • Epidemiology and Outcomes of Clavicle Fractures - PI, Daniel S. Horwitz, MD - Purpose of the study is to investigate the epidemiology of clavicle fractures in a central Pennsylvania settings and the outcomes of high energy and low energy mechanisms in clavicle fractures.
  • Nailed Diaphyseal Fractures of the Tibia With and Without Associated Ipsilateral Tibia-fibula Fractures: Surgical Technique and Outcomes - PI, Daniel S. Horwitz, MD - The objective of this investigation is to retrospectively analyze records at GMC to evaluate the effect of nailing of these diaphyseal fractures of the tibia with and without associated fractures on fracture healing and overall functional outcome.
  • Ankle Fractures with Syndesmotic Injuries: Is Implant Removal Essential? - PI, Daniel S. Horwitz, MD - The objective of this retrospective study is to evaluate the various implants used for surgical management, the radiologic, clinical and functional results as well as hardware related effects like implant related pain, implant loosening, implant breakage and the need for implant routine removal.
  • Determinants of Outcomes After Femur Fracture - PI, Daniel S. Horwitz, MD - The purpose of this study is to determine rate of complications and the risk factors for poor outcomes after surgery for a fracture of the femur and to assess the effectiveness of post-fracture care.
  • Outcomes and Complications of Acetabular Fractures - PI, Daniel S. Horwitz, MD - The purpose of this study is to evaluate all patients of operatively treated acetabular fractures with primary focus on the documented neurologic injury. We aim to draw a possible relationship between fracture pattern, displacement and severity of neurologic problems, so that physicians can provide patients with prognostic data.
  • Clinical Performance of the Malleolar Sled Fixation Device versus the Conventional Two Lag Screw Technique - PI, Daniel S. Horwitz, MD - The aim of this study is to compare the effectiveness of the TriMed malleolar sled versus conventional lag screw fixation in treating medial malleolar fractures using retrospective data analysis and analysis of prospective data collected through telephone surveys.
  • Outcomes of Tibia and Fibula Fractures - PI, Daniel S. Horwitz, MD - Tibial fractures with or without associated fibula fractures are very common orthopaedic injuries requiring operative interventions. Different methods of fixation depending upon anatomical site and fracture patterns exist. These can be intramedullary nails, plates or casts. Though these surgeries generally result in excellent functional outcomes, complications do arise from these surgeries. The purpose of this retrospective study is to examine the outcomes of tibia fractures managed using different surgical techniques.
  • Use of Small Bone Innovations/Avanta SR Proximal Interphalangeal (PIP) Joint - PI, Joel Klena, MD - The Small Bone Innovations PIP finger prosthesis is authorized be Federal law for use in arthroplasty surgery of the PIP joint when either the patient is in need of a revision of failed PIP prosthesis or the patient expects to place his/her hands under loading situations which preclude the use of an alternative implant in the painful osteoarthritic and post traumatic arthritic PIP joint.
  • Use of Small Bone Innovations/Avanta SR Metacarpophalangeal (MCP) Joint - PI, Joel Klena, MD - The Small Bone Innovations proximal MCP finger prosthesis is authorized by Federal law for use in arthroplasty surgery of the PIP joint when either the: patient is in need of a revision of failed MCP prosthesis or the patient expects to place his/her hands under loading situations, which preclude the use of an alternative implant in the painful osteoarthritic and post traumatic arthritic MCP joint.
  • Clinical Outcomes of Locked Circular Plate Fixation in Four Corner Arthrodesis - PI, Joel Klena, MD - A number of plating systems are currently used to achieve four-corner arthrodesis. To date, no study has documented the clinical outcomes of the locked circular plate fixation system. We aim to establish the clinical results of the locked circular plate fixation in four-corner arthrodesis in patients 18 years of age and older.
  • Flexor Tendon Irritation with Volar Locked Plating - PI, Joel Klena, MD - We aim to establish the incidence of flexor tendon complications for patients who have undergone operative fixation of distal radius fractures using either the Synthes' variable angle volar distal radius plate or Synthes' juxta-articular volar distal radius plate. In addition, we plan to evaluate other demographic factors to see if they were independent risk factors for flexor tendon complications.
  • Flexor Tendon Complications with the Use of Volar Distal Radius Plates - PI, Joel Klena, MD - Purpose of the study is to establish the incidence of flexor tendon complications for patients who have undergone operative fixation of distal radius fractures using either the Synthes variable angle volar distal radius plate or the Synthes juxta-articular volar distal radius plate.
  • Tibial Shaft Fracture and Thrombosis: Is Chemical Prophylaxis Necessary for Prevention? - PI, Joel Klena, MD - Assess the rate of deep venous thrombosis (DVT) and pulmonary embolism (PE ) in the treatment of tibial shaft fractures.
  • Outcomes After Comminuted Fracture of the Distal Radius - PI, Joel Klena, MD - There is little literature describing the outcomes after distal radius fractures. It is thought these injuries result in loss of motion, strength and functional capacity as well as residual pain and post-traumatic arthritis. The objective of this study is to conduct a retrospective analysis of data contained in the GMC electronic health record between June 1, 2004 to December 31, 2013 in addition to a 12-month review of prospectively collected data collected from standard of care outcome measures of patients treated surgically and non-surgically for distal radius fractures by a single fellowship trained hand surgeon.
  • Epidemiology and Cost Analysis of Orthopaedic Injuries Associated with Farming and Agricultural Accidents. - PI, Joel Klena, MD - Farming is an ancient occupation which remains critical to the infrastructure of the United States. However there are significant risks associated with farming. In Pennsylvania alone there were 145 farm-related fatalities from 2005-2009. The objective of this study is retrospectively review medical records at Geisinger Medical Center to analyze the epidemiology and the cost of traumatic musculoskeletal injuries sustained by adult and pediatric patients resulting from farming and agricultural related accidents.
  • Repair of Ulnar Collateral Ligament Injuries to the Thumb - PI, Joel Klena, MD - The purpose of this study is to retrospectively analyze medical records at GMC to assess outcomes and complications of the direct repair of both acute and chronic ulnar collateral ligament injuries of the thumb.
  • Epidemiology, Outcomes, and Economic Analysis of Orthopaedic Injuries in the Amish Community - PI, Michael Suk, MD - The objective of this study is to retrospectively review medical records at Geisinger Medical Center (GMC) to analyze the epidemiology and cost of traumatic musculoskeletal injuries sustained by adult and pediatric members of the Amish and Mennonite communities.
  • The Effect of Surgical Approach on Total Brake Time in Total Hip Arthroplasty Patients - PI, James C. Widmaier, Jr., MD - The return to driving is a genuine concern for patients recovering form total hip replacement surgery. Currently returning to driving after total hip replacement surgery is primarily based on physician recommendations and standardized time frames with little scientific data to support these ideas. Total Brake Time (time from initial stimulus presentation to the moment the brake reaches its endpoint) is an important measure of a patient's motor abilities when driving. This prospective study will compare the total break time of patients (>18 years of age) undergoing total hip replacement surgery performed either with a direct anterior approach or a posterior approach.
  • Three-Dimensional Computed-Tomography Reconstruction for the Classification of Acetabular Fractures – PI, Michael Suk, MD. Acetabular fractures are some of the most complex fractures treated in orthopaedic surgery.  Classification of these fractures pre-operatively plays a large role in surgical approach and eventual outcome.  If not fixed optimally, significant morbidity is expected.  Traditional classification has been with Judet radiographs augmented with two-dimensional (2D) computed tomography (CT).  Three-dimensional (3D) CT reconstructions offer increased clarity in the 3D anatomy that could offer insight in to the reliability and clinical use of previous classification systems and treatment algorithms.  The purpose of this prospective study is to determine the reliability and clinical utility of 3D CT reconstructions of acetabular fractures compared to plain radiographs and 2D CT images when determining the classification and subsequent treatment of acetabular fractures.
  • Major Extremity Trauma Research Consortium (METRC): Streamlining Trauma Research Evaluation with Advanced Measurement: STREAM Study – PI, Michael Suk, MD. The Major Extremity Trauma Research Consortium (METRC) Streamlining Trauma Research Evaluation with Advanced Measurement (STREAM) Study is a multi-center prospective study.  PROMIS (patient reported outcomes measurement information system) has developed tools, such as item banks, short forms, and computer-adaptive tests (CATs) that can help standardize measurements for many health-related quality of life domains related to physical mental, emotional, and social functioning.  The proposed project will examine the reliability, validity, and responsiveness of the PROMIS tools for clinical research following orthopaedic trauma.
  • Major Extremity Trauma Research Consortium (METRC): A Prospective Randomized Trial to Assess Fixation Strategies for Severe Open Tibia Fractures: Modern Ring External Fixators vs. Internal Fixation (FIXIT Study) – PI,  Michael Suk, MD. The METRC (Major Extremity Trauma Research Consortium) FIXIT Study (Assess Fixation Strategies for Severe Open Tibia Fractures: Modern Ring External Fixators vs. Internal Fixation) is a multi-center, prospective study. The primary aim of the study is to compare the outcomes associated with modern ring external fixators versus standard internal fixation techniques in treating “severe” open tibia shaft or metaphyseal fractures with or without a bone defect of any size.  The hypothesis is among patients with open tibia shaft or metaphyseal fractures (with or without a bone defect of any size), the rate of re-hospitalization for major limb complications will be lower for patients treated with ring fixators than those treated with standard internal fixation.
  • When to Say “No” to Primary Total Joint Arthroplasty Using the ACS Risk Calculator – PI, Elie Ghanem, MD. There are several risk factors for periprosthetic joint infection after primary total joint arthroplasty that have been identified along with their respective interactions. This has culminated in the development of numerous risk calculators including the American College of Surgeons Risk Calculator to predict postoperative complications and reoperations after . We believe that the ACS risk calculator can accurately predict 30 and 90 day complications including periprosthetic joint infection, venous thromboembolism, reoperations, and mortality. The ACS risks for periprosthetic joint infection can be used to determine a cut-off value above which the event predictability for developing deep infection becomes significant, at which time the patient is counseled against undergoing a TJA.
  • Blunt Cerebrovascular Injury in Cervical Trauma Patients – PI, Michael Haak, MD. All patients who sustain a cervical spine injury receive a Computed  Tomography Angiogram (CTA) per Geisinger Clinic protocol.  Often patients are diagnosed with a Blunt Cerebral Vascular Injury (BCVI) based on imaging with no accompanying neurologic symptoms.  The literature is limited on neurologic outcomes of patients with asymptomatic positive CTA imaging for BCVI.  The purpose of this retrospective study with a prospective data collection arm is to determine the incidence of vertebral artery injury in cervical spine injuries and assess neurological outcomes in patients with cervical spine fractures diagnosed with asymptomatic BCVI.
  • SWIFT Trial: Surgical Weight-loss to Improve Functional status Trajectories following Total Knee Arthroplasty – PI, Christopher Still, MD. In many patients, obesity is associated with arthritis in the knee that causes pain and difficulty moving or walking, which may get worse over time as the arthritis progresses.  Many patients choose knee replacement surgery to reduce the knee pain and improve mobility and quality of life. However, knee replacement surgery in patients with obesity may have a higher risk of complications than knee replacement surgery in patients without obesity.  Because of these concerns, patients with obesity are encouraged by many joint replacement centers to lose weight prior to undergoing knee replacement surgery. Weight loss surgery, commonly referred to as bariatric surgery, is the most effective therapy for achieving and maintaining weight loss for patients with obesity.  Several recent studies suggest that having weight loss surgery before knee replacement surgery may lower the risk of the knee replacement surgery and improve long-term outcomes in patients with obesity.  The purpose of this study is to determine whether weight-loss surgery prior to total knee replacement surgery reduces risk and improves long-term outcomes including measures of orthopedic outcomes (e.g., knee range of motion and knee pain) as well as physical function (e.g., ability to walk 400 meters). Patients who are candidates for both total knee arthroplasty (TKA, commonly referred to as total knee replacement) surgery and weight loss (bariatric) surgery are eligible to participate.  Participants who choose to go ahead with immediate knee replacement surgery, will be asked to take part in the Control Arm of this study.  Following their standard of care total knee replacement surgery they will be followed by the research team for two years.  If they choose to have weight loss surgery prior to their total knee replacement surgery, they will be asked to take part in the Test Arm of this study.  Test Arm study patients will undergo weight loss surgery (Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Bypass).  Approximately one year following weight loss surgery they will be re-assessed by their orthopedic surgeon to determine if they still require knee replacement surgery.  If they still require total knee replacement surgery, they will undergo total knee replacement surgery as part of their standard of care.  Following their standard of care total knee replacement surgery they will be followed by the research team for up to two years.  If they no longer require or defer total knee replacement surgery they will also be followed by the research team for up to two additional years.
  • Determinants of Outcomes after fracture of the humerus – PI, Daniel Horwitz, MD. Fractures of the humerus are commonly treated injuries in orthopaedic surgery.  Several patient-related and hospital-related factors have been indicated as potential causes of the increased morbidity and mortality in this population.  The purpose of this study is to determine rate of complications and the risk factors for poor outcomes after surgery for a fracture of the humerus and to assess the effectiveness of post-fracture care.
  • Suture-Button Fixation Compared with Screw Fixation of Isolated Lisfranc Ligament Injuries – PI, Gerard Cush, MD. The objective of this retrospective chart review with a prospective data collection arm via telephone surveys is to analyze records at GHS and compare the clinical results of the screw fixation to tightrope fixation for Lisfranc injuries. We hypothesize that Lisfranc injuries treated with tightrope fixation would have the same or better functional short and medium-term outcomes as treatment with screw fixation.
  • Comparison of Alignment Achieved Using Single-Use versus Reusable Instrumentation in Total Knee Arthroplasty (TKA): A Prospective, Non-Randomized Multi-Center Investigation – PI, David Kolessar, MD. The purpose of this study is to evaluate knee alignment after using ATTUNE® Single Use Instruments compare to ATTUNE® reusable instruments.  Also, this study is looking to see if using ATTUNE® Single Use Instruments can increase operating room efficiency by reducing operating room set up and clean down times and or by making surgery more predictable through eliminating last minute missing or non-sterile instruments.
  • Triathlon Tritanium Knee Outcomes Study: A prospective, post-market, multi-center study of the outcomes of the Triathlon Tritanium Knee system – PI, Elie Ghanem, MD. The Triathlon Knee System, a predecessor to the Triathlon Tritanium Knee System is designed to meet patients' reasonable expectations for lifestyle recovery.  It is designed to provide patients with more natural motion and the potential for greater implant longevity.  As a next-generation knee replacement, the Triathlon Knee System is designed to more closely mimic natural knee motion.  The primary objective of this prospective, non-randomized, post-market, multi-center study is to evaluate the success rate of cementless primary total knee replacement with he Triathlon Tritanium Tibial Baseplate and Triathlon Tritanium Patella.
  • Secur-Fit Advanced Outcomes Study: A prospective, post-market, multi-center evaluation of the clinical outcomes of the Secur-Fit Advanced Hip Stem – PI, Elie Ghanem, MD. Total Hip Replacement is one of the most clinically successful and cost-effective interventions in health care.  Numerous surgeons have reported excellent long-term results in terms of reducing pain, improving function and quality-of-life in patients with debilitating hip disease.  The purpose of this prospective, post-market study is to evaluate and determine the success rate of the Secur-Fit Advanced Hip Stem and compare with those reported for other primary hip stems in the scientific literature.
  • PEDSCOLI - Multicenter, prospective, partially randomized, controlled trial of robotic-guided vs. freehand corrective surgery for pediatric scoliosis – PI, Meagan Fernandez, MD. Placement of implants such as pedicle screws is very common during spinal surgery.  Placing implants accurately within the spine is important for the integrity and functionality of the implants, as well as to avoid undesirable damage to the surrounding nerves and blood vessels.  Fortunately, serious injury because of misplaced implants is uncommon. Renaissance made by Mazor Robotics - is a guidance system designed to assist surgeons during spinal surgery by precisely guiding their surgical tools and implants according to a plan made by the surgeon prior to the surgery.  Renaissance-guided surgery has shown some promising results by increasing the accuracy of spinal instrumentation, reducing potential complications and improving various other elements of the surgical procedure.  However, the benefits of the technology have not been assessed in direct comparison to alternative surgical techniques in pediatric corrective surgery for scoliosis. The purpose of this prospective, partially randomized, controlled study is to compare the accuracy and clinical outcomes of scoliosis correction performed with versus without Renaissance-guidance, in pediatric and adolescent scoliosis patients.
  • Preservation of Thoracic Kyphosis and Coronal Curve Correction as a Function of Rod Stiffness in the Surgical Treatment of Adolescent Idiopathic Scoliosis with the Use of the K2M MESA Rail Deformity System – PI, W Fred Hess, MD. The purpose of this study is to collect data on clinical and radiographical outcomes after spine surgery to correct Adolescent Idiopathic Scoliosis (AIS) utilizing the K2M MESA Rail™ system as compared to literature reported outcomes for standard Colbalt Chrome rod systems in the treatment of AIS.  This implant is commercially available and is currently used throughout the United States, Europe, Australia, and a number of other countries.
  • Determinants of Outcomes After Intertrochanteric Femur Fracture – PI, Daniel Horwitz, MD. Intertrochanteric fractures of the femur are common and are a significant source of patient morbidity in orthopaedic surgery.  Despite hip fractures being a commonly treated injury, there is no established protocol for follow-up.  Subsequent to hip fracture, post-operatively the patients have increased health service utilization which leads to significant cost of care.  The role and necessity of clinic visits and radiographs obtained during follow-up of intertrochanteric hip injuries after the fracture has not been evaluated.  The purpose of this retrospective review is to determine rate of complications and risk factors for poor outcomes after surgery for a fracture of the femur and to assess the effectiveness of post-fracture care.
  • Tibial Plateau Fractures and Outcomes – PI, Daniel Horwitz, MD. Tibial fractures with or without associated fibula fractures are very common orthopaedic injuries requiring operative interventions. Different methods of fixation depending upon anatomical site and fracture patterns exist.  This study will examine the outcomes of tibia fractures managed using different surgical techniques.
  • Knee Arthrodesis with Lateral Locking Compression Plating for Failed Total Knee Arthroplasty – PI, Daniel Horwitz, MD. Knee arthrodesis provides a reasonable option for management of failure of total knee arthroplasty due to infective or non-infective causes. Intramedullary fixation has been the popular choice of techniques for knee arthrodesis (Conway et al. 2004). Combined medial and lateral plating with conventional or locking compression plates has been described and reported to be successful in the literature (Nichols et al. 1991, Kuo et al. 2005). Lateral plating with locking compression plate has been utilized by some surgeons but has not been described in the literature. The aim of this study to describe the technique of staged procedure of knee arthrodesis involving placement of antibiotic loaded cement spacer followed by knee arthrodesis with lateral locking compression plating. Also with this study we intend to evaluate the radiological outcomes, clinical outcomes and complications in the patients who underwent this procedure for failed total knee arthroplasty.
  • The Plantar vs. Dorsal Approach in Lesser Metatarsal Head Resection for Rheumatoid Patients – PI, Gerard Cush, MD. The purpose of this retrospective cohort study is to compare patients who have undergone the plantar approach to metatarsal head resection with a matched cohort of patients who have undergone the dorsal approach to metatarsal head resections.   Our hypothesis is that the plantar based approach will lead to fewer postoperative complications, time to complete wound healing, and incidence of revision surgery.
  • Outcomes of dual plating for the humerus shaft nonunion – PI, Michael Suk, MD. The incidence of nonunion of humeral shaft is reported between 2% and 20% after conservative treatment and between 8% and 12 % after operative treatment1,2. Risk factors include age, history of smoking/alcoholism, open fracture, mechanism of injury, initial treatment, infection, and fracture pattern3,4. The treatment modalities available are single plating, dual plating, intramedullary nails, external fixation, bone grafting (fibular strut grafting/ vascularized bone grafting/ iliac crest grafting), and unconventional plating techniques. Selection method for the treatment modality has not been standardized in the literature5,6. Factors influencing the treatment outcomes of the humerus nonunion include open/closed initial fracture, initial management of fracture, infection, proximal nonunion and type B/C fracture according to AO/OTA classification5,6. Comparison between the treatment modalities have been performed to understand the advantages one treatment modality has over the other7. We intend to study the results of the dual plating performed for the humerus shaft nonunion with regard to intraoperative complications, intraoperative blood loss, possibility of early rehabilitation, time to union and occurrence of complications. We also intend to compare these results with those of the single plating.
  • The Treatment of the Diabetic Ankle Fracture Patients with Diabetic Comorbidities by Ankle Fusion with Nail – PI, Daniel Horwitz, MD. Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to practicing clinicians. Complications of impaired wound healing, infection, malunion, delayed union, nonunion, and Charcot arthropathy are highly prevalent in this patient population. Controversy exists as to which is the best treatment for diabetic ankle fractures between noninvasively, open reduction and internal fixation or ankle fusion, particularly for patients with diabetes and Charcot arthropathy. The objective of this investigation is to analyze retrospective records at GMC to assess outcomes in a cohort of ankle fracture patients with diabetic comorbidities treated with a hindfoot intramedullary nail. We will set up a protocol and hypothesize that the use of a hindfoot fusion nail is safe and successful in treating ankle fractures in patients with diabetes mellitus or Charcot arthropathy at GMC.
  • Scaphotrapeziotrapezoid Arthritis: Radiographic Prevalence and Clinical Correlation – PI, Joel Klena, MD. Scaphotrapeziotrapezoid (STT) and carpometacarpal (CMC) arthritis are common degenerative conditions in the hand. While the incidence of CMC arthritis has been well defined, the incidence of STT arthritis has been less frequently analyzed. Recent authors have assessed the radiographic prevalence of STT arthritis but did not include a clinical correlation with intraoperative findings (Scordino). The objective of this investigation is to retrospectively analyze medical records at GMC for patients who have underwent a CMC arthroplasty to assess the incidence of STT arthritis both radiographically and intraoperatively. We also plan to evaluate for risk factors for the development of STT arthritis in this patient population. Our hypothesis is the following: The radiographic severity of STT arthritis in patients who have underwent CMC arthroplasty will correlate well with the intraoperative findings. Furthermore, we predict that patients with CMC arthritis treated with arthroplasty will have a higher incidence (both radiographically and intraoperatively) of STT arthritis than previously reported in literature.

If you're interested in learning more about research at the Geisinger Orthopaedic Institute, please send an email to orthoresearch@geisinger.edu.

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Publications

  • Haidukewych, GJ, Horwitz, DS, Liporace, FA, Sems, A, Giannoudis, P, Metzinger, AJ, & Berthusen, AH. (2016). U.S. Patent No. 9,295,504. Washington, DC: U.S. Patent and Trademark Office.
  • Kempegowda, H, Maniar, HH, Tawari, AA, Fanelli, GC, Jones, CB., Sietsema, DL, .& Horwitz, DS. (2016). Knee Injury Associated With Acetabular Fractures: A Multicenter Study of 1273 Patients. Journal of orthopaedic trauma, 30(1), 48-51.
  • Horwitz, DS, Tawari, A, & Suk, M. (2016). Nail Length in the Management of Intertrochanteric Fracture of the Femur. Journal of the American Academy of Orthopaedic Surgeons, 24(6), e50-e58.
  • Kempegowda, H, Maniar, HH, Richard, R, Tawari, A, Jove, G, Suk, M, & Horwitz, DS. (2016). Posterior Malleolar Fractures Associated with Tibial Shaft Fractures and Sequence of Fixation. Journal of orthopaedic trauma.
  • Maniar, HH., Wingert, N, McPhillips, K, Foltzer, M, Graham, J, Bowen, TR., & Horwitz, DS. (2016). Role of Sonication for Detection of Infection in Explanted Orthopaedic Trauma Implants. Journal of orthopaedic trauma, 30(5), e175-e180.
  • Tawari, A, Kempegowda, H, Jove, G, Suk, M., & Horwitz, DS. (2016). The Agreement of Level of Evidence Ratings of Articles Submitted to JOT from 2012 to 2014. Journal of orthopaedic trauma.
  • Kempegowda, H, Tawari, A, Suk, M, & Horwitz, DS. (2016). Evaluation and Management of an Unstable Intertrochanteric Fracture of the Femur: A case report. Journal of orthopaedic trauma.
  • Tawari, AA, Kempegowda, H & Horwitz, DS. (2016). Nonunion Tibia Shaft Treated with IMN/Bone Grafting. In Fractures of the Tibia (pp. 225-234). Springer International Publishing.
  • Maniar, HH, Tawari, AA, Suk, M, Bowen, TR, & Horwitz, DS. (2015). Percutaneous and Mucocutaneous Exposure Among Orthopaedic Surgeons: Immediate Management and Compliance With CDC Protocol. Journal of orthopaedic trauma, 29(10), e391-e394.
  • Maniar, H, McPhillips, K., Torres, D., Wild, J., Suk, M., & Horwitz, D. S. (2015). Clinical indications of computed tomography (CT) of the head in patients with low-energy geriatric hip fractures. Injury, 46(11), 2185-2189.
  • Kubiak, EN, Haller, JM, Kemper, DD., Presson, AP, Higgins, TF, & Horwitz, DS. (2015). Does the lateral plate need to overlap the stem to mitigate stress concentration when treating vancouver c periprosthetic supracondylar femur fracture?. The Journal of arthroplasty, 30(1), 104-108.
  • Tawari, AA. Kempegowda, H, Suk, M & Horwitz, DS. (2015). What makes an intertrochanteric fracture unstable in 2015? Does the lateral wall play a role in the decision matrix?. Journal of orthopaedic trauma, 29, S4-S9.
  • Horwitz, DS. Tawari, A & Suk, M. (2016). Nail Length in the Management of Intertrochanteric Fracture of the Femur. Journal of the American Academy of Orthopaedic Surgeons, 24(6), e50-e58.
  • Kempegowda, H, Maniar, HH, Richard, R, Tawari, A, Jove, G, Suk, M & Horwitz, DS. (2016). Posterior Malleolar Fractures Associated with Tibial Shaft Fractures and Sequence of Fixation. Journal of orthopaedic trauma.
  • Tawari, A, Kempegowda, H, Jove, G, Suk, M., & Horwitz, DS. (2016). The Agreement of Level of Evidence Ratings of Articles Submitted to JOT from 2012 to 2014. Journal of orthopaedic trauma.
  • Kempegowda, H, Tawari, A, Suk, M., & Horwitz, D. S. (2016). Evaluation and Management of an Unstable Intertrochanteric Fracture of the Femur: A case report. Journal of orthopaedic trauma.
  • Tawari, AA, Kempegowda, H, Suk, M & Horwitz, DS. (2015). What makes an intertrochanteric fracture unstable in 2015? Does the lateral wall play a role in the decision matrix?. Journal of orthopaedic trauma, 29, S4-S9.
  • Maniar, H, McPhillips, K, Torres, D, Wild, J, Suk, M & Horwitz, DS. (2015). Clinical indications of computed tomography (CT) of the head in patients with low-energy geriatric hip fractures. Injury, 46(11), 2185-2189.
  • Kempegowda, H, Tawari, A, Suk M & Horwitz, DS. Department of Orthopaedic Surgery, Geisinger Medical Center, 100 N. Academy Ave, Danville.
  • Suk, M. (2015). I've Been Served… Now What?. Journal of orthopaedic trauma, 29, S15-S16.
  • Maniar, HH, Tawari, AA, Suk, M, Bowen, TR & Horwitz, DS. (2015). Percutaneous and Mucocutaneous Exposure Among Orthopaedic Surgeons: Immediate Management and Compliance With CDC Protocol. Journal of orthopaedic trauma, 29(10), e391-e394.
  • Bowen,TR, Kennedy, EA, Saunders, DC., Nguyen, EHD, Gabryluk, CL, Levy, JD & Wohlman, SJ. (2015). U.S. Patent No. 9,155,500. Washington, DC: U.S. Patent and Trademark Office.
  • Nelson, CL, Vanushkina, M, Irgit, K, Strohecker, K & Bowen, TR. (2015). Stemmed femoral implants show lower failure rates in revision total knee arthroplasty. The Knee, 22(5), 429-434.
  • Irgit, K, Richard, RD, Beebe, MJ, Bowen, TR, Kubiak, E & Horwitz, DS. (2015). Reverse oblique and transverse intertrochanteric femoral fractures treated with the long cephalomedullary nail. Journal of orthopaedic trauma, 29(9), e299-e304.
  • Maniar, HH, Wingert, N, McPhillips, K, Foltzer, M, Graham, J, Bowen, TR & Horwitz, DS. (2016). Role of Sonication for Detection of Infection in Explanted Orthopaedic Trauma Implants. Journal of orthopaedic trauma, 30(5), e175-e180.
  • Maniar, HH, Tawari, AA, Suk, M, Bowen, TR & Horwitz, DS. (2015). Percutaneous and Mucocutaneous Exposure Among Orthopaedic Surgeons: Immediate Management and Compliance With CDC Protocol. Journal of orthopaedic trauma, 29(10), e391-e394.
  • Rutter, MR, Richard, RD, Irgit, K & Cush, GJ. (2015). The Wire-form Fixation Device: A New Device for the Fixation of Medial Malleolar Fractures. Techniques in Foot & Ankle Surgery, 14(2), 94-98.
  • Alejandro, SF, Maloney, PJ, Grandizio, LC & Cush, GJ. (2015). The Sequelae of Drop Foot After Knee Dislocation: Evaluation and Treatment. Operative Techniques in Sports Medicine, 23(4), 348-356.
  • Grandizio, LC, Shim, SS, Graham, J, Costopoulos, C, Cush, G & Klena, JC. (2016). Analysis of Orthopedic Resident Ability to Apply Levels of Evidence Criteria to Scientific Articles. Journal of surgical education, 73(3), 381-385.
  • Fanelli, GC. (Ed.). (2015). Posterior cruciate ligament injuries: a practical guide to management. Springer.
  • Kempegowda, H, Maniar, HH, Tawari, AA, Fanelli, GC, Jones, CB, Sietsema, DL & Horwitz, DS. (2016). Knee Injury Associated With Acetabular Fractures: A Multicenter Study of 1273 Patients. Journal of orthopaedic trauma, 30(1), 48-51.
  • Levy, BA, Fanelli, GC, Miller, MD & Stuart, MJ. (2015). Advances in posterior cruciate ligament reconstruction. Instructional course lectures, 64, 543-554.
  • Fanelli, GC. (2015). Fibular Head-Based Posterolateral Reconstruction of the Knee: Surgical Technique and Outcomes. Journal of Knee Surgery, 28(06), 455-463.
  • Fanelli, GC. (2015). Posterior cruciate ligament injuries: what I have learned. In Posterior Cruciate Ligament Injuries. A Practical Guide to Management (pp. 3-18). Springer, New York.
  • Fanelli, GC. (2015). Evaluation and Treatment of Medial Instability of the Knee. Sports medicine and arthroscopy review, 23(2), 61-62.
  • Fanelli, GC. (2015). Evaluation and Treatment of Posterolateral Instability of the Knee. Sports medicine and arthroscopy review, 23(1), 1.
  • Fanelli, GC & Fanelli, DG. (2016). Knee Dislocations and PCL-Based Multiligament Knee Injuries in Patients Aged 18 Years and Younger: Surgical Technique and Outcomes. Journal of Knee Surgery, 29(04), 269-277.
  • Fanelli, GC & Fanelli, DG. (2015). Fibular Head–based Posterolateral Reconstruction of the Knee Combined With Capsular Shift Procedure. Sports medicine and arthroscopy review, 23(1), 33-43.
  • Fanelli, GC. (2016). Complex Topics in Knee Dislocations. Journal of Knee Surgery, 29(04), 267-268.
  • Grandizio, LC & Fernandez, MM. (2014). Common Pediatric Fractures. In Pediatric Surgery (pp. 113-120). Springer International Publishing.
  • Grandizio, LC & Fernandez, MM. (2014). Pelvic Fractures. In Pediatric Surgery (pp. 107-112). Springer International Publishing.
  • Wingert, NC, Gotoff, J, Parrilla, E, Gotoff, R, Hou, L & Ghanem, E. (2016). The ACS NSQIP Risk Calculator Is a Fair Predictor of Acute Periprosthetic Joint Infection. Clinical Orthopaedics and Related Research®, 474(7), 1643-1648.
  • Ghanem, E, Ward, DM, Robbins, CE, Nandi, S, Bono, JV & Talmo, CT. (2015). Corrosion and adverse local tissue reaction in one type of modular neck stem. The Journal of arthroplasty, 30(10), 1787-1793.
  • Papadopoulos, EC., Boachie-Adjei, O, Hess, WF, Perez-Grueso, FJS, Pellisé, F Gupta, M.& Kim, HJ. (2015). Early outcomes and complications of posterior vertebral column resection. The Spine Journal, 15(5), 983-991.
  • Boachie-Adjei, O, Yagi, M, Nemani, VM, Sacramento-Dominguez, C, Akoto, H, Cunningham, ME & Papadopoulus, EC. (2015). Incidence and Risk Factors for Major Surgical Complications in Patients With Complex Spinal Deformity: A Report From an SRS GOP Site. Spine Deformity, 3(1), 57-64.
  • Sacramento-Domínguez, C, Yagi, M, Ayamga, J, Nemani, VM, Akoto, H Mahmud, R & Sánchez-Pérez-Grueso, F. (2015). Apex of deformity for three-column osteotomy. Does it matter in the occurrence of complications?. The Spine Journal, 15(11), 2351-2359.
  • Lee, AK, Beck, JD, Mirenda, WM & Klena, JC. (2015). Incidence and Risk Factors for Extensor Pollicis Longus Rupture in Elastic Stable Intramedullary Nailing of Pediatric Forearm Shaft Fractures. Journal of pediatric orthopedics.
  • Grandizio, LC, Huston, JC, Shim, SS, Parenti, JM, Graham, J & Klena, JC. (2015). Levels of evidence have increased for musculoskeletal trauma questions on the orthopaedic in-training examination. Journal of surgical education, 72(2), 258-263.
  • Grandizio, LC, Huston, JC, Shim, SS., Graham, J & Klena, JC. (2016). Levels of Evidence for Hand Questions on the Orthopaedic In-Training Examination. HAND, 1558944715620793.
  • Speeckaert, AL, Brothers, JG, Wingert, NC, Graham, JH & Klena, JC. (2015). Airborne Exposure of Methyl Methacrylate During Simulated Total Hip Arthroplasty and Fabrication of Antibiotic Beads. The Journal of arthroplasty, 30(8), 1464-1469.
  • Grandizio, LC, Wagner, BR, Graham, J, Klena, JC & Suk, M. (2015). Orthopaedic trauma in the Anabaptist community: epidemiology and hospital charges. Journal of agromedicine, 20(2), 140-148.
  • Grandizio, LC, Shim, SS., Graham, J, Costopoulos, C, Cush, G & Klena, J. C. (2016). Analysis of Orthopedic Resident Ability to Apply Levels of Evidence Criteria to Scientific Articles. Journal of surgical education, 73(3), 381-385.

 

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Announcements

AOCSC Platinum Certification

In April 2012, Geisinger Orthopaedic Institute was the second site in the United States to receive the certificate indicating that it is now an Arbeitsgemeinschaft für Osteosynthesefragen (AO) Clinical Study Center (AOCSC) site, and was awarded the Platinum status, the highest level of certification offered.

"This certification will reflect our quality standards and abilities to participate in and manage clinical studies (not only with the AO but with industry as well)," says Dr. Suk. "AO Centers will be the destination of choice for implant testing, comparative research projects and innovations in biologic materials. It promises to open an important pipeline to sponsored research."

If you're interested in learning more about research at Geisinger Orthopaedic Institute, please send an email to orthoresearch@geisinger.edu.

METRC Satellite Clinic Selection

Geisinger Orthopaedic Institute was approved as a Major Extremity Trauma Research Consortium (METRC) Satellite Clinical Site in July 2012, and hopes to soon be enrolling in two METRC clinical studies: the Antibacterial Plate Sleeves (APS) study and the OUTLET study.

METRC was established in September of 2009 with funding from the Department of Defense (DOD). It consists of a network of clinical centers and one data-coordinating center that works together with the DOD to conduct multicenter clinical research studies relevant to the treatment and outcomes of orthopaedic trauma sustained in the military. The overall goal of the consortium is to produce the evidence needed to establish treatment guidelines for the optimal care and outcomes of service members and civilians who sustain high-energy trauma to the extremities.

Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) Project

"Each year, more than 700,000 adults in the United States elect total knee replacement (TKR) or total hip replacement (THR) surgery to restore physical function and eliminate the persistent pain of advanced knee or hip arthritis," says Dr. Suk. "By 2030, primary and revision TKR and THR use is projected to grow significantly, especially among patients under 65 years of age."

Presently there is wide variation in TKR and THR implant selection, surgical approach, post-surgery functional improvement and implant revision rates. The majority of existing research is retrospective and limited to the Medicare population.

The FORCE-TJR project focuses on working adults under 65 years of age. Its goals are to:

  • Guide decisions on optimal implant timing, surgical approach, implant selection and perioperative management,
  • Decrease complications and improve implant longevity and function following surgery, and
  • Inform policy to reach currently underserved minority populations.

Geisinger has enrolled at least 1,478 patients for this project.

Geisinger Poised to Conduct Musculoskeletal Outcomes Research

Through the 2010 Affordable Care Act, legislation established the Patient-Centered Outcomes Research Institute. It is anticipated that much of future research will be orthopaedic in nature, so it is important to be able to provide critical input on the clinical effectiveness and appropriateness of medical treatments and services. Dr. Suk is the lead author of one of the only textbooks of musculoskeletal outcomes, instruments and measures, positioning Geisinger to quickly establish a Center for Musculoskeletal Outcomes Research.

"We can harness the electronic medical record for epidemiologic data to help identify trends in musculoskeletal disease, track clinical outcomes and develop registries," says Dr. Suk. "These are just a few obvious things that can be a critical component of our efforts to continually seek ways to improve and maximize Geisinger's competitive edge."

Bucknell University Collaboration

Bucknell University and Geisinger Health System jointly provide financial support for collaborative healthcare research projects between Bucknell faculty and staff, and Geisinger physicians and scientists. "The primary focus of this competitive funding opportunity is to encourage and enhance collaborative efforts that target the areas of medical devices, neuroscience or high performance computing in relation to current healthcare challenges," says Michael Suk, MD, JD, MPH, chairman, department of orthopaedic surgery at Geisinger Health System and orthopaedic trauma surgeon. "A secondary focus is to provide mechanisms for the establishment of collaborative interactions that have lasting potential."

A proposal submitted by James Widmaier, MD, Geisinger orthopaedic surgeon; Adam Lee, MD, Geisinger orthopaedic resident; and Sarah Manoogian, MD, Bucknell Department of Mechanical Engineering, was awarded the Bucknell-Geisinger Research Initiative grant in 2013. The study is entitled, "Methodology for determining the relationship between surgical drill parameters and bone temperature."

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Resources

Geisinger Orthopaedic Institute encourages patients and physicians to learn as much as possible about current research that may relate to their diagnosis or their patients.

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Research Fellows

Amrut Borade, MD, international research fellow

Amrut Borade, MD, joined the orthopaedic research group at Geisinger Medical Center from the Division of Shoulder Surgery at Johns Hopkins Hospital, Baltimore, Md., where he worked as a clinical research fellow. Prior to that, Dr. Borade worked as a registrar at Hinduhrudaya Samrat Balasaheb Thackeray Hospital & Trauma Centre, Jogeshwari, Mumbai-400060, and also as a registrar (senior resident) at Seth G.S. Medical College & K.E.M. Hospital, Mumbai-400012, Maharashtra, India. Dr. Borade is a 2008 graduate from Seth G. S. Medical College and K.E.M. Hospital Parel, Mumbai – 400012, and completed his residency in 2013 from S.M.S. Medical College & Hospital, Jaipur-302004, Rajasthan, India. He has numerous international merits and accomplishments in his career so far, and is continuing to conduct and publish peer reviewed clinical research in the orthopaedic field.

Daniela Morales-Sanchez, MD, international research fellow

Daniela Morales-Sanchez, MD, joined the orthopaedic research group at Geisinger Medical Center from Hospital Universitario Fundación Santa Fe de Bogotá, Orthopaedic Trauma Service, where she assisted with the creation, implementation, analysis and follow-up for the geriatric fracture center while also working as a research assistant in the orthopaedic trauma service. Prior to that, Dr. Sanchez worked as a graduate teacher assistant in forensic and legal medicine. Dr. Daniela is a 2008 graduate from The English School in Bogota, Columbia and she received her Doctor of Medicine in 2015 from Universidad de los Andes – Bogotá, Colombia. She has participated in international grant funded research studies, and is looking forward to conducting and publishing her orthopaedic clinical research.

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Research Fellow Alumni

Kann Irgit, MD, international research fellow

Kaan Irgit, MD, joined the orthopaedic research group at Geisinger Medical Center in June 2011 from Cankaya Hospital, Ankara, Turkey. Dr. Irgit was a 1999 graduate of Dokuz Eylul Medical School and completed his orthopaedic residency in 2005. He is also a member of Turkish National Society of Foot and Ankle Surgeons and Turkish National Society of Arthroscopy, Knee Surgery & Orthopaedic Sports. While at Geisinger, Dr. Irgit conducted and published peer reviewed clinical research with an emphasis on orthopaedic trauma injuries. He was also involved with implementing and improving standardized treatment protocols for various traumatic orthopaedic injuries.

Since completing his research fellowship at Geisinger in June 2012, Dr. Irgit has moved on to become a practitioner of orthopaedics at the Ozel Medicabil Hastanesi in the Bursa Providence of Turkey.

Harish Kempegowda, MD, international research fellow

Harish Kempegowda, MD, joined the orthopaedic research group at Geisinger Medical Center from Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, India. Earlier he worked as an assistant professor in Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, India. He has been honored with a gold medal for securing highest marks in M.S. (orthopaedics residency) from the Maharashtra University of Health Sciences for 2013. Dr. Harish is a 2009 graduate of Mysore Medical College and completed his residency in 2013 from TNMC & Nair Hospital, Mumbai.

Currently he is an active member of Bombay Orthopaedic Society and Indian Orthopaedic Research Group. He has given numerous lectures and paper presentation in various national and international conferences. Dr. Harish continues conducting and publishing peer reviewed clinical research with an emphasis on orthopaedic trauma injuries.

Hemil Maniar, MD, international research fellow

Hemil Maniar, MD, joined the orthopaedic research team from Mumbai, India in May 2013. He graduated from medical school and completed his internship in 2007 from L.T.M. Medical College, Mumbai, after which he joined an orthopaedic residency and graduated in 2011 from T.N. Medical College, Mumbai, a level I trauma center. His interest in traumatic injuries of the extremities and spine encouraged him to seek for further education in these subspecialties. He is a lifetime member of Bombay Orthopaedic Society, Indian Orthopaedic Association and Indian Society for Trauma and Acute Care as well as international organizations like AO Spine and Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT).

Dr. Maniar's keen interest in orthopaedic trauma was reflected in his work here at Geisinger which led to initiation and completion of multiple projects including some basic science studies and clinical research. He was actively involved in maintaining the orthoapedic trauma registry, a database of all trauma cases operated here at Geisinger. He completed his research fellowship at Geisinger in July 2014 with multiple articles submitted for peer review as well as podium presentations in prestigious conferences.

Dr. Maniar's stint at Geisinger was instrumental towards realizing his goal of obtaining clinical training in the United States as he left to pursue a clinical trauma fellowship at University of Louisville, Kentucky.

Kristin McPhillips, MD, research fellow

Kristin McPhillips, MD, joined the orthopaedic research team in July 2013. After graduating from the Albany Medical College in Albany, N.Y., Dr. McPhillips completed her residency in the Department of General Surgery at the University of Virginia Hospital, in Charlottesville, Va. Her work in the department spawned an interest in orthopaedic trauma.

During Dr. McPhillips' fellowship at Geisinger she was able to contribute to several different research projects and helped to maintain the orthopaedic trauma registry. She completed her research fellowship in May 2014 and has moved on to the department of general surgery at Memorial Health Medical Center in Savannah, Ga.

Richard Raveesh, MD, research fellow

Richard Raveesh, MD, joined the orthopaedic research team July 2012 after graduating from the University of Miami Miller School Of Medicine, Miami, Florida, and completing an internship in the general surgery department at the University of Texas. Upon completion of his internship he was able to pursue his interest in orthopaedic trauma here at Geisinger.

During Dr. Raveesh's fellowship at Geisinger, he was able to contribute to several different research projects. He completed his fellowship in July 2013 and moved on to become a resident in the Geisinger Orthopaedics Department.

Akhil Tawari, MD, international research fellow

Akhil Tawari, MD, joined the orthopaedic research group at the Geisinger Medical Center from Lokmanya Tilak Municipal Medical College and General Hospital (LTMMC & LTMGH), Mumbai, India. Dr. Tawari completed his graduation in 2009 and orthopaedic residency (M.S. Orthopaedics) in 2012, both from LTMMC & LTMGH. He has gained considerable experience in orthopaedic trauma while working at LTMMC & LTMGH which has one of highest trauma loads in the country. He is a 2013 Diplomat National Boards (DNB)-Orthopaedics and an active member of the Bombay Orthopaedic Society as well as the Indian Orthopaedic Research Group.

Dr. Tawari has presented numerous papers and posters at various national and international conferences pertaining to the subspecialty of orthopaedic trauma and spine surgeries. He is involved in multiple research projects especially relating to orthopaedic trauma at the Geisinger Medical Centre. Dr. Tawari is hopeful that the experience gained at the Geisinger Medical Center will help him to conduct breakthrough research in his country.

 

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Contact Us

Geisinger Medical Center
100 North Academy Ave.
Danville, PA 17822
Tel: 570-271-6211

Geisinger Wyoming Valley
1000 E. Mountain Blvd.
Wilkes-Barre, PA
Tel:570-808-7300
 
Geisinger Woodbine Outpatient Clinic
115 Woodbine Lane
Danville, PA 17822
Tel: 570-271-6621

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