Get to Know our SRH Staff: Anthony I. Riccio, M.D.

Get to Know our SRH Staff: Anthony I. Riccio, M.D.

Where did you go to college? Medical school? 
I earned my undergraduate degree from Dartmouth College in Hanover, New Hampshire and attended medical school at Georgetown University School of Medicine in Washington, D.C.
 
You had an internship at National Naval Medical Center General Surgery – can you explain your time and training there?
In the 1990’s and early 2000’s, orthopedic residents were still required to complete a one-year general surgery internship prior to beginning their orthopedic training. As I attended medical school under the support of the Naval Health Professions Scholarship Program (HPSP), I was required to complete that intern year in a military medical facility. Since NNMC was right up the road from Georgetown (where I had attended medical school and where I would be completing my orthopedic residency), it seemed like the perfect place to do my internship.
From an educational standpoint, the general surgery internship itself was really no different than any civilian internship. I learned the fundamentals of surgical and medical management that are necessary for care of orthopedic patients. I worked in the surgical ICU, on multiple general surgery services, the cardiothoracic service and with the vascular surgery team among other rotations. As a military intern, I was also required to learn “military readiness” by doing things such as spending a month performing field medicine for the marines at Marine Corps Base Quantico, running most mornings with my regimen and earning my rifle and sidearm qualifications. 

How long were you in the Navy? 
I was commissioned in 1995 and discharged in 2010, so technically I was in for 15 years. Most of this time was spent on Inactive Ready Reserve, while I completed my medical education and training. I was on active duty for five years altogether: one as an intern and four as an attending surgeon.
How did that impact you as a doctor? 
My Navy time impacted me in many ways, but more than anything, I learned the true value of being part of something that was far bigger and more important than myself. I served during the Iraq and Afghanistan wars and took care of countless wounded warriors, all of whom made incredible sacrifices for our country, our freedom and our families.

My role and contribution was so small compared to what they were doing overseas and just a tiny part of a greater mission to liberate people from oppression abroad. It instilled in me a certain humility that I try to carry with me into every patient encounter I have to this day. It also made me realize that the biggest impact I could have as a physician was in the service of a meaningful mission. The only mission I’ve believed in as much as that of our wartime military was the mission of Scottish Rite Hospital. Hence, when the opportunity came to return, the decision was a no brainer.

Why did you want to become a doctor? Have you always wanted to work in pediatric orthopedics?
I initially wanted to become a college professor to teach and study moral and epistemological development during adolescence. I was advised by my college mentor to do this through the route of medical school and then psychiatry. 
During medical school, I was exposed to orthopedic surgery and realized that it was a far better fit for me than psychiatry. The orthopedic residency director at Georgetown was a pediatric orthopedic surgeon named Jack Delahay. He was the greatest teacher I’ve even met. Though he was incredibly intimidating, he was also very inspiring. Jack took me under his wing during medical school and residency. I credit him fully for turning me on to pediatric orthopedic surgery.  
What led you to Scottish Rite Hospital?
I think it’s the dream of every former fellow to one day have the opportunity to return and work at Scottish Rite Hospital alongside those staff who mentored and supported us throughout fellowship. But in all honesty, I never thought I’d be one of the few who was given that opportunity. Dr. Herring was aware that a huge part of my clinical practice with the Navy was caring for service men and women with war related extremity trauma. As my naval commitment was winding down, he called one day and asked if I’d consider coming back to apply the knowledge I’d gained towards managing and researching pediatric orthopedic trauma. As far as I know, no one had ever said no to Dr. Herring and I wasn’t about to be the first!
 
How long have you worked at Scottish Rite Hospital? 
Almost 10 years as staff.
 
What are your specialties? 
Though I started out focusing exclusively on pediatric orthopedic traumatology, my practice has shifted over the years and my current interests include clubfoot along with other infantile foot deformities as well adolescent/young adult foot and ankle deformity.
 
How do you help your patients feel comfortable and confident? 
I really don’t do anything special. I just be myself – not just with patients but with everyone. When patients, parents and colleagues know that they’re getting the “real you” in every situation, it eliminates barriers to communication, puts folks at ease and allows for an open and honest interchange of thoughts and concerns. 

What is your favorite part of your job?
Teaching residents and fellows.

What was your first job?
My first job was as pediatric orthopedic surgeon at Naval Medical Center San Diego. 

I was there on active duty for over four years, during which time I also took on the role of Orthopaedic Surgery Residency program director and became the Director of the Pediatric Orthopaedic and Scoliosis Surgery division.

Tell us something that might surprise us about you:
I’ve been on Saturday Night Live multiple times. Take a look at some re-runs from the late nineties through 2007 or so, chances are you can find me.

Pediatric Foot Disorders: What Are We Learning From Research?

Pediatric Foot Disorders: What Are We Learning From Research?

Scottish Rite for Children Center for Excellence in Foot includes a multidisciplinary team that is dedicated to advancing the treatment for complex pediatric foot conditions. Directed by Anthony I Riccio, M.D., the center conducts comprehensive research into clubfoot – a congenital disorder in which the child’s foot is severely turned inward and pointed downward. In addition, Dr. Riccio leads the research for complex adolescent foot disorders. Alongside an adult foot and ankle surgeon, Riccio works with a diverse group of specialists to analyze these cases and conducts research to advance how the disorders are treated. 

Prospective Evaluation of Treatment for Clubfoot
Purpose:  To help orthopedic surgeons better understand and treat patients with a diagnosis of clubfoot.  

The research team is collecting data from hospital patients who volunteer to participate in the study. The team is currently evaluating the immediate and long-term outcomes of patients who undergo surgical and non-surgical treatment interventions. Participants are followed until skeletal maturity and are asked to participate in questionnaires, motor and strength tests, gait analyses and pedobarographs (a device that measures foot pressure abnormalities) along the way. Currently, there are over 1,500 patients enrolled in the study. This research will establish a protocol for the collection of relevant clinical and functional outcome measures on our patients with a diagnosis of clubfoot.

The Foot and Ankle Registry
Purpose: To further the understanding of the functional and long-term outcomes of adolescents treated for a foot and/or ankle deformity by creating a prospective registry for patients treated at the hospital.

The research team is currently collecting data on adolescent patients who visit the hospital for any form of foot or ankle deformity. Currently, there are about 300 patients enrolled. Some of the deformities include bunions, flat feet, coalitions and several others of varying severity. If eligible, patients are invited to voluntarily participate in the study activities. These include:

  • Questionnaires
  • Clinical photos in the media department
  • X-rays
  • Gait analysis in the movement science lab 

The data collected will provide the research team the opportunity to evaluate the immediate and long-term clinical, functional and radiographic outcomes of this understudied patient population. By doing this, the foot and ankle experts hope to better define the treatment methods for the varying foot and ankle diagnoses throughout the hospital.

Redefining the Juvenile Bunion
Purpose: To understand the formation of juvenile bunions and if experts should treat them differently from the adult deformity. 

This was a study using the questionnaires, X-rays and pedobarographic data from 32 bunion patients in the Foot and Ankle Registry. The study team collected data from the X-rays through measurements of different angles associated with the foot and correlated them to the completed questionnaires from patients and performance during the pedopbarograph. The study team found that greater angles correlated with skewed pressure distribution of the foot resulting in higher pain and less functionality. Overall, this study will open the door to many more comparative projects to assess the best method of treating juvenile bunions.

Learn more about the research being conducted in the Center for Excellence in Foot.

Doctors Travel to Israel for International Pediatric Orthopedic Conference

Doctors Travel to Israel for International Pediatric Orthopedic Conference

Doctors from the hospital are attending the 38th annual European Paediatric Orthopaedic Society (EPOS) meeting in Tel Aviv, Israel. EPOS is an international association comprised of over 500 surgeons from across the world. This four-day conference allows members to discuss research and collaborate on latest treatment techniques to ultimately advance the quality of care for children with orthopedic conditions.

As active members of EPOS, hospital staff attend and participate throughout this international meeting each year. Several are in attendance, along with past fellows, presenting the hospital’s original research. Below are the projects being presented:

  • Can real time monitoring with a controlled advancement drill decrease plunge depth?
  • Metaphyseal fracture displacement is predictive of intra-articular diastasis in adolescent triplane ankle fractures
  • Gait analysis in children with proximal femoral focal deficiency

In addition to these research presentations, surgeons from Scottish Rite Hospital are directing the first ever web-based joint educational endeavor between EPOS and the Pediatric Orthopaedic Society of North America (POSNA). During this symposium, entitled “Across the Pond: International Differences in Pediatric Orthopaedic Trauma Management,” staff and former fellows from the hospital will discuss and debate current trauma treatment strategies with a panel of European trauma specialists. The debate will be recorded at the EPOS meeting and broadcast worldwide.

Pediatric orthopedic surgeon and director of resident education Anthony I. Riccio, M.D., is one of the hospital’s key representatives for EPOS. “As doctors and leaders within pediatric orthopedics, we have a responsibility to conduct research in order to better understand and find innovative techniques for treating complex conditions,” says Riccio. “It is an honor to travel the world to share our expertise and have the opportunity to both educate and learn from other specialists. Not only does this advance how we care for our patients here in Texas, but it evolves the treatment for pediatric orthopedic patients across the globe.”

Learn more about the hospital’s research.

Hospital Staff Attend 33rd Annual Orthopaedic Trauma Association Meeting

Hospital Staff Attend 33rd Annual Orthopaedic Trauma Association Meeting

Orthopedic staff from Scottish Rite Hospital are attending the 33rd annual Orthopaedic Trauma Association (OTA) meeting in Vancouver, British Columbia. Established in 1985, OTA now has over 2,000 members, including medical professionals in all areas of the world. Members gather each year to share the latest research and collaborate with fellow colleagues to bring better care to the injured patient.

At this year’s meeting, 950 abstracts were submitted, with just over 250 being accepted for presentation. Scottish Rite Hospital is being represented by several orthopedic staff and past fellows, with four projects selected for presentation. The research being presented from the hospital:

  • Is Less More? Assessing the Value of Early Clinical and Radiographic Follow-Up for Operative Supracondylar Humerus Fractures
  • The Utility of Intra-Operative Arthrogram in the Management of Pediatric Lateral Condyle Fractures of the Humerus
  • Does Delay to Surgery in Type III Supracondylar Humerus Fractures Lead to Longer Surgical Times and More Difficult Reductions?
  • Does a delay in treatment of displaced pediatric lateral condyle fractures increase the risk of complications?

In addition to scientific presentations, hospital faculty work closely with the OTA to assure ongoing education of colleagues and trainees in the discipline of pediatric orthopedic trauma management. Assistant Chief of Staff Philip L. Wilson, M.D. and staff orthopedists Anthony I. Riccio. M.D. and Lane Wimberly, M.D. continue to direct the pediatric module at the annual OTA Comprehensive Resident Fracture Course. Staff orthopedist Christine Ho, M.D. also serves as faculty for a newly developed trauma symposium for advance practice nurses and physician assistants.

As members of the Orthopaedic Trauma Association, our doctors can be a part of a world-wide medical community that is dedicated to advancing the treatment and prevention of musculoskeletal injuries. Scottish Rite Hospital is honored to have the opportunity to present the most recent research on a global stage to ultimately bring better care back to our patients and children everywhere.