For Professionals

NewYork-Presbyterian

2019 Innovations Reports for Orthopedics

Innovations at a Glance

Foot and Ankle  Conducted a study, published in the Journal of the American Academy of Orthopaedic Surgeons, Global Research & Reviews, that determined the uninjured leg could be used to establish ankle fitness after injury in the absence of baseline testing and despite wide ranges of normal performance. When assessing performance with the side hopping test or other function tests, normal function is restored when the injured leg reaches 90 percent of the ability of the uninjured side.

Implantable Osteochondral Allograft

Hand and Upper Extremity  In collaboration with bioengineers in the Columbia Biomedical Technology Accelerator, developed an implantable osteochondral allograft custom-bent to resurface the trapezial side of the basal joint that can be delivered ready for transplantation to the surgeon.

Hip and Knee Reconstruction  Demonstrated that adductor canal block (ACB) alone is an inferior method to periarticular anesthetic injections (PAI) for pain management in total knee arthroplasty, with no significant differences noted in pain control between PAI alone and ACB plus PAI. Results were published in The Journal of Bone and Joint Surgery.

Orthopedic Oncology  Described intra-articular conditions and findings to facilitate a differential diagnosis of common neoplasms and determine when a referral to an orthopedic oncologist is indicated in order to consider a diagnosis of a malignant condition or an aggressive benign process and subsequent evaluation and treatment. Published in The Journal of Bone and Joint Surgery.

Pediatric Orthopedics  Led the development of best practice guidelines for nonoperative treatment of adolescent idiopathic scoliosis, including hosting a Best Practice Guidelines meeting with 38 international experts at the 2019 Society on Scoliosis Orthopaedic and Rehabilitation Treatment Conference.

Four Bones

Shoulder, Elbow and Sports Medicine  Demonstrated that a canal-sparing total shoulder arthroplasty system that uses multiplanar osteotomy restores proximal humeral anatomy with improved accuracy and precision compared to a stemmed arthroplasty system. Results were published in the Journal of Shoulder and Elbow Arthroplasty.

Spine  Developed best practice guidelines on wrong level surgery in spinal deformity. Published in Spine Deformity, the guidelines are based on the consensus of 16 fellowship-trained spine surgeons and serve to reduce the variability in preoperative and intraoperative practices.

Dr. Thomas S. Bottiglieri

Dr. Thomas S. Bottiglieri

Addressing Physician Health and Well-Being

According to the American Psychiatric Association, 300 to 400 doctors commit suicide each year in the United States, more than double the general population. “Something has happened in medicine that has caused disillusionment and disengagement, whether it’s because of pressure from industry, trying to meet standards that might not match clinical experience, or case volumes that are too high. There are innumerable reasons for burnout,” says Thomas S. Bottiglieri, DO, primary care sports medicine specialist and Director of Wellness for Orthopedics. In this new position, Dr. Bottiglieri serves on a task force that includes Jenny Castillo, MD, Emergency Medicine, and Lourival Baptista- Neto, MD, Psychiatry, to identify resources to aid clinicians who may be at risk. “We are now establishing a Council of Wellness within orthopedics with representatives from each specialty,” says Dr. Bottiglieri. “Our goal is to find ways to communicate with all the stakeholders — administrators, physicians, surgeons, medical support staff — to identify obstacles and strategize ways to minimize the stress of physician life. Wellness and maintaining a life balance are critical.”