Volume 24, Spring 2014

Letter from the Editors-in-Chief
Vishal Saxena, Joshua A. Gordon

Dedication to Dr. Ernest J. Gentchos
Vishal Saxena, Joshua A. Gordon

Letter from the Dedicated
Ernest J. Gentchos

Letter from the Chairman
L. Scott Levin

Letter from the Program Director
Craig L. Israelite

Clinical Articles

Penn Presbyterian Medical Center Hip and Knee Risk Reduction Program Overview
Eric L. Hume, Atul F. Kamath, P. Maxwell Courtney, Finnah Pio, Laura Kosseim, Craig L. Israelite

Multimodal Analgesia for Total Joint Arthroplasty
Rosemary MG Hogg, Jiabin Liu, Eric Hume, Nabil M. Elkassabany

An Analysis of the Demographic and Technical Characteristics Associated with Iliac Cortical Perforation During Insertion of Iliosacral Screws
J. Stuart Melvin, Nicholas Pulos, Keith Baldwin, Amer Mirza, Michael J. Gardner, Samir Mehta

Safety of Bilateral Total Knee Arthroplasty: Simultaneous Versus Staged at a Week Interval
P. Maxwell Courtney, Christopher M. Melnic, Hassan Alosh, Roshan P. Shah, Charles L. Nelson, Craig L. Israelite

Strategies and Application of Ankle-Spanning Multiplanar External Fixators
Ryan M. Taylor, Matthew P. Sullivan, Derek J. Donegan, Jaimo Ahn, Samir Mehta

Length, Alignment, and Rotation: Operative Techniques for Intramedullary Nailing of the Comminuted, Diaphyseal Femur Fracture
Matthew P. Sullivan, Ryan M. Taylor, Derek J. Donegan, Samir Mehta, Jaimo Ahn

Treatment of Thumb Basal Joint Arthritis With Hematoma and Distraction Arthroplasty Compared to LRTI in a Predominantly Male Population
Stephen Y. Liu, Christina F. Endress, David R. Steinberg

Functional Knee Outcomes in Suprapatellar and Infrapatellar Tibial Nailing: Does Approach Matter?
P. Maxwell Courtney, Anthony Boniello, Derek J. Donegan, Jaimo Ahn, Samir Mehta

Anterior Hip Dislocation Five Months After Hip Arthroscopy: A Case Report and Review of the Literature
Daniel C. Austin, John G. Horneff III, John D. Kelly IV

Intraoperative Use of Rib-to-Pelvis Traction to Correct Pelvic Obliquity in the Neuromuscular Spine
Martin J. Morrison III, John M. Flynn

Arthroscopic-Assisted Reduction and Buttress Fixation of Tibial Plateau Fracture Using a Bioabsorbable Interference Screw
Pramod B. Voleti, Surena Namdari, John D. Kelly IV

Balanced Cranial Suspension for Intraoperative Correction of Cervical Kyphosis
Michael T. Talerico, Venus Vakhshori, Andrew H. Milby, Adam T. Griska, Harvey E. Smith, Vincent M. Arlet

Idiopathic Avulsion Fractures of the Lesser Trochanter in Pediatric Patients
Christine M. Goodbody, Wudbhav N. Sankar

Core Decompression Surgery for Avascular Necrosis Can Delay Femoral Head Collapse in Patients with Sickle Cell Disease: A Case Report
Afamefuna Nduaguba, Christine Goodbody, Wudbhav N. Sankar, Lawrence Wells

Operative Technique:Arthroscopic Repair of Massive Rotator Cuff Tears
Michael H. McGraw, John D. Kelly IV

Displaced Inferior Ramus Fractures as a Marker for Pelvic Instability
P. Maxwell Courtney, Ryan M. Taylor, John Scolaro, Derek J. Donegan, Samir Mehta

Alternative Protocol for Heterotopic Ossification Prophylaxis in Posterior Approaches for Acetabulum Fractures
Deren T. Bagsby, Karl Shively, Brian H. Mullis

EOS Imaging: Insight Into This Emerging Musculoskeletal Imaging System
Emmanouil Grigoriou, Saba Pasha, John P. Dormans

For Patients With Impingement Syndrome, is the Acromion Innocent?
Shawn Bifano, Kevin B. Freedman, Joseph Bernstein, Fotios Tjoumakaris

Basic Science

Biomechanics of Ligament and Tendon

Overuse Following a Large Rotator Cuff Tear Alters Trabecular Bone Architecture but Not Glenoid Curvature in a Rat Model
Michael W. Hast, Sarah Yannascoli, George W. Fryhofer, Wei-Ju Tseng, Allison Altman, X. Sherry Liu, Louis J. Soslowsky

Collagen V Null Mice Have Decreased ACL Mechanical Properties and Altered Fibril Morphology
Brianne K. Connizzo, Benjamin R. Freedman, Mei Sun, David E. Birk, Louis J. Soslowsky

Evaluating Changes in Tendon Crimp with Fatigue Loading as an Ex Vivo Structural Assessment of Tendon Damage
Benjamin R. Freedman, Andrey Zuskov, Joseph J. Sarver, Mark R. Buckley, Akash Kumar, Louis J. Soslowsky

Scapular Dyskinesis is Detrimental to Shoulder Tendon Properties and Joint Mechanics in a Rat Model
Katherine E. Reuther, Stephen J. Thomas, Jennica J. Tucker, Sarah M. Yannascoli, Adam C. Caro, Rameen P. Vafa, Andrew F. Kuntz, Louis J. Soslowsky

The Effect of Type II Diabetes on Native Mechanical and Biologic Shoulder Joint Properties in a Rat Model
Stephen J. Thomas, Joseph J. Sarver, Sarah Yannascoli, Jennica J. Tucker, John D. Kelly IV, Rexford A. Ahima, Mary F. Barbe, Louis J. Soslowsky

Exercise Protocol Induces Muscle,Tendon, and Bone Adaptations in the Rat Shoulder
Sarah I. Rooney, Emanuele Loro, Joseph J. Sarver, Cathryn D. Peltz, Michael W. Hast, Wei-Ju Tseng, X. Sherry Liu, Tejvir S. Khurana, Louis J. Soslowsky

Intra-Articular Tibiofemoral Injection of a Nonsteroidal Anti-Inflammatory Drug has no Detrimental Effects on Joint Mechanics in a Rat Model
Corinne N. Riggin, Jennica J. Tucker, Louis J. Soslowsky, Andrew F. Kuntz

Alterations in the Mechanical Properties of Patellar Tendons in Bone Sialoprotein-Null Mice
Andrey Zuskov, Andrew A. Dunkman, Yohannes Soenjaya, Benjamin R. Freedman, Louis J. Soslowsky, Harvey A. Goldberg

Musculoskeletal Tissue Engineering

Trajectory-Based Tissue Engineering for Cartilage Repair: Impact of Maturation State and Rate on Integration Potential
Matthew B. Fisher, Nicole Soegaard, Elizabeth A. Henning, George R. Dodge, David R. Steinberg, Robert L. Mauck

Enhanced Nutrient Transport Improves Depth-Dependent Properties of a Tri-layered HA Construct With Zonal Co-culture of Chondrocytes and MSCs
Minwook Kim, Jason A. Burdick, Robert L. Mauck

A Radiopaque Electrospun Scaffold for Engineering Fibrous Tissues: Characterization and In Vivo Application
John T. Martin, Andrew H. Milby, Subash Poudel, Christian G. Pfeifer, Harvey E. Smith, Dawn M. Elliott, Robert L. Mauck

Validation and Screening in a High Throughput Mechanical Injury Model of Engineered Cartilage
Bhavana Mohanraj, Greg R. Meloni, Rodolfo Finocchi, Robert L. Mauck, George R. Dodge

Material-Mediated Degradation of the Meniscus Wound Interface Enhances Integration
Feini Qu, Michael P. Pintauro, Elizabeth A. Henning, John L. Esterhai, Matthew B. Fisher, Robert L. Mauck

Maturation and Material Dependent Response of AF and NP Cells to Mechanical Perturbation
Dong Hwa Kim, Lachlan J. Smith, Dawn M. Elliott, Robert L. Mauck

Enhanced Integration with Treatment of Sprifermin (rhFGF18) in a Cartilage Injury-Repair Model
Alexandra JE Farran, Ryan A. Cocca, Gregory Meloni, Bhavana Mohanraj, Anne Gigout, Robert L. Mauck, George R. Dodge

Perlecan Expression is Strongly Reduced in Aging Cartilage but Increased by Physiological Loading
Ryan A. Cocca, Arjan van Caam, Alexandra Farran, Bhavana Mohanraj, Gregory Meloni, Robert L. Mauck, Peter M. van der Kraan, George R. Dodge

Stem Cell Mechanobiology

Rapid and Sustained Changes in Nuclear Architecture and Mechanics in Mesenchymal Stem Cells in Response to Dynamic Stretch
Su-Jin Heo, Stephen Thorpe, Tristan P. Driscoll, Sohaib K. Hashmi, David A. Lee, Robert L. Mauck

Inherent and Emergent Heterogeneity in Clonal Stem Cell Populations
Brian D. Cosgrove, Megan J. Farrell, Margaret Dunagin, Claire M. McLeod, Allison J. Cote, Arjun Raj, Robert L. Mauck

Engineered Fiber Crimp Alters Scaffold Mechanics, Cell Shape, and Strain Transfer to the Nucleus
Tristan P. Driscoll, Jefferson Chang, Ty’Quish S. Keyes, Michael W. Hast, Su-Jin Heo, Robert L. Mauck, Pen-Hsiu Grace Chao

Fracture Healing

Bone Morphogenetic Protein and Fractures:A Meta-Analysis
Mara L. Schenker, Sarah M. Yannascoli, Derek J. Donegan, Keith D. Baldwin, Jaimo Ahn, Samir Mehta

Deficient Geriatric Fracture Healing is Associated with Alterations in Immune Cell Function and Cell Cycle
Luke A. Lopas, Lee McDaniel, Nicole S. Belkin, Patricia L. Mutyaba, Derek Dopkin, Kurt D. Hankenson, Jaimo Ahn

Local Activation of Notch Signaling Enhances Geriatric Bone Regeneration
Patrick N. Domerchie, Derek Dopkin, Kurt D. Hankenson, Jaimo Ahn

Cartilage and Bone Biology

Enhanced Individual Trabecular Repair and its Mechanical Implications in PTH and Alendronate Treated Rat Tibial Bone
Allison R. Altman, Chantal M. de Bakker, Abhishek Chandra, Beom Kang Huh, Ling Qin, X. Sherry Liu

Delayed Chondrocyte Differentiation and Altered Indian Hedgehog Signaling Contribute to Failed Vertebral Bone Formation in Mucopolysaccharidosis VII
Chelsea M. del Alcazar, Joseph A. Chiaro, Eileen M. Shore, Mark E. Haskins, Lachlan J. Smith

Deep Sequencing of Notochord-Derived Cells During Embryonic Formation of the Nucleus Pulposus: Preliminary Findings
Lachlan J. Smith, Joseph A. Chiaro, Kendra K. McKee, Neil R. Malhotra, Robert L. Mauck, Brian D. Harfe

Changes in the Trabeculae-Vessel Function Unit in Response to Estrogen Deficiency-Induced Bone Loss and Intermittent Parathyroid Hormone-Induced Bone Gain
Wei-Ju Tseng, Tiao Lin, Chantal MJ de Bakker, L. Scott Levin, Ling Qin, X. Sherry Liu

Alendronate and PTH Combination Therapy Stimulates Bone Formation While Inhibiting Bone Resorption Activities in the Rat Tibia:A Longitudinal, In Vivo, Dynamic Bone Histomorphometry Study
Chantal M. de Bakker, Allison Altman, Connie Li, Wei-Ju Tseng, Mary Beth Tribble, Beom Kang Huh, Abhishek Chandra, Ling Qin, X. Sherry Liu

Alleviation of Radiotherapy-Induced Local Trabecular Bone Loss by PTH(1-34) is Associated with Improved DNA Repair and Cell Survival in Osteoblasts
Abhishek Chandra, Tiao Lin, Ji Zhu, Beom Kang Huh, Allison Altman, Sarah Hagan, Keith Cengel, X. Sherry Liu, Ling Qin

Comparison Between Ovariectomy and Lactation Induced Bone Loss:A Dynamic Imaging Study
Connie Li, Carina Lott, Allison R. Altman, Chantal M. de Bakker, X. Sherry Liu

Increased Endocortical Formation and Periosteal Resorption in Premenopausal Women with Idiopathic Osteoporosis Treated with Intermittent Parathyroid Hormone
Mary Beth Tribble, Adi Cohen, Chantal M. de Bakker, Kyle Nishiyama, Elizabeth Shane, X. Sherry Liu

Translational Animal Models

Development of a Large Animal Model of Osteochondritis Dissecans (OCD) of the Knee
Christian G. Pfeifer, Stuart D. Kinsella, Andrew H. Milby, Matthew B. Fisher, Nicole S. Belkin, Robert L. Mauck, James L. Carey

Healing Response and Subchondral Bone Remodeling with Treatment of Focal Cartilage Lesions in a Porcine Model
Matthew B. Fisher, Nicole S. Belkin, Andrew R. Milby, Elizabeth A. Henning, George R. Dodge, David R. Steinberg, Robert L. Mauck

Percutaneous Delivery of Chondroitinase ABC Induces Moderate Disc Degeneration in a Goat Model
Andrew H. Milby, Brent L. Showalter, Joanne Haughan, Robert L. Mauck, Dawn M. Elliott, Neil R. Malhotra, Thomas P. Schaer, Lachlan J. Smith

A Rat Model for Elbow Allotransplantation
Scott M. Tintle, Juyu Tang, L. Scott Levin

Heterotopic Ossification

Gain-of-Function Alk2 Mutation Enhances Chondrocyte Differentiation and Promotes Heterotopic Endochondral Ossification
Andria L. Culbert, Salin A. Chakkalakal, Robert J. Caron, Eileen M. Shore

Heterozygous Inactivation of Gnas Induces Heterotopic Ossification and Impairs Normal Skeletal Development
Girish Ramaswamy, Deyu Zhang, Frederick S. Kaplan, Robert J. Pignolo, Eileen M. Shore


“Together We Build” – Penn Orthopaedics and the Philadelphia 76ers
Brian J. Sennett

Clinical Research Update
Annamarie D. Horan

Penn Orthopaedics in Nicaragua
Ryan M. Taylor, Jaimo Ahn, Samir Mehta

Penn Orthopaedics in Trinidad
Nicole S. Belkin, Vincent M. Arlet

From the Penn Orthopaedics Human Tissue Lab
Joshua A. Gordon

Penn Microsurgical Skills Cadaver Course for Hand Fellows and Residents
T. Shane Johnson, Joshua A. Gordon, L. Scott Levin

International Congress for Joint Reconstruction Inaugural Philadelphia Revision Arthroplasty Course
James E. Murphy, Joshua A. Gordon

Administrative Chief Residents’ Perspective
Mara Schenker, Adam Griska, Chancellor Gray

Penn Orthopaedics Service Summary: 2013 at a Glance
Lori Gustave, Fabian Marechal, Ryan Gonzales

A Tribute to Anthony (Tony) Searles
Frederick S. Kaplan

Health System Updates

Hospital of the University of Pennsylvania
John L. Esterhai, Jaimo Ahn, Derek Donegan, Keith Baldwin, Kristy Weber, L. Scott Levin, Samir Mehta

Penn Presbyterian Medical Center
David J. Bozentka

Pennsylvania Hospital
Neil P. Sheth

The Children’s Hospital of Philadelphia
John P. Dormans, Ashley Trocle

Philadelphia Veterans Affairs Medical Center
John L. Esterhai

Bayhealth Medical Center
Christos D. Photopoulos, Stephen G. Manifold

McKay Orthopaedic Research Laboratory
Louis J. Soslowsky

The PVAMC Translational Musculoskeletal Research Center is “Open for Business”
Robert L. Mauck, George R. Dodge

Building Our Tomorrow
Alyson Cole