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University of Pennsylvania Department of Orthopaedic Surgery

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Alexis Greenhut, BS. Basic Science. Louis Soslowsky, PhD. Director of McKay Orthopaedic Laboratory ... Kelsey Seybold Clinic, TX. Larkin Community, FL. Las ... – PowerPoint PPT presentation

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Title: University of Pennsylvania Department of Orthopaedic Surgery


1
University of Pennsylvania Department of
Orthopaedic Surgery
Shoulder and Elbow Service
2
UPHS Hospitals
  • Presbyterian Hospital
  • Hospital of the University of Pennsylvania
  • Pennsylvania Hospital
  • Veterans Affairs Hospital
  • Assoc. with Childrens Hospital of Philadelphia

3
Presbyterian Medical Center
  • www.pennhealth.com/presby

4
Tradition of Orthopaedic Excellence
  • 1889 First free-standing Department of
    Orthopaedic Surgery in the US
  • 273 trained residents
  • 48 residents with academic rank
  • 8 chairmen

5
Orthopaedic Services
6
University of Pennsylvania Residency Program
  • 42 Residents
  • 8 per year
  • 2 in McKay Labs
  • 24 Full-time clinical faculty
  • Five hospitals
  • University of Pennsylvania (HUP)
  • Presbyterian (Presby)
  • Childrens Hospital of Philadelphia (CHOP)
  • Veteran's Affairs (VA)
  • Pennsylvania Hospital (PAH)

7
Residents Medical Schools
  • Penn
  • U of Virginia
  • Georgetown
  • Utah
  • U of Florida
  • Wayne State
  • Northwestern
  • Pitt
  • Harvard
  • Medical College of Ohio
  • SUNY Brooklyn
  • Albany
  • Boston U
  • Finch U of Health Sci
  • UT-Southwestern
  • LSU
  • Yale
  • Temple
  • UMDNJ
  • Vanderbilt
  • Drexel
  • Jefferson
  • Mt. Sinai
  • USC
  • Cornell

8
Shoulder and Elbow Service
  • 27 trained fellows to present date

9
Shoulder and Elbow Faculty
  • Joseph Iannotti MD, PhD
  • Past Director
  • Dr. Gerald Williams MD
  • Current Director

10
Joseph Iannotti, MD, PhD
  • Current chairman of the Orthopaedic Department at
    the Cleveland Clinic Foundation

11
Shoulder and Elbow Faculty
  • Gerald Williams, MD
  • Matthew Ramsey, MD
  • David Glaser, MD

12
Shoulder and Elbow Faculty
  • Gerald Williams
  • Director of Shoulder and Elbow Service
  • AAOS Board of Directors (02-04)
  • Matthew Ramsey, MD
  • Director of Elbow service
  • Only fellowship trained elbow program associated
    with a fellowship trained shoulder program
  • David Glaser, MD
  • Clinician Scientist
  • Louis Soslowsky, PhD
  • Director of McKay Research Laboratory

13
Upper Extremity Service
  • Dr. Williams
  • Shoulder
  • Dr. Ramsey
  • Shoulder and Elbow
  • Dr. Glaser
  • Shoulder and Elbow
  • Dr. Bozentka
  • Hand and Elbow
  • Dr. Beredjiklian
  • Hand, Elbow
  • Dr. Steinberg
  • Hand and Elbow
  • Dr. Stein
  • PMR
  • Dr. Chou
  • PMR
  • Dr. Sennnett
  • Sports Medicine
  • Dr. Hoffman
  • Sports Medicine
  • Dr. Webner
  • Family Med, Sports Med, Shoulder
  • Dr. Gentchos
  • General

14
History of the Shoulder and Elbow Service
  • 1986 Shoulder and Elbow Service started by
  • Joseph Ianotti, MD, PhD
  • 1987 Shoulder and Elbow Fellowship program
  • started by Joseph Ianotti, MD, PhD
  • 1991 Gerald Williams, MD joined the service
  • Completed fellowship with Charles Rockwood, MD

15
History of the Shoulder and Elbow Service
  • 1991 Gerald Williams, MD joined the service
  • Completed fellowship with Charles Rockwood, MD
  • 1998 Louis Soslowsky, PhD
  • started as the director of the McKay Basic
    Science Research Laboratory
  • 1998 Matthew Ramsey, MD joined service
  • Completed shoulder and elbow fellowship at Penn
  • Completed elbow training at the Mayo Clinic

16
History of the Shoulder and Elbow Service
  • 2001 David Glaser, MD joined service
  • Completed shoulder and elbow fellowship at Penn
  • 2003 Kenneth Rogers, PhD, ATC joined service
  • Director of clinical research and outcomes

17
Awards to Shoulder and Elbow Faculty
  • Neer Award 1996 (Williams and Iannotti) and
    2001 (Williams and Ramsey)
  • ASES European Exchange Fellow
  • ORS New Investigator
  • OREF Clinician-Scientist Award
  • North American Traveling Fellowship

18
Grants
  • NIH Grants
  • Aircast
  • OREF
  • Whitaker Foundation
  • Selective Genetics
  • Cali Foundation
  • McCabe Foundation

19
Upper Extremity Service
  • Integration of Services / Departments
  • Orthopaedics
  • Shoulder and Elbow
  • Hand
  • Sports Medicine
  • Physical Medicine and Rehabilitation
  • Electrodiagnostic
  • Physical Therapy
  • Occupational Therapy
  • Family Medicine

20
Upper Extremity Service
  • Vision
  • Prevention
  • Diagnosis
  • Treatment
  • Rehabilitation
  • Outcomes

21
Shoulder and Elbow Research Staff
  • Clinical Research
  • Dr. Kenneth Rogers, PhD, ATC
  • Alexis Greenhut, BS
  • Basic Science
  • Louis Soslowsky, PhD
  • Director of McKay Orthopaedic Laboratory
  • Vice Chair of Research Orthopaedic Department

22
Current Research Projects
  • Nerve conduction monitoring during elbow
    contracture release surgery
  • Nerve conduction monitoring during shoulder
    replacement surgery
  • Cellular Examination of Healing Musculoskeletal
    Tissue Following BMT
  • Humeral fracture nonunion - biomechanics study
  • Functional Outcome Following the Repair of the
    Distal Biceps Tendon
  • Frozen Shoulder - efficacy of treatment
    injection and therapy with injection

23
Current Research Projects
  • Proximal Humerus 4 part valgus fractures
  • Proximal Humerus Percutaneous Pinning
  • Scapula Fracture - Operative and Non-operative
    treatment
  • The Tension Required at Repair To Re-Appose the
    Supraspinatus Tendon to Bone Rapidly Increases
    Following Injury
  • Post-Operative Immobilization Improves Tendon to
    Bone Healing of the Rotator Cuff

24
Clinical and Basic Science Research Efforts
  • Coordinated with the Physical Medicine and
    Rehabilitation department, Family Medicine
    department, Hand, and Sports Medicine services of
    the Orthopaedic department
  • McKay Orthopaedic Lab
  • Musculoskeletal Research Core
  • Radiology Department
  • Genomics Department
  • Biomechanics Department
  • Engineering Department

25
Publication Record
  • Journal of Bone and Joint Service
  • American Journal of Sports Medicine
  • American Society of Shoulder and Elbow Surgery
  • Clinical Orthopaedics and Related Research
  • Sports Medicine and Arthroscopic Review
  • Physical Therapy
  • Journal of Orthopaedic and Sports Physical Therapy

26
Publication Record
  • Books
  • Chapters
  • Abstracts and Posters
  • AAOS
  • AANA
  • AAOSM
  • ICSS
  • ASES
  • APTA
  • NATA

27
Area of Research
  • Basic Science
  • Soft Tissue Healing
  • Fracture Healing
  • Fracture Treatment
  • Clinical Science
  • Surgical Clinical Outcomes
  • Treatment Clinical Outcomes
  • Evidence Based Medicine

28
Faculty Presentations
  • International
  • International Congress for Shoulder Surgery
  • National
  • AAOS
  • National Meeting and Instructional
  • Course Lectures
  • ASES
  • AANA
  • Local
  • Pennsylvania Orthopaedic Society
  • Philadelphia Orthopaedic Society

29
Faculty Service
  • National
  • AAOS
  • ASES
  • Local
  • Pennsylvania Orthopaedic Society
  • Philadelphia Orthopaedic Society

30
Shoulder and Elbow Fellowship Application
Process
  • Between 15 25 applicants per year
  • 10 - 20 applicants interviewed
  • 1-2 sessions
  • 3 attendings, 2 fellows, 1 resident
  • 4 rooms
  • Positions available
  • Two 1-year slots

31
Fellowship Paperwork
  • Match Program
  • Cover Letter
  • ASES Shoulder Fellowship Application
  • Transcripts
  • Curriculum Vita
  • 3 Letters of Recommendation
  • Scores
  • Jpeg photo at interview
  • All information is sent to Barb OConnor

32
Fellowship Offer
  • ASES Fellowship Match Program

33
Fellowship Acceptance
  • Formal letter of agreement
  • Provided with contact names to clear hurdles
  • UPHS system requirements
  • State requirements

34
Shoulder and Elbow Fellow Residency Programs
  • Mount Sinai
  • Royal College of Surgeons
  • Rush - Presbyterian St. Lukes
  • Summa Health System
  • Thomas Jefferson
  • Univ. of Miami
  • University of Colorado
  • Univ. of Pennsylvania
  • Washington University
  • Akron City Hospital
  • Brown University
  • Carolinas Medical Center
  • Case Western Reserve
  • Cleveland Clinic Foundation
  • George Washington
  • Kingston General
  • Long Island Jewish
  • Loyola University

35
Shoulder and Elbow Fellowship Placement
  • Academic Institutions
  • Community Based Hospitals
  • Private Practice

36
Shoulder and Elbow Post Fellowship Placement
  • Las Vegas Orthopaedics
  • Loyola University Medical Center
  • Mount Sinai Hospital
  • St. Anthonys, CO
  • St. Marys, TN
  • Stevens Orthopedic Group, WA
  • University of Arkansas
  • University of Penn
  • Washington University
  • Aurora Health Care, CO
  • Blue Ridge Orthopaedics, VA
  • Carolinas Medical Center
  • Coral Gables Hospital, FL
  • Fallon Community Health, MA
  • Good Samaritan, PA
  • Grand River Med. Ctr, CO
  • Kelsey Seybold Clinic, TX
  • Larkin Community, FL

37
Fellowship Benefits
  • Health
  • Dental
  • Disability
  • Malpractice
  • On-call meals
  • Parking on-site
  • White coats
  • UPHS E-mail
  • Access to Penn Libraries
  • Vacations
  • three non-consecutive weeks (21 days)
  • Salary
  • 45,000
  • Minor adjustments for inflation

38
Conferences
  • 1 meeting per year approved by Fellowship
    Director

39
The Alumni Retreat
  • Combined University of Pennsylvania and Cleveland
    Clinic Fellowship Programs

40
Fellowship Rotation
  • Three month rotation per surgeon
  • Williams
  • Ramsey
  • Glaser surgery coverage with increase in
  • clinical office demand
  • Three office locations
  • Presbyterian 1x per week per surgeon
  • Cherry Hill 2 x per month with Dr. Ramsey
  • Radnor 1x week with Dr. Williams
  • 2 x per month with Dr. Ramsey

41
Resident PGY 2 Coverage
  • Upper extremity
  • 6 weeks _at_ Presby
  • Drs. Williams, Ramsey Glaser

42
Resident PGY 5 Coverage
  • Upper Extremity
  • 6 weeks _at_ Presby
  • Drs. Williams, Ramsey, Glaser

43
Call Schedule
  • No call schedule

44
Surgery Coverage
  • Dr. Glaser 1 day per week
  • Dr. Ramsey 2 days per week
  • Dr. Williams 2 days per week

45
Source Case Volume
  • Level I Trauma Center
  • Tertiary referral center
  • Wide range of cases
  • Total cases ? 1200 / year
  • 65 - Shoulder
  • 35 - Elbow

46
Operative Cases
  • Shoulder
  • Rotator Cuff
  • 150 per fellow per year
  • 80 Arthroscopic
  • 20 Open
  • Arthroplasty
  • 100 per fellow per year
  • Instability
  • 70 per fellow per year
  • 80 Arthroscopic
  • 20 Open
  • Fractures
  • 30 per fellow per year
  • Open and percutaneous
  • Tendon Transfers
  • 5-10 per fellow per year

47
Operative Cases
  • Elbow
  • Ligament Reconstruction
  • 20 per fellow per year
  • Arthroplasty
  • 10 per fellow per year
  • Fractures
  • 50 per fellow per year
  • Open
  • Stiffness/Contracture
  • 30 per fellow per year
  • 50 Arthroscopic
  • 50 Open

48
Weekly Didactic Conferences
  • Upper Extremity Conference
  • Wednesday, 530 PM at Presby
  • One to Two presentations per year
  • Attendings, Fellows, Residents, Allied Health
    staff, and other staff are present

49
Monthly Research Conferences
  • Meet every Second Tuesday of every month
  • New research project proposal
  • Review research projects
  • Discuss research issues

50
Grand Rounds
  • Thursday, 730 AM at HUP
  • Speakers
  • Dr. Rockwood
  • Dr. Boden
  • Dr. Mankin
  • Dr. Beatty
  • Dr. Morrey
  • UPHS Faculty
  • Fellows invited to dinner with faculty and Grand
    Rounds speaker

51
Grand Rounds
  • Ernest Gentchos Lecture
  • Prominent speaker on Shoulder and Elbow topic

52
Physical Therapy
  • Outpatient
  • Located on the same floor as the clinic offices
  • Home program
  • Formalized Program
  • Research Collaboration
  • Works closely with physician during clinic hours

53
Occupational Therapy
  • Outpatient
  • Located on the same floor as clinic offices
  • Home program
  • Formalized Program
  • Research Collaboration
  • Works closely with physician during clinic hours

54
Physician Assistant
  • One PA for each Dr. Williams and Dr. Ramsey
  • Work closely with the fellow during rotations
    with each physician
  • Patient management
  • Clinical management
  • Post-op management
  • Calls from patient

55
McKay Orthopaedic Labs
  • 3rd largest NIH funded Orthopaedic Research Lab
  • Annual budget 4 million
  • 15 out of 15 abstracts accepted to 2003 ORS
    meeting
  • Over 50 staff and trainees

56
McKay Orthopaedic Labs
  • Faculty
  • Dr. Soslowsky, Director
  • Dr. Kaplan, Director
  • Dr. Elliot
  • Dr. Shore
  • Dr. Clark
  • Dr. Nicoll
  • Dr. Friedenberg
  • Dr. Brighton
  • Dr. Glaser

57
McKay Orthopaedic Labs
  • Research areas
  • Biomechanics
  • Biomaterials
  • Tissue engineering
  • Tissue culture
  • Biochemistry
  • Cell Molecular Bio
  • Histology
  • Microscopy
  • Animal Studies

58
McKay Orthopaedic Labs
  • Current projects
  • Rotator Cuff Injury Model
  • SIS
  • Overuse
  • BMP signaling
  • FOP
  • Tendon Healing
  • Genetic mice
  • Fetal tissue
  • Degenerative Disc Disease
  • http//www.uphs.upenn.edu/orl/

59
McKay Orthopaedic Labs
  • Clinical faculty involvement
  • Two orthopaedic surgery residents / year enter
    lab after PGY-2
  • Basic science research opportunities available

60
Philadelphia Ortho Society
  • Excellent Speakers (2002-2003)
  • Dr. Poka
  • Dr. Salvati
  • Dr. Iannotti
  • Dr. Torg
  • Dr. Goldberg
  • Resident Bowl
  • Meet attendings and residents from the area in a
    social setting
  • Free for residents

61
UPOJ
  • University of Pennsylvania Orthopaedic Journal
  • Entirely resident organized
  • Peer-reviewed
  • Distribution of 1500
  • Penn Tradition

http//www.uphs.upenn.edu/ortho/oj/
62
Fitness (clear your head)
  • Gyms
  • Penn Campus
  • Gimbel
  • Hutchinson
  • Sweat
  • Worlds
  • 12th Street

63
Philadelphia
http//www.gophila.com
64
Philadelphia History
  • Independence Hall
  • Liberty Bell
  • Carpenters Hall
  • 1st Federal Reserve Bank
  • Betsy Ross House
  • Reading Terminal
  • Italian Market
  • Constitution Center
  • Home of the Cheesesteak

65
Philadelphia Neighborhoods
  • Rittenhouse Square
  • Manayunk
  • Society Hill
  • China Town
  • Center City
  • University City
  • Washington Square
  • South Philly
  • The Northeast

66
Philadelphia Museums
  • Rodin Museum
  • Philadelphia Museum of Art
  • Franklin Institute
  • Academy of Natural Sciences
  • Mütter Museum

67
Philadelphia Sports
68
Philadelphia Sights Sounds
69
Additional Information
  • Barbara OConnor
  • 215.349.8851
  • penn.ortho.shoulderelbow_at_uphs.upenn.edu
  • Department of Orthopaedic Surgery
  • Presbyterian Medical Center UPHS
  • 39th and Market Streets
  • 1 Cupp Pavilion
  • Philadelphia, PA 19104

70
University of Pennsylvania Department of
Orthopaedic Surgery Shoulder and Elbow Service
Training Tomorrows Leaders Today …
71
(No Transcript)
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