Volume 26, Spring 2016

Letter from the Editors-in-Chief
Cody Hillin MD MS, James M Friedman MD

Dedication: Gerald Williams MD
James M Friedman MD, Cody Hillin MD MS

Honored and Humbled
Gerald R Williams MD

Clinical Research


Techniques in Cementation for Hip Hemiarthroplasty
Joshua C. Rozell, MD, Neil P. Sheth, MD

Novel Classification System for Bone Loss in the Setting of Revision Total Knee Arthroplasty
Charles L. Nelson, MD, Francis J. Aversano, BS, Nicholas Pulos, MD, Craig L. Israelite, MD, Neil P. Sheth, MD

Diagnosing Infection in Patients Undergoing Conversion of Prior Internal Fixation to Total Hip Arthroplasty
Daniel Gittings MD, P. Maxwell Courtney MD, Blair Ashley MD, Patrick Hesketh MD, Derek Donegan MD, Neil Sheth MD

Epidermal Growth Factor Receptor (EGFR) Signaling in Cartilage Prevents Osteoarthritis Progression
Haoruo Jia, Xiaoyuan Ma, Basak Doyran, Wei Tong, Xianrong Zhang, Motomi Enomoto-Iwamoto, Lin Han, Ling Qin


Hot Topics in Orthopaedic Clinical Research Methodology
Matthew Sloan MD MS, Keith D. Baldwin MD MSPT MPH


Operative Technique: Use of a volar plate for restoration of volar tilt intra-operatively
Jenna Bernstein MD, Benjamin Gray MD


Treatment of Hip Flexion Contracture with Psoas Lengthening Through the Middle Window of the Ilioinguinal Approach
Daniel Gittings MD, Jonathan Dattilo MD, Derek Donegan MD, Keith Baldwin MD

Pediatric Shoulder Instability: Current Trends in Management
Christian A. Refakis BA, Eileen P. Storey BA, Christopher M. Brusalis BA, Theodore J. Ganley MD

Prone Positioning for Open Reduction Internal Fixation of Pediatric Medial Epicondyle Fractures
Aristides I. Cruz Jr. MD, J. Todd R. Lawrence MD PhD, Theodore J. Ganley MD

New Approach to Characterize Juvenile Osteochondritis Dissecans
Saba Pasha PhD, Eileen P. Storey BA, Theodore J.Ganley MD

The Ponseti Method for Clubfoot Treatment in Low and Middle-Income Countries: A Systematic Review of Barriers and Solutions to Service Delivery
James M. Friedman MD, Rachel R. Johnson BA, Andrew M. Becker BS, David A. Spiegel MD

Shoulder & Elbow

Doxycycline Improves Sedentary, but not Exercised, Supraspinatus Tendon and Muscle in a Rat Model
Sarah I. Rooney, Daniel J. Torino, Rachel Baskin, Rameen P. Vafa, Pooja S. Khandekar, Andrew F. Kuntz, Louis J. Soslowsky

Effects of Autologous Tenocyte-Seeded Nanofibrous Scaffolds in Rotator Cuff Repair are Age-Dependent
Huegel J, Kim DH, Cirone JM, Pardes AM, Morris TR, Nuss CA, Mauck RL, Soslowsky LJ, Kuntz AF

Rat Supraspinatus Tendon Responds Acutely and Chronically to Exercise
Sarah I. Rooney, Daniel J. Torino, Rachel Baskin, Rameen P. Vafa, Andrew F. Kuntz, Louis J. Soslowsky

Pulsed Electromagnetic Field Therapy Improves Tendon-to-Bone Healing in a Rat Rotator Cuff Repair Model
Jennica J Tucker, James M. Cirone, Tyler R. Morris, Courtney A. Nuss, Erik I. Waldorff, Nianli Zhang, James T. Ryaby, Louis J. Soslowsky

Simvastatin Recovers Supraspinatus Tendon Mechanical and Histological Properties in a Diet-Induced Hypercholesterolemia Rat Model
Jennica J Tucker, Louis J. Soslowsky


Revisiting Anterior Stand-Alone Fixation (ASAF) Devices for the Treatment of Single Level Lumbosacral Degenerative Disease
Blair Ashley MD, Vincent Arlet MD

Fabrication, Maturation, and Implantation of a Composite Tissue-Engineered Total Disc Replacement
Dong Hwa Kim, John T. Martin, Sarah E. Gullbrand, Christian G. Pfeifer, Dawn M. Elliott, Lachlan J. Smith, Harvey E. Smith, Robert L. Mauck

Recapitulating the Spectrum of Intervertebral Disc Degeneration in a Large Animal Model
Sarah E. Gullbrand, Neil R. Malhotra, Thomas P. Schaer, Zosia Zawacki, John T. Martin, Justin Bendigo, Andrew H. Milby, George R. Dodge, Edward J. Vresilovic, Dawn M. Elliott, Robert L. Mauck, Lachlan J. Smith


Biomechanical Estimation of Elbow Valgus Loading in Throwing Athletes as a Means to Reduce Injury Risk
Ryan L. Crotin PhD CSCS, Sarah A. Zinamon BSE, John D. Kelly IV MD, Josh R. Baxter PhD

Low-Fidelity Simulation: An Emerging Trend in Orthopaedic Surgical Education
Christopher M. Brusalis BA, Eileen P. Storey BA, Christian A. Refakis BA, Theodore J. Ganley MD

Perfectionism—The Foe of Happiness
John D. Kelly IV MD


Trauma Tips and Tricks: Measurement and Management of Compartment Syndrome
Tyler R. Morris, MD, Daniel P. Lim, MD, Derek J. Donegan, MD

Locking Cap Designs Improve Fatigue Properties of Polyaxial Screws in Upper Extremity Applications
Surena Namdari MD, Samir Mehta MD, Michael Hast PhD

Use of a “Kickback” Screw in Olecranon Fractures Stabilization Increases Stability
Samir Mehta MD, Surena Namdari MD, Michael Hast PhD

Arthroscopic Lysis of Adhesions Improves Knee Range of Motion After Fixation of Intra-Articular Knee Fractures
Daniel Gittings MD, Patrick Hesketh BS, John Kelly IV MD, Samir Mehta MD

Peroneal Nerve Palsy I: Evaluation and Diagnosis
Tyler R Morris MD, Keith D Baldwin MD MPH MSPT


Considering Cartilage Lesions in the Evaluation of the Adult with Joint Pain
Russell Stitzlein MD, Kristy Weber MD

Study of the Different Methods of Management of Defects After Curettage of Benign Cystic Bone Lesions
Ihab Badawi MD Orth, Awad Abdel Mmoniem Rafalla MD, El Sayed Abd El-halim Abdullah MD

Basic Science Research Articles


Progression of Vertebral Bone Disease in Mucopolysaccharidosis VII Dogs from Birth to Skeletal Maturity
Sun H. Peck, Jennifer L. Kang, Joseph A. Chiaro, Neil R. Malhotra, Patricia O’Donnell, Mark E. Haskins, Margret L. Casal, Lachlan J. Smith

The Critical Role of Mesenchymal Progenitors in Initiating the Secondary Ossification Center at the Epiphyseal Cartilage
Wei Tong, Haoruo Jia, Xiaoyuan Ma, Motomi Enomoto-Iwamoto, Ling Qin

Suppression of Sclerostin Alleviates Radiation Damage to Bone by Protecting Bone forming Cells
Abhishek Chandra, Tiao Lin, Wei-ju Tseng, Keith Cengel, Michael A. Levine, X. Sherry Liu, Ling Qin


Temporal Dynamics of Nascent ECM Production by Chondrocytes and MSCS via Multi-Color Protein Labeling
Claire M. McLeod, Robert L. Mauck

Matrix Degradation Enhances Cell Mobility in Dense Connective Tissues
Feini Qu, Miltiadis H. Zgonis, John L. Esterhai, Robert L. Mauck

Platelet-Derived Growth Factor Promotes Interstitial Cell Migration in the Knee Meniscus
Feini Qu, Julianne L. Holloway, Michael P. Pintauro, Jason A. Burdick, Robert L. Mauck

Aberrant Glycosaminoglycan Accumulation and Sulfation in Epiphyseal Cartilage in Mucopolysaccharidosis VII
Sun H. Peck, Jennifer L. Kang, George R. Dodge, Neil R. Malhotra, Mark E. Haskins, Lachlan J. Smith

Impaired Wnt Signaling Contributes to Delayed Chondrocyte Differentiation in Mucopolysaccharidosis VII Dogs
Sun H. Peck, Eileen M. Shore, Neil R. Malhotra, John W. Tobias, Maurizio Pacifici, Mark E. Haskins, Lachlan J. Smith

Tendon & Ligament

Engineered Nanofiber Crimp Alters Scaffold Mechanics and Mesenchymal Stem Cell Mechanotransduction
Spencer E. Szczesny, Pang-Ching Liu, Tristan P. Driscoll, Robert L. Mauck, Pen-Hsiu G. Chao

Electrospun PLGA Nanofiber Scaffolds Release Ibuprofen Faster and Degrade Slower after In Vivo Implantation
Corinne N Riggin, Feini Qu, Dong Hwa Kim, Julianne Huegel, David R Steinberg, Louis J Soslowsky, Robert L Mauck, Joseph Bernstein

Injured Tendons Increase Lactate Synthesis and Pharmacological Inhibition of Lactate Synthesis Improves Tendon Repair
Motomi Enomoto-Iwamoto, Kairui Zhang, Michael W. Hast, Leslie Cantley, Masahiro Iwamoto, Louis J. Soslowsky

Structure and Composition in Tendons with Altered Collagen V Expression are Location-Dependent
Brianne K. Connizzo, Sheila M. Adams, David E. Birk, Louis J. Soslowsky

Collagen V-Deficient Tendons Exhibit Altered Dynamic Mechanical Behavior at Multiple Hierarchical Scales
Brianne K. Connizzo, Lin Han, David E. Birk, Louis J. Soslowsky

Ground Reaction Forces Are More Sensitive Gait Measures Than Temporal Parameters in Rodents Following Rotator Cuff Injury
Pardes AM, Freedman BR, Soslowsky LJ

Immunohistochemical Analysis of Muscle Tissue Following Blunt Achilles Tendon Transection in a Rat Model
Tyler R Morris, Benjamin R Freedman, Pankti R Bhatt, Joshua A Gordon, Alexis A Williams, Louis J Soslowsky

Sex Differences Are Present in Uninjured Achilles Tendon and Muscle
Pardes AM, Freedman BR, Fryhofer GW, Salka NS, Bhatt PB, Soslowsky LJ

Aggressive Rehabilitation with Nonsurgical Treatment Demonstrates Improved Fatigue Mechanics and Functional Outcomes Following Achilles Tendon Rupture in an Animal Model
Benjamin R. Freedman, Tyler M. Morris, Courtney A. Nuss, Corinne N. Riggin, Nabeel S. Salka, Joshua A. Gordon, Aricia Shen, Daniel C. Farber,Louis J. Soslowsky


Whole-Transcriptome Profiling of Notochord-Derived Cells during Embryonic Nucleus Pulposus Formation
Sun H. Peck, Kendra K. McKee, Neil R. Malhotra, John W. Tobias, Robert L. Mauck, Brian D. Harfe, Lachlan J. Smith

Sustained Release of Ibuprofen from Labrafil-Modified PLGA Microspheres
Dong Hwa Kim, Feini Qu, Corinne N Riggin, Joseph Bernstein, Louis J Soslowsky, Robert L. Mauck

A Low-Cost, Wearable Magnet-Based Detection System to Assess Joint Kinematics in Humans and Large Animals
Feini Qu, Brendan D. Stoeckl, Peter M. Gebhard, Robert L. Mauck

Variations in Media Formulation Impact ECM Synthesis and Retention in NP Cell-laden HA Hydrogels
Dong Hwa Kim, John T. Martin, Kensuke Ikuta, Harvey E. Smith, Dawn M. Elliott, Lachlan J. Smith, and Robert L. Mauck

Department Updates

Letter from the Chairman
L. Scott Levin, MD, FACS

Letter from the Program Director
Craig L. Israelite MD

Service Line Strategy: Procedures to Pathways
Lori Gustave, Rachel Kleinman

Division Updates


Hip and Knee Arthroplasty Bundle Experience at the University of Pennsylvania, Department of Orthopaedic Surgery
Eric L. Hume, MD, Laura L. Kosseim, MD, Atul F. Kamath, MD, Joanne J. Piscitello, MSN, RN, Finnah L. Pio, MS

Foot & Ankle

Department of Foot & Ankle Update
Daniel Farber, MD


Division of Hand and Upper Extremity Update
David Bozentka MD

The First Bilateral Pediatric Hand Transplant
Colen D, Thibaudeau S, McAndrew C, Levin S


The Children’s Hospital of Philadelphia
Michelle Ho BSE, John (Jack) Flynn MD

Shoulder & Elbow

Department of Shoulder & Elbow Update
David Glaser, MD


Division of Spine Update
James Friedman MD, Vincent Arlet MD




Advancing Clinical Care and the Science of Sarcoma Orthopaedic Oncology at Penn
Kristy Weber, MD

Veterans Affairs Medical Center

Philadelphia Veterans Affairs Medical Center Update
John Esterhai, MD, PVAMC Chief of Orhopaedics

Basic Science Research Updates

McKay Orthopaedic Research Laboratory

The Center for Research in FOP & Related Disorders Update
Frederick S. Kaplan MD, Robert J. Pignolo MD PhD, Eileen M. Shore PhD

Penn Center for Musculoskeletal Disorders
Louis J. Soslowsky PhD

Update on Biedermann Lab
Michael W. Hast, Ph.D, Director of Biedermann Lab for Orthopaedic Research

International Orthopaedic Surgery Update
James Friedman MD

Education Update

Visiting Professor Lecture Series
Cody D. Hillin MD MS, James M Friedman MD, Russell Stitzlein MD, Chase Woodward MD MPH

Chief Residents

Current Residents

Resident Alumni