Orthopaedic Surgery NEWS
UCDAVIS
Winter 2009
Health System
A View from the Chair’s Corner
A
s the calendar year comes to a
close and I look back on the department’s
achievements in 2008, I have a sense of
pride for the growth of the department
and the outstanding accomplishments
of our faculty, residents and fellows.
Yes, there have been growing pains
and times of frustration with the pace
it takes to structurally implement our
ideas into actions; yet we, our faculty,
staff and trainees have relentlessly
persevered to successfully enhance our
UC Davis missions of clinical care,
community engagement, research and
teaching.
friends have been on the forefront. We
have enhanced our communication
avenues by updating our website,
starting a quarterly newsletter, and
strengthening our relationship with 740
orthopaedic physicians in our community
by launching our new physician-tophysician referral line. We had our first
grateful patient campaign. These donations
coupled with our endowments and
private gifts from our alumni and
friends have provided a fiscal stimulus
for our education and research missions.
For this, I extend a gracious thank you.
Clinically, we have expanded our
specialty care by 25 percent with the
recruitment of our new service chiefs
for foot and tumor oncology. We have
implemented an interal block release
program, which has increased
utilization for our operating rooms.
This has greatly contributed to our
increase in RVU production. For
FY08, we had just over 100,000 work
RVUs for our department, an increase
of 21% compared to FY07.
Our research structure continues to
evolve. This fall, we recruited an
epidemiologist who will begin to
develop a clinical registry outcomes
database in early 2009. Our faculty and
trainees continue to reach out to
industry for research support and as a
result, we have seen an increase in grant
approvals and reasearch projects.
Orthopaedic research continues to be
cutting edge with our faculty’s
participation in stem cell advancement
and biomechanics.
As our clinical productivity increased,
the need for us to strengthen partnerships
with other hospitals grew apparent.
This past October, we began performing
elective cases at Mercy San Juan. This
opportunity has solidified our
coordination of care efforts and has
improved access for our patients. Our
sports medicine physicians continue
to provide care to our UCD sports
teams and our community basketball
teams, the Kings and Monarchs. Beyond
Sacramento, our faculty offer service,
through treatment and education, to
those beyond our borders.
Forefront research, community
engagement and clinical care are the
educational experiences we aspire to
provide. Our trainees, residents,
fellows, research students and acting
interns are top notch. As our programs
expand, a more robust infrastructure is
being implemented. We now have
co-instructors of record, an assistant
residency director in addition to our
residency director and a growth in
fellowship directors as our pediatrics
fellowship will begin in 2009 and a
sports medicine fellowship is targeted
for 2010.
Community engagement efforts to
reach out to our patients, alumni and
As you look back on 2008, I ask that
you think about the attainments for
which you are proud and then take a
moment to start to develop your line
of sight to those goals you have set to
accomplish in 2009.
Seasons greetings.
Paul E. Di Cesare, MD, FACS
Michael W. Chapman Endowed Chair
Faculty Awards through
Sponsored Programs
The following faculty have received
awards through Sponsored Programs
this year:
Paul Di Cesare, MD was
awarded $54,194.02 from
GlaxoSmithKline for “The
Effects of Arixtra on Wound
Drainage Following Total
Joint Arthroplasty”
Tania Ferguson, MD was
awarded $34,000.00 from
Stryker for “Compare the
strength of trans-sacral
fixation with iliosacral
fixation with/without anterior
fixation in a vertically
unstable pelvic ring fracture”
Mark Lee, MD was awarded
$57,000.00 from Smith &
Nephew for “Biomechanical
Comparison of VLP: Tubular
Plates in Osteoporotic Fibula
Fracture”
Robert Szabo, MD was
awarded $11,400.00 from
Stryker for “Biomechanical
Comparison of Metacarpal
Plating
Clinical Expansion in the Forecast
Inpatient/Outpatient
Surgical
CasesCases
Inpatient/Outpatient
Surgical
5000
4342
4500
3841
4000
3441
3500
3000
Inpatient
Cases
Outpatient
Cases
2206
1466
2049
Total
Cases
734
500
732
1000
1792
1500
1466
1975
2000
2136
2500
0
FY07
FY08
FY09 (July-Nov)
FY09
Annualized
The trend shows in increase in our outpatient surgery cases. This is largely
due to the opening of the Same Day Surgery Center in November 2007.
Total Work
Total
WorkRVUs
RVUs
120000
100000
103709
100711
80000
79338
ACGME Site Review
Our Residency Program underwent
an ACGME site visit for its
accreditation on December 9, 2008.
Richard Haynes, Pediatric
Orthopaedics, was our site visit
representative from the ACGME.
While results of the site visit are not
yet available, we anticipate full
accreditation with a 5 year accreditation
cycle. In addition to the normal residency
review process, we have submitted
to the ACGME permission to expand
the program from 4 to 5 residents per
year. Action on the request will be
determined by the Residency Review
Committee on January 16, 2009.
As we approach the new academic
year, we work collectively to provide
for our residents a world class
Orthopaedic Residency training
experience, carrying on the legacy of
excellence in Orthopaedics championed
by Dr. Michael Chapman and other
founders of the UC Davis Department
of Orthopaedics.
60000
40000
Resident Applicants...
...did you know?
43212
•
20000
0
FY07
FY08
FY09 (July-Nov)
FY09
Annualized
Our clinical productivity is in an upward trend. Since FY07, we have
increased our clinical faculty by four, created an internal operating room
block release system, and are working to minimize clinic cancellations.
•
•
•
Growth
Projections
Growth
Projections
•
18
58
18
78
8
7
20000
15
15
1
15000
OP Surg Cases
•
IP Surg Cases
10000
ACC Clinic Visits
•
68
25
52
20
36
21
06
22
75
19
14
66
5000
•
0
FY 07 Actuals
FY 09 Annualized
FY 13 Projected
Using FY07 data, Health Strategies & Solutions, Inc. predicts Orthopaedics
will increase inpatient surgeries by 30 percent; outpatient surgeries by 40
percent, and clinic visits by 24 percent by 2013. As seen above, we are on
par to hit this target 4 years ahead of schedule.
374 applicants applied for 4 spots
(5-3 year slots and 1-6 year slot)
12.8 percent of all applicants are
interviewed
17 of 48 selected for interview
were acting interns at UCD
Department of Orthopaedics
Resident interviews are January 12
and 20, 2009
Resident applicants are invited
to enjoy a social gathering with
current residents the evening prior
to interview
10 faculty and 2 chief residents
conduct the round robin interview
sessions
Applicants receive a tour of the
hospital, attend grand rounds,
experience morning triage, and
meet with the residency director
Our new residency brochure
can be viewed at www.ucdmc.
ucdavis.edu/orthopaedics/
education/ residency
News from the Lawrence J. Ellison Musculoskeletal Research Center
Staff Leadership
Kimberly Anderson, MHA
Kimberly has been the
Chief Administrative
Officer since August
2007. Her prior
position was Manager
of Program Operations,
Medical Director’s
Office, University of
Washington Medical Center. In 2006,
Kimberly graduated from the University
of Washington Masters in Health
Administration Executive Program.
Dyana Greene, MBA
Dyana is our Financial
Analyst. She began
her career with UC
Davis three years ago
as a financial analyst
in Internal Medicine;
she has been with
Orthopaedics since
March 2008. Dyana has a bachelors
degree in finance and an MBA with a
concentration in accounting.
Janet Saldana, CCS-P
Janet is the Practice
Manager of the ACC
Clinic. She has been
with UCD for 28 years
and has worked in
Health Information
Management, Coding
and Decedent Affairs,
Professional Billing for Orthopaedics,
Neurosurgery and OB-Gyn, and MSA
Billing for Orthopaedics and all surgical
departments.
Tanya Johnson, RN, BSN
Tanya is the Nurse
Manager for the
Ambulatory Care
Clinic. She has been
an ER nurse for 17
years and an OR
Nurse/Manager for 2
years. She has been
with the Orthopaedic Department since
2000, and she loves what she does. She
lives with her husband in Woodland, and
together, they have 9 children.
Fyhrie selected for study section of
NIH’s Center for Scientific Review
David Fyhrie, PhD, UC Davis Professor of
Orthopaedic Surgery, has been appointed as a member
of a study section for the National Institute of Health’s
Center for Scientific Review.
Fyhrie has been selected to serve on the Skeletal
Biology Structure and Regeneration Study Section
through June 2012. Members are selected on the
basis of their demonstrated competence and
achievement in their scientific discipline, as reflected
by the quality of their research accomplishments,
publications in scientific journals, and other significant scientific activities,
achievements and honors.
Fyhrie is the Director of the Orthopaedic Research Laboratory and holds the
David Linn Chair in Orthopaedic Surgery. His research interests include bone
biomechanics, bone remodeling, cartilage mechanical properties, bone cell
mechanobiology, fracture mechanics and finite element modeling.
Spotlight on.......
Orthopaedic
Sports Medicine Service
The Sports Medicine service at UC
Davis was established in 1986. At the
time, a subspecialty devoted to caring
for athletic injuries, providing athletic
team coverage and specializing in
arthroscopic surgery were relatively
new concepts. Since then, the service
has experienced rapid growth. To
answer increased demands, UC Davis
Sports Medicine was developed at J
Street to offer comprehensive care for
sports injuries. There are operative and
non-operative clinicians, on-site
physical therapy and a sports physiology
lab. Satellite clinics have been added
to the Auburn, Folsom, Davis and
Roseville Primary Care Network
offices in order to extend sports
medicine services to the greater
Sacramento area. In 2007, the delivery
of operative care was modernized with
the opening of the Same Day Surgery
Center at the Sacramento campus.
Richard Marder, MD, our service
chief, established the service in 1986.
He graduated from the UCLA
orthopaedic residency and trained in
sports medicine under Dr. Zarins in
Boston at Harvard. As a sport injury
(continued on next page)
G
rateful Patients express
ratitude through
enerosity
In October 2008, we lauched our
Grateful Patient Campaign, and as
of January 2009, we have been
fortunate to receive 33 donor gifts!
The collective total is $1,910.00.
These donations will be used to
enhance our departmental education
programs and research endeavors.
Many thanks to our patients’
generosity!
If you are interested in contributing to
the financial viability of the Department
of Orthopaedics, please check our
webite at http://www.ucdmc.
ucdavis.edu/orthopaedics/giving/
or call 916.734.9400.
Spotlight on.......
Orthopaedic
Sports Medicine Service
(continued from previous page)
specialist, Dr. Marder has been head
team physician for Sacramento’s
professional men’s basketball team
since 1987. He has also worked with
the Sacramento professional soccer
and women’s basketball teams, as
well as the Sacramento Ballet and
intercollegiate athletics at UC Davis
and American River College.
Kirk Lewis, MD joined the service
in 2007. He received his Sports
Medicine training at UCLA under
Dr. Finerman. He brings 23 years of
experience to UC Davis. His practice
focuses on knee and shoulder
arthroscopy and reconstruction, and,
along with Dr. Marder, he serves as
team physician to UC Davis athletics
and the Sacramento Kings and
Monarchs.
Eric Giza, MD joined the service
as the Foot and Ankle specialist in
2008. He is a graduate of the Harvard
Combined Orthopaedic Residency and
did his Sports Medicine fellowship
with the Santa Monica Orthopaedic
and Sports Medicine Group. Dr. Giza
specializes in reconstruction of the
foot and ankle, arthroscopy, and knee
and shoulder surgery. He is a member
of the US Soccer Federation physician
pool.
Another member of our service is
James Van den Bogaerde, MD. He
is a graduate of the UC Davis
Orthopaedic residency and did his
Sports Medicine fellowship at the
Steadman Hawkins Clinic in Vail,
Colorado. His practice includes
Save the date!
Resident Symposium and
Graduation
June 18-19, 2009
Granite Bay Golf Club
shoulder, elbow and knee arthroscopy,
reconstruction and arthroplasty. He
is a member of the US Ski Team
physician pool.
With the support of Chair Michael
Chapman, MD in 2001, Dr. Marder
teamed up with Dr. Jeffrey Tanji as
co-directors to establish the multidisciplinary specialty practice site for
UC Davis Sports Medicine at the J
Street building in mid-town Sacramento.
Board certified specialists include
Jeffrey Tanji, MD, David Cosca, MD
and Gina Lokna, MD from the Prmary
Care Network, as well as Brian Davis,
MD and Brandee Waite, MD;
faculty of the Department of Physical
Medicine and Rehabilitation. Sports
Medicine physicians have access to
their own x-ray suite, physical therapy
and the Sports Performance Lab for
physiological testing, biomechanical
analysis, sports nutrition and sport
psychology consults. Research
interests in sports medicine and
exercise science have fostered
collaberative efforts between
Gretchen Casazza, PhD and several
of the members of the orthopaedic
faculty. Rebecca Misner is the on-site
academic coordinator for Dr. Marder
and Dr. Lewis.
Within the Ambulatory Care Division,
Penny Herbert, MS, provides the
seasoned leadership for all musculoskeletal services. As the Practice
Manager, Nancy Sardon, MHSA,
manages the daily operations for the
(continued on back page)
In 2010 we are hoping to expand
our educational offerings by
implementing a Sports Medicine
Fellowship. The department is
slated to present this request to
UCDavis in February 2009.
Fast and friendly
Physician-to-Physician
referrals
916.734.5885
Live assistance is available
Monday through Friday, 9 am to 5 pm
All services are accepting
new patients
Annual Meeting Presentations
T he following members of our department are scheduled to present at upcoming annual meetings:
The American Academcy of Orthopaedic Surgeons (Feb 25-28) and The Orthopaedic Research Society (Feb 22-25)
AAOS
Mark A Lee, A. Hari Reddi, Susan
Tseng. Poster: Prevention vs.
Treatment of a Rat Atrophic
Nonunion with Bone MarrowDerived Mesenchymal Stem Cells
Robert A Zlotecki, Zachary B Adler,
Mark Thomas Scarborough, C Parker
Gibbs Jr,. Robert M Tamurian.
Poster: Morbidity of an Unplanned
Excision of Soft Tissue Sarcomas: A
Quantitative Assessment
GD DuRaine, CP Neu, A. Hari
Reddi. Abstract: Alternative Splicing of prg4 is Regulated by the TGF-β
Pathway
Tania Ann Ferguson, Ravi Patel,
Mark A Lee, Mohit Bhandari,
William Page. Poster: Technical
Considerations in the Surgical
Management of Femoral Neck
Fractures in Young Patients
Tania Ann Ferguson, Ravi Patel,
Mark A Lee, Stephen J Pinney,
William Page. Poster: Timing of
Femoral Shaft Fracture Fixation:
A Survey of Orthopaedic
Traumatologists
Jason Collins, Patrick A Meere,
Edward M Adler, Joshua Landa,
Nachum Levin, Paul E DiCesare,
Marc R. Fajardo. Poster: The Effect
of Intra-Articular Analgesic Injection
following Bilateral Total Knee
Arthroplasty
Richard A. Marder, Charley N. Lind,
Eric A. Heiden. Paper Presentation:
Calcific Tendinitis of the Shoulder:
Debridement Alone versus Debridement
and Subacromial Decompression
Robert M. Szabo. ASSH Specialty
Day Presentation: Carpal Tunnel
Syndrome: Where are we now?
Edward Harvey, Lawrence X. Webb,
Philip R. Wolinsky & Nirmal C.
Tejwani (Moderator). Trauma
Educational Session #272:
Management of High Energy Soft
Tissue Trauma in Orthopaedics
John T. Gorczyca, Sean E. Nork,
Nirmal C. Tejwani, Philip R.
Wolinsky, Mark A. Lee (Moderator).
Trauma Educational Session 351:
High Energy Proximal Tibia
Fractures: Treatment Options and
Decision Making
Dominik Haudenschild. Moderator.
Session 31: Mesenchymal Stem Cells/
Chondrogenesis
Bertha Kuo, David Fyhrie. Poster:
Substrate Stiffness Affects Spreading
in UMR106 Osteoblasts
Mark A. Lee & Pierre Guy. OTA
Specialty Day -- Fracture
Management Controversies: Open
Grade IIIA Tibia at 11:00pm: Can It
Wait Until 7:00am?
David Fyhrie, Xiang Wang, Matthew
Allen, David Burr. Poster:
Influence of Bone Hardness on
Microcrack Density
ORS
David Fyhrie. Poster: The Evolution
of Cancellous and Cortical Bone
Paul Di Cesare. Moderator Session
34 Total Knee
Matthew Soicher, Xiang Wang,
Roger Zauel, David Fyhrie. Paper
Presentation: Damage Initiation Sites
in Osteoporotic and Normal Human
Cancellous Bone
SMT Chan, Corey P Neu, K
Komvopoulos, AH Reddi,
Paul Di Cesare. Poster: Friction and
Wear of Biomaterials Against
Articular Cartilage
RC Entwistle, SC Sammons, RF
Bigley, Scott J. Hazelwood,
David Fyhrie, SM Stover. Poster:
Cortical Bone Material Properties are
Related to Stress Fracture
Tomasz Antkowiak, David
Moehring, Afshin Khalafi, Corey
Neu. Poster: Biomechanical
Evaluation of the Surgical Implant
Generation Network (SIGN)
Intramedullary Tibial Nail
RC Entwistle, Scott J. Hazelwood,
David P. Fyhrie, SM Stover Poster:
Sites of Stress Fracture Lack
xtensive Remodeling Prior to Injury
GD DuRaine, CP Neu, A. Hari
Reddi. Abstract: Alternative Splicing of prg4 is Regulated by the TGF-β
Pathway
Calvin Kuo, David Fyhrie, Amir
Jamali. Poster: The Role of Opioid
Agonists for Chondrocyte Preservation in
the Storage of Osteochondral
Allografts
Dominik Haudenschild, J Chen,
Lotz, D’Lima. Poster: Short Talk: Rho
Kinase Phosphorylates and
Activates Sox9 in Chondrocytes
Dominik Haudenschild, J Chen,
N Pang, Steklov, Lotz, D’Lima.
Poster: The Vimentin Cytoskeleton
Contributes to Chondrocyte Stiffness
and changes with OA
RK June, Dominik Haudenschild,
J Chen, Lotz, RA Terkeltaub, D’Lima.
Poster: Transglutaminase 2
Colocalizes with Vimentin and Actin
in Chondrocytes
RC Entwistle, SC Sammons, Scott
Hazelwood, David P. Fyhrie, SM
Stover. Poster: Cortical Bone
Material Properties are affected by
High-Speed Training and Exercise
YN Yeni, M Zinno, D Vashishth,
David Fyhrie. Poster: Trabecular
Stress and Microstructural
Variability are Associated with
Osteocyte Density in Human
Vertebral Cancellous Bone
YN Yeni, M Zinno, J Yerramshetty,
R. Zauel, David P Fyhrie. Poster:
Within-bone Variability of Human
Vertebral Trabecular Microstructure
is Age, Gender and VertebraDependent and Affects Stress
Distribution Properties
Independently from Average Bone
Volume
Spotlight on.......
Orthopaedic
Sports Medicine Service
physical therapist, is dedicated to
providing physical therapy for patients
with musculoskeletal injuries.
(continued from page 4)
The Sports Performance Laboratory
performs physiological testing and
biomechanical analysis for athletes
as well as active adolescents and
adults. Supervised by Stacey
Streuber, MS, the team of exercise
physiologists includes Judd Van
Sickle, MS, Cortney Martellucci,
MEd, John Hansen, MS, Gretchen
Casazza, PhD and Diana Prince.
Clients with sports nutrition concerns
are referred to Marlia Braun, RD, PhD,
while Kimberly Cusimano, PhD
provides consults on sports psychology.
J Street practice. Nurse Manager
Tanya Johnson, RN, supervises the
nursing team, which includes Christina
Lozada, RN, Kristin Brocco, Irene
Jamlig, Satpreet Johal and Kimberly
Coughlin. Having nine years of
experience in the Sports Medicine
practice, Geanie Flores oversees the
clerical functions of seven coordinators
for the clinic. Kalan Winston, CRT
works closely with the physicians as
the x-ray technician, both on-site and
at ARCO Arena. Dan Quasius,
A word from one of our
residents...
“The faculty’s commitment to
education is phenomenal....
especially in the area of didactic
education and
the diverse and frequent
operative experience
from the junior year on.
But the primary reason that
I selected this program is
because of the exceptional
camaraderie between residents
and between
residents and faculty.....
it’s the best I’ve ever seen.”
-Tomasz Antkowiak, PGY2
Department of Orthopaedic Surgery
University of California, Davis
4860 Y Street, Suite 3800
Sacramento, CA 95817
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