Volume 31, June 2021

Letter from the Editors
Sachin Gupta, MD and Matthew Stein, MD

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

Letter from the Program Director
Daniel C. Farber, MD

Letter from the Vice Chair of Inclusion, Diversity and Equity
Lawrence Wells, MD

Dedication: Dr. Craig Israelite, MD
Sachin Gupta, MD

Faculty, Department, and Resident Updates

Chief’s Corner: Academic Chief Update
Michael Eby, MD, Christina Nypaver, MD, and William Ryan, MD

Class of 2012 Alumni Residents—Where are they now?
Matthew Stein, MD

Dr. Kristy Weber Presidential Address and Q&A
Ashleigh N. Bush, MD

Penn Center for Advanced Cartilage Repair and Osteochondritis Dissecans Treatment Update
Hannah M. Zlotnick, BS, Tomasina M. Leska, BS, Divya Talwar, PhD, MPH, Jay M. Patel, PhD, Jonathan H. Galarraga, BS, Jason A. Burdick, PhD, Theodore J. Ganley, MD, Robert L. Mauck, PhD, and James L. Carey, MD, MPH

Medical Education in a COVID Era: The Role of Virtual Conference
Matthew Stein, MD, Samir Mehta, MD, L Scott Levin, MD, and Derek J. Donegan, MD

Providing Orthopaedic Care During a Pandemic
Andrew Kanoff, MHA, Sean Looby, MHA, and Eric Hume, MD

Current Residents

Current Fellows

Department Updates

Orthopaedic Trauma Division Update
Samir Mehta, MD

Spine Division Update
Harvey Smith, MD

Sports Division Update
Brian Sennett, MD

Hand Division Update
David Bozentka, MD

Shoulder and Elbow Division Update
David Glaser, MD

Adult Reconstruction Division Update
Charles Nelson, MD

Foot and Ankle Division Update
Casey Humbyrd, MD

Orthopaedic Oncology Division Update
Kristy Weber, MD

Neuro-Orthopaedic Division Update
Keith Baldwin, MD, MPH, MSPT

Orthoplastics Limb Salvage Division Update
Meghan Wilson, RN, Stephen Kovach III, MD and L. Scott Levin, MD, FACS

Health System Update

Corporal Michael J. Crescenz VA Medical Center
Richard E. Grant, MD

Pennsylvania Hospital
Neil Sheth, MD

Children’s Hospital of Philadelphia Update
Divya Talwar, PhD, MPH and John Flynn, MD

Penn Center for Musculoskeletal Disorders
Louis J. Soslowsky, PhD

McKay Orthopaedic Research Laboratory
Robert L. Mauck, PhD

VAMC Translational Musculoskeletal Research Center
Carla R. Scanzello, M.D., Ph.D. and Robert L. Mauck, PhD

Human Motion Lab
Josh Baxter, PhD

Clinical Research Section
Annamarie D. Horan, MPA, PhD

Staying the Course During COVID-19 MSKR Service Line
Sean Looby, MHA

Ready to Rebuild
Neil Ravitz, MBA

Human Tissue Lab
Lorianne Kish-Burdsall

Advanced Practice Provider Update
Christine McAndrew, PA-C

Research Articles

Tips & Tricks

Trauma Tips & Tricks: “Kickstand Screw” for Restoration of Volar Tilt in Distal Radius Open Reduction Internal Fixation
Kendall M. Masada, MD and Samir Mehta, MD

Spine Tips & Tricks:Anterior Column Realignment with Expandable Cage in Treating Sagittal Malalignment
Aymen Alqazzaz, MD and Amrit S. Khalsa, MD

Sports Tips & Tricks
Lauren M. Boden, MD, Susanne H. Boden, MD, and Miltiadis H. Zgonis, MD

Hand Tips & Tricks: Relative Motion Extension Orthosis for Extensor Tendon Injuries
Kelsey Young, MD, Gayle Severance, MS, OT/L, CHT, and David R. Steinberg, MD

Pediatrics Tips & Tricks: Appropriate Use of Medial Pinning for Pediatric Supracondylar Humerus Fractures
Cody H.Hansen, MD and J.Todd R.Lawrence, MD, PhD

Shoulder and Elbow Tips & Tricks: A Case Study in Shoulder Hemiarthroplasty for Proximal Humerus Fractures:The Importance of Accurate Humeral Head Length Measurements
Kathleen Collins, MD, and John Gabriel Horneff, III, MD, FAAOS

Arthroplasty Tips & Tricks: Rapidly Progressive Avascular Necrosis of the Femoral Head Following a Single Intra-articular Corticosteroid Injection
Ryan D. DeAngelis, MD, Brian T.Velasco, MD, Bijan Dehghani, MD, MS, and Christopher Travers, MD

Foot and Ankle Tips & Tricks: Syndesmotic Screw Fixation—Principles and Technique
Brian T.Velasco, MD, Ryan D. DeAngelis, MD, Bijan Dehghani, MD, and Casey J. Humbyrd, MD, MBE

Oncology Tips & Tricks: Pathologic Fractures in Metastatic Cancer: Presentation and Workup Considerations
Dainn Woo, MD and Kristy L.Weber, MD

Orthoplastics Tips & Tricks: Case Report: Orthoplastic Limb Salvage in a Patient with Chronic Nonunion, Infection, Deformity, and Wound
Ashleigh Bush, MD, Stephen Kovach, MD, and Samir Mehta, MD


Statistical Shape Models May Accurately Predict Subacromial Impingement of Shoulder Fractures in the Absence of CT Images
Christopher Pinto, Kayley Dear, BS, MSE, Samir Mehta, MD, Surena Namdari, MD, and Michael Hast, PhD

Historical and Projected Incidence of Alcohol-related Upper Extremity Fractures
Christina Nypaver, MD, Kevin Pirrucio, BS, Nikolas Kazmers, MD, MSE, and Benjamin Gray, MD

A Geriatric Hip Fracture Care Pathway:An Operational Approach to Quality Improvement
Derek Donegan, MD, MBA, Kelsey Bonilla, MD, Rachel Kleinman, BS, MHSA, and Samir Mehta, MD


Hydroxyapatite Coating of Porous Polycaprolactone to Enhance Integration of a Tissue-Engineered Total Disc Replacement
Sarah E. Gullbrand, PhD, Beth G. Ashinsky, MD, PhD, Sai Mandalapu, BA, Kamiel Saleh, MS, Robert L. Mauck, PhD, and Harvey E. Smith, MD

Risk of Ventricular Peritoneal Shunt Malfunction In Surgically Treated Early Onset Scoliosis
Mitchell A. Johnson, BSE, Carina Lott, MS, Patrick J. Cahill, MD, Gregory Heuer, MD, PhD, and Jason B. Anari, MD

Patient Undergoes Halo-Gravity Traction While Virtually Participating in School During COVID-19 Pandemic: A Case Report
Mitchell A. Johnson, BSE, Carina Lott, MS, Patrick J. Cahill, MD, and Jason B. Anari, MD


Multiligamentous Knee Injury in Siblings with Associated Peroneal Nerve Deficits: A Case Report
Jake Schroeder, MD, Margaret Wright, MD, Ronit Shah, BS, Ishaan Swarup, MD, and Theodore Ganley, MD

Genetic Contributions to Osteochondritis Dissecans: A Systematic Review
Max Cornell, BS, Ryan Guzek, BS, Mitchell Johnson, BS, Tomasina Leska, BS, Soroush Baghadi, MD, ROCK Study Group, and Theodore J. Ganley, MD

Patellar Stabilization Using a Modified Basket-Weave Allograft MPFL/MQTFL Reconstruction
Brendan A. Williams, MD, Stephanie Logterman, MD, Daniel Weltsch, MD, and J.Todd R.Lawrence, MD, PhD

Arthroscopic Diagnosis of Occult Posterolateral Meniscocapsular Separations: Another Hidden Lesion
Robert L. Parisien, MD, Max Shin, BA, Lauren M. Boden, MD, Stephanie Y. Jo, MD, PhD, Lisa Victorious, PA, Brian J. Sennett, MD, and Miltiadis H. Zgonis, MD


A Decade of Change: Levels of Evidence at the ASSH Podium from 2010-2019
Joshua T. Bram, BS, Andrew Parambath, BA, Nishank Mehta, BA, Faris Z. Fazal, BS, and Apurva S. Shah, MD, MBA

A Case Report of Ecthyma Gangrenosum affecting the Thumb
Corey T. Clyde, MD, John M. Roberts, MD, John R. Lien, MD, and Benjamin L. Gray, MD MSCE

Anterior Interosseous Nerve Transfer for Ulnar Neuropathy: How, When and Why
John M. Roberts, Corey T. Clyde, and David J. Bozentka

Thumb CMC Arthroplasty. Is it Time to Move Away from LRTI?
Jonathan B. Lundy, MD, Erin L.Weber, MD, Mitchell Hallman, MD, Zvi Steinberger, MD, David R. Steinberg, MD, and David J. Bozentka, MD


Juvenile Osteochondritis Dissecans of the Knee Shows Early Evidence of Radiologic Irregularity
Ryan Guzek, BS, Max Cornell, BS, Jie Nguyen, MD, MS, and Theodore J. Ganley, MD

Increases in Pediatric Sports Injuries Late in the COVID-19 Pandemic
Nicolas Pascual-Leone, BA, Mitchell Johnson, BSE, Tomasina Leska, BS, and Theodore Ganley, MD

Psychosocial Factors Impacting the Mental Health of the Orthopaedic Workforce
Divya Talwar, Soroush Baghdadi, Heidi Nocka, and Alexandre Arkader

SutureBridge Transosseous Fixation of Complete Radial Tears:A Philosophical Approach
Tomasina Leska, BS, Soroush Baghdadi, MD, Max Cornell, BS, and Theodore Ganley, MD

Shoulder and Elbow

Poly-N-Acetyl Glucosamine (sNAG) is Dose Dependent for Healing of a Rat Rotator Cuff
Courtney A. Nuss, AS, Julianne Huegel, PhD, Sergio Finkielsztein, Andrew F. Kuntz, MD, and Louis J. Soslowsky, PhD

State of the Field: Proposed Suture Anchor Design for Rotator Cuff Repair in Osteoporotic Bone
Lori Jia, BS, Ali S. Farooqi, BA, Alexander Lee, BS, and John D. Kelly IV, MD


Tertiary Care Centers Provide Successful Revision TKA to External Referrals, Despite Increased
Patient Complexity 186 Brian A. Perez, MD, Nicolas A. Selemon, BA, Brian D. Cortese, BS, Aaron Gebrelul, MD, Kevin Pirruccio, BA, and Neil P. Sheth, MD

Pre-operative Complexity Scoring Accurately Predicts Total Knee Arthroplasty Operative Time
Joseph Koressel, MD, Max Shin, BS, Matthew K. Stein, MD, Matthew Sloan, MD, andNeil P. Sheth, MD

Evaluating Dental Clearance Prior to Total Joint Replacement at the Philadelphia Veterans Affairs Medical Center: One Answer, Ten More Questions
Lori Jia, BS, Kendall M. Masada, MD, Jacob C. Harris, BA, Vincent M. Moretti, MD, Eric L. Hume, MD, and Joseph Bernstein, MD

Foot and Ankle

Prospective Evaluation of Opioid Consumption in Multimodal Analgesia following Isolated Hallux Valgus Correction or First MTP Joint Arthrodesis
Wonyong Lee, MD, Dan Prat, MD, Daniel C. Farber, MD, Keith L. Wapner, MD, and Wen Chao, MD

Comparison of Four Different Fixation Strategies for Midfoot Arthrodesis: A Retrospective Comparative Study
Wonyong Lee, MD, Dan Prat, MD, Keith L.Wapner, MD, Daniel C. Farber, MD,and Wen Chao, MD


MALPs Promote Osteoclastogenesis in Bone Remodeling and Pathologic Bone Loss
Wei Yu, MD/PhD, Leilei Zhong, PhD, Lutian Yao, MD/PhD, Yulong Wei, MD, Tao Gui, Ziqing Li, MD, Hyunsoo Kim, PhD, Nicholas Holdreith, Xi Jiang, MS/MD, Wei Tong, PhD, Nathaniel Dyment, PhD, Xiaowei S. Liu, PhD, Shuying Yang, Yongwon Choi, PhD, Jaimo Ahn, MD/PhD, and Ling Qin, PhD

Transient Expansion and Myofibroblast Conversion of Marrow Adipogenic Lineage Precursors (MALPs) Mediate Bone Marrow Repair after Radiation
Leilei Zhong, PhD, Lutian Yao, MD/PhD, Zhen Miao, Mingyao Li, PhD, Jaimo Ahn, MD/PhD, and Ling Qin, PhD


Correction of Congenital Upper Extremity Contracture with Flexor Origin Slide
Daniel Gittings, MD, Shane Korber, MD, Peter Wilton, MD, Kristen Sochol, MD, Rachel Lefebvre, MD, and Milan Stevanovic, MD, PhD

Basic Science


Targeting Cartilage EGFR Pathway for Osteoarthritis Treatment
Tao Gui, Yulong Wei, MD, Lijun Luo, PhD, Feifan Yu, Lesan Yan, PhD, Lutian Yao, MD/PhD, Leilei Zhong, PhD, Wei Yu, MD/PhD, Biao Han, PhD, Jay M. Patel, PhD, Frank Beier, PhD, Zengwu Shao, PhD, Lin Han, PhD, Robert L. Mauck, PhD, Andrew Tsourkas, PhD, Jaimo Ahn, MD/PhD, Zhiliang Cheng, PhD, and Ling Qin, PhD

Marked Differences in Local Bone Remodeling Based on Marrow Stimulation Technique in a Large Animal
Hannah M Zlotnick, BS, Ryan C Locke, PhD, Brendan D Stoeckl, MSE, Jay M Patel, PhD, Sachin Gupta, MD, Kevin D Browne, BA, Jason Koh, MD, MBA, James L Carey, MD, MPH, and Robert L Mauck, PhD


High Dose Enzyme Replacement Therapy Attenuates Joint Disease Progression and Preserves Mobility in Mucopolysaccharidosis VII Dogs
Rahul Gawri, Yian Khai Lau, George R. Dodge, Carla R. Scanzello, Stephanie Jo, Chenghao Zhang, Wilfried Mai, Margret L. Casal, and Lachlan J. Smith

Fate of Mechano-Sensitive Microcapsules after Intra-Articular Onjection in a Large Animal
Hannah M Zlotnick, Ana P Peredo, Daeyeon Lee, George R Dodge, and Robert L Mauck

Muscle, Tendon, and Biomechanics

Collagen V Haploinsufficiency Results in Delayed Healing and Altered Wound Matrix Post-Injury in Murine Tendons
Jaclyn A. Carlson, Sun M, Adams SM, Stephanie Weiss, David Birk, and Louis Soslowsky

Scaffold-free 3D Tendon Cell Culture Using Mouse Tendon Cells
Yeonju Lee, Na Rae Park, Nathaniel A. Dyment, and Kyu Sang Joeng

Stat3 Mediates the Function of mTORC1 in Fibrovascular Scar Formation During Postnatal Tendon Development
Na Rae Park, and Kyu Sang Joeng

Adverse Mechanical Consequences from Abnormal Activation and Deactivation of the mTORC1 Pathway in Tendons
Snehal S. Shetye, Yeonju Lee, and Kyu Sang Joeng

Tendon Resident Macrophages Internalize Type 1 Collagen and Express Trophic Signaling Factors
Catherine A. Bautista, Mary Kate Evans, Tonia K. Tsinman, and Nathaniel A. Dyment

Collagen XII Regulates Tendon Dynamic Mechanical Properties and Collagen Fiber Realignment
Ashley K. Fung, Nathaniel A. Dyment, David E. Birk, and Louis J. Soslowsky

Tendon Pathology Alters Chromatin Organization and Mechano-sensitivity in Human Tenocytes
Su-Jin Heo, Shreyasi Thakur, Claudia Loebel, Boao Xia, Rowena McBeath, Jason Burdick, Melike Lakadamyali, and Robert Mauck

Segment Mass Property Errors Have Less Impact on Estimated Joint Loading in Human Gait Than Ground Reaction Force Errors
Todd J. Hullfish, J. Drazan, and J. Baxter

Collagen V Knockdown During Phases of Tendon Healing Differentially Impacts Gene Expression
Ryan J. Leiphart, Brittany L Taylor, Stephanie N Weiss, Nathaniel A Dyment, and Louis J Soslowsky

Moving Outside the Lab: Markerless Motion Capture Accurately Quantifies Planar Kinematics During the Vertical Jump
William T Phillips, John F Drazan, PhD, Todd J Hullfish, BSME, and Josh R Baxter, PhD

Morphogenesis of Fibrous Structures in the Embryonic Knee is Severely Disrupted by a Lack of Muscle Contraction
Tonia K. Tsinman, Saima Ahmed, Aurélie Levillain, Yuming Huang, Niamh C. Nowlan, Nathaniel A. Dyment, and Robert L. Mauck

A Subset of FAP Cells Expressing Gli1 Promote Muscle Regeneration With Less Fat Accumulation
Lutian Yao, MD, PhD, Elisia D.Tichy, PhD, Leilei Zhong, PhD, Sarthak Mohanty, Luqiang Wang, PhD, Emily Ai, Shuying Yang, MD, MS, PhD, Foteini Mourkioti, PhD, and Ling Qin, PhD