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Orthopaedics
Contents 3 Adult Reconstructive Surgery 9 Cartilage Restoration 13 Comprehensive Spine Center 19 Hand and Upper Extremity 25 Hip Preservation 29 Infection Control Program 35 Heart and Vascular Center Update 39 Orthopaedics Newsletter
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Department of Orthopaedics
Adult Reconstructive Surgery w Full spectrum of treatment options w Distinctive pre-operative risk reduction program w Comprehensive care for any comorbidity
The Ohio State University Wexner Medical Center is ranked by U.S News & World Report as one of the premier sites in the country for orthopaedic surgery.
Matching the right physician and right procedure to solve each patient’s pain The adult reconstruction team at Ohio State’s Wexner Medical Center offers a full spectrum of treatment options to solve each patient’s pain, including nonoperative therapy and surgery — from arthroscopy to complex revision procedures and total joint replacements. Fellowship-trained surgeons, assisted by a dedicated team of nurses, therapists and other ancillary care providers, work together to offer complete care. The program sees patients for post-traumatic osteoarthritis, avascular necrosis, osteoarthritis, inflammatory arthritis, childhood hip disease, traumatic and pathologic problems, failed total joint replacement and periprosthetic fractures. “We’re the ‘somewhere else’ that surgeons can feel comfortable referring to when patients have a complication or comorbidity,” says Andrew Glassman, MD,
chief, Division of Adult Reconstructive Surgery. “We handle these cases — as well as the straightforward cases — with aplomb.”
Deep Experience Leads to Expertise • Ohio State’s surgeons have more experience with MAKOplasty robotic-assisted partial knee replacement than any other facility in central Ohio. • The division developed a risk reduction program, using evidence-based criteria, to assess and prepare patients for joint replacement surgery. The program, which focuses on controlling factors that cause complications in joint replacement surgery, was recently presented to the American Academy of Orthopaedic Surgeons. • Division of Adult Reconstructive Surgery Chief Andrew Glassman, MD, has almost 30 years of experience. He is from Columbus and trained at Ohio State. After completing a fellowship with preeminent total joint replacement surgeon Charles Engh, MD, Dr. Glassman was in private practice in Columbus and joined Ohio State’s Wexner Medical Center in 2010. • Dr. Glassman has performed several thousand hip and knee replacements. He has participated in the design of more than a dozen total hip and two total knee replacement prostheses.
Unmatched Specialty Care From the moment patients enter the Division of Adult Reconstructive Surgery — whether they are a hospital surgical patient or a rehabilitation clinic patient — their care is managed with utmost attention. Our team of specialists develops comprehensive care plans that address patients’ needs from start to finish, including care for their comorbidities, to ensure a seamless continuum of care. Patients are cared for in a dedicated joint replacement unit where everyone is part of a highly skilled specialty team. From preoperative testing and patient education 4 Adult Recontructive Surgery
to inpatient services and post-surgical care, the group of physicians, nurses, case managers, physical therapists, occupational therapists and other support team members provides unparalleled specialty care for joint replacement patients.
Special Expertise for Complex Cases Patient care extends well beyond the boundaries of the division. Today, many patients’ orthopaedic reconstruction needs are highly complex. They’re accompanied by comorbidities that create significantly higher risks. Ohio State is uniquely positioned to care for these multifaceted patients. Whether patients have cardiovascular conditions, obesity, diabetes, HIV/AIDS, sickle cell anemia, hemophilia or an organ transplant, the comprehensive and specialty-rich Medical Center is well equipped for the expected and the unexpected. “We’re Buckeyes — we’re part of The University,” says Dr. Glassman. “This prestigious medical center is loaded with specialties that make us fully prepared to handle any comorbidity or emergency.”
The risk reduction program developed at Ohio State focuses on controlling the factors that cause complications in joint replacement surgery. The program uses evidence-based criteria to assess and prepare patients for surgery, which includes a screening protocol and 50-point checklist. Patients have a comprehensive skin examination, a dental exam to rule out periodontal disease, cultures from various sites to rule out MRSA carrier status and prophylactic antibiotics. To ensure absolute sterility, surgeries are performed in highly filtered surgical suites by a team wearing surgical isolation suits and portable miniature lamination flow hoods. This focus has a dramatic effect on infection rates, which are below the national average. “We’ve developed protocols to determine what constitutes ‘medical clearance’ for total joint replacement,” says Dr. Glassman. “Joint replacement is a major intervention. It is our responsibility to the patients we serve to optimize their health so they can reap the benefits of joint replacement. Sometimes, this means delaying surgery until the risks can be reduced.”
Evidence-Based Technology and Tools Distinctive Pre-operative Risk Reduction Program The Department of Orthopaedics is a leader in infection control and risk reduction. Dr. Glassman and his colleagues recently presented to the American Academy of Orthopaedic Surgeons on the topic “Preoperative Risk Stratification and Risk Reduction for Elective Total Hip and Knee Reconstruction.”
Technology, such as robotically assisted surgery, and tools, including various implants, are utilized only when they are evidence-based. “I’ve seen technologies come and go in my almost three decades of practice,” says Dr. Glassman. “If we use it, you can be assured it’s tried and true and supported by hard data. It will never be the case that we are distracted by the ‘new, shiny thing.’ We continue to critically evaluate technologies as they evolve.”
How to refer patients... Department of Orthopaedics Please call 614-293-BONE (2663) or 1-888-861-8081 for patient referral. Our promise to you We promise to communicate with you about your patients, provide feedback about their care and refer them back to you for ongoing care. Our policy is to accept all patients referred to our Department. If we determine that a referred patient would be better served by another specialty, we will arrange that visit for your patient.
5 Adult Recontructive Surgery
MAKOplasty
Research
After thorough evaluation by Ohio State’s Robotics Steering Committee, in 2011, the division began using MAKOplasty, a robotic-assisted partial knee resurfacing treatment for early to mid-stage osteoarthritis in the medial, patellofemoral or lateral compartment. Our surgeons have more experience than anyone in central Ohio at performing MAKOplasty partial knee replacement.
The Division was awarded the largest National Institutes of Health 401 grant in the history of the Department of Orthopaedics. The grant supports research to test intraoperative and postoperative knee stability, and to study the effect of intraoperative stability on postoperative function and survivorship of implants. This work is in collaboration with Robert Siston, PhD, of Ohio State’s Department of Mechanical and Aerospace Engineering.
A MAKOplasty procedure involves resurfacing only the diseased portion of the knee, sparing healthy bone and surrounding tissue. Outfitted with an implant, the patient’s knee joint is able to move smoothly and painlessly afterward and heal faster than a full knee replacement.
The Division of Adult Reconstruction Surgery also is conducting research to study the application of platelet-enriched plasma for reducing postoperative blood loss and surgical site infection after total hip and knee replacement.
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Team Andrew Glassman, MD, MS Chief, Division of Adult Reconstructive Surgery Associate Professor, Department of Orthopaedics Clinical Interests: Total hip and knee joint replacement, complex primary and revision total hip and knee replacement, robotically assisted total hip and knee replacement Fellowship: Adult Reconstructive Surgery, The Anderson Orthopaedic Institute and The National Hospital for Orthopaedics and Rehabilitation, Arlington, VA. Residency: Orthopaedic Surgery, The Ohio State University Internship: University of Southern California Medical Center/ USC Medical School and The Ohio State University Medical School: Medical College of Ohio Member, the Hip Society and the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons Committee for the Hip Current President, the Columbus Orthopaedic Society
Matthew Beal, MD Assistant Professor, Clinical Orthopaedics Clinical Interests: Hip and knee reconstruction surgery, rapid rehabilitation after total joint replacement, robot-assisted partial knee replacement Fellowship: Orthopaedic Surgery Adult Reconstruction, Massachusetts General Hospital, Boston Residency: Orthopaedic Surgery, University of Chicago Hospital Internship: Orthopaedic Surgery, University of Chicago Hospital Medical School: The Ohio State University College of Medicine
Jeffrey Granger, MD Assistant Professor, Clinical Orthopaedics Clinical Interests: General adult orthopaedics, including fractures, knee arthroscopy, hip and knee joint replacement, foot surgery Residency: Orthopaedic Surgery, The University of Michigan Medical Center Internship: General Surgery, The University of Michigan Medical Center Medical School: The University of Chicago Pritzker School of Medicine
Thomas Ellis, MD Vice Chair, Department of Orthopaedics Chief, Hip Preservation Associate Professor, Orthopaedics Clinical Interests: Hip arthroscopy, labrum hip, labral hip tear, hip impingement, hip dysplasia, ganz pelvic osteotomy, pelvic osteotomy, hip resurfacing, hip replacement, anterior total hip replacement, femoroacetabular impingement, hip pain in young adults, lower extremity orthopaedic trauma Fellowship: Total Joint Arthroplasty, Anderson Orthopaedic Research Institute, Alexandria, Va. Fellowship: Orthopaedic Trauma Fellowship, Hennepin County Medical Center, Minneapolis Fellowship: John Border Memorial European AO Trauma, Bern, Switzerland/Hanover, Germany Residency: Orthopaedic Surgery, Texas A&M University and Scott & White Hospital, Temple, Texas Internship: Orthopaedic Surgery, Texas A&M University and Scott & White Hospital Medical School: Vanderbilt University School of Medicine, Nashville
For full CVs on each of these physicians, including recent publications, please visit ortho.osu.edu and search by name under the Directories tab. 7 Adult Recontructive Surgery
The Ohio State University Wexner Medical Center Adult Reconstruction Surgery ortho.osu.edu
Š 2012 The Ohio State University Wexner Medical Center CORP20120105-07
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The Ohio State University Wexner Medical Center
Orthopaedics — Cartilage Restoration Program w Full spectrum of cartilage restoration treatments, including options not offered elsewhere in central Ohio w Fellowship-trained surgeon w Individualized care for complex procedures w Comprehensive care for any comorbidity
The Ohio State University Wexner Medical Center is ranked by U.S News & World Report as one of the premier sites in the country for orthopaedic surgery.
Cartilage Restoration: An Increasing Demand The Ohio State University Wexner Medical Center is a leader in the growing field of cartilage restoration. This treatment option is more important than ever, as rates of cartilage damage are increasing among patients at younger ages due to athletic-related injuries. Greater numbers of osteoarthritic knees in young people will lead to more early-age total joint replacements. We believe many of these younger patients may be candidates for less invasive cartilage restoration procedures. Fellowship-trained surgeon David Flanigan, MD, leads Ohio State’s Cartilage Restoration Program and offers every restoration treatment currently available, including some options not found at any other hospital in the region.
who have cartilage damage from injury but do not yet have osteoarthritis are ideal candidates. “Once they develop changes consistent with osteoarthritis that are visible on X-ray, it’s too late for cartilage restoration. At that point, arthroscopy isn’t always a fix,” Dr. Flanigan says. “We want to help these patients prevent further damage by evaluating them for treatment during that window of opportunity.” The number of people who could benefit from cartilage restoration is considerable. It is estimated that 63 percent of patients who have knee arthroscopy have cartilage defects, with 19 percent of that group affected by Outerbridge grade IV cartilage change. Patients who fit these criteria may be candidates for cartilage restoration: • Age 55 or younger
Points of Excellence • Ohio State offers every procedure currently available for cartilage restoration. • We’re one of the top centers in the United States for autologous chondrocyte implantation. • Ohio State is one of only 30 sites in North America offering the DeNovo and CAIS (Cartilage Autograft Implantation System) clinical trials. • The team at Ohio State’s Wexner Medical Center is helping to define the algorithms used for cartilage restoration treatments nationwide. According to Dr. Flanigan, “Ohio State is compiling a database to determine which factors have the greatest effect on treatment and which treatment is best for each patient.”
The Window of Opportunity for Cartilage Restoration More and more active patients are excited by the possibility that cartilage restoration could save more of their natural knee joint and allow them to continue to be active without pain or total knee replacement. According to Dr. Flanigan, athletes are six to seven times more likely to develop cartilage injuries than the general population, injuries that will likely lead to osteoarthritis if not treated. He says there is a distinct window of opportunity to restore knee cartilage, and that patients
• Injuries due to athletics or work • Persistent knee pain or swelling • Recurrent injury • Cartilage injury, including osteochondritis dissecans • Ligament injury, such as ACL • Meniscus tear • No X-ray evidence of changes from osteoarthritis • Previous knee surgery Being able to use cartilage restoration to give patients functional knees without pain is rewarding, says Dr. Flanigan. “Osteoarthritis is prevalent today and will continue to have a significant economic impact on society. Treating patients before osteoarthritis develops is important. We don’t yet know if cartilage restoration prevents joint replacement, but it can delay joint replacement.”
Full Spectrum of Procedures Ohio State’s Cartilage Restoration Program provides the full spectrum of cardiac restoration procedures: • Autologous chondrocyte implantation – Healthy cartilage cells are removed from a non-weight-bearing joint, grown in the lab, and then implanted in the defective areas of the joint
10 Adult Recontructive Surgery
• Osteochondral allograft transfer – Healthy cartilage tissue or a graft is used from a bone bank donor and transplanted in the area of defective cartilage • Osteochondral autograft transfer – Plugs of cartilage are taken from the non-weight-bearing areas of the knee and transferred to the damaged areas of the joint • Microfracture – Tiny holes are made in the injured joint surface (subchondral bone) to create a new blood supply and stimulate new cartilage growth • DeNovo cartilage implantation – This clinical trial uses a living cartilage implant with juvenile cellbased technology • CAIS (Cartilage Autograft Implantation System) – This clinical trial uses healthy cartilage from a patient’s non-weight- or low-weight-bearing region for surgical treatment of damaged cartilage Related procedures and services include: • Meniscal transplantation and meniscal repair • ACL reconstruction
rehabilitation clinic patient – their care is managed with utmost attention. Our team of specialists develops comprehensive care plans that address each patient’s needs from start to finish, including care for their comorbidities, to ensure a seamless continuum of care. From preoperative testing and patient education to inpatient services and post-surgical care, our team of physicians, nurses, case managers, physical therapists, occupational therapists and support members provides unparalleled specialty care for cartilage restoration patients. The heart of our patient care, of course, rests in our fellowship-trained surgeons. This level of subspecialty training ensures the highest quality of care. Today, many patients’ orthopaedic needs are highly complex, often accompanied by comorbidities that create significantly higher risks. Ohio State is uniquely positioned to care for these multifaceted patients and to respond to any expected or unexpected complications that arise.
• Multiligament reconstruction • Corrective osteotomy
Research
Rehabilitative Care
Dr. Flanigan is leading a study funded by the NFL (National Football League) Charities to determine the effects of football play on articular cartilage in knee joints.
Complete recovery from a cartilage restoration procedure and a return to athletic activity can take six to 18 months. The Cartilage Restoration Program works closely with the physical therapy and rehabilitation specialists at Ohio State to assist patients in returning to full range of motion, strength and flexibility. “We’ve had very positive reaction from cartilage restoration patients,” says Dr. Flanigan. “They’re happy not to have pain anymore and, just as important, they’re pleased to still be active during the years when people are meant to be very active. We also work with them to teach them how to prevent further injury or damage.”
Unmatched Specialty Care for Comorbidities
“Specifically, we’re examining how a season of play affects the cartilage in NFL offensive linemen – the players at highest risk for developing arthritis,” says Dr. Flanigan. “Then, we’ll try to determine the measures that can prevent cartilage breakdown.” The NFL study is in collaboration with Robert Siston, PhD, of Ohio State’s Department of Mechanical and Aerospace Engineering, and Ajit Chaudhari, PhD, OSU Sports Medicine and co-director of Ohio State’s Movement Analysis and Performance Program. Dr. Flanigan is a member of the Multicenter Orthopaedic Outcomes Network (MOON) and the Multicenter ACL Revision Study (MARS) – multicenter ACL reconstruction and revision outcome research studies. He also is involved in cartilage restoration clinical trials with DeNovo and CAIS.
From the moment patients enter the Cartilage Restoration Program – whether they are a hospital surgical patient, an outpatient surgical patient or a 11 Adult Recontructive Surgery
David Flanigan, MD Director, Cartilage Restoration Program Assistant Professor, Clinical Orthopaedics Team Physician, OSU Athletic Department Fellowship: Sports Medicine, University of Wisconsin, Madison Residency: Orthopaedics, Northwestern University, Evanston, Ill. Internship: Northwestern University, Evanston, Ill. Medical School: University of Iowa College of Medicine, Iowa City Clinical Interests: sports medicine; knee and shoulder injuries; cartilage injuries and restoration; knee ligament injuries (ACL, LCL, PCL); revision ACL injuries to the knee; multiligament injuries and knee dislocations Research Interests: cartilage injury and repair; MR imaging of cartilage; meniscus repair and preservation; clinical outcomes of knee injuries and interventions
How to refer patients... The Ohio State University Wexner Medical Center Department of Orthopaedics Please call 614-293-2413 or 1-888-861-8081 for patient referrals. Our promise to you We partner with referring physicians to provide specialty orthopaedics care for your patients. Our policy is to accept all patients referred to our Department. If we determine that a referred patient would be better served by another specialty, we will arrange that visit for your patient. We welcome you to refer your patients to us when you feel that they would benefit from more specialized care. We promise to communicate with you about your patient’s condition, provide feedback about their care and refer them back to you for ongoing care.
ortho.osu.edu
12 Š 2012 The Ohio State University Wexner Medical Center CORP20120105-08 Comprehensive Spine center
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Ohio State’s Comprehensive Spine Center
Collaborative Care for the Back and Neck w Multidisciplinary, interdisciplinary atmosphere w Prompt access, efficient diagnosis w Treatment ranging from therapy to interventions to surgery w Full complement of pain management techniques w Focus on returning patients to normal function as quickly as possible
Comprehensive Spine Center Medical Director:
Gary Rea, MD, PhD
with the appropriate information, including possible outcomes, so they can make informed decisions about treatment options,” says Dr. Rea. “Our approach is not paternalistic. We want patients to be fully engaged in decision-making.”
The Comprehensive Spine Center at The Ohio State University Wexner Medical Center features spine care in a multidisciplinary atmosphere, with enhancements focused on prompt access, efficient diagnostic processes and individualized care aimed at returning patients to normal function.
With a new, more spacious location and on-site access to two non-operative neurosurgeons, three operative neurosurgeons, two orthopaedic spine surgeons, five physical medicine and rehabilitation physicians, and five anesthesia/pain specialists, patients at the Comprehensive Spine Center enjoy more immediate access to care.
Specialists from the following disciplines collaborate to resolve spine-related problems with diagnostic testing, imaging, pain management, surgery and rehabilitation in a single location at our new CarePoint East facility:
“We see patients quickly, direct them to the appropriate specialty care and get them on the path to improvement so they can return to work and normal functioning as soon as possible,” says Dr. Rea.
• • • •
In addition to providing patient evaluation, diagnosis and treatment, professionals in the Spine Center are happy to provide second opinions for patients who are considering surgery.
Orthopaedic Spine Surgery Neurologic Spine Surgery Physical Medicine and Rehabilitation Anesthesiology/Pain Medicine
The care is multidisciplinary and interdisciplinary—a truly collaborative, combined approach. “A rehabilitation physician can walk down the hall and consult with a surgeon while the patient is still in the Spine Center to agree on a direction for care,” says Gary Rea, MD, PhD, a neurosurgeon and director of the Comprehensive Spine Center. “In a single visit, a patient can have diagnostic testing, receive a pain injection and see a spine surgeon. There’s no need to wait to be referred to multiple physicians. A referral to the Comprehensive Spine Center opens the door to spine-focused specialists and even integrative, nontraditional services such as medically restorative massage, aquatic therapy and acupuncture.” Rapid Access and Treatment Plans Most Spine Center patients see nonsurgical physicians for a comprehensive evaluation. These physicians determine if patients need to see a surgeon. When surgery is necessary, many procedures can be performed within two weeks. The Spine Center promotes patient involvement in treatment decisions. “Patients should be provided
Nonsurgical Treatment Nonsurgical treatment in the Spine Center involves specialists from Physical Medicine and Rehabilitation and Anesthesiology/Pain Medicine. Patients who have neck or back pain that has not responded to traditional treatment in four to six weeks are appropriate referrals. Before interventions are employed, other means of treatment are exhausted as appropriate to the patient’s condition. Physical Medicine and Rehabilitation (PM&R) physicians assess patients and develop nonsurgical treatment plans, including physical therapy, exercise and medication. PM&R specialists work closely with their Spine Center colleagues in Anesthesiology/Pain Medicine and Orthopaedic and Neurologic Surgery. When patients do not respond to conservative measures, they may be candidates for interventions. Physicians who specialize in interventional procedures in the Spine Center are board-certified or board-eligible. They use technology advances to treat spine pain, including fluoroscopic imaging with X-ray to safely pinpoint medication injection. Digital subtraction angiography helps to ensure medication is targeted. “We have extensive training in interventional spine
14 Comprehensive Spine Center
procedures and use sophisticated technology to provide the safest possible injection therapy,” says Kenneth Nguyen, DO, a physical medicine and rehabilitation and pain management specialist. “When patients are having pain medication injected in the spinal area, the experience of the physicians is important. Our six interventionalists are fellowshiptrained and board-certified, which should be an absolute requirement for this type of treatment.”
upon completion of a fellowship in pain medicine at Loyola,” he says. “I wanted to be part of the resident training, research and large patient base that Ohio State afforded me. Also, the comprehensive approach at the Spine Center was of great interest. The focus is on doing what is best for each and every individual patient, not what is easy or popular. We practice evidence-based medicine with a personalized approach.” Surgical Treatment
meeting a huge demand Dr. Nguyen completed his residency at Ohio State, followed by a fellowship in Detroit, before returning to Ohio State. “Exciting things are happening at the Medical Center, and I wanted to be part of the growth and expansion,” says Dr. Nguyen. “The new Spine Center is meeting a huge demand for comprehensive spine care. We have the technology and expertise and high degree of collaboration among specialists to provide the best care available anywhere.” Nonsurgical treatment available in the Spine Center includes: • • • • • • • • • • • • •
Physical therapy Electromyography Functional discography Lumbar traction with electrical stimulation Trigger point injections Epidural steroid injections Intra-articular injections Sympathetic nerve blocks Spinal cord stimulation Radiofrequency ablation Cooled radiofrequency ablation Implantable intrathecal drug delivery systems Vertebroplasty
Raj Swain, MD, an anesthesiologist and pain medicine specialist in the Spine Center, uses fluoroscopy to guide nerve ablation in cooled radiofrequency ablation procedures to treat lumbar spine pain. “We are one of a few facilities offering cooled radiofrequency ablation, in which the patient is under anesthesia during the ablation procedure. This procedure is performed in the hospital, with excellent patient comfort and outcomes,” he says. Dr. Swain has extensive experience with cooled radiofrequency ablation and is one of the leaders nationally using this technique. Like Dr. Nguyen, Dr. Swain completed a residency in anesthesiology at Ohio State and returned after his fellowship training. “I wanted to practice at Ohio State
Ohio State’s Spine Center provides the most advanced surgical interventions when surgery is determined to be appropriate for conditions including: • • • •
Herniated cervical or lumbar disks Cervical or lumbar stenosis Scoliosis Deformity correction
Minimally invasive spine surgery with minimal tissue damage is increasingly popular, and provides patients with reconstructive back procedures with much less damage to muscles and ligaments. Several surgeons in the Spine Center are trained and experienced in these minimally invasive techniques. Jim Thoman, MD, who trained at Ohio State and then did fellowship training in minimally invasive procedures, joined the Spine Center staff in February 2012. Dr. Rea provides guidance for surgical intervention. “About 97 percent of people with spine problems do not need surgery or injections and will improve on their own,” he says. “Even if patients have herniated disks, approximately 85 percent of them will improve without surgery. We offer excellent nonsurgical treatment.” Dr. Rea advises consultation in these cases: • Patients with acute neck and arm pain • Patients with acute back and leg pain • Patients older than 65 with pain in the back and down the legs “Surgery for a herniated disk may be a reasonable choice for patients who are miserable and who either have waited to see if it resolves over time or cannot wait due to intensity of pain,” says Dr. Rea. “One condition that tends to respond better to surgical intervention than nonsurgical treatment is lumbar stenosis,” says Dr. Rea. “Typically, these patients are older, have severe pain when walking or standing and have lost mobility.”
15 Comprehensive Spine Center
New Specialist Treating Complex Spinal Disorders Safdar N. Khan, MD, a recent addition to Ohio State’s Wexner Medical Center, specializes in complex adult and pediatric spine and spinal deformity surgery. Many spinal conditions often go untreated for years, until patients become so debilitated that treatment options become limited. Adult scoliosis patients often develop arthritis, bony spurs that press on the spinal cord, as well as pain and deformity, complicating a condition that is already difficult to manage.
Dr. Khan treats the following conditions: • Simple and complex trauma: cervical fractures, thoracolumbar injuries
• Spinal stenosis • Spondylolisthesis • Kyphosis
• Scoliosis (adult and pediatric) • Spinal deformity (adult and pediatric) • Herniated discs
“I am confident that regardless of what spinal problems a patient is experiencing, we can provide treatment options that will help the patient better manage their condition,” says Safdar N. Khan, MD. “We have the ability to evaluate each patient and make sure he or she receives the best treatment, even if other physicians have been nervous about recommending additional treatments or procedures.”
• Spinal tumors • Spinal trauma
C A SE STU D Y A 19-year-old man came in with complaints of upper back pain and presented with untreated adolescent idiopathic scoliosis and a stiff 70 degree thoracic curve that was also hyperkyphotic (increased forward curvature) in the thoracic spine. The patient underwent successful posterior spinal fusion with instrumentation T2-L3.
Minimally Invasive Surgery Minimally invasive surgery for the treatment of adult scoliosis and disorders involving the cervical discs, offers great benefit to patients. Not only is the surgery less invasive, reducing the risk for infection, the recovery time is much faster and allows patients to resume a normal activity level much faster post-surgery. Cervical Total Disc Arthroplasty Dr. Khan is now evaluating patients who may be candidates for cervical total disc arthroplasty. Patients who are typically good candidates for this procedure have neck and arm pain for more than than six months and have tried other treatment options without success. This procedure is done in place of a fusion surgery and replaces discs between the vertebral bodies in the neck.
Pre-surgical: Patient with untreated adolescent idiopathic scoliosis and a stiff 70 degree thoracic curve that was also hyperkyphotic.
Post-Op: Patient’s spine following a successful posterior spinal fusion with instrumentation T2-L3.
How to refer patients... Comprehensive Spine Center | Please call 614-293-BACK We see patients at the following locations: CarePoint East 543 Taylor Ave. Columbus, OH 43203
CarePoint Lewis Center 6515 Pullman Drive Lewis Center, OH 43035
CarePoint Gahanna 920 N. Hamilton Road Gahanna, OH 43230
OSU Spine and Neurological Surgery 680 Park Ave. West, Suite 203 Mansfield, OH 44906
Our promise to you No question or concern about your patient is too small. Our policy is to accept all appropriate patients referred to the Spine Center. 16 Comprehensive Spine Center
C o mprehe n s i v e Sp i n e C e n t er
Neurosurgery
Gary Rea, MD, PhD
J. Bradley Elder, MD
H. Francis Farhadi, MD, PhD
Carole Miller, MD
Orthopaedic Surgery
Safdar N. Khan, MD
Physical Therapy
Laurie Bell, PT
Jennifer Belu, PT
Physical Medicine and Rehabilitation
Theresa Calimlim, MD
Kenneth Nguyen, DO
Francine Pulver, MD
Pain Medicine
Hans Miller, MD
William J. Thoman, MD
Mike Evers, MD
Kenneth Nguyen, DO
Anshuman Swain, MD 17 Comprehensive Spine Center
Joseph Tu, MD
Cari Hanler, PT, DPT
The Ohio State University Wexner Medical Center Comprehensive Spine Center medicalcenter.osu.edu
Š 2012 The Ohio State University Wexner Medical Center CORP2012015–09
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The Ohio State University Wexner Medical Center
Orthopaedics — Hand, Upper Extremity and Shoulder w Full spectrum of treatment options from shoulder to fingertips w High degree of subspecialization, including complex revision procedures w Fellowship-trained, board-certified surgeons w Comprehensive care for any comorbidity
The Ohio State University Wexner Medical Center is ranked by U.S News & World Report as one of the premier sites in the country for orthopaedic surgery.
Complete Care — Shoulder to Fingertips The Department of Orthopaedics at The Ohio State University Wexner Medical Center offers the highest caliber of expertise in its Hand and Upper Extremity and Shoulder divisions. The growth the department has experienced in the last several years means that, today, seven subspecialty-trained surgeons provide complete care from the shoulder to the fingertips. Patients benefit from fellowship-trained surgeons who perform high-volume, new and revision reconstruction, joint replacement, reattachment, tissue transfer, microsurgery, soft tissue procedures, fracture repair and nerve decompression.
The Right Diagnosis, Right from the Start
Michael Ruff, MD, hand surgeon
“We want to partner with referring physicians to make sure patients get the right diagnoses from the start to ensure they receive appropriate initial treatment and decrease the need for revision surgeries,” says Michael Ruff, MD, director, Hand and Upper Extremity Surgery Center. “We’re happy to see your patients and provide our opinion on the best course of action.” Points of Excellence — Hand and Upper Extremity Division • Hand surgeons in the division performed more than 3,500 surgeries, treatments and procedures in 2011. • Surgeons in the division performed the Medical Center’s first wrist arthroplasty and first toe-to-thumb transplant in 2011. • Michael Ruff, MD, leads a team of hand and microsurgeons with expertise in complex upper limb reconstruction. Dr. Ruff also specializes in arthritis surgery of the hand and wrist and endoscopic carpal tunnel release. • Sonu Jain, MD, recently joined the division to specialize in adult hand and microsurgery • The division provides difficult-to-match elbow surgery capabilities.
• The division welcomed its first Hand and Upper Limb Surgery fellow in an ACGME-accredited fellowship in August 2011. The fellowship was made possible by increased patient and surgical volumes, a revamping of the hand didactic curriculum and a robust expansion of research activities. This fellowship is a collaboration between the departments of Orthopaedics and Plastic Surgery and is one of only approximately 80 such fellowships nationwide. Points of Excellence — Shoulder Division • Julie Bishop, MD, and R. Bryan Butler, MD, perform the highly subspecialized reverse total shoulder surgery. • Julie Bishop, MD, has been inducted into the American Shoulder and Elbow Surgeons (ASES), an invitation-only group with about 350 members worldwide. She is one of only five female members in the United States and the only surgeon in central Ohio to belong. Grant Jones, MD, will be inducted in fall 2012. “It speaks very highly of Ohio State’s Shoulder Division that we have one surgeon in the group and another in progress,” says Dr. Bishop. • Dr. Butler won the prestigious Mel Post Award for Excellence in Clinical Research at the 2012 Biennial AAOS/ASES Shoulder and Elbow meeting.
20 Hand, Upper Extremity and Shoulder
Hand and Upper Extremity The Ohio State University Wexner Medical Center’s Department of Orthopaedics has five fellowship-trained hand and upper extremity surgeons whose expertise spans the spectrum of available procedures: • Microsurgery
“Shoulder cases can be extremely complicated. Despite your best efforts, every case doesn’t have the outcome the patient hoped for. Sometimes this is due to comorbidities such as rheumatoid arthritis or obesity. The level of expertise required to perform such a high volume of these complex revision procedures makes us even more skilled at the routine cases.”
• Reconstructive surgery • Joint replacement surgery • Reattachment • Microsurgical free tissue transfer • New and revision procedures This surgical knowledge is applied to the hand, wrist, forearm, elbow and shoulder for conditions including arthritis, severed limbs, carpal tunnel syndrome, distal radio-ulnar problems, joint degeneration, crush injuries, fractures, tendon laceration, trigger finger, joint pain, severed nerves and dislocations. “Often, we see patients whose surgeries have not had the desired outcomes, and our subspecialty expertise leads them or their referring physicians to Ohio State,” says Dr. Ruff. “We’re pleased to determine if further surgical repair is possible. This high caliber of subspecialization of our surgical team is what makes our program successful. Patients appreciate the convenience of our Hand Center where all care is provided — from the initial visit with exam and imaging, through outpatient surgery and therapy.”
Shoulder Surgeons in the Shoulder Division specialize in revision cases. Their capabilities, which are completely arthroscopic, include: • Complex fractures • Difficult instability procedures with bone loss • Reconstruction • Joint replacement • Reverse total shoulder • Scapular nerve decompression • Complicated elbow procedures • Soft tissue arthroscopic procedures, including rotator cuff and labral repair • Revision procedures
“We are a tertiary referral center for shoulder problems, so please do not hesitate to consult us for any problem,” says Dr. Bishop. “Whether it is a shoulder problem with seizure disorder, bone loss on the socket side in a shoulder dislocation or an infected joint, we are here to help you and your patients.”
Dr. Bishop encourages physicians to refer complicated cases for diagnosis. “Many failed surgeries are due to inaccurate diagnoses,” she says. “We’re expert diagnosticians, and we can help determine when surgery is unnecessary. Shoulder surgery is a significant endeavor and requires as long as a year of recovery and rehabilitation. Working together, we can make sure surgery is performed only when indicated.” Dr. Bishop says that a female specializing in shoulder surgery surprises some people—physicians and patients alike. “Some patients ask me if I’m ‘big enough’ to do their surgeries,” she says. “I tell them it’s about technique, not brute force. I have excellent results and happy, satisfied patients. Orthopaedic surgeons need stamina. I’m a marathon runner and triathlete. I did two total shoulder replacements the day before I had my third child. I can handle anything that comes my way.”
Comprehensive Care The hand, wrist, elbow and shoulder are comprised of delicate anatomy. The orthopaedic programs focusing on these body parts work closely with physicians, surgeons and other clinicians in Plastic Surgery, Sports Medicine, Anesthesiology, Neurology, and Physical Medicine and Rehabilitation to provide comprehensive patient care. Often, patients who come to a university tertiary referral center have complex needs due to comorbidities. Many practices and facilities are not equipped to treat these patients and the significantly higher risks involved in their surgical care. The comprehensive and specialty-rich Ohio State University Wexner Medical Center is uniquely positioned to
21 Hand, Upper Extremity and Shoulder
care for these multifaceted patients — both their expected and their unexpected needs. As a Level 1 Trauma Center, we offer sophisticated care for complex multiple injuries to limb injury and fracture.
Ready to Serve Your Patients and You Any condition, any time. From the highly complex to the straightforward cases, the Hand, Upper Extremity and Shoulder teams accept every patient. Can you help me determine if I can manage this patient on my own? Can I seamlessly transfer the patient to you? Can you give me a second opinion? Can you review this case and determine if anything more can be done for the patient? The answer is “yes.” “We assume care of your patients the day you refer to us, and we become an advocate for you and for your patient’s care,” says Dr. Bishop. “We’re all about relationship-building — with you and the patient. We appreciate every case you refer to us.”
Research
Dr. Bishop has received grants in successive years from the OmeGA Foundation. Her work focuses on developing new teaching methods to improve anatomy education among medical students and residents, and involves faculty from the entire Department of Orthopaedics. Dr. Bishop and Dr. Jones are part of the MOON (Multicenter Orthopaedic Outcomes Network) Shoulder Project, consisting of orthopaedic surgeons from several of the top orthopaedic institutions in the United States. This group is working together on research to give shoulder patients the best possible care.
Shoulder Referrals: 614-293-3600 or 614-366-4263 (HAND) Magenta line does not print
The Hand and Upper Extremity Division is involved in 12 ongoing research projects including four prospective clinical studies.
How to refer patients...
Hand and Upper Extremity Center Referrals: 614-366-4263 (HAND) or 1-866-298-HAND Our promise to you We promise to communicate with you about your patients, provide feedback about their care and refer them back to you for ongoing care. We partner with referring physicians to provide specialty orthopaedics care for your patients. Our policy is to accept all patients referred to our Department. If we determine that a referred patient would be better served by another specialty, we will arrange that visit for your patient.
22 Hand, Upper Extremity and Shoulder
Team Michael Ruff, MD
Ryan Klinefelter, MD
Director, Hand and Upper Extremity Center Director, Hand Fellowship Training Program Clinical Associate Professor, Orthopaedic Surgery
Assistant Professor, Orthopaedic Surgery
Clinical Interests: Reconstructive surgery of the hand and wrist, arthritis surgery, microsurgery, endoscopic carpal tunnel surgery Fellowship: Hand and Microsurgery, The Ohio State University and Riverside Methodist Hospital Fellowship: Hand Surgery, University of Louisville Residency: Orthopaedic Surgery, Ohio State University Internship: General Surgery, Riverside Methodist Hospital, Columbus, Ohio Medical School: The Ohio State University College of Medicine
Hisham Awan, MD Assistant Professor, Clinical Orthopaedics Clinical Interests: Complex elbow trauma, compression neuropathies, wrist fractures, reconstruction of the elbow, wrist and hand Fellowship: Hand Surgery, University of Pittsburgh Residency: Orthopaedic Surgery, Ohio State University Medical Center Internship: Wayne State University/Detroit Medical Center Medical School: Wayne State University School of Medicine, Detroit
R. Bryan Butler, MD Assistant Professor, Clinical Orthopaedics Clinical Interests: Sports, arthritic and trauma disorders of the shoulder and elbow, shoulder and elbow primary and revision replacements, rotator cuff and instability repairs, ligament reconstructions of the elbow, arthroscopy of the elbow, fracture treatment of shoulder and elbow Fellowship: Shoulder and Elbow Surgery, Harvard University, Massachusetts General Hospital/Brigham and Women’s Hospital Residency: Orthopaedics, University of Maryland, Baltimore Internship: University of Maryland Medical Center Medical School: University of Maryland School of Medicine
23 Hand, Upper Extremity and Shoulder
Clinical Interests: Complex hand and wrist injury repair Fellowship: Hand Surgery, The Indiana Hand Center, Indianapolis Residency and Internship: Orthopaedic Surgery, The Ohio State University Medical Center Medical School: The Ohio State University College of Medicine
Julie Bishop, MD Associate Professor, Clinical Orthopaedics Team Physician, Ohio State’s Sports Medicine Center Clinical Interests: Sports injuries in shoulder and knee, rotator cuff injuries, shoulder fractures, shoulder replacements, orthopaedic injuries in female athletes Fellowship: Shoulder Surgery, The Mount Sinai Hospital, New York, NY Residency: George Washington University, Washington, DC Internship: George Washington University, Washington, DC Medical School: Cornell University Medical College, Ithaca, NY
Grant Jones, MD Associate Professor, Clinical Orthopaedics Team Physician, Ohio State’s Sports Medicine Center Clinical Interests: Sports medicine, shoulder and knee injuries Fellowship: Sports Medicine, The Hughston Clinic Residency: The Ohio State University Internship: The Ohio State University Medical School: The Ohio State University College of Medicine
Sonu Jain, MD Assistant Professor, Plastic Surgery Clinical Interests: Hand microsurgery Fellowship: Hand, Upper Extremity, and Microsurgery, Massachusetts General Hospital, Harvard Medical School Residencies: Plastic and Reconstructive Surgery, Lahey Clinic, Burlington, MA, Otolaryngology-Head and Neck Surgery, Charity Hospital/Louisiana State University Health Sciences Center School of Medicine Medical School: MCP Hahnemann University School of Medicine (Drexel University College of Medicine), Philadelphia, PA
The Ohio State University Wexner Medical Center Orthopaedics – Hand, Upper Extremity and Shoulder ortho.osu.edu handcenter.osu.edu
Š 2012 The Ohio State University Wexner Medical Center CORP20120105-06
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The Ohio State University Wexner Medical Center
Hip Preservation w Treatment of labral tears, femoroacetabular impingement (FAI), hip dysplasia and hip arthritis in the young patient. w Surgical expertise in hip arthroscopy, femoral pelvic osteotomies and direct anterior total hip replacement w Complete surgical care of the active patient with hip pain
The Ohio State University Wexner Medical Center is ranked by U.S News & World Report as one of the premier sites in the country for orthopaedic surgery.
Helping Young Patients with Hip Problems Resume an Active Life More Quickly Hip preservation is a unique and emerging field in medicine and our specialists are able to provide young patients with leading-edge care. At The Ohio State University Wexner Medical Center, hip preservation is highlighted by a multidisciplinary program approach that includes physicians, clinicians and researchers from orthopaedics, physical therapy, athletic training, clinical sports psychology, radiology, family practice and sports medicine. Thomas Ellis, MD, vice-chair of the Department of Orthopaedics and chief of the Division of Hip Preservation, specializes in the treatment of hip disorders and pain in the young, active, adult patient (< 50 years old). He performs all surgeries for the hip, including joint-preserving surgeries (hip arthroscopy and hip osteotomy) and joint replacement surgeries (including direct anterior total hip replacement). He is an expert in the treatment of hip labral tears, FAI, snapping hip, hip dysplasia, hip arthritis and avascular necrosis. His extensive experience in hip arthroscopy for labral tears or FAI, Ganz periacetabular osteotomy for hip dysplasia, femoral osteotomies and direct anterior hip replacement has made him one of a few surgeons in the nation able to offer the full completment of treatment options to this patient population.
WHEN TO CONSIDER HIP ARTHROSCOPY Many different hip procedures can be performed arthroscopically including the following most common procedures: Femoroacetabular Impingement (FAI) is a condition affecting the hip joint and is characterized by abnormal contact between the femoral head (hip ball) and the rim of the acetabulum (hip socket), which leads to damage to the articular cartilage (lining or gristle) in the acetabulum, or to the labrum of the hip, or both. The labrum is a ring of cartilage that surrounds the acetabulum and looks very much like the meniscus of a knee joint, although its function is different. Damage to the labrum and/or articular cartilage will likely cause pain. An abnormality in the shape of the femoral head or acetabulum, or both, may cause FAI. Activities that involve recurrent hip motion can increase the frequency of this abnormal contact, such as kicking sports. FAI generally presents in three forms: cam impingement, pincer impingement and mixed impingement (involving both cam and pincer type). FAI can affect all age groups from the early teens and throughout adult life and is being increasingly recognized as a factor that may predispose patients to osteoarthritis of the hip. It is felt by many that without early intervention surgery, there is a high likelihood of developing osteoarthritis with the subsequent requirement for either a hip replacement or other major hip operation. Hip arthroscopy can be used to reshape the femoral head and socket to prevent impingement, and aims to protect the hip from developing osteoarthritis, in addition to relieving current symptoms.
Benefits of Hip Arthroscopy • Effective treatment for FAI • Less muscle damage than open techniques • Faster recovery with quicker return to normal function • Ability to return to activities more quickly
26 Hip Preservation
WHEN TO CONSIDER PELVIC OSTEOTOMY FOR HIP DYSPLASIA
When to consider Direct Anterior total hip Replacement
In acetabular dysplasia, the hip socket is poorly developed, resulting in a socket that is shallow and shaped like a saucer, rather than a cup. The top part of the socket is obliquely inclined, and it incompletely covers the ball. This results in abnormally high stress on the outer edge of the socket (also called acetabulum) and leads to early damage to the acetabular articular cartilage or the adjacent acetabular labrum. Once this damage occurs, individuals often begin experiencing hip pain.
Total hip replacement is an effective treatment for hip arthritis that is nonresponsive to conservative care. During traditional hip replacement surgery, muscles are cut during the surgical procedure to enable the surgeon to gain access to the hip joint. With direct anterior total hip replacement, no muscles are cut.
Treatment of hip dysplasia depends on a variety of factors:
The surgeon is able to access the joint by going between individual muscle groups. This leads to a shorter hospital stay and less recovery time. This technique is rapidly gaining popularity in the U.S. as its benefits are realized. Dr. Ellis is one of a handful of surgeons in the region who offers this treatment option.
• age of the patient • severity of dysplasia
Benefits of Direct Anterior Total Hip Replacement
• presence or absence of arthritis
• Less muscle damage than traditional total hip replacement
• degree of symptoms
• Faster recovery
• patient’s expectations In patients with mild dysplasia and symptoms, physical therapy for core strengthening or a short course of anti-inflammatory medications may be indicated. If patients are more symptomatic or have mild symptoms but a more severe degree of dyplasia, a surgery called a periacetabular osteotomy may be indicated. Also referred to as a Ganz osteotomy or a PAO, this surgery involves cutting the pelvic bone and then rotating the socket to a more normal position. The cut socket is then reattached to the pelvis using screws. In the appropriate patient, treatment of hip dysplasia with a periacetabular osteotomy may improve pain and delay or possibly prevent the onset of hip arthritis. Patients with hip dysplasia who have painful hip arthritis are often best served with hip replacement surgery. The periacetabular osteotomy surgery is usually performed on patients under age 40, but occasionally, individuals over 40 are candidates for this surgery. In most cases, individuals over 40 with painful hip dysplasia already have moderate arthritis, and are usually best treated with hip replacement surgery.
Benefits of Pelvis Osteotomy • Effective treatment of hip dysplasia • Will delay or prevent progression of arthritis • Will allow for return to normal activities after surgical recovery
• Less risk of dislocation • Fewer postoperative restrictions • Improved assessment of leg lengths to prevent leg length discrepancy after surgery
Advancing research Dr. Ellis focuses his research on hip preservation and its outcome. He recently implemented a clinical outcomes database that captures presurgical, surgical and postsurgical datapoints. “By following our patients for up to 20 years, we will be able to identify which treatment options work best for patients — not just for an immediate fix, but for long-term success,” says Dr. Ellis. Additionally, he is collaborating with researchers within physical therapy to evaluate the effectiveness of nonoperative treatment of femoroacetabular impingement (FAI) and on preoperative predictors of outcomes following surgical treatment of FAI. Dr. Ellis is also collaborating with researchers in the Department of Radiology at the Wright Center of Innovation to develop advanced imaging techniques for the hip, including cartilage imaging sequences. By collaborating with the clinical and research arm of a wide range of departments, The Ohio State University Wexner Medical Center is able to focus on continuing to provide patients with the best and most personalized treatment options available for hip pain and hip disorders.
27 Hip Preservation
Thomas Ellis, MD Vice Chair, Department of Orthopaedics Chief, Hip Preservation Associate Professor, Orthopaedics Clinical Interests: Hip Arthroscopy, Pelvic Osteotomy, Direct Anterior Total Hip Replacement Fellowship: Total Joint Arthroplasty, Anderson Orthopaedic Research Institute, Alexandria, Va. Fellowship: Orthopaedic Trauma Fellowship, Hennepin County Medical Center, Minneapolis Fellowship: John Border Memorial European AO Trauma, Bern, Switzerland/Hanover, Germany Residency: Orthopaedic Surgery, Texas A&M University and Scott & White Hospital, Temple, Texas Internship: Orthopaedic Surgery, Texas A&M University and Scott & White Hospital Medical School: Vanderbilt University School of Medicine, Nashville
How to refer patients... Call 614-293-3541 to schedule a referral. We partner with referring physicians to provide specialty orthopaedics care for your patients. Our policy is to accept all patients referred to our Department. If we determine that a referred patient would be better served by another specialty, we will arrange that visit for your patient.
Ohio State’s Department of Orthopaedics delivers personalized care focused on the whole patient, utilizing the full resources of Ohio’s leading academic medical center, driven by the latest research and evidence-based medicine. The Ohio State University Wexner Medical Center Orthopaedics Program is consistently ranked by U.S.News and World Report as one of the premier sites in the country for orthopaedic surgery.
The Ohio State University Wexner Medical Center Hip Preservation ortho.osu.edu
© 2012 The Ohio State University Wexner Medical Center CORP20120105-05
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The Ohio State University Wexner Medical Centerâ&#x20AC;&#x2122;s
Musculoskeletal Infection Program from the Department of Orthopaedics w Singular expertise in musculoskeletal infection w One of only a few such programs in the nation w Addresses limb- and life-threatening infections complicated by co-morbidities
Ohio State’s Wexner Medical Center’s Musculoskeletal Infection Program The Musculoskeletal Infection Program in the Department of Orthopaedics is one of only a handful of such programs in the country. This innovative program was established to address challenging limb- and life-threatening infections that are further complicated by co-morbidities. Specialists at Ohio State’s Wexner Medical Center have the exceptional expertise and evidence-based protocols to prevent infection and the experience to treat it when it occurs. The program focuses on three key areas: • Prevention – Careful evaluation and monitoring of surgical candidates, especially those with comorbidities, to optimize surgical outcomes and decrease infection risk. • Treatment – Multidisciplinary care for complex patients from specialists in Orthopaedics, Infectious Diseases, Plastic Surgery and Physical Medicine & Rehabilitation (PM&R). • Easy Consultation – About any case because our specialists want to minimize the life-threatening and life-changing damage severe musculoskeletal infections can cause. The Department has benefited greatly from the vast experience of Jason Calhoun, MD, founder and driver of the Musculoskeletal Infection Program. Dr. Calhoun brings to the Medical Center more than 25 years of unrivaled expertise in musculoskeletal infection prevention and treatment. His experience includes:
• Teaching courses on the Ilizarov apparatus, a minimally invasive external fixation system that stimulates new bone formation, often used in treatment of infected bone. • Co-founding the Musculoskeletal Infection Society (MSIS), and working with physicians around the country who specialize in this area to advance research, education and patient care. • Serving on Ohio State’s Surgical Care Improvement Project (SCIP), a national quality partnership sponsored by the Centers for Medicare & Medicaid Services, and developing protocols to reduce infections. • Receiving a $1.6 million Department of Defense grant, “Modification of an Accepted Animal Model of Osteomyelitis to Simulate and Evaluate Treatment of War Extremity Wounds.” Since Dr. Calhoun joined the Department of Orthopaedics and established the Musculoskeletal Infection Program, the Department’s rate of surgical site infections has decreased dramatically. This is attributable to an aggressive approach to infection prevention in the department.
• Performing almost 7,000 surgeries to treat these infections during his career. • Traveling throughout the United States and around the world to share his knowledge about surgical treatment of infection. • Writing three books, 100 chapters and 165 publications in peer-reviewed journals about infection control.
30 Musculoskeletal Infection Program
Prevention of Musculoskeletal Infection
Treatment of Severe Musculoskeletal Infection
The prevalence of musculoskeletal infection can be attributed, in part, to patients’ medical conditions and lifestyles. Patients who smoke, have multiple medical problems or have a chronic disease such as diabetes or rheumatoid arthritis are more likely to develop infections. Thorough screening and careful monitoring of patients seeking orthopaedic surgery is critical to optimizing their outcomes, including infection risk. Ohio State’s Wexner Medical Center participates in numerous national and international initiatives to prevent infection occurrence.
When infection does occur, a multidisciplinary team provides highly specialized treatment. In addition to Dr. Calhoun, the team includes orthopaedic surgeon Jeffrey Granger, MD, and infectious diseases specialist Dr. Meredith Deutscher, MD. Involved as needed are specialists in Plastic Surgery, PM&R, and Physical and Occupational Therapy.
Among the steps taken are:
As part of Ohio State’s Wexner Medical Center’s protocol for treating infections, Dr. Calhoun developed the ABCs of treating severe musculoskeletal infection:
• Optimize patient’s health before surgery: This includes testing for diabetes, and ensuring diabetes and other chronic diseases are controlled. Obese patients may be recommended to have a bariatric procedure before orthopaedic surgery to reduce the risk of infection and, in some cases, eliminate the need for the orthopaedic procedure. • Use antibiotics prophylactically. • Screen for existing infection: This involves culturing tissues around the surgical site for the presence of bacteria and treating with additional antibiotics. • Prepare the surgical site: Use medication and topical applications to thoroughly cleanse the area for surgery. • Work in a sterile environment: Employ sterile techniques and ultra-high filtration wound sterilization in the operating room. • Monitor post-surgically: Dress the wound properly and be vigilant about detecting early signs of infection. “Our Orthopaedics department is one to watch,” Dr. Calhoun says. “Not only has it grown remarkably in the last couple of years, but we have a departmentwide obsession to reduce infection and strictly adhere to protocols. Coupled with that, we now have the expertise to tackle infection risk and to apply the very finest knowledge available in treating the most severe types of musculoskeletal infections.”
The team has expertise in treating conditions including total joint infections with or without prosthetic involvement, osteomyelitis and other bone infections, gangrene and gas gangrene, cellulitis, necrotizing fasciitis and diabetic foot infections.
A | Amputate if the infection is severe enough and the tissue is dead. Ohio State’s Wexner Medical Center is involved in research of state-of-the-art prostheses, including the customized, high performance Flex-Foot and C-Knee, and related dressings and garments to enhance prosthetic efficacy. Ohio State’s Wexner Medical Center has expertise in revision and reconstruction amputation surgery to improve functionality. B | Beat it down or suppress it. When conventional care demonstrates no measurable signs of improvement, this phase of treatment involves working with specialists in infectious diseases to optimize medication therapy, and with Ohio State’s Comprehensive Wound Center to apply the latest in dressings, hyperbaric oxygen therapy and vacuumassisted closure (VAC). C | Cure it, debride it, remove infected tissue or prosthesis, identify the bacteria and promote clean tissue development. This phase of treatment involves surgical procedures for debridement, antibiotic bead therapy (locally applied antibiotic agents), reconstruction and the Ilizarov apparatus. The goal in each phase is to minimize the patient’s residual problems from the infection and maximize functioning. Reconstruction may be necessary after treatment of intractable infection. The musculoskeletal infection control team works closely with colleagues in orthopaedic reconstructive surgery to restore patients’ functioning after infection treatment.
31 Musculoskeletal Infection Program
Coordinating Care with Referring Physicians “Patients with severe musculoskeletal infections can be among a physician’s most challenging and difficult to treat for a variety of reasons,” Dr. Calhoun says. “We respect the primary physician’s relationship with the patient. We will work with referring physicians to provide the best possible infection treatment and return the patient to you for ongoing care. No question or concern from a referring physician is too small. We are happy to provide a formal or informal second opinion or consultation in our quest to minimize or, ideally, eradicate the life-threatening and life-changing damage from severe musculoskeletal infection.”
Ohio State’s Wexner Medical Center was awarded an “A” grade for patient safety by the Leapfrog Group in 2012.
How to refer patients... Please call 614-293-2663 (BONE) or 888-861-8081 for patient referral. Our promise to you No question or concern is too small when it comes to infection control. Please don’t hesitate to call on us at any time you need help or would like an informal or formal patient consultation. Our policy is to accept all patients referred to our program and return the patients to you for ongoing care.
32 Musculoskeletal Infection Program
Department of Orthopaedics Musculoskeletal Infection Program
Jason Calhoun, MD Professor and Interim Chair, Department of Orthopaedics Chief, Foot & Ankle Division Chief, Musculoskeletal Infection Director of Research, Department of Orthopaedics Clinical Interests: foot and ankle, osteomyelitis, orthopaedic infections, orthopaedic biomechanics.
Jeffrey Granger, MD Assistant Professor of Clinical Orthopaedics Clinical Interests: adult orthopaedics including orthopaedic infections, fractures, knee arthroscopy, joint replacement of the hip and knee, foot surgery.
Division of Infectious Diseases
Meredith Deutscher, MD Assistant Professor, Internal Medicine Assistant Medical Director, Antimicrobial Stewardship Program Member, Infectious Diseases Society of America Clinical Interests: prevention of healthcare-associated infections through judicious use of antimicrobials and developing models of antimicrobial stewardship programs for different hospital settings; musculoskeletal infections in diabetic patients and injection drug users.
33 Musculoskeletal Infection Program
The Ohio State University Wexner Medical Centerâ&#x20AC;&#x2122;s Musculoskeletal Infection Program from the Department of Orthopaedics ortho.osu.edu
Š 2012 The Ohio State University Wexner Medical Center CORP20120105-12
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The Ohio State Un iv ersity Wexner Medical Cent er
Heart and Vascular Center Update Level One Heart and Vascular Emergency Program The Ohio State University Wexner Medical Center now offers a Level One Heart and Vascular Emergency Program modeled after its successful STEMI program for heart attack patients. The new Level One program coordinates and speeds access to lifesaving cardiac and vascular care in Ohio and surrounding areas for diagnoses including: • • • • • •
STEMI (ST-segment elevation myocardial infarction) Cardiac arrest requiring therapeutic hypothermia Ruptured abdominal aortic aneurysm Acute aortic dissection Acute limb ischemia Cardiogenic shock
“The STEMI program we introduced in 2009 has received outstanding feedback from referring hospitals, emergency service providers and emergency departments. More importantly, by reducing patient transfer times, the program has improved heart attack survival rates. In collaboration with referring facilities, we have saved patients’ lives by facilitating immediate access to critical care. It makes absolute sense to apply the same process and protocols to other acute cardiovascular conditions,” says Raymond Magorien, MD, director of the Level One Heart and Vascular Program.
Ohio State’s Level One Heart and Vascular Emergency Program is led by Charles Bush, MD; Ahmet Kilic, MD; Raymond Magorien, MD; Sharon Hammond-Heaton, RN; Mark Moseley, MD; and Michael Go, MD
directly to program director Raymond Magorien, MD. The transfer process begins with a briefing on patient status and comorbidity and a mode of transport is determined. • The moment the call ends, teams and resources needed to treat the incoming patient are activated at Ohio State’s Ross Heart Hospital. • The transport team is met upon arrival in the ED to ensure smooth transfer and treatment begins.
Each step in our process is designed to ensure rapid delivery of lifesaving care:
• The Level One program’s nurse coordinator contacts the referring facility to provide nursing staff with follow-up information.
• The referring facility calls the 24/7 Level One Heart and Vascular Emergency Program hotline at 614-366-8111.
Why It Is Vital
• The call is answered within two rings and is triaged to the appropriate cardiovascular specialist. If the specialist is not immediately available the call goes
“Our Level One program is refined to activate a protocol-based system and alert a highly specialized team with a single phone call,” says Ahmet Kilic, MD, surgical director of the Level One Heart and Vascular continued on page 2
Call 614-366-8111 for immediate access and transfer to The Ohio State University Wexner Medical Center Level One Heart and Vascular Emergency Program. 35 Heart and Vascular Center Update
Female-Specific Ischemic Heart Disease Leading the Charge in Research, Diagnosis and Treatment of Microvascular Disease Female patients who have recurrent symptoms of cardiovascular disease but whose angiograms appear normal – no evidence of obstructive lesions – often confound physicians. Martha Gulati, MD, MS, FACC, FAHA, director for Preventive Cardiology and Women’s Cardiovascular Health, heads a team of clinicians and researchers at The Ohio State University Wexner Medical Center that is providing unique diagnostic capabilities for this patient population. Dr. Gulati, a co-investigator on the National Institutes of Health’s National Heart, Lung, and Blood Institute WISE study (Women’s Ischemia Syndrome Evaluation), and her team at Ohio State’s Richard M. Ross Heart Hospital use stress test magnetic resonance imaging (MRI) to see the complete picture of cardiovascular blood flow during exercise. This includes the very important microvascular areas of the heart. “Women’s anatomic and physiologic differences, for reasons we don’t yet fully understand, cause different manifestations of ischemic heart disease,” says Dr. Gulati. “Women have less evidence of obstructive lesions in the large coronary arteries that are seen with coronary angiography, with vessels often appearing normal. Nonetheless, there is often disease at the microvascular level, which we cannot see.” But it is detectable in a diagnostic tool developed at Ohio State’s Medical Center.
Cardiologist Subha Raman, MD, has advanced cardiovascular imaging with the exercise stress testcompatible MRI. A non-metal treadmill allows MRI evaluation of patients during exercise, a diagnostic tool that is superior to other forms of diagnostic stress testing, including pharmacologically induced MRI testing for ischemic heart disease. The test has shown evidence of microvascular disease that was not detected by angiography or intravascular ultrasound. This innovation is available only at Ohio State’s Medical Center and select sites involved in Dr. Raman’s research. “We encourage physicians whose patients’ symptoms persist after normal results from the cath lab to consider female-specific ischemic heart disease and this advanced testing to determine if microvascular obstruction is a factor,” says Dr. Gulati. Researchers at Ohio State lead efforts to study the diagnosis, causes and treatment of female-specific ischemic heart disease. “Women have a 56-percent lower risk of having significant obstructive coronary disease but have worse outcomes after a heart attack or stable angina,” says Dr. Gulati. “This points to causative factors other than obstructive arterial lesions. Not providing these female patients with the same level of diagnostic evaluation and treatment is not acceptable. We’re on a mission to redress this difference, reduce their high risk of future cardiac events and improve the outcomes of all patients.”
Continued from page 1 | Level One Heart and Vascular Program
Emergency Program. “The few U.S. medical centers that have established similar programs have markedly improved outcomes through this system. We already provide this level of complex, high-intensity care every day at Ohio State. The difference now is that it’s better coordinated, faster and easier for referring facilities.” According to vascular surgeon Michael Go, MD, “Whether the patient needs immediate heart catheterization, surgical repair for an aortic dissection
or aneurysm, or a procedure for acute limb ischemia, Ohio State has the subspecialty care to ensure the best possible outcome. And, importantly, we have the necessary post-procedure cardiac and vascular intensive care.” Call 614-366-8111 for immediate access and transfer to The Ohio State University Wexner Medical Center Level One Heart and Vascular Emergency Program.
36 Heart and Vascular Center Update
The Ohio State University Wexner Medical Center has Ohio’s largest group of female cardiologists, covering every subspecialty. (from left): Jennifer Dickerson, MD; Debbra Debaets, MD; Subha Raman, MD; Sharon Roble, MD; Susan Moffatt-Bruce, MD, PhD; Ayesha Hasan, MD; Veronica Franco, MD; Laxmi Mehta, MD; Martha Gulati, MD; Maria Litzendorf, MD; Jean Starr, MD; Cindy Baker, MD; Mary Fontana, MD; Molly Sachdev, MD; Mary Beth Breckenridge, MD and Kavita Sharma, MD
Adenosine vs. Exercise Stress CMR • 42 year-old F with exertional chest pain and nonobstructive LAD plaque (confirmed by IVUS) • Adenosine and treadmill stress CMR run on consecutive days • More chest pain similar to symptoms with exercise vs. adenosine • More prominent perfusion defect (arrows)
Adenosine Stress
Treadmill Stress 37 Heart and Vascular Center Update
LCA Angiogram
The Ohio State University Heart and Vascular Center Research Organization manages more than 150 trials. Current trials accepting patients include: Uncontrolled Hypertension – Ernest Mazzaferri Jr., MD, is studying the initial safety, indication of physiologic response, and performance of the Symplicity Catheter System in patients with refractory hypertension with or without end-stage renal disease. Patients meeting study criteria will have bilateral renal denervation performed percutaneously with a catheter-based system that delivers radiofrequency energy through the luminal surface of the renal artery. Then, patients will be followed to determine if renal denervation contributes to hypertension control and improves renal function. Patients are randomized into either a treatment group or a control group. Only patients in the treatment group will receive the experimental procedure. Key inclusion criteria include individuals receiving a stable medication regimen including full tolerated doses of three or more anti-hypertensive medications of different classes, of which one must be a diuretic that is expected to be maintained without changes for at least six months. To enroll a patient or to receive more study information, please contact Denise Fadorsen, RN, at 614-292-5315 or via pager at 614-346-3256. Typical Atrial Flutter – Troy Rhodes, MD, is investigating the effectiveness of the Therapy Cool Flex Irrigated Ablation System in the treatment of typical atrial flutter (cavo-tricuspid dependent) and whether its use results in an unacceptable risk of intra-procedural serious cardiac events. All treated patients will receive ablation therapy for typical atrial flutter using this ablation system in the trial. Key inclusion criteria includes the presence of typical atrial flutter. If subjects are receiving anti-arrhythmic drug therapy for an arrhythmia other than typical atrial flutter, then the subject needs to be controlled on their medication for at least three months, with one documented occurrence of arrhythmia in the past six months. To enroll a patient or to receive more study information, please contact Keri Baia, LPN, at 614-247-7731 or via pager at 614-346-2456. Heart Failure – Ayesha Hasan, MD, is investigating the safety and efficacy of the Left Atrial Pressure (LAP) Monitoring Systems. The purpose of this clinical investigation is to evaluate the safety and clinical effectiveness of the Sponsor’s LAP Monitoring Systems linked with a physician-directed, patient self-management therapeutic strategy to limit LAP excursions in patients with advanced heart failure, with a Control group receiving optimal medical therapy. The HeartPOD is available in a standalone lead or Combo System CRT-D pulse generator. The combo system uses market approved leads with the exception of the LAP lead. Patients must have experienced at least one prior hospital admission within the last 12 months for exacerbation of heart failure, with one calendar date change where the patient received intravenous diuretic therapy. In lieu of the hospitalization, the patient may have a BNP of 400 pg/ml at the screening visit to qualify. To enroll a patient or to receive more information, please contact Debra Cannon, RN, at 614-292-6789 or via pager 614-303-8734. For more information about The Ohio State University Heart and Vascular Center Research Organization, call 614-688-5901 or email cardiovascular.research@osumc.edu.
Continuing Medical Education
To learn more, visit ccme.osu.edu.
August 29............................. Mid-Ohio Endovascular Club September 14 ..................... Fourth Annual Women’s Cardiovascular Disease Course* September 21 . ................... Fourth Annual Acute Myocardial Infarction Update: Beyond STEMI: An Introduction to a Level One Heart and Vascular Emergency Program* September 28-30................. Fourth Annual Contemporary Multidisciplinary Cardiovascular Medicine* in Orlando, Florida October 5 ............................ Heart Failure at the Shoe XI* October 12 .......................... Controversies in Vascular Diseases October 13 .......................... Fifth Annual Vascular Non-invasive Testing Symposium December 5......................... Mid-Ohio Endovascular Club All courses will take place on Ohio State’s campus in Columbus, unless otherwise noted. *Applications for category 1 CME credits pending © 2012 The Ohio State University Wexner Medical Center CORP20120105-11
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Inside this Issue... 1
New Sports Medicine Therapy Speeds Soft-Tissue Healing
New Platelet-Rich Plasma Therapy
2 Global Diabetes Summit
Benefits at a Glance: • Uses body’s own platelets to stimulate healing • Appropriate for injuries to ligaments and tendons
2 New Research Center Unveiled
3 New Wound Service for Referring Physicians
3 Outpatient Rehabilitation Services
4 Emergency Departments Earn National Award
4 Progress of the new James Cancer Hospital and Solove Research Institute and Critical Care Center
5 Medical Record Access to Your Patients
5 New Gioblastoma Treatment Offered
• May delay or eliminate long-term treatments or surgery Platelet-Rich Plasma (PRP) therapy is a new procedure offered by Ohio State’s Sports Medicine that may accelerate healing of soft tissue injuries, such as tendons and ligaments, by using the body’s own blood to stimulate tissue and wound healing, possibly eliminating the need for more extensive treatment such as surgery. The therapy stimulates an inflammation in the affected tissues, speeding the healing process. Uses of PRP PRP is used primarily for, but not limited to, tissues of the elbows, knees and shoulders. While response to treatment varies from individual to individual, most patients will require one to three procedures. For the procedure, which takes about one hour, blood is drawn from the patient, then put in a centrifuge to extract the platelet-rich plasma. A local anesthetic is applied to the injection site. This plasma is then injected into the injured tissue, with the aid of an ultrasound guide as needed. Post-Procedure In general, the procedure may cause local soreness and mild discomfort, which may last one to three weeks. A possibility of temporary worsening symptoms may occur after the injection, which may last one to three weeks, likely due to the body’s natural response to fight the inflammation. Get started PRP Therapy is offered at all OSU Sports Medicine locations. To refer patients, please call 614-293-3600.
Plan to Attend the Second Global Diabetes Summit At a Glance:
and to formulate an interdisciplinary road map for the prevention, detection and treatment of diabetes and common co-morbidities. The emergence of personalized health care and genetic testing, as well as issues relating to the important role ethnicity, age and gender play in the diagnosis, treatment and management of diabetes, will be a central focus.
• International summit taking place at Ohio State’s Wexner Medical Center • World’s leading experts on all aspects of diabetes • November 14-17, 2012, at The Ohio Union The pandemic of obesity and diabetes poses a threat to all countries, both developed and underdeveloped. In the U.S., the annual diabetes expenditure is estimated to be $218 million and constitutes 15 percent of the total healthcare cost. If unabated, it is projected that diabetes and its related expenditures could bankrupt most developing countries. The escalation of diabetes in the U.S. and globally has been partially attributed to its association with the growing number of overweight, obese and physically inactive adults and children.
Register Today! Global Diabetes Summit 2012 New Horizons in Diabetes: Genetics to Personalized Health Care Nov. 14 – 17, 2012 The Ohio Union 1739 N. High Street, Columbus, Ohio 43210 To register, visit: go.osu.edu/diabetessummit or call Lindsay Cowgill at 614-293-3576
This four-day, live symposium will bring together local, national and international experts to discuss the latest seminal outcomes in diabetes research
New Research Center Unveiled at Ohio State The Ohio State University has established a partnership of experts who will work together to discover novel treatments to accelerate wound healing and rehabilitation for patients. Ohio State’s Center for Regenerative Medicine and Cell-Based Therapies was created to further develop the research programs in these respective fields. “By leveraging existing partnerships and utilizing the expertise of our clinicians and research faculty, we will deliver cutting-edge health solutions to our patients,” says Steven G. Gabbe, MD, senior vice president for health sciences at Ohio State and chief executive officer of The Ohio State University Wexner Medical Center. Chandan Sen, PhD
“The Center allows a partnership with multiple colleges at the University, and will enhance development of innovative therapeutics that will help us improve the healing of chronic wounds and salvage extremities threatened by low blood flow and diabetes,” says E. Christopher Ellison, MD, Robert M. Zollinger Professor and chairman of Ohio State’s Department of Surgery. Chandan Sen, PhD, associate dean for translational and applied research in The Ohio State University College of Medicine, is director of the Center for Regenerative Medicine and Cell-Based Therapies. Along with Dr. Sen, the Center’s leadership includes key faculty from the above colleges and Nationwide Children’s Hospital. Battelle, the world’s largest, independent research and development organization, is also a partner.
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New Wound Inpatient Service At a Glance:
Expansive Outpatient Rehabilitation Services
• Evidence-based care for acute and chronic wounds • Expanded treatment at more inpatient locations The Comprehensive Wound Center and the Plastic Surgery Department are pleased to announce a new inpatient service, the Comprehensive Wound Physician Service. This service is dedicated to providing evidence-based care for patients with acute and chronic wounds. Patients with a primary diagnosis of a wound can be admitted to this service as well. The Comprehensive Wound Physician Service team will now be able to provide treatment and consults to patients within University, Ross, James, Dodd and Harding Hospitals. Under the direction and leadership of Gayle Gordillo, MD, the team will be comprised of Michelle Giovannelli CNP, CWS; wound ostomy and continence (WOC) nurses and other surgical faculty members. The WOC nursing team will continue to be consulted for ostomy care, negative pressure, skin tears and wound exudate management. For additional information, please contact Michelle Giovannelli, nurse practitioner, at 614-366-7292 or Michelle.Giovannelli@osumc.edu.
Ohio State’s Wexner Medical Center offers a wide range of rehabilitation services by specialty-trained and certified experts including: physical therapy, speech therapy, occupational therapy, orthopaedic, neurological and assistive technology rehabilitation and nearly 20 specialty programs. These services are offered at three convenient locations with free parking for patients. Martha Morehouse 2050 Kenny Road, 2nd floor of Pavilion Suite 2134 Columbus, OH 43221 Ph: (614) 293-4523 Assistive Technology Center (located in suite 3300 of Pavilion) Ph: (614) 685-5600 Gahanna YMCA 551 YMCA Pl. Gahanna, OH 43230 Ph: (614) 366-0722 Powell YMCA 7798 N. Liberty Road Powell, OH 43065 Ph: (614) 366-7028 Visit medicalcenter.osu.edu/rehabilitation for more information about Outpatient Rehabilitation Services.
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Progress Report: The New James Cancer Hospital and Solove Research Institute and Critical Care Center On May 21, the final structural beam of the new James Cancer Hospital and Solove Research Institute and Critical Care Center was raised. This important milestone marks the next step toward the 2014 opening of the new hospital. By the Numbers: • 276 — beds in the new James Cancer Hospital and Solove Research Institute • 144 — beds in the Critical Care Center, which includes the new Intensive Care Unit, operating rooms and Burn Unit • 310,000 — patients who will be cared for annually through Medical Center Expansion facilities
• Ohio State’s Wexner Medical Center Expansion project will add a patient-friendly central concourse to the Medical Center’s main campus that links hospitals, clinics, laboratories, classrooms, administrative offices and garages, and also offers patients and family members convenient access to healthcare services and other amenities throughout the Medical Center.
• The main hospital tower will be 20 stories: the tallest building on the Ohio State campus. It will be one of the 15 tallest hospitals in the United States and one of the 25 tallest in the world. • While the building will be 20 stories tall, the floors will be numbered up to 21. There will not be a 13th floor, as is traditional in most U.S. hospitals that reach this height.
• An expanded Emergency Department — double the previous size, with new public and ambulance entrances, is also included in this project.
Ohio State’s Emergency Departments Earn “Excellence” Status The Ohio State University Wexner Medical Center’s Emergency Departments have been named recipients of the HealthGrades Emergency Medicine Excellence Award™ for the third year in a row. Ohio State’s Wexner Medical Center Emergency Departments at University Hospital and University Hospital East are the only emergency departments in central Ohio to earn this distinction for 2012. Recipients of the award represent the top five percent of hospitals in emergency medicine in the nation. A study found that a typical patient is much more likely to survive an emergency hospitalization at a topperforming hospital than at all other hospitals. Ohio State’s Wexner Medical Center is one of 263 nationally to receive this award. For the group of patients reviewed in this study, Emergency Medicine Excellence Hospitals had, on average, 41.52 percent lower risk‐adjusted mortality than all other hospitals. If all hospitals performed at the level of the Emergency Medicine Excellence Hospitals from 2008 through 2010, an additional 170,856 people could have potentially survived their emergency hospitalization.
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New Treatment for Glioblastoma Patients Now at the James At a Glance: • New treatment for aggressive brain tumors • Novel, non-invasive therapy • Fewer side effects than traditional treatments The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) is one of 13 centers in the U.S. to prescribe a new FDA-approved treatment for patients with the most common and aggressive type of brain tumor, glioblastoma multiforme (GBM). Our neuro-oncology faculty and staff have been trained and are certified to treat patients with recurrent GBM with a new therapy called Tumor Treating Fields. This novel, non-invasive therapy is provided using a portable device, known as the NovoTTF-100A, made by Novocure. The device uses alternating electrical fields to disrupt and destruct the rapid division exhibited by cancer cells. TTF therapy provides physicians with another treatment option for brain tumors, in addition to surgery, radiation therapy and chemotherapy. Advantages of TTF therapy: • • • • •
Completely outpatient Portable device Alternative to standard treatment Non-invasive Fewer side effects than standard cancer treatments
DocLink Provides Electronic Medical Record Access to Your Patients Now there is a fast, convenient way for you to access your patients’ records during and after their care at Ohio State’s Wexner Medical Center. Our DocLink 2.0 portal provides you with access to comprehensive medical chart information on your patients, including: • Full visit histories and treatment plans • Complete chart detail, results review, allergies, histories and problem list • The ability to communicate electronically with Ohio State attending physicians involved in your patients’ care. To request a DocLink 2.0 account, please contact one of the numbers below: Bill Cox: 614-293-2824 Karen Mitchell: 614-293-4352 DocLink Help Desk: 614-293-3861, option 2
How to Refer:
Sav e the Date
For questions or to refer a patient to the OSUCCC – James Division of Neuro-Oncology, please contact Danette Birkhimer, MS, RN, at 614-293-2897.
2nd Annual Transplant Symposium Presented By:
The Ohio State University Wexner Medical Center Comprehensive Transplant Center
Transplantation in 2012: Optimizing Outcomes Through Seamless Communication Saturday - October 13, 2012 8 a.m. to 1:30 p.m. Longaberger Alumni House 2200 Olentangy River Rd. | Columbus, OH 43210 Earn 4.5 AMA PRA Category 1 Credits™. Look for details and registration information coming soon to ccme.osu.edu!
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Connect with Resources from Ohio State’s Wexner Medical Center
Our Regional Outreach team is here to assist you in accessing the resources, education and patient referral information you need most from Ohio State’s Wexner Medical Center. Call your regional outreach coordinator at any time for information such as: • Help with the referral process • Requests for visits/calls with Ohio State physicians • Requests for patient materials • Access to CME and clinical research opportunities
Franklin County 614-366-6680 East/Southeast Ohio Karen Mitchell | 614-293-4352 North/West Ohio Bill Cox | 614-293-2824
Your Resources Referring Physicians medicalcenter.osu.edu/referringphysicians Referring physician information, links, downloads and forms, patient education materials, maps and directions The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute The James Line: 614-293-5066 cancer.osu.edu Patient referral center, clinical trials and research information, patient education materials Continuing Medical Education ccme.osu.edu Continuing Medical Education programs, including Category I CME offerings online through Ohio State’s MedNet21, traditional lecture series and Grand Rounds Physician-to-Physician Consultation Line 800-293-5123, option 1 Consult with an Ohio State’s Wexner Medical Center physician, discuss specific patient-related cases, appointment referral, transfer a patient © 2012 The Ohio State University Wexner Medical Center CORP20120105-03
Physician Relations 800-293-4326 or mdrelations@osumc.edu Physician Relations supports the needs of community physicians and their staff as they interact with Ohio State’s Wexner Medical Center Ohio State’s Regional Outreach Program Franklin County......................................614-366-6680 East/Southeast Ohio, Karen Mitchell.....614-293-4352 North/West Ohio, Bill Cox......................614-293-2824 Outreach provides access to Ohio State’s Wexner Medical Center services, specialty physicians, continuing medical education and other Medical Center programs Physician Directories To request a copy of our physician directory or to request updated sections for your existing directory, please call your Regional Outreach Coordinator (above). Physician Referral Guide To request a copy of the Physician Referral Guide, call your Regional Outreach Coordinator or visit medicalcenter.osu.edu/referringphysicians to access an online version.
Physician Resources Contact doclink.osumc.edu
DocLink
Online tool for secure access to your patient’s
medical records during and after their care
at Ohio State.
medicalcenter.osu.edu Referring physician information, patient
Ohio State’s Wexner Medical Center
The Arthur G. James Cancer Hospital and
www.cancer.osu.edu Patient referral center, clinical trials and
Richard J. Solove Research Institute Ohio State’s Wexner Medical Center
education materials, maps and directions
ccme.osu.edu
information, patient education materials Web site featuring Continuing Medical
Center for Continuing Medical Education Education programs including: Category I CME offerings online through OSU MedNet21, Physician-to-Physician
traditional lecture series and Grand Rounds
1-800-293-5123; option 1 Consult with an OSU Medical Center
Consultation Line
physician, discuss specific patient-related
cases, appointment referral, transfer a patient
Physician Relations
1-800-293-4326 or Physician Relations supports the needs of
mdrelations@osumc.edu
community physicians and their staff as they interact with Ohio State’s Wexner Medical Center
Ohio State’s Regional
Franklin County: 614-366-6680
Outreach Program
East/Southeast Ohio: 614-293-4352 access to Ohio State’s Wexner Medical Center
North/West Ohio: 614-293-2824
Outreach provides referring physicians with services specialty physicians, continuing medical education and other medical center programs
www.medicalcenter.osu.edu/referringphysicians