Volume 32, June 2022

Letter from the Editors
Kendall M. Masada, MD and Jordan S. Cohen, MD

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

Letter from the Program Director
Daniel C. Farber, MD

Dedication: G. Russell Huffman, MD, MPH
Sachin Gupta, MD and David Glaser, MD

Editorials & Perspectives: Leadership Edition

Reflections of a Chairman: What I Wish I Had Known Then That I Know Now
L. Scott Levin, MD, FACS, FAOA

Developing Resident Leadership Skills: Implementation of a Formal Leadership Training Curriculum
Matthew K. Stein, MD, Stephen R. Barchick, MD and John D. Kelly IV, MD

Lessons as a Surgical and Leadership Trainee
Lauren M. Boden, MD, David P. Falk, MD, Gregory T. Minutillo, MD, MPH, and Matthew K. Stein, MD, MS

A Decade-long Journey to the Gender Tipping Point and Beyond in the Penn Orthopaedic Program
Kristy L . Weber, MD

Training Tomorrow’s Physicians: Undergraduate Medical Education in Orthopaedic Surgery
Cara A. Cipriano, MD, MSc

Expansion of a Healthcare System: Establishing Orthopaedic Care at CHOP’s New Hospital in King of Prussia
John M. Flynn, MD

Building a Young Adult Hip Preservation Center: Reflections and Lessons from the Last 13 Years
Wudbhav N. Sankar, MD

Serving the Community: Experience Establishing an Orthopaedic Clinic for Underserved Patients
Viviana Serra Lopez, MD, MS, Brian Perez, MD, Joseph Koressel, MD, and George Fryhofer, MD, MTR

Health Policy: Current Issues and Orthopaedic Surgeon Involvement
Roshan P. Shah, MD, JD and Joshua Kerr

Orthopaedic Surgery in a Global Context
David A. Spiegel MD

Expanding Access to Orthopaedic Surgical Services in Northern Tanzania: Creating a Durable Strategy to Reach the Most Underserved
Neil P. Sheth MD, FACS

Delivery of Orthopaedic Care Abroad: Leadership Exemplified
Luke A. Lopas, MD

Creating a Social Media Presence as an Orthopaedic Surgeon
Yelena Bogdan, MD, FACS, FAAOS

Creating a New Category—A Disruptive Journey
Derek J. Donegan, MD, MBA

Surgeon-Industry Partnership: My Experience Working with Industry
Frank A. Liporace, MD

Department Updates

Trauma Division Update
Samir Mehta, MD

Spine Division Update
Harvey E. Smith, MD

Sports Division Update
Brian J. Sennett, MD

Hand Division Update
David J. Bozentka, MD

Shoulder and Elbow Division Update
David L. Glaser, MD

Adult Reconstruction Division Update
Charles L. Nelson, MD

Foot and Ankle Division Update
Casey Jo Humbyrd, MD, MBE

Orthopaedic Oncology Division Update
Cara A. Cipriano, MD, MSc

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

Orthoplastics Limb Salvage Division Update
Meghan E. Wilson, RN, Christine McAndrew PA-C, Stephen Kovach, MD, L. Scott Levin, MD, FACS, and Samir Mehta, MD

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

Health System Updates

Corporal Michael J. Crescenz Veterans Affairs Medical Center Update
David R. Steinberg, MD

Pennsylvania Hospital Update
Neil P. Sheth, MD, FACS

Penn Center for Musculoskeletal Disorders Update
Louis J. Soslowsky, PhD

McKay Orthopaedic Research Laboratory Update
Robert L. Mauck, PhD

Veterans Affairs Medical Center Translational Musculoskeletal Research Center
Carla R. Scanzello, MD, PhD and Robert L. Mauck, PhD

Clinical Research Section Update
Annamarie D. Horon, MPA, PhD

Chief Operating Officer Update
Neil Ravitz, MBA

Musculoskeletal Service Line Update
Hannah Lacko, MA, CSSBB

Orthopaedic Advanced Practice Providers Update
Christine T. McAndrew PA-C

Resident & Fellow Updates

Letter from the Administrative Chiefs
Yehuda (Yudi) Kerbel, MD, Liane Miller, MD, and Agnes Dardas, MD, MSc.

Current Residents

Current Fellows

Penn Medicine Orthopaedic Surgery Residency Intern Class 2022-2023

Visiting Professors
Jordan S. Cohen, MD

Resident Life
Kendall M. Masada, MD

Class of 2012 Alumni Residents: Where Are They Now?
Kendall M. Masada, MD

Clinical Research

Trauma

Trauma Tips and Tricks: Current Concepts Review of Ballistic Injuries
Eric Schweppe, MD, Matthew Bryan, BS, Derek Donegan, MD, and Samir Mehta, MD

Spine

Spine Tips & Tricks: Lateral Lumbar Interbody Fusion: Preoperative Positioning for Success
Stephen R. Barchick, MD, Bradley O. Osemwengie, MD, Colin M. Whitaker, MD, and Amrit S. Khalsa, MD

A Rare Case of Chronic, Atraumatic Atlantoaxial Rotatory Fixation in an Adult Treated with Halo Traction Suspension, Open Reduction and C1-C2 Fusion
David P. Falk, MD, Jay S. Reidler, MD, Stephen R. Barchick, MD, and Vincent Arlet, MD

Combined Lateral Corpectomy with Posterior Instrumented Fusion for the Management of Post-Infectious Kyphosis
David P. Falk, MD, Srish Chenna, Steven Zhang, MD, Stephen R. Barchick, MD, Amrit S. Khalsa, MD, and David S. Casper, MD

Sports

Sports Tips & Tricks: Lateral Decubitus Positioning of Shoulder Arthroscopy
Joung Heon Kim, MD and John D. Kelly IV, MD

Hand

Hand Tips & Tricks: Management of Nailbed Laceration Repair in the Emergency Department: Attending-specific Preference and Tips for Residents
Aymen Alqazzaz, MD, Kelsey Young, MD, and Andrew D. Sobel, MD

Traumatic Articular Lesions of the Lunate Fossa Without Corresponding Changes on MRI
David P. Falk, MD, Rikesh A. Gandhi, MD, Matthew Winterton, MD, Viviana Serra Lopez, MD, MS, Stephen R. Barchick, MD, and David R. Steinberg, MD

Shoulder and Elbow

Shoulder and Elbow Tips & Tricks: Arthroscopic-Assisted AC Joint Reconstruction
C. Lucas Myerson, MD, Kathleen Collins, MD, Weston Smith, MD, and J. Gabriel Horneff, MD

Why Total Shoulder Arthroplasty Patients Cancel on the Day of Surgery
Joung Heon Kim, MD, Brandon Romero, MD, Andrew F. Kuntz, MD, David L. Glaser, MD, and John G. Horneff, III, MD

Results of Anatomic Total Shoulder Arthroplasty with Modern Metal-Backed Glenoid
C. Lucas Myerson MD, Joung Heon Kim MD, Weston Smith MD, Brandon Romero MD, David L. Glaser MD, Andrew F. Kuntz MD, John G. Horneff, III, MD, and G. Russell Huffman MD, MPH

To APE or not to APE? Case Series and Novel Technique of Arthroscopic Polyethylene Exchange for Metal-Backed Glenoids in Total Shoulder Arthroplasty
Brandon A. Romero, MD, Joung H. Kim, MD, John G. Horneff, III, MD, Andrew F. Kuntz, MD, and David L. Glaser, MD

Adult Reconstruction

Adult Reconstruction Tips & Tricks: Systematic Approach to THA Templating 160
Bradley Osemwengie, MD, Brian T. Velasco, MD, Daniel A. Velasco, BS, and Christopher Anthony, MD

Acetabular Revision in Total Hip Arthoplasty: Using Tantalum Uncemented Porous Metal Cups and Augments 163
Gregory T. Minutillo MD/MPH, Aaron Gebrelul MD, Kevin Pirruccio, BA, and Neil P. Sheth MD, FACS

Foot & Ankle

Foot & Ankle Tips & Tricks: Posterior Ankle Pain After Ankle Sprain: Bony and Soft Tissue Impingement 171
Steven Zhang, MD, Wonyong Lee, MD, and Wen Chao, MD

Development and Validation of a Patient Decision Aid for the Treatment of Ankle Arthritis 175
Oluseye I. Raymond, BA, Kyla M. Cordrey, MD, Nigel N. Hsu, MD, and Casey Jo Humbyrd, MD, MBE

Oncology

Oncology Tips & Tricks: The Role of Imaging in the Evaluation of Suspected Bone Lesions 179
Jaret M. Karnuta, MD, MS and Cara A. Cipriano, MD, MSc

Orthoplastics

Orthoplastics Tips & Tricks: Orthoplastics Tips and Tricks: Free Lateral Arm Flap for Reconstruction of the Hand Following Traumatic Injury: A Case Presentation 184
Mitchell Hallman, MD, Stephen R. Barchick, MD, Charles C. Jehle, MD, Corey Clyde, MD, and L. Scott Levin, MD, FACS

Pediatrics

Pediatrics Tips & Tricks: Initial Management of Pediatric Both Bone Forearm Fractures
Kelsey Young, MD, Michael Young, BS, and Aymen Alqazzaz, MD

The Epidemiology of Pediatric Basketball Injuries Presenting to US Emergency Departments: 2011-2020
Nathan Houlihan, BS, Patrick England, BA, Sara N. Kiani, BA, and Theodore J. Ganley, MD

Does Patient Race, Ethnicity, or Socioeconomic Status Impact Surgical Decision Making? Analysis of a Common Pediatric Orthopaedic Surgical Procedure
Patrick England, BA, Lori Jia, BS, Zoe E Belardo, BA, and Apurva S. Shah, MD, MBA

An Analysis of Femoral Nerve Block Use for Pediatric ACL Reconstruction
Sara N. Kiani, BA, Michael Carter, BA, Joseph L. Yellin, MD, Nathan V. Houlihan, BS, Alexandra C. Stevens, BS, Soroush Baghdadi, MD, and Theodore J. Ganley, MD

Are Height and Weight Associated with Mechanism of Injury for a Toddler’s Fracture? A Retrospective Evaluation of Playground Related Toddler’s Fractures
Patrick England, BA, Jenny Zheng, BS, Chaeyeon Kim, Jacob Lizak, BA, and Lawrence Wells, MD

Basic Science

Bone & Development

The Addition of Cerclage Wiring Does Not Improve Fixation of Mid-Diaphyseal Periprosthetic Humerus Fractures
Richa Gupta, BS , Elaine C. Schmidt, MS, Surena Namdari, MD, Michael Stone, MD, and Michael W. Hast, PhD

Mechano-active Therapeutic Release to Preserve Subchondral Bone After Nanofracture in a Large Animal
Hannah M. Zlotnick, BS, Ryan C. Locke, PhD, Sanjana Hemdev, BS, Brendan D. Stoeckl, MS, Sachin Gupta, MD, Ana P. Peredo, BS, David R. Steinberg, MD, James L. Carey, MD, Daeyeon Lee, PhD, George R. Dodge, PhD, and Robert L. Mauck, PhD

Proteomic Screening Identifies Novel Biomarkers of Synovial Joint Disease in Mucopolysaccharidosis I Dogs
Chenghao Zhang, PhD, Rahul Gawri, PhD, Yian Khai Lau, MS, Margret L. Casal, DVM, PhD, George R. Dodge, PhD, and Lachlan J. Smith, PhD

Strut Thickness But Not Unit Cell Length Alters Mechanical Properties of 3D Printed Rib Implants: A Preliminary Study
Richa Gupta, BS, Lauren Judkins, BS, Christine Gabriele, Charles Tomonto, PhD, Guha Manogharan, PhD, and Michael W. Hast, PhD

Engineered Hierarchical Surface Roughness Regulates Mesenchymal Stem Cell Spreading, Proliferation, and Differentiation on Titanium Implants
Su-Jin Heo, PhD, Ali Kiapour, PhD, Lewis Harrison, MS, MBA, Saeed Ahmed, MS, Brendan Stoeckl, MSE, Yujia Zhang, BS, Matthew Begley, PhD, Jessee Hunt, and Robert L. Mauck, PhD

Cartilage, Meniscus & Disc

Effects of Organ Culture and Mesenchymal Stem Cell Delivery on the Cellular Composition of the Nucleus Pulposus
Chenghao Zhang, PhD, Yian Khai Lau, MS, Dong Hwa Kim, PhD, Rahul Gawri, MBBS, Thomas P. Schaer, VMD, George R. Dodge, PhD, Neil R. Malhotra, MD, Robert L. Mauck, PhD, and Lachlan J. Smith, PhD

Surgical Reattachment of the Anterior Horn Slows OA Progression in a Large Animal Injury Modell
Brendan D Stoeckl, MSE, Kyle D. Meadows, BSE, Edward D. Bonnevie, PhD, John M. Peloquin, PhD, Adriana Barba, DMV, Klaus Hopster, DMV, Sonia Bansal, PhD, David R. Steinberg, MD, Thomas P. Schaer, VMD, Miltiadis H. Zgonis, MD, Dawn M. Elliott, PhD, and Robert L. Mauck, PhD

A Large Animal Model of Motion Segment Degeneration for Evaluation of Engineered Disc Replacements Disc Replacements
Sarah E. Gullbrand, PhD, Sonal Mahindroo, Matthew Fainor, B, Kyle Meadows, BS, Adriana Barba, DVM, Klaus Hopster, DMV, Thomas P. Schaer, VMD, Dawn M. Elliott, PhD, Robert L. Mauck, PhD, and Harvey E. Smith, MD

Fabrication of Extracellular Matrix-Based Hydrogel System for Meniscus Repair: Donor Age-Dependent Effects on Meniscal Fibrochondrocytes
Se-Hwan Lee, PhD, Zizhao Li, MS, Yujia Zhang, BS, Shreya Mondal, MS, Dong Hwa Kim, PhD, Lucy Hederick, Undergraduate, Melike Lakadamyali, PhD, Jason Burdick, PhD, Robert Mauck, PhD, and Su-Jin Heo, PhD

Intervertebral Disc and Facet Cross-talk in a Rabbit Puncture Model of Spine Degeneration
Matthew Fainor, BS, Sonal Mahindroo, Sachin Gupta, MD, Robert L. Mauck, PhD, Harvey E. Smith, MD, and Sarah E. Gullbrand, PhD

Single-Cell Transcriptomics Reveals Emergent Nucleus Pulposus Cell Subpopulations in the Postnatal Mouse Disc
Chenghao Zhang, PhD, Yian Khai Lau, MS, Leilei Zhong, PhD, Lutian Yao, MD, PhD, Meilun Wu, Ling Qin, PhD, Neil R. Malhotra, MD, and Lachlan J. Smith, PhD

Superficial Layer Meniscus Cells Migrate Faster and are Less Mechanosensitive than those in the Meniscus Body
Sereen S. Assi, BS, Ryan C. Locke, PhD, Sung Yeon Kim, BS, Ryan Daniels, BS, Brendan Stoeckl, MSE, Eddie D. Bonnevie, PhD, and Robert L. Mauck, PhD

Superoxide Dismutase-Loaded Porous Polymersomes as Highly Efficient Antioxidant Nanoparticles for Osteoarthritis Therapy
Tao Gui, MD, Lijun Luo, PhD, Bonirath Chhay, PhD, Jun Li, MD/PhD, Yulong Wei, MD/PhD, Leilei Zhong, PhD, Lutian Yao, MD/PhD, Wei Yu, MD/PhD, Andrew Tsourkas, PhD, Zhiliang Cheng, PhD, and Ling Qin, PhD

The Effects of Hydroxyapatite Coating on Poly(caprolactone) Micromechanics and Mesenchymal Stem Cell Behavior
Matthew Fainor, BS, Kerri R. Betz, Sonal Mahindroo, Ryan C. Locke, PhD, Harvey E.Smith, MD, Robert L. Mauck, PhD, and Sarah E. Gullbrand, PhD

Muscle, Tendon & Ligament

Mouse Supraspinatus Tendon Mechanical and Structural Properties Are Dependent on Region and Age
Michael S. DiStefano, BS, Patrick L. Paglia-Garcés, Stephanie N. Weiss, BS, Snehal S. Shetye, PhD, Andrew F. Kuntz, MD, and Louis J. Soslowsky, PhD

Tracking Day-To-Day Achilles Tendon Loading Progression During Rupture Recovery
Ke Song, PhD, Stephanie G. Cone, PhD, Jennifer A. Zellers, PhD, Darryl G. Thelen, PhD, and Josh R. Baxter, PhD

Knockdown of Decorin and Biglycan During the Early Proliferative and Remodeling Phases of Tendon Healing Alters Gene Expression and Fibril Morphology
Thomas P. Leahy, BS, Ashley K. Fung, M.Eng, Stephanie N. Weiss, MD, Sheila M. Adams, BS, Nathaniel A. Dyment, PhD, David E. Birk, PhD, and Louis J. Soslowsky, PhD

A Double Cortical Button Technique Yields Similar Biomechanics as the Traditional Docking Technique for Ulnar Collateral Ligament Reconstruction
Richa Gupta, BS, Christine Piper MD , G. Russell Huffman, MD, MPH, and Michael W. Hast, PhD

Knockdown of Decorin and Biglycan at Time of Tendon Injury Alters Gene Expression and Fibril Morphology
Ashley K. Fung, MEng, Thomas P. Leahy, BS, Stephanie N. Weiss, BS, Sheila M. Adams, MS, Nathaniel A. Dyment, PhD, David E. Birk, PhD, Louis J. Soslowsky, PhD

Regional FDL Tendon Development Involves Differential Pericellular Matrix Expression and Presence
Ryan J. Leiphart, BS, Stephanie N. Weiss, BS, Nathaniel A. Dyment, PhD, and Louis J. Soslowsky, PhD

Aging Alters Epigenetic and Mechanobiological Status in Murine Tenocytes
Saeed B. Ahmed, MS, Yujia Zhang, BS, Ryan Daniels, BS, Catherine Bautista, ScM, Lena Hamvas, BS, Xi Jiang, MD, Zizhao Li, MS, Melike Lakadamyali, PhD, Nathaniel A. Dyment, PhD, Robert L. Mauck, PhD, and Su-Jin Heo, PhD

The Regulation of Tenocyte Differentiation and Morphological Maturation by mTORC1
Yeonju Lee, PhD, Na Rae Park, PhD, Nathaniel A. Dyment, PhD, and Kyu Sang Joeng, PhD

FAK Inhibition Attenuates Increased Tendon Cell Nuclear Aspect Ratio with Applied Mechanical Strain In Situ
Thomas P. Leahy, BS, Nathaniel A. Dyment, PhD, and Louis J. Soslowsky, PhD

Mucopolysaccharidosis I and VII Dogs Exhibit Impaired Anterior Cruciate Ligament Mechanical Properties
Yian Khai Lau, MB, Rahul Gawri, MD, PhD, Snehal Shetye, PhD, Khaled Abdoun, MS, George R. Dodge, PhD, Margret L. Casal, DVM, PhD, and Lachlan J. Smith, PhD

Collagen V Knockdown Alters Collagen Fibril Size, but Not Mechanics, in Mature Female Murine Tendons
Ryan J. Leiphart, BS, Stephanie N. Weiss, BS, Jaclyn A. Carlson, ME, Patrick L Paglia-Garcés, and Louis J. Soslowsky, PhD

Collagen XII is a Critical Regulator of Tendon Function: Development of a Conditional Mouse Model
Ashley K. Fung, BS, Mei Sun, MS, Louis J. Soslowsky, PhD, and David E. Birk PhD

Collagen III Deficiency Alters Mechanical Properties and Decreases Regulation of Fibrillogenesis Following Injury in Female Murine Tendons
Jaclyn A. Carlson, MEng, BS, Stephanie N. Weiss, BS, Susan W. Volk, VMD, PhD, and Louis J. Soslowsky, PhD