Annual Report 2010 - 2011

DEPARTMENT OF ORTHOPAEDICS

CLINICAL: For fiscal year 2011, the Department of Orthopaedics had 7,849 cases, a 1.2% increase from FY10.  The number of visits increased 10.5% at 62,511 throughout 7 locations, with work RVUs at 212,977, a 5% increase from 2010.  The Department has expanded to include Greensboro and Lexington locations for targeted orthopaedic services.  Additionally, physicians provide coverage for orthopaedic needs at the Veterans Hospital in Salisbury. 

Fourteen faculty members were chosen this year for Best Doctors in America. All aspects of subspecialty care—sports medicine; adult reconstruction, oncology; hand; foot and ankle; spine; pediatric orthopaedics—have continued to expand and provide additional services.  In order to enhance musculoskeletal care and improve patient access for nonoperative conditions, Dr. Mathew Ravish, a pediatrician, specializing in nonoperative pediatric orthopaedics and Dr. Tadhg O’Gara, a nonoperative spine physician joined the practice.  Additionally, Dr. Ishaq Syed joined the practice to expand operative spine care.

Specialized care includes refinements in limb salvage, development and testing of new joint arthroplasty procedures, the development of upper extremity fixation devices to improve outcomes in hand deformity and after‑fracture, novel arthroscopic techniques, multi‑modal management of cerebral palsy and related disorders, and state-of-the-art trauma management.  The operating rooms are equipped with the latest digital equipment to support these services, thus adding to the efficiency of patient care and strengthening our teaching program.

Innovative orthopaedic surgical services include total joint procedures and joint conservation service, total ankle replacements, improved diabetic foot care, correction of congenital spine deformity, computer navigated joint replacement, brachial plexus surgery, pediatric and adult minimally invasive fracture stabilization in trauma, and minimally invasive procedures in every orthopaedic subspecialty.  Additionally, the hip arthroscopy program has grown in 2010-2011, providing state-of- the art outpatient hip care.

ACADEMIC:  For fiscal year 2012, The Department of Orthopaedics has 24 residents and 6 fellows. The Department of Orthopaedic Surgery has developed several projects with investigators from other medical center departments.  Collaborative efforts involve projects with the Center for Nanotechnology to expand the understanding of the indolence of osteomyelitis and the development of innovative measurements of interstitial pressure in muscle compartments.  The Orthopaedic Research Lab is also expanding its biomechanical testing capabilities.  In conjunction with the Department of Biomedical Engineering, faculty and residents have been involved in several collaborative studies using biomechanical testing to study different types of fixation for Achilles tendon repair and testing cadaveric femurs to study the effects of core decompression.  Other studies are using mathematical modeling to study rotator cuff injuries.   Walton Curl, MD serves on the advisory board for the WFUBMC Center for Integrative Medicine.  Jason Lang, MD is working with others in the Center on an ongoing research project in using Guided Imagery with TJ patients to decrease pain and decrease anxiety in Total Hip patients

Collaborations with the Wake Forest Institute for Regenerative Medicine are developing biological scaffolds for tendon, ligament, and meniscus repair.  Additional Wake Forest Institute for Regenerative Medicine (WFIRM) collaborations include studies to facilitate nerve repairs and heal boney defects.   Cristin Ferguson, MD ( sports Medicine) , one of our  surgeon scientists, received a prestigeous  K-1 award and continues outstanding work in developing novel tissue -engineered constructs for knee reconstruction.

The Department of Orthopaedic Surgery has partnered with KeraNetics LLC, a company investigating the use of novel biomaterials (keratin) to promote nerve regeneration and bone growth.  Studies are underway in a primate model to determine if keratin hydrogel containing nerve guides promote nerve regeneration of the median nerve.   Over  two million dollars in funding was received from the Department of Defense (Z. Li, MD, PhD - Hand and Upper Extremity) for a   randomized-controlled multicenter  clinical study to evaluate the use of keratin filled conduits in patients with peripheral nerve injuries.  Additional animal model studies are evaluating the use of biomaterials as a resuscitation fluid.  Dr. Li  also has developed a rat model to study the changes in muscle and bone in the shoulder in order to develop an understanding of the natural history of anatomical changes related to brachial plexus birth palsy. 

The Human Performance and Biodynamics Laboratory represents collaboration between Winston-Salem State University (WSSU) and Wake Forest University School of Medicine (WFUSM).  Its primary focus is to use three-dimensional motion capture technology to quantitatively evaluate clinical outcomes and to support the teaching and education missions of both.  Specific research areas include evaluation of gait in children with cerebral palsy, measuring performance differences in orthopaedic implants, testing of proprioception and balance control before and after orthopaedic interventions, and measuring and evaluating rehabilitation programs.