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A New Approach in ACL Reconstruction Helps to Reduce Re-injury in High Risk Population

A New Approach in ACL Reconstruction Helps to Reduce Re-injury in High Risk Population

by | Nov 27, 2019 | Sports Medicine

Recently, Assistant Chief of Staff Philip L. Wilson, M.D., and pediatric orthopedic surgeon Henry B. Ellis, M.D., published a novel technique for treating an anterior cruciate ligament (ACL) injury. 

Too many young and growing athletes who have an ACL injury and reconstruction reinjure the same leg or have a new injury in the opposite leg within two years of the initial reconstruction. In fact, the rate of re-injury can be as high as one out of every four (25%). “Young children and adolescents are the most challenging to treat after an ACL injury because their growth plates are still open,” says Wilson. “Because of this and their commitment to returning to a high level of activity, they require special techniques to both allow continued growth and give them the best chance of not re-tearing.” 

Since 2012, our team has been studying the results of a unique approach for this surgery. Our experts have combined a surgery intended for younger children (less than 12 years old) with a commonly used procedure for an older child. This approach has resulted in a reduced rate of re-injury to approximately 5% compared to 25%.

While allowing for uninterrupted function of the growth plates, the technique provides additional support when compared to other treatments for this rapidly growing population. The technique adds both additional lateral knee support as well as added ACL graft size, both of which have been demonstrated to reduce the risk of ACL reinjury. The reduced rate of secondary ACL injury in the study are less than half of any other reported results in a similar group. In many cases, ACL injuries take very young athletes out of play for a year. This important step in reducing the risk of secondary injury helps to ensure that athletes can stay active once they are cleared to return. 

“This surgical technique is very promising,” says Ellis. “As an institution committed to innovation, we are proud of the work that has gone into this project. It is rewarding to help athletes get them back to doing what they love and know that they have a much lower risk of re-injury.”

This research study was presented at the 2019 annual meetings of two prestigious organizations: Pediatric Orthopedic Society of North America and the American Orthopedic Society of Sports Medicine. The manuscript has also published in a highly rated, peer-reviewed journal American Journal of Sports Medicine. The data include outcomes from this procedure in almost 60 athletes (age 11-16 years) collected over a five-year period. The combined TPH/ITB technique has a low re-injury rate (5.3%) and high return to sport rate (91%) and a low risk of minor growth-related changes (5.5%).

Learn more about the ongoing research in the Center for Excellence in Sports Medicine.

Get to Know our SRH Staff: Molly McGuire, Research

Get to Know our SRH Staff: Molly McGuire, Research

by | Mar 26, 2019 | Spotlight

What is your role at the hospital? What do you do on a daily basis? 
My job involves working with teams of surgeon-researchers and coordinators all over the world to collect data about patients they treat for Perthes disease, a rare disease that impacts formation of the hip. We then study this information to understand the phenomenon of Perthes disease and help families. The organization is called the International Perthes Study Group. I help this multicenter research effort by coordinating legal, regulatory, communications and operational aspects of enrollment and data monitoring. I also recruit our own hospital patients for various Perthes-related research projects.  

What led you to Texas Scottish Rite Hospital for Children? How long have you worked here?
I was an academic research coordinator at UT Southwestern. Prior to that, I was in Lima, Peru working on grant-funded research for the University of Pennsylvania and Tulane University. I have been at the hospital for one year, and I’m loving it!  

What do you enjoy most about Texas Scottish Rite Hospital for Children?
My co-workers and colleagues energize and humble me and are the best part of the job.  

What was your first job? 
I was a lifeguard during a shift no one else wanted – 5-9 a.m.in the morning.  

What do you like to do in your spare time?
I spend as much time as I can in the company of my dog, and I play on a recreational women’s soccer team.  

Three words to best describe you:
Studious, committed and adventurous  

What would you do (for a career) if you weren’t doing this?
Professor or CIA, can’t decide.  

What’s the most adventurous thing you’ve ever done?
I served in the Peace Corps.

Learn more about the research conducted in the Center for Excellence in Hip. 

Get to Know our SRH Staff: Lisa Gardner, Research

Get to Know our SRH Staff: Lisa Gardner, Research

by | Mar 4, 2019 | Spotlight

What is your role at the hospital? What do you do on a daily basis? 
I provide administrative support to Matt Ferguson, assistant administrator for the Research department and Harry Kim, M.D., director for the Center of Excellence in Hip Disorders.
In addition to Matt’s research responsibilities (I believe we have approximately 60 people in our department), he is also a board member on the Stemmons Corridor Business Association and several times a year, I will assist with events for the association. Dr. Kim is the chair for the International Perthes Study Group (IPSG). This group meets at the hospital annually and I help as I can. When the Research department has people interested in observing, I help with their visits.
 
What led you to Texas Scottish Rite Hospital for Children? How long have you worked here?
My neighbor worked here and everything she told me made me want to become a part of this hospital family. I have been here for 34 years and throughout my time, I have worked in several different areas. I started in security, moved to human resources, then to administration and now, I am in research.
 
What do you enjoy most about Texas Scottish Rite Hospital for Children?
There are so many things that I love about the hospital! The research that is conducted here is wonderful because it can lead to finding causes and ultimately cures of conditions that many of our patients have. We are all dedicated to doing what is best for the children.  
 
What was your first job? What path did you take to get here? 
My first job was at an M.E. Moses Store, which does not exist anymore. When I started working here, I assumed it would be for a short time, yet 34 years later and I cannot imagine working anywhere else.
 
What do you like to do in your spare time?
I love to spend time with my family, especially my granddaughters. I also enjoy reading and traveling.
 
Three words to best describe you:
Compassionate, sincere, loyal
 
What would you do (for a career) if you weren’t doing this?
I cannot imagine being anywhere else. Scottish Rite Hospital isn’t really a job, it’s much more. I’m extremely lucky to be a very small part of what we do here. 
 
What’s the most adventurous thing you’ve ever done?
I am the opposite of adventurous! Although, I do love to ride just about any ride at amusement or water parks – my granddaughters inspire me to be brave.

A Collaborative Research Program Advances Care for Children Diagnosed with Cerebral Palsy

A Collaborative Research Program Advances Care for Children Diagnosed with Cerebral Palsy

by | Jul 19, 2018 | Research & Innovation

At Scottish Rite Hospital, our team is dedicated to providing individualized, expert care to each child. The hospital’s Neurology department is focused on providing treatment to orthopedic patients who have related neuromuscular diseases and neurological disorders. Over the years, the hospital has established specialized clinics for children with these complex conditions. Through the collaboration between our trained neurologists and orthopedic team, the patients are able to receive multidisciplinary care to address their specific needs. 

To continue advancing the care and treatment of our neurology patients, the department is committed to ongoing research. Each year, the hospital hosts a two-week research program for children diagnosed with hemiplegic (one side of the body) cerebral palsy. To participate in this research, children meet study inclusion criteria and go through an evaluation one week prior to being enrolled in the program. Constraint induced movement therapy (CIMT) is a form of treatment where the child’s stronger arm is put into a splint forcing them to use the affected arm for all daily activities. The two-week therapy program includes gross and fine motor activities that encourage independence with identified goals. Activities include crafts, making snacks and games. The program also includes the use of the Armeo®Spring Pediatric (an upper limb video game based robotic exoskeleton). As part of the research, our team evaluates the child before and immediately after completing the program as well as six months later. By analyzing the progress of these children, the data has shown an impact from the therapy including improvement in range of motion, function and use of the affected arm. 

Like many of the research projects that take place at the hospital, this program involves staff from multiple departments. Our Neurology team works closely with the hospital’s research occupational therapists, Angela Shierk, Ph.D., O.T.R. and Heather Roberts, Ph.D., O.T.R., to make this a success. Pediatric clinical nurse specialist Nancy Clegg, Ph.D., R.N., has been involved with this program over the years and can see the impact it has made. “The children we see in our clinics and those who participate in this program are in need of specialized care,” says Clegg. “Our neurologists, orthopedic surgeons and therapists are able to conduct robust research to bring more knowledge and better care back to the patients affected by cerebral palsy. The CIMT program is just one of the many research programs that allow us to collaborate and discover innovative treatment options to enhance overall care.” 

Integrated Team Approach to Patient Care Shows Positive Results

Integrated Team Approach to Patient Care Shows Positive Results

by | Apr 23, 2018 | Research & Innovation

At Scottish Rite Hospital, our experts are dedicated to caring for the whole child—mind, body, and spirit. The hospital includes six Centers for Excellence that each cultivate the mission of patient care, research, and education. Within those centers lies integrated services that allow our specialists to provide world-renowned care to every patient. 

The hospital’s psychology department is an essential component of the overall success of our patients before, during, and after treatment. As integrated members of the hospital’s health care team, our licensed psychologists work closely with our orthopedic staff to promote a healthy lifestyle for the child through clinical care, education, and ongoing research. 

Recently, an article from the hospital was published in the Journal of Pediatric Orthopaedics titled, “Perioperative Interdisciplinary Intervention Contributes to Improved Outcomes of Adolescents Treated with Hip Preservation Surgery.” It is a collaborative project including pediatric psychologists, researchers, and orthopedic surgeons. This study evaluated adolescent candidates for hip preservation surgery and the impact of perioperative interdisciplinary care on pre-operative and post-operative outcomes. Patients who undergo hip preservation surgery typically present with chronic pain lasting longer than six months, which has the potential to develop negative psychological effects on the adolescent. 

The team evaluated a total of 67 patients before and after undergoing hip preservation surgery. Our psychologists worked closely with this group of patients before surgery to provide education, counseling, and self-reported outcomes. In comparison to patients who did not receive psychological intervention prior to having surgery, those who did recorded:

  • Higher self-esteem and self-reliance
  • Less anxiety and depression
  • Decrease in school problems and social stress

In conclusion, the project revealed that pre-operative education and counseling for patients undergoing hip preservation surgery improved their overall physical and psychological function after surgery. Pediatric psychologist Heather Richard, Psy.D. is excited about the results of this research and what it means for the future of care. “This collaborative study shows the true impact education and counseling can have on a patient undergoing surgery,” says Richard. “Our psychology team is proud to be a part of an institution that understands the importance of this service and how it can positively influence the patient. We look forward to continuing our research to improve our care of the whole child.” 

Read more about the published article.