Innovations in Review 2024
Orthopedists and orthopedic surgeons at NewYork‑Presbyterian and Columbia are constantly working to innovate care through research, trials, and new techniques. Cross specialty collaboration and new surgical approaches mean that patients can return to their normal lives faster, stronger, and with fewer side effects. Over the last year, physicians and researchers established a better understanding of how time to surgery affects outcomes in acetabular fracture, the effects of spine injuries on professional athletes, and other key developments that are changing the way conditions of the bones and joints are addressed and treated.
Read more about our top research and key innovations from 2024:
PJAC Allograft Transplant Effective in Challenging Condition
Uncovering the Burden of Spine Injuries on MLB Players
Assessing Anterior Knee Pain Strategies Post-Arthroplasty
Creating Acceptable Knee Malalignment Ranges in X-Ray Imaging
Time to Surgery Impact on Geriatric Patients with Hip Fractures
Joint Effort: A Collaborative Surgery Revolutionizing Hip Preservation
In athletes with patellofemoral articular cartilage defects, particulated juvenile articular cartilage (PJAC) allograft transplantation can effectively heal this difficult-to-treat condition. NewYork‑Presbyterian and Columbia orthopedic surgeon David P. Trofa, MD, led the largest review to date on the promising treatment, which used cartilage tissue from donors ages 13 and younger to repair the recipient’s knee, including some patients with pre-existing knee pathologies. Unlike other therapies, one favorable aspect of PJAC is that it can address all concomitant pathology of the patellofemoral joint in one setting. Patients in this study had a remarkable 100% return-to-sport rate after their PJAC transplantation.
To better understand how spine issues affect professional baseball players, Christopher Ahmad, MD, chief of sports medicine at NewYork‑Presbyterian and Columbia and team physician for the New York Yankees, and Ronald Lehman Jr., MD, director of the Athlete Spine Center at Och Spine at NewYork‑Presbyterian and Columbia, led a retrospective case series analyzing the frequency and impact of spine injuries experienced by Major League Baseball (MLB) and Minor League Baseball (MiLB) players. The surgeons used the MLB-commissioned Health and Injury Tracking System (HITS) and found that 3,447 neck and back strains and sprains accounted for nearly 40,000 aggregate days missed in the MLB and MiLB; 136 of these cases were season-ending and 22 were career-ending. These data are leading to future collaborations with training staff and physical therapists to develop protocols that will help injured athletes return to their daily activities, and to the field.
Orthopedic surgeons at NewYork‑Presbyterian and Columbia worked to advance understanding and diagnosis of anterior knee pain (AKP) after total knee arthroplasty (TKA). Roshan P. Shah, MD, director of complex adult hip and knee reconstruction at NewYork‑Presbyterian and Columbia, authored a critical review to understand a less-appreciated cause of AKP post-TKA that cannot be detected via X-ray: issues in synovium and other soft tissues. While questions about AKP after TKA remain, this research contributed to an improved understanding of postoperative pain in TKA, and how techniques can evolve so that AKP after TKA is less common in the future and the 20% patient dissatisfaction rate with TKA is no longer an acceptable norm.
The majority of patients who present with lateral knee radiographs used to measure the posterior tibial slope (PTS) have some degree of knee malalignment in their imaging. Lauren H. Redler, MD, an orthopedic surgeon at NewYork‑Presbyterian and Columbia, led a study to understand how much is too much when it comes to knee malalignment. The results indicated that abduction and adduction both affect accuracy more than malrotation; lateral radiographs are acceptable to measure PTS if the proximal-distal distance between the femoral condyles is less than 5 mm and the anterior-posterior distance is less than 15 mm. These findings will help reduce the number of patients who are sent back for repetitive scans and help orthopedic surgeons make more informed decisions about the best way to treat knee injuries.
Nicholas C. Danford, MD, an orthopedic surgeon at NewYork‑Presbyterian and Columbia, conducted a study assessing how the time from hospital admission to surgery impacts postoperative complications and mortality for patients with acetabular fractures, particularly older adults. The study’s results underscored the importance of time to surgery, showing that shorter time between admission and surgery is associated with fewer complications; less than 5% of patients experienced complications if they had surgery within two days of admission, and the likelihood of a complication increased by 7% with each day after admission. If a patient is healthy enough to undergo surgery, the results of this study support the practice of optimizing surgery timing for patients with acetabular fractures.
Though NewYork‑Presbyterian and Columbia orthopedic surgeons Robert Christian, MD, MBA, and Samuel Van de Velde, MD, PhD, specialize in different areas, they run a combination clinic focused on hip preservation with the shared goal of preserving their patients’ native hip function for as long as possible. On the Advances in Care podcast, the two surgeons discussed their unique collaboration, with Dr. Christian specializing in minimally invasive hip arthroscopy while Dr. Van de Velde takes the lead on periacetabular Ganz osteotomy. Their clinic is only one of a few in the country to offer this type of treatment option in a single procedure.
