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Foot and Ankle Services
Impacting OrthopedicsAn Annual Review 2015-2016
ORTHOPEDICS
1
Table of Contents
Introduction 2
LeaderswithImpact 3
ImpactingPatients 4
ImpactingtheCommunity 6
CombinedPractices 7
TotalJointReconstruction 8
FootandAnkle 10
HandandUpperExtremity 12
PediatricOrthopedics 14
SpineandInterventionalMedicine 16
SportsMedicine 18
TraumaandFractureCare 20
SumterOrthopaedicAssociates 22
ResidencyProgram 23
AncillaryServices 24
Research 26
ContinuumofCare 28
Leadership 31
PatientReferral 32
2 3
Introduction Leaders with Impact
In April 2016, Palmetto Health-USC Medical Group Orthopedics was created by combining five orthopedic practices (the former Moore Clinic, USC Orthopaedics, Premier Orthopedic Specialists, Orthopaedic & Spine Surgeons of South Carolina and Sumter Orthopaedic Associates) in and around the Midlands to form the largest orthopedic presence in the state. Forty surgeons and physicians came together with the vision of offering the full continuum of orthopedic care while keeping quality and affordability in mind. Each physician is an orthopedic specialist in one of the following areas: foot and ankle, joint replacement, orthopedic trauma, pediatric orthopedics, spine, sports medicine, interventional medicine or hand and upper extremity.. Patients have access to state-of-the-art imaging, specialized rehabilitation and even total wellness.
The group has a strong focus on community outreach, research, education and growth opportunities to meet the needs of its growing patient population. Community outreach programs include comprehensive care to a large number of high schools, middle schools, colleges and other sports groups through the Sports Medicine Athletic Trainer program. Research is underway to collect clinical data to report outcomes on surgical patients as well as to investigate new prostheses and techniques to continue leading in orthopedic innovation. Resident education is expanding to better reflect the size and scope of the practice, including medical residents, physical therapy residents and athletic training residents. Finally, the practice plans to increase its service offering to meet the needs of its patient population through the addition of physicians and the integration of ancillary services such as pain management and rheumatology.
This is an exciting time for orthopedic health care in the Midlands and surrounding areas. The commitment of Palmetto Health-USC Medical Group Orthopedics is to impact orthopedic care through research, education and specialization. Each physician is committed to leadership, innovation, and the utmost patient experience in orthopedics. Bradley Presnal, MD, and John Walsh IV, MD, co-chairs of orthopedics, invite you to learn more about the expertise this new practice has to offer in this comprehensive Annual Review: Impacting Orthopedics.
MissionWe provide compassionate care, preeminent medical education and transformative research.
VisionTo be known for clinical excellence and remembered for compassionate care.
Values• Service• Excellence• Professionalism• Partnership• Integrity• Accountability• Transparency
As part of the formation of the Palmetto Health-USC Medical Group Orthopedics, five diverse orthopedic groups have merged to become the most comprehensive musculoskeletal practice in South Carolina. Combining forces with physicians, physical therapists, occupational therapists, athletic trainers and experienced medical staff, we will be able to provide each patient the highest level of care for musculoskeletal injuries and disease. We have linked academic training, adult and pediatric care, subspecialty expertise and all forms of orthopedic therapy into a single entity. Uniting the knowledge and experience of 40 physicians into one group will allow for the quality of service and care for our patients that we expect for our own families. We hope this publication will highlight some of the many endeavors and expertise of our organization and introduce you to South Carolina’s largest orthopedic group.
Sincerely,
Bradley P. Presnal, MDSenior Medical DirectorPalmetto Health-USC Medical Group,Department of Orthopedics
I am very happy to introduce the new Palmetto Health-USC Medical Group Orthopedics Annual Review: Impacting Orthopedics. This publication is an exciting introduction to our new practice. We have merged five orthopedic practices situated in nine locations in the Midlands. This has brought together 40 talented physicians committed to being leaders in orthopedic surgery, the medical community in our state and throughout the southeast. As part of the largest multispecialty medical group in the Midlands, we have a unique opportunity to impact health care in this community, and provide more access to complete orthopedic care. I am excited about the opportunities that lie before us and invite you to learn more about our history and vision in this comprehensive look at orthopedics at Palmetto Health-USC Medical Group.
Sincerely,
John J. Walsh, MDProfessor and ChairPalmetto Health-USC Medical Group, Department of Orthopedics
Luke Davis knows firsthand how important a strong support system is when dealing with a traumatic injury. Five years ago Luke was the victim of a serious car accident that left him facing amputation of his right leg. With an already positive outlook, Luke found a strong support system with his friends, family and team of medical professionals at Premier Orthopedic Specialists. Luke describes his experience with Dr. Thomas Jones and Dr. Michael Tucker and staff as comforting, saying “They made it easy. They made it emotionally easy. They showed you life wasn’t going to change just because you’re missing a body part.” He remembers them as
“[fostering] more of a personal relationship than a strictly professional one.”
For some, this could have been a reason to give up the things they love. But for Luke, this was an opportunity to overcome and thrive. This adventure seeker wasn’t going to let his injury stop him from participating in the sports he loves or even from becoming an action photographer. Today, Luke acts as a patient advocate visiting new amputee patients as a support system for them. About once a month, Luke is called to visit a patient who is facing or has recently undergone an amputation of an extremity. Luke’s motivation for helping others is the change in attitude he sees in patients after their visit. “So many I go see are terrified of having a limb amputated, and many times just seeing me walk in with no limp, soreness or any indication I’m an amputee besides [my prosthesis], shows them it’s not the end of the world,” Luke says.
“So many I go see are terrified of having a limb amputated, and many times just seeing me walk in with no limp, soreness or any indication I’m an amputee besides [my prosthesis], shows them it’s not the end of the world,” Luke says.
Millions of children across the globe lack access to quality medical care. Eleven-year-old Xochitl Beltran is one of those children. Xochitl lives with her parents in San Salvador, a rural village in El Salvador. Xochitl has an array of medical concerns, including severe Congenital Scoliosis, a sideways curvature of the spine caused by abnormally formed vertebra present at birth. Congenital Scoliosis occurs in approximately one in 10,000 newborn children and severe cases can only be corrected with delicate and intricate surgical intervention. In addition to her abnormal vertebra, she also has sacral agenesis where her sacrum at the bottom of her spine is not completely formed. Xochitl found herself with a spinal deformity in a country where health care reform is on the upswing, but still sparse for such a unique operation.
Dr. Christopher Hydorn, a pediatric orthopedist at Palmetto Health Children’s Hospital, had the opportunity to offer his services through Spring Valley Rotary Club’s Gift of Life program. They identified Xochitl as a patient in need, facilitated her travel to Columbia and served as her host family. Dr. Hydorn and the pediatric orthopedic specialists at Palmetto Health Orthopedics see and treat hundreds of children each year with spinal deformities.
Once Xochitl arrived in South Carolina, Dr. Hydorn developed a comprehensive plan to correct her spine. Xochitl initially underwent orthopedic surgery to correct her congenital scoliosis, which involved removal of one of her deformed vertebra and used rods to straighten her remaining curve. As a result, Xochitl can expect no further progression of her spinal curvature and an improvement in her long-term health and well-being. Thanks to resources provided by Spring Valley Rotary Club, Palmetto Health Children’s Hospital, and a generous medical device company, Xochitl’s quality of life has been greatly improved. She and her mother, Lillian, returned home in January 2016 grateful for the care they received; care that was not available in El Salvador.
PEDIATRIC ORTHOPEDICS
Xochitl Adriana Beltran
4 5
Impacting Patients
TRAUMA
Luke Davis
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Impacting The Community Combined Practices
0-9
10-19
20-29
30-39
40-49
50-59
60-69
70-79
80-89
90-99
100+
AGE PATIENTS
3,410
13,037
5,219
5,814
9,152
14,156
14,321
8,398
3,138
479
6
AGE DEMOGRAPHIC
TOTALS FOR ALL PRACTICES
FEMALE
MALE
44,285
32,840
73,219
49,640
16,568
COLUMBIA (2 and 14 Medical Park)
LEXINGTON
BAPTIST PARKRIDGE
PATIENT VOLUMES (OFFICE VISITS)
35+ PHYSICIANS
NUMBER OF PHYSICIANS
|0-9
10-19
20-29
30-39
40-49
50-59
60-69
70-79
80-89
90-99
100+
AGE PATIENTS
3,410
13,037
5,219
5,814
9,152
14,156
14,321
8,398
3,138
479
6
AGE DEMOGRAPHIC
TOTALS FOR ALL PRACTICES
FEMALE
MALE
44,285
32,840
73,219
49,640
16,568
COLUMBIA (2 and 14 Medical Park)
LEXINGTON
BAPTIST PARKRIDGE
PATIENT VOLUMES (OFFICE VISITS)
35+ PHYSICIANS
NUMBER OF PHYSICIANS
|7 Colleges
11Professional Teams and
Organizations(Not all pictured)
34 High Schools
18,000+ High School Athletes 2,100+ College Athletes20+ Middle Schools
PATIENT POPULATION MAP
CLINICAL EXPERTISE
The physicians of the Palmetto Health-USC Medical GroupOrthopedics are experts in their specialty areas. The subspecialty includes four fellowship-trained joint replacement surgeons with a combined total of nearly 100 years of experience in joint replacement surgery. The team utilizes multiple surgical approaches to perform unicompartmental, primary and revision knee replacement, primary and revision hip replacement, and osteotomies. As a group, which includes Hand and Upper Extremity, they perform more than 200 elective procedures a month. The team also includes multiple board certified orthopedic surgeons who perform knee, hip, ankle, elbow and shoulder replacement surgeries. Our joint replacement surgeons actively participate in education, research and publication, with nearly 50 publications amongst them covering a wide range of topics. As a group, they have presented nearly 100 educational sessions and posters for local, state, national and international audiences. They also actively participate in the American Academy of Orthopaedic Surgeons (AAOS), the American Association
of Hip and Knee Surgeons (AAHKS) and the Association of Bone and Joint Surgeons. Dr. Kim Chillag is a member of the editorial review board for the Journal of Arthroplasty and reviews articles for Clinical Orthopedics and Related Research; Dr. Frank Voss serves as chair of the AAHKS Practice Management Committee, AAOS representative to the AMA CPT Committee, member of the AAHKS Health Policy Committee and AAOS Committee on Coding, Coverage and Reimbursement. All four of our fellowship-trained joint replacement surgeons are Fellows of the AAOS.
Nathanael Hall, PA-C; Janine Moseley, PA-C; James Coffey, PA-C; Jeffrey S. Hopkins, MD; Andrew T. McGown, MD; Bradley P. Presnal, MD; Frank R. Voss, MD; Kim J. Chillag, MD; Karin Duffy, PA-C; David E. Koon Jr., MD
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RESEARCH INITIATIVES
Palmetto Health Richland, in collaboration with the Palmetto Health Quality Collaborative, recently participated in the inaugural Joint Replacement Learning Community (JRLC) with the Institute for Healthcare Improvement and Harvard Business School. The JRLC consisted of a cohort of 32 joint replacement programs from across the U.S. as well as international groups who focused on providing high quality, cost effective care for hip and knee replacement patients. The subspecialty has performed in-depth reviews of the processes involved in a joint replacement surgery, beginning with the visit to the surgeon’s office, preparation for surgery, the surgery itself and the patient’s rehabilitation. The 32 JRLC programs shared processes and best practices so that, as a combined group were able to determine what would be the ideal processes for a successful joint replacement program. Improvements were made to the office processes, the hospital and post-discharge. Through this project costs were decreased, processes streamlined to ensure that our patients have excellent outcomes and a great experience. Results from this review have now been applied across the entire hospital system. Projects have been established to look at joint replacement patient reported outcomes. This information initially is gathered when the patient and surgeon decide that joint replacement is the right treatment for that patient’s condition and then several months after surgery the same questions are asked again. This ongoing communication with our patients will help us to refine our processes to better meet their needs and ensure that they have a great experience during their joint replacement journey.
FUTURE DIRECTIONS
The Palmetto Health-USC Medical Group Total Joint Replacement team is looking ahead and preparing for the future now. Active plans are in process to expand our scope of service and capacity by seeking additional fellowship-trained joint replacement partners with expertise in anterior approach hip replacement as well as traditional approach joint replacements. In conjunction with the Palmetto Health Quality Collaborative, the medical group subspecialty has worked with local insurers for several years on a bundled payment model for primary joint replacement surgeries. This payment model, very similar to the new CMS Comprehensive Care for Joint Replacement, reimburses for the entire episode of care rather than reimbursing on a fee-for-service basis. This model includes not only financial accountability but also quality and performance accountability. Participation in these programs leads to a more holistic approach to joint replacement where we emphasize pre-operative health optimization of the entire patient to ensure excellent postoperative outcomes. The future of joint replacement is shorter postoperative lengths of stay in the hospital and an expectation that patients will go home after surgery. Knowing that patients who go directly home recover more quickly; therefore, our team is looking at innovative ways to decrease the percentage of patients that discharge to a rehabilitative facility due to social reasons. This new model has decreased the average post-operative length of stay by one day, but look for that number to decrease further as patients are better prepared for surgery. Eventually same-day surgery for hip and knee replacement will be the norm and our initiatives offer the preparation to be able to provide this type of service.
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Ongoingcommunicationwithourpatientshelpsustorefineour
processestobettermeettheirneedsandensurethattheyhavea
greatexperienceduringtheirjointreplacementjourney.
Total Joint Reconstruction
CLINICAL EXPERTISE
Foot and ankle injuries are common. Nearly 80 percent of the population will experience foot or ankle pain at some point in their life. From sports-related injuries to degenerative problems, such as arthritis, our physicians and physician assistants are trained in treating the many different conditions that can affect the foot and ankle. Our three fellowship-trained foot and ankle surgeons have spent a year of additional training to provide their patients expert level care.
Each patient will enjoy a thorough evaluation and work with our Foot and Ankle specialists to develop a unique, patient-centered and comprehensive treatment plan. We collaborate with each patient to determine whether a surgical or nonsurgical approach is the most appropriate treatment option. If surgery is necessary, the physician will discuss the procedure with the patient and answer any questions to ensure the patient is comfortable with the prescribed treatment plan. Our surgeons offer the most innovative patient-centered treatment options available in the country. They offer numerous non-operative options including: bracing, orthotics, casting, strapping and physical therapy. Surgical options range from minimally invasive arthroscopic treatment to advanced reconstruction options including ankle replacement and Taylor Spatial Frame. They utilize their collective decades of experience to develop care that meets the needs and expectations of their patients.
Our physicians have been recognized by their peers for their excellence in foot and ankle surgery and serve in regional and national leadership roles. Drs. Benjamin Jackson, Ryan Putnam and Bret Smith are members of the American Orthopaedic Foot and Ankle Surgeons (AOFAS). Dr. Smith is a member of the Education committee. Dr. Jackson serves on the AOFAS program, research and CME committees. Dr. Putnam has published several articles on foot and ankle disorders in premier national journals.
RESEARCH INITIATIVES
Our team is focusing on patient-centered experience research by instituting a collection system for patient reported outcome (PRO) metrics through iPad devices. The belief is that with our patients perspective on their current state of health and their response to treatment should guide our decision-making. Our team is also seeking to provide efficient and cost-effective care to our patients. To that end, our physicians are studying the utility of ultrasound to diagnose tendinopathy of the foot and ankle. They believe that this tool, when properly utilized, could allow for a more rapid and dynamic assessment of disease and provide a more cost effective way to deliver care. The physicians believe that, with our patients, they can study the effect of treatments to determine a more evidence-based plan of care. This can be accomplished with thoughtful study design and by keeping our patients at the center of the outcomes measured.
The Foot and Ankle team continues to stay on the cutting edge of orthopedic research. In academic year 2015, our team applied for more than $400,000 of grant funding. Currently there are six IRB-approved research studies involving foot and ankle patients and look forward to doubling that number during the next calendar year.
FUTURE DIRECTIONS
The Foot and Ankle team is building for the future now. While this Annual Review was being written a new office location in Northeast Columbia opened and there are plans in place to add an additional foot and ankle physician assistant to increase accessibility to patients in a multi-location system. This provider will offer specialty care for non-operative foot and ankle conditions.
Methods are being sought to provide more cost-effective treatment options for patients by reducing inefficiencies of care and offering proven, cost-effective solutions for patients’ disorders. Our team currently utilizes the latest business analytics to evaluate treatment options and their effectiveness for our patients. This helps to reduce unnecessary costs while restoring our patients back to their desired activities and while continually improving and keeping the patient at the center of our care.
SERVICES OFFERED
Treatment for• Achilles problems• Ankle pain• Arthritis• Athletic injuries• Bunions• Calluses• Claw toes• Hammertoes• Fractures
and sprains• Painful flat feet• Diabetic foot
ulcer• Instability• Foot pain
J. Benjamin Jackson III, MD; Rebecca Daubert, PA-C; Randy Bell, PA-C; W. Bret Smith, DO, MS; Ryan M. Putnam, MD
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Foot and Ankle
In partnership with our patients, we believe we can study the effect of treatments to determine a more evidence-based plan of care. This can be accomplished with thoughtful study design and by keeping our patients at the center of the outcomes measured.
SERVICES OFFERED
Treatment for• Tendonitis• Arthritis• Trigger finger• Ganglion cysts• Cubital tunnel
syndrome• Nerve
decompressions such as carpal tunnel release
• Fractures and dislocations
• Dupuytren’s disease
• DeQuervian’s tendonitis
• Rotator cuff tear• Shoulder instability• Tennis elbow• Golfers elbow• Tendon repair
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John J. Walsh IV, MD; Mae E. Young, MD; Gregory Mangione, PA-C; David B. Fulton, MD; Earl B. McFadden Jr., MD; Jessamyn Bartley, PA-C
Hand and Upper Extremity
CLINICAL EXPERTISE
The Palmetto Health-USC Medical Group Hand and Upper Extremity team consists of four orthopedic surgeons with a multitude of fellowship training and experience. The clinical expertise of the team includes injuries and disorders of the hand, wrist, elbow and shoulder. Common procedures performed include carpal tunnel release, trigger finger release, tendon and nerve repair, wrist arthroscopy, fracture care, joint replacement for hand arthritis, shoulder replacement, and arthroscopic surgery of the shoulder. Patients of the Hand and Upper Extremity team have access to specialized care for their specific needs. Extremity imaging is a convenient service offered to patients who need an MRI of the upper extremity, offering a comfortable and open experience. Patients who require rehabilitation have access to the largest team of certified hand therapists in the Midlands. These occupational therapists are specially trained in the intricacies of the hand and upper body to ensure patients have the best chance for full recovery from surgery or injury. The physicians work closely with the therapists to ensure optimal levels of care following a surgical procedure.
RESEARCH INITIATIVES
The Hand and Upper Extremity team is working to develop research data that may be used in the future for outcome studies in upper extremity orthopedic care. The group regularly attends national meetings within the specialty to stay up to date on the latest trends and technology in orthopedic surgery. Dr. Earl McFadden joined a group of orthopedic surgeons to participate in a clinical trial using the most innovative shoulder replacement technique. With more than 50
peer reviewed publications, the Hand and Upper Extremity team prides itself on being on the front line of advancing medicine. Dr. John Walsh leads the School of Medicine faculty in education and teaching. The Hand and Upper Extremity team also is active in teaching the Orthopedic Resident class and developing physicians of the future.
FUTURE DIRECTIONS
The Hand and Upper Extremity team strives to provide the utmost health care experience to each and every patient. The evolving institution of medicine allows for expansion and innovation in each specialty area, especially upper extremity and hand. This team is committed to continuing in research, specialization and expanding resources in order to deliver the best possible patient experience and outcomes.
The Hand and Upper Extremity team is committed to continuing in research, specialization and expanding resources in order to deliver the best possible patient experience and outcomes.
CLINICAL EXPERTISE
The Pediatric Orthopedic team is the largest pediatric musculoskeletal program in South Carolina and includes the only specialized pediatric orthopedic rehabilitation facility in the Midlands. Our growing team consists of three board-certified pediatric orthopedic surgeons and two physician assistants with a passion for children and innovation. The rehabilitation facility consists of specialized pediatric physical and occupational therapists trained to treat growing bodies. Patients ages 0-18 utilize
the program to seek care for conditions such as fractures, scoliosis, spinal deformity, growth disorders and clubfoot, among other disorders. On average, 15,000 patients are seen each year with the goal of returning to normal, active lifestyles. Fellowship-trained pediatric orthopedic surgeons are on call 24 hours a day, seven days a week for pediatric orthopedic trauma and urgent patient needs, providing a constant ease of mind for parents as the patient is always in specialized hands.
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Shelly Hill, PA-C; Mark D. Locke, MD: Christopher R. Hydorn, MD; Jennifer Cooper, PA-C; Michael P. Horan, MD, MS
Pediatric Orthopedics
In looking to the future the pediatric orthopedic department aims to continue to serve the community in preventative educational discussions as well as immediate care for injured children.
RESEARCH INITIATIVES
In order to continue leading the way in pediatric orthopedics, the physicians and therapists are involved in orthopedic research to better understand and treat growing children effectively. Research initiatives include patellar femoral syndrome, vitamin D effects, and multiple athletic injury protocols in the high school athlete. In addition to research, education is a key focus. Dr. Christopher Hydorn leads the pediatric education portion of the Orthopedic Residency program by conducting conferences throughout the year and monitoring case studies presented by residents and medical students. Dr. Mark Locke is a clinical assistant professor at the University of South Carolina School of Medicine (USCSOM), sharing his experience and knowledge with future physicians. Dr. Michael Horan serves as a clinical associate professor with the USCSOM as well. The University of South Carolina School of Medicine provides rotations in the pediatric orthopedic service, providing a learning environment and opportunities to further the education of others.
FUTURE DIRECTIONS
As needs of patients grow, so will the pediatric orthopedic program. In looking to the future, the Pediatric Orthopedic team aims to continue to serve the community in preventative educational discussions as well as immediate care for injured children. The unique medical care of pediatric orthopedics can only be found in passionate physicians who aim to learn the underdeveloped musculoskeletal system of a child, and the pediatric orthopedic team pioneers and stays up to date on the latest medical advancements in this area.
Dr. Horan and the Pediatric Orthopedic team travel to other areas of the world to ensure young lives are able to reach their full healthy potential.
EVALUATED 13,913 PATIENTS
PERFORMED 3,600 SPINAL INJECTIONS
PERFORMED 1,080 SURGICAL PROCEDURES
COMPLETED 100 INDEPENDENT MEDICAL EXAMS
PERFORMED 1,772 WORKMAN’S COMP VISITS
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Spine and Interventional Medicine
CLINICAL EXPERTISE
The physicians of the Palmetto Health-USC Medical Group Spine and Interventional Medicine team are truly experts in the field. Our team consists of eight physicians who offer the continuum of operative and non-operative care for any spine issue. Our five fellowship-trained spine surgeons have a total of more than 50 years of serving the Midlands. The surgical team is able to provide a full spectrum of operative interventions including outpatient and minimally invasive surgeries, fusion procedures, motion preserving spine surgery, and complex revision procedures, depending upon the needs of the patient.
Our three physical medicine and rehabilitation providers are experts in the non-operative management of spinal disorders. Working in conjunction with our group of physical therapists, they help coordinate patient-centered therapy programs as well as provide diagnostic support in the form of EMGs and nerve conduction studies. They also perform more than 3,600 outpatient interventional procedures such as epidural steroid injections, facet injections and medial branch blocks per year.
The Spine and Interventional Medicine team is recognized locally, regionally and nationally for their contributions to education and leadership in the field. As a group, they have more than 50 publications and presentations for audiences in South Carolina and around the U.S. They are active members of numerous professional societies including the South Carolina Orthopedic Association, AO Spine, American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, and North American Spine Society. Dr. Michael Peelle has taught physicians around the country the minimally invasive, cervical disc arthroplasty procedure. Drs. P. Douglas deHoll and Michael Peelle are on the Board of the South Carolina Spine Society, serving as president and treasurer, respectively. Dr. Gregory Grabowski serves as Residency Program Director for the Orthopedic Residency program. He also is a faculty member for AOSpine North America, the premier spine
We are continually looking to improve the care of our patients, evaluate our outcomes by critically examining PROs and shaping the future of spine care that is delivered locally, regionally and nationally.
SERVICES OFFERED
Treatment for• Adult Spine Care• Cervical and
lumbar spine surgery
• Cervical fusions• Disc herniations• Electrodiagnostic
testing• Interventional
spine procedures• Microdiscectomy• Physical medicine
and rehabilitation• Sciatica• Scoliosis surgery
(for adults)
W. Alaric Van Dam, MD; John Clavet, MD; David A. Scott, MD; J. Talley Parrott, MD; Michael W. Peelle, MD, MHA; P. Douglas deHoll, MD;Pranitha R. Nallu, MD; William T. Felmly, MD; Caroline Clark, PA-C; Kurt Judson, PA-C; Gregory Grabowski, MD; Farrah Schildknecht, NP
education group in the world. In this capacity, he has served as a teacher of spinal surgery techniques to surgeons at various courses throughout the U.S. and Canada.
RESEARCH INITIATIVES
First and foremost, the Spine and Interventional Medicine team is committed to achieving the best outcomes for our patients. In conjunction with our Division of Research, we have been collecting patient-reported outcome (PRO) metrics on surgical patients for four years and will be transitioning to an electronic data collection system later this year. By collecting and critically evaluating these data, the Spine team is able to alter decision making to maximize patient outcomes.
Through the observation of the data from the PROs, Dr. Grabowski knows that some of his most challenging patients in spine are those 70 and older. These patients often present with complex spinal pathology and have limited physiologic reserve, increasing their peri-operative risk profile. As a pilot project, Dr. Grabowski has partnered with the providers at Palmetto Health Senior Primary Care to provide innovative and specialized care for this group. These patients are seen and evaluated pre-operatively by geriatricians and then post-operatively medically co-managed by a multidisciplinary team on the Acute Care for the Elderly (ACE) Unit of Palmetto Health Richland. This novel approach to geriatric spine care will be evaluated for its effectiveness and may be expanded to the Palmetto Health system.
FUTURE DIRECTIONS
The goal of the Palmetto Health-USC Medical Spine and Interventional Medicine team is to provide patients and referring providers in South Carolina with unparalleled access to truly comprehensive and seamless spine care. Regardless of the cause, duration, or complexity of the problem, the providers will be able to manage any spinal condition. We will continue to evolve with trends in spine to minimize patient costs while maximizing patient outcomes. We are continually looking to improve the care of our patients, evaluate our outcomes by critically examining PROs and shaping the future of spine care that is delivered locally, regionally and nationally.
OVER THE LAST YEAR OUR PHYSICIANS HAVE:
CLINICAL EXPERTISE
The Sports Medicine team includes physicians, physician assistants, physical and occupational therapists, athletic trainers, sports performance and biomechanics specialists and registered dietitian nutritionists dedicated to delivering high quality care to the active patient. From the weekend warrior to the elite athlete, patients receive complete orthopedic care in state-of-the-art facilities that offer all the resources they need to take them from diagnosis and treatment to recovery.
Our physician team includes seven orthopedic sports medicine surgeons and four primary care sports medicine physicians, all of whom are board certified and fellowship trained. As a group their clinical interests and expertise spans a wide variety of pathologies. Minimally invasive, the arthroscopic surgery technique is the cornerstone of sports medicine surgery. Each surgeon has expertise in arthroscopic surgery of the knee, shoulder, hip, elbow and ankle, and ligament reconstruction and cartilage
repair in these joints are performed daily. These include ACL reconstructions, shoulder labral repair and instability surgery, shoulder arthroscopic rotator cuff repair, Tommy John elbow ligament reconstruction in throwers, hip arthroscopic labral repair, and many others.
The Sports Medicine team serves as the official team physicians for the University of South Carolina Athletics, The Columbia Fireflies and dozens of other professional, university/college, high schools, middle schools and recreational teams throughout South Carolina. In addition, the sports medicine physicians supervise one of the largest athletic trainer outreach programs in South Carolina. The physicians and a team of athletic trainers serve 34 high schools and seven colleges where they serve on the sidelines to prevent, diagnose and treat injuries.
Our physicians are committed to being leaders in the community as well as in orthopedics. The physicians stay active in the community with a mission of improving health care in the Midlands. Dr. Wendell Holmes and Dr. Jeffrey
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Tenley E. Murphy, MD; Dean Levesque, PA-C; Matthew Power, PA-C; Adam Baier, PA-C; Christopher G. Mazoue, MD; Ryan W. Hess, MD; S. Wendell Holmes Jr., MD; Mickey F. Plymale, MD; Matthew R. Pollack, MD; Frank K. Noojin III, MD;
Jeffrey P. Holloway, MD; David A. Scott, MD; Guillaume D. Dumont, MD; Jeffrey A. Guy, MD
Sports Medicine
Guy serve as co-medical directors of Sports Medicine at Palmetto Health-USC Medical Group, bringing together a large team of orthopedic talent to better serve the community. Dr. Holmes serves as the chair for the Medical Aspect of Sports Committee for the South Carolina Medical Association. Dr. Guy is the University of South Carolina Athletics Medical Director and team physician. Drs. Jeffrey Holloway, Christopher Mazoué, Tenley Murphy and Matthew Pollack also serve as team physicians for the University of South Carolina. Drs. Mickey Plymale and Guillaume Dumont serve as South Carolina State University’s team physicians. Drs. Wendell Holmes, Christopher Mazoué and Mickey Plymale all serve as team physicians for The Columbia Fireflies.
FUTURE DIRECTIONS AND RESEARCH
Sports Medicine team research initiatives and interests include cartilage repair, knee ligament reconstruction and injury prevention in the throwing athlete. This research is aimed at improving surgical outcomes and preventing further injury.Health care continues to change and the needs of the community continue to grow. As leaders in sports medicine, our physicians are committed to changing and growing to better serve the active population in the Midlands. The physicians will continue to build relationships with schools, community groups, the medical community, and athletes to promote safety and injury prevention in sports. The addition of rehabilitation, sports science and sports performance facilities will offer athletes and patients access to state-of-the-art technology and equipment for injury recovery and performance enhancement. Outreach will not stop with traditional athletes, but a focus on offering quality health care to all active individuals will be a priority.
The physicians at Palmetto Health-USC Medical group are committed to being leaders in the community as well as in orthopedics. The physicians stay active in the community with a mission of improving health care in the midlands.
CLINICAL EXPERTISE
The Orthopedic Trauma and Fracture Care team is staffed by two fellowship-trained, board-certified orthopedic trauma surgeons. Drs. Michael Tucker and Thomas Jones specialize in the surgical treatment of critically injured patients and their associated fractures. They provide the full spectrum of orthopedic trauma care to their patients, with a focus on complex periarticular fractures, pelvis and acetabular fractures, post-fracture deformity correction, and nonunion repair. In addition to their clinical practice, Drs. Tucker and Jones also are committed to training the next generation of orthopedic surgeons. Both are educators in the Department of Orthopedics at the USC School of Medicine as well as mentors for the residency program. They also provide orthopedic trauma education and serve as staff for the resident physicians from the Dwight D. Eisenhower Army Medical Center orthopedic surgery program.
Drs. Tucker and Jones actively participate in research and continuing education, having presented at more than 50 meetings at the regional, state and national levels. They have authored nearly 20 publications, and most recently
collaborated on a textbook chapter entitled Patella Fractures and Injuries to the Extensor Mechanism, published in the AAOS, OKU Trauma 5th edition. Each is a fellow of American Academy of Orthopaedic Surgeons (AAOS), a member of the Orthopaedic Trauma Association (OTA), the Southeastern Fracture Consortium (SEFC), and the South Carolina Orthopaedic Association. They serve as faculty at the annual Southeastern Fracture Symposium (SEFS). Dr. Tucker serves as an attending physician and director of orthopedic trauma services at Palmetto Health Richland, the only American College of Surgeons (ACS) verified Level I trauma center in the Midlands and one of only two in the state. Dr. Jones is a member of the Association for the Study of Internal Fixation (AO/ASIF) of North America and serves as faculty at AO/ASIF resident education courses. He also is an attending physician at Palmetto Health Richland.
RESEARCH INITIATIVES
The Orthopedic Trauma and Fracture Care team has several ongoing research projects exploring ways to improve their surgical techniques and the quality of
Thomas M. Jones, MD; Brittany Buchanan, NP; Patrick Todd, NP; Michael C. Tucker, MD
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life of their patients. Drs. Tucker and Jones recently have reported on their novel positioning and reduction techniques for subtrochanteric femur fractures, with this work having been selected for a poster presentation at the South Carolina Orthopaedic Association and the Southern Orthopaedic Association annual meetings. They also have recently reported on their experience of dual plating of highly comminuted supracondylar femur fractures, with these results presented at the USC School of Medicine Annual Scholarship Day. They are actively participating in several multi-center clinical trials. One study is evaluating whether operative or non-operative treatment of humeral shaft fractures will lead to better outcomes, with another focusing on whether the Reamer Irrigator Aspirator (RIA) device reduces complications and improves outcomes in patients with femoral shaft fractures. These ongoing clinical research projects aim to provide other physicians with information to guide treatment decisions and improve outcomes for their patients.
CLINICAL INITIATIVES
The Orthopedic Trauma and Fracture Care team is actively involved in guiding fracture care for Palmetto Health. Most recently, Drs. Jones and Tucker were instrumental in the establishment of the Palmetto Health Geriatric Fracture Care Pathway. With support from the Palmetto Health administration, they collaborated with representatives from a multitude of medical and surgical specialties, including orthopedics, internal medicine, geriatrics, anesthesiology, cardiology, emergency medicine and physical therapy to develop a coordinated care model for this group of patients. The model will not only focus on safe and efficient surgical care of the acute injury, but also will address the comprehensive care of these patients from admission through their recovery and subsequent follow up. This multidisciplinary approach will be tailored to the specific needs of the geriatric fracture patient, taking into consideration each patient’s medical, family and social situation. This longitudinal approach to geriatric fracture care has been shown to decrease hospital length of stay, reduce preoperative morbidity and mortality, hasten return to function and reduce the likelihood of these patients sustaining another fracture. The Palmetto Health Geriatric Fracture Pathway currently is in use at Palmetto Health Richland, with plans to expand it throughout the Palmetto Health system in the coming months.
Theorthopedictraumaservicehasseveralongoingresearch
projectsexploringwaystoimprovetheirsurgicaltechniquesand
thequalityoflifeoftheirpatients.
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Trauma and Fracture Care
“Dr. Tucker, Dr. Jones and the staff are all wonderful,” says Luke Davis, “They all foster more of a personal relationship than a strictly professional one, even to the point of conversing outside of the office setting.”
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Kurt T. Stroebel, MD; Danny H. Ford, MD; Warren Pyles, PA-C; Ryan C. Zitzke, MD
Sumter Orthopaedic Associates
The physicians of Sumter Orthopaedic Associates is the largest orthopedic clinic in the Sumter area. Drs. Kurt Stroebel, Danny Ford and Ryan Zitzke have a combined 41 years of experience and are all board-certified surgeons with fellowships in sports medicine and trauma. As a group, the team provides more than 100 elective procedures a month, including total knee and hip replacements, knee and shoulder scopes, carpal tunnel and deQuervains release, ACL reconstruction, AC joint reconstruction, open and closed fracture. Dr. Ryan Zitzke also offers patients a customized total knee replacement – a knee solution designed specifically for each patient’s unique anatomy.
Dr. Danny Ford completed his orthopedic surgery residency at West Virginia University and has been a surgeon in Sumter since 1997. Dr. Kurt Stroebel completed his fellowship in sports medicine at the University of Alabama in Birmingham and his orthopedic residency at the University of Louisville in Kentucky and has been an orthopedic surgeon in Sumter since 1998. The newest member of the team, Dr. Ryan Zitzke, specializes in trauma
and fracture care as well as joint reconstruction. He completed his residency at the University of Florida at Jacksonville and an orthopedic trauma fellowship at Grant Medical Center in Ohio. All belong to the American Academy of Orthopaedic Surgeons, the Sumter Clarendon Lee County Medical Society, South Carolina Orthopaedic Association, the South Carolina Medical Association and the Shaw Sumter Community Council.
Rounding out the staff is physician assistant Warren Pyles. He is board certified by the NCCPA and also is a fellow member of the American Academy of Physician Assistants and the Sumter Clarendon Lee County Medical Society, as well as the Physician Assistants Orthopaedic Surgery Organization.
Sumter Orthopaedic Associates believes that you will get the same care in Sumter as you would in any larger city. The surgeons continually update their education and stay current on the latest technology and tools. The goal is to treat patients like family because it helps them feel at ease, ask better questions and have an overall better experience. Patients really want to know only four things: “What’s wrong with me?” “What are my treatment options?” “What are the pros and cons?” and, “What is the ultimate choice?” So these surgeons do their best to see patients in a timely manner, explain things well and deliberately go through those questions so that patients feel confident and proactive about their care. As Sumter Orthopaedic Associates continues to grow, the practice will add physicians in subspecialties, and the surgeons will continue to provide state-of-the-art technology and treatment to patients so they can receive the care they deserve without having to travel out of town. The practice also is considering an after-hours orthopedic clinic to help Sumter children who are participating in summer sports, to keep them from having to go to the emergency department with seasonal injuries.
The University of South Carolina School of Medicine, in conjunction with Palmetto Health, offers two fully accredited five-year orthopedic residency program positions in Columbia, South Carolina. Our residents are involved in the care of orthopedic patients in every subspecialty of orthopedics. Our full-time faculty is subspecialty trained in sports medicine, spine, hip and knee arthroplasty, hand and foot and ankle. We also have faculty with adjunct clinical appointments who provide patient care and resident education in pediatric orthopedics, trauma and orthopedic oncology.
Our program is unique for several reasons. First, the early operative experience and one-on-one mentorship model are unparalleled. Starting on day one, residents spend one-on-one time in both the clinic and operative settings with attending physicians. Very rarely are the residents double-scrubbed on cases. This permits an intimate and highly individualized educational experience.
Research opportunities are numerous. The program has a dedicated research director and research coordinator. Each resident participates in a self-designed, mentored project with the goal of a publication or presentation at a regional or national meeting. Our current residents have done presentations at AAOS, South Carolina Orthopaedic Association, OREF/ORS Resident Research Symposia, Kimbrough Moore Resident Research Day and the Palmetto Health Resident Research Day.
The curriculum and didactic schedule offer a wide range of experiences and learning to allow a complete education in both general and subspecialty training. The program revolves around a two-year cycle in which a resident rotates through all subspecialties in years two and three and again in years four and five. This allows residents to become closely familiar with each subspecialty before choosing a fellowship path. All subspecialty lectures are taught by an attending physician. We have an orthopedic oncology attending guest lecture once each month. Didactics occur each morning, allowing us to spend more time concentrating on clinical duties.
Residency ProgramChief Resident Class of 2016, Kristen Nathe, MD
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analyses and breakdown of motion to apply performance engineering to improve speed, agility and increase the ability for the body to react in different situations. The APEX Athletic Performance team, led by Medical Director Dr. Mickey Plymale, is supported by professionals in the health care and sports performance industry. The team holds a significant number of certifications from the National Strength and Conditioning Association, Orthopedic Clinical Specialist American Physical Therapy Association and Functional Movement Systems and National Academy of Sports Medicine. The knowledgeable team, with multiple graduate and terminal degrees, provides athletes of all ages the ability to perform at the highest level and achieve goals in a safe and effective manner.
RESEARCH INITIATIVES
The APEX Athletic Performance team is continuously researching and developing new ways to enhance athletic performance. In addition to completing the most supported techniques in strength and conditioning literature, the team is led by researchers who conduct performance enhancing research studies across all populations with the same mind-set as coaches.
FUTURE DIRECTIONS
Visions for the APEX program involve improving training techniques and protocols individualized for athletes. Soon, the team will offer camps and combine specific events and training to help athletes reach the next level in greatness. In addition to teaming up with the wellness program, APEX also will implement a Tactical Training Program that will incorporate strength and conditioning protocols and training specifically for law enforcement and emergency response services, including firefighters and emergency medical technicians.
Rehabilitation
Orthopedic surgery and rehabilitation have evolved in similar fashions. Just as orthopedic surgeons have become more focused on certain joints or extremities, so too have the physical and occupational therapists who treat those patients. However, the way our group evolved may be a little different.
What sets our group apart is our ability to match therapists with their individual strengths and passions. While it’s not unusual for an occupational therapist to specialize in hand and fine motor rehabilitation, it is less common for physical therapists to concentrate on specific joints. Until six to seven years ago, our physical therapists each could have patients with a rotator cuff repair, low back pain and an ACL reconstruction all in succession. Each patient needs to be treated very differently: different skills, different attitude and different pace.
In the past several years, we have created a rehabilitation team with physical therapists who specialize in pediatrics, adolescent, spine, total joint, general orthopedic and high-performing athletic rehabilitation. This not only allows us to attract great clinicians, but also provides the patients with a level of care that is unmatched in the area.
Our occupational therapists provide the same high level of care. With two dedicated hand center locations, we provide patients with hand injuries a place just for them to get back to normal activity. Our board certified hand therapists are trained in complicated hand rehabilitation including custom splint fabrication. Their entire patient caseload is made up of hand, wrist and elbow pathologies.
With this type of specificity, we have a great opportunity to collect data and outcomes in a short period of time. Our research area works closely with the rehabilitation team to come up with new treatment plans for certain diagnoses and identify what treatment is most effective. We also are trying to identify more cost effective ways of evaluating our patients’ ability. For example, we are looking at ways to evaluate post-operative knee patients for return to competitive sport, without using an isokinetic testing device. As we continue to grow and develop, our commitment to outstanding patient care and outcomes will continue to grow as well. The plan is to build services that support rehabilitation patients before and after formal therapy.
our athletic trainers were responsible for roughly 10,000 student athletes encompassing secondary school and collegiate athletic settings. The members of the athletic training team are in every divisional level within the South Carolina High School League as well as many of the institutions found within the South Carolina Independent School Association. Additionally, services at the collegiate level have been provided to eight NCAA Division I, Division II, or NAIA institutions within the Midlands region of South Carolina. This involvement has contributed to the athletic training service line at Palmetto Health being one of the most prolific and productive athletic training outreach systems in the Carolinas.
The role of athletic trainers has served and continues to serve in Midlands area communities through our community education efforts and coverage of community athletic events. It is through our continuing efforts and involvement with county and state recreation departments and associations that the educational aspects of prevention, injury awareness and care continue to be promoted and emphasized to parents, coaches and athletes actively participating in programs within the region. It is these efforts that will have a lasting impression and earn the trust of patients.
APEX Athletic Performance
CLINICAL EXPERTISE
APEX Athletic Performance is a unique program offered for sports performance training specifically designed to safely and effectively support athletes reach their highest potential. The APEX program is primarily geared toward athletes ages 8 to 23 years, either coming off an injury or just wanting to get bigger, faster and stronger. The team is split into several programs: accelerated rehabilitation, sports nutrition, sports performance and sports science. Each pillar is led by experienced health care professionals who also are former athletes. Accelerated rehabilitation is a medically supervised program that helps athletes transition from their post-surgical physical therapy to a higher intensity regimen that will prepare them to safely and effectively return to their sport. Sports nutrition is led by a registered dietitian nutritionist and is available to help athletes learn how nutrition plays a significant role with achieving maximum performance. Sports performance offers individualized programming for varied sports and positions to enhance performance to the highest level. The sports science program is a unique offering by APEX which offers
The purpose is to reduce cost, improve outcomes and the overall patient experience. Those services include wellness services for patients preparing and recovering from total joint replacement, aquatic therapy and sports performance training for athletes recovering from athletic injuries and motivated to return to competition.
Athletic Training
Athletic trainers are health care professionals who collaborate with physicians in prevention, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and illnesses. Our athletic trainers provide an unparalleled continuum of care for not only athletes, but also individuals from a wide array of patient populations that are included in the physical medicine and rehabilitation spectrum of care. During the 2013-2014 calendar year, nearly 7.8 million student athletes participated in sports nationwide. In 2013, there were 1.24 million emergency room visits resulting from the 14 commonly played sports by students under the age of 19.1. These facts aid in the vital importance of the role of athletic trainers in communities today, and are contributing to answering this need within our community.
Our athletic training team can be found in a variety of settings throughout the local communities we serve. Our athletic trainers can be found in secondary schools (middle and high schools), colleges, physician offices and hospitals within the Midlands region of South Carolina. Specifically, these providers play vital care roles in 50 secondary school and college institutions as well as support roles within the physician clinic system. In the last academic year,
Ancillary Services
Mickey F. Plymale, MD; Amy Knogge, MAT, ATC; Jason Wimberly, MS, ATC; Julie Sandy, MS, ATC; Frank K. Noojin III, MD
POSTERS
Nathe, K. Open Ankle Fracture in the Elderly: A multi-center study. Presented at PH Scholarship Day.
Arrojas, A. The treatment of Single and Multi-level Cervical Stenosis: A Review of the ABOS Database. Presented at PH Scholarship Day.
Arrojas, A. Isolated lower extremity fractures in the elderly; is there an increased morbidity and mortality? A single center retrospective review at a level one trauma center. Presented at PH Scholarship Day.
Robertson, R. Lateral Decubitus Mini-plate Assisted IMN for Subtrochanteric Femur Fractures. Presented at PH Scholarship Day.
Davies, J. Resident Value on Call. Presented at PH Scholarship Day.
Swintek, A. Bicondylar Plating for Supracondylar Femur Fractures with Extensive Bone Loss. Presented at PH Scholarship Day, South Carolina Orthopaedic Association.
Pilato, A. Prevalence of Concominant Hip and Lumbar Spine Pathology. Presented at PH Scholarship Day.
Williams, K. Vitamin D3 Supplementation and Stress Fracture Occurrence in High Risk Collegiate Athletes. Presented at PH Scholarship Day.
Mobley, K. An analysis of current methodology for assessing the integrity of sterile wrappers for surgical instruments. Presented at PH Scholarship Day.
Melton, W. Comparing the Accuracy of Head-Mounted Sensors versus Ball Accelerometers Measuring Forces Exerted By the Head from the Ball During Soccer Match Play. Presented at PH Scholarship Day.
Money, A. A prospective Analysis of the Utility of ABI Measurements in Trauma Patients. Presented at PH Scholarship Day.
Ergan, T. Analysis of Risk Factors for Aspiration Positive Septic Arthritis. 1st Place and Winner. Presented at PH Scholarship Day.
GRANTS
AO Trauma Advanced Course Travel Fund. DePuy Synthes Orthopaedics. November 18-November 22, 2015.
Palmetto Health Grant In Aid. September 8, 2015.
AOSpine Course Travel Fund. DePuy Synthes Spine. August 20-August 25, 2015.
Magellan Mini-Grant Apprentice Fall 2015. Dr. Jackson (Mentor) and Samantha Giaccio
Magellan Grant Fall 2015 Dr. Jackson (Mentor) and Alexandra Moreira
J. Benjamin Jackson, III, MD, Lance Jacobson MD, Rahul Banerjee MD, Florian Nickisch MD. Subtalar Distraction Bone Block Arthrodesis. Foot and Ankle Clinics of North America – Subtalar Joint.
Ornusa Chalayon MD, Bibo Wang MD, Brad Blankenhorn MD, J. Benjamin Jackson, III, MD, Florian Nickisch MD, Timothy Beals MD. Factors Affecting the Outcomes of Uncomplicated Primary Open Ankle Arthrodesis. Foot and Ankle International. May 2015.
J. Benjamin Jackson, III, MD. The Value of the Orthopaedic Resident: What are we worth? American Journal of Orthopaedics. May 2015.
PRESENTATIONS
Arrojas A. Trends In The Treatment Of Cervical Stenosis: A Review Of The ABOS Database. Southern Orthopaedic Association. Naples, FL. July 27-30, 2016 South Carolina Orthopaedic Association. Kiawah Island, SC, August 4-6th, 2016.
Arrojas A, Moreira A. Outcomes Of Geriatric Patients With Isolated Lower Extremity Fractures. Southern Orthopaedic Association. Naples, FL. July 27-30, 2016.
Davies J. A Prospective Multicenter Evaluation of The Value Of The On-Call Orthopaedic Resident. Southern Orthopaedic Association. Naples, FL. July 27-30, 2016. South Carolina Orthopaedic Association. Kiawah Island, SC, August 4-6th, 2016.
Pilato, A. Prevalence of Concominant Hip and Lumbar Spine Pathology. South Carolina Orthopaedic Association. Kiawah Island, SC, August 4-6th, 2016.
Williams, K. Vitamin D3 Supplementation and Stress Fracture Occurrence in High Risk Collegiate Athletes. South Carolina Orthopaedic Association. Kiawah Island, SC, August 4-6th, 2016. Mobley, K. An analysis of current methodology for assessing the integrity of sterile wrappers for surgical instruments. South Carolina Orthopaedic Association. Kiawah Island, SC, August 4-6th, 2016.
Melton, W. Comparing the Accuracy of Head-Mounted Sensors versus Ball Accelerometers Measuring Forces Exerted By the Head from the Ball During Soccer Match Play. South Carolina Orthopaedic Association. Kiawah Island, SC, August 4-6th, 2016.
Robertson R. Mini-plate Assisted Intramedullary Nailing Of Subtrochanteric Femur Fractures. Southern Orthopaedic Association. Naples, FL. July 27-30, 2016.
Grabowski G. Primary training in hyperbaric oxygen: Chronic refractory osteomyelitis National Baromedical Services, Primary Training in Hyperbaric Medicine. Columbia, SC. May 7; June 25; August 13; October 22; December 10, 2015.
Nathe K., Grabowski G., Boguski J, Jackson JB III. Open ankle fractures in the elderly: A multicenter study. 2015 Oscar Miller Day Symposium. Charlotte, North Carolina. October 30, 2015.
Mazoue CG. Occupational shoulder injuries: Diagnosis, treatment and return to work. Workers Compensation and Occupational Health Seminar. Columbia, SC. October 1, 2015.
Guy JA. SLAP lesions: When to repair. The Wider Scope of Arthroscopy Smith and Nephew Fellowship Program. Andover, MA, Sept 13, 2015.
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Research
Francis Spinale, MD, PhD, VP of Research, presenting Thomas J. K. Ergen, MD, PGY-1 with his first place award
Robertson RN, Jones T. Mini-plate assisted reduction and intramedullary nailing of subtrochanteric femur fractures in the lateral decubitus position. South Carolina Orthopaedic Association. Kiawah Island, SC, August 6-9, 2015.-Poster
Arrojas A, Jackson JB III, Grabowski G. Isolated lower extremity fractures in the elderly, is there an increased morbidity and mortality? A single center retrospective review at a level one trauma center. South Carolina Orthopaedic Association. Kiawah Island, SC, August 6-9, 2015. 2nd Place Winner.
Pollack MR. PRP: Harnessing the body’s own healing potential. SC Athletic Trainers Association. Columbia, SC . July 10, 2015.
Voss FR. Chronic refractory osteomyelitis. Primary Training in Hyperbaric Medicine - June Course. Columbia, SC. June 26,2015.
Jensen M., Mazoue CG., Cooper B. Progressive Rehabilitation of a Grade II Open Tibia and Fibula Fracture in a Division 1 Collegiate Soccer Player. National Athletic Trainers’ Annual Symposium. St. Louis, MO. Jun24-26, 2015.-Poster Presentation
Mazoue CG. Revision UCL Reconstruction. American Sports Medicine Fellowship Society Biannual Meeting. Birmingham, Al. June 18-20,2015.
Voss FR. International classification of diseases (ICD) 10. International Congress for Joint Reconstruction. Charleston, SC. May 29, 2015.
Mazoue CG. Full-Thickness Rotator Cuff Tears in Professional Pitchers. Sri Ramachandra Arthroscopy and Sports Sciences Center. Chennai, India. May 27, 2015.
Mazoue CG. Sports Medicine for the Young: Athlete: Management and Prevention of Common Youth Injuries. Sri Ramachandra Arthroscopy and Sports Sciences Center. Chennai, India. May 27, 2015.
Guy JA. 40th Annual Greenville Orthpaedic Day. Patella femoral disorders in the collegiate athlete. Greenville, South Carolina, May 15, 2015.
Mazoue CG. Full thickness rotator cuff tears in professional pitchers. 40th Annual Greenville Orthopaedic Day. Greenville, SC. May 15, 2015.
Nathe K, Grabowski G. Laminectomy with non-instrumented fusion for adult degenerative scoliosis with stenosis: Complications and outcomes. Palmetto Health Resident Research Day Symposium. Columbia, SC, May 7, 2015
AWARDS
James Davies, MD, presenting his Resident Value on Call study
James Davies, MD, Resident. 2016 South Carolina Orthopaedic Association Harley and Betty Baxter Resident Award 2016: Resident Value on Call.
Thomas Ergen, MD. 2016 Medical Scholarship Day of Focus 1st Place Outcomes/Quality: Analysis of Risk Factors for Aspiration Positive Septic Arthritis.
Alfredo Arrojas, MD. 2015 South Carolina Orthopaedic Association 2nd Place Lower Extremity Fracture Study: Isolated lower extremity fractures in the elderly; is there an increased morbidity and mortality? A single center retrospective review at a level one trauma center.
PUBLICATIONS
J. Benjamin Jackson, III, MD, Steven L. Frick, Brian K. Brighton, Scott Broadwell, Eric Wang, Virginia Casey. Angiographic Documentation of Restoration of Blood Flow to an Ischemic Proximal Femoral Epiphysis by Modified Dunn Procedure for Unstable Slipped Capital Femoral Epiphysis. Journal of Pediatric Orthopaedics. May 2016.
J. Benjamin Jackson, III, MD, Anthony Crimaldi MD, DDS, Richard Peindl PhD, H. James Norton PhD, William E. Anderson MS, Joshua C. Patt MD, MPH. The Effect of Polyether Ether Ketone on Therapeutic Radiation to the Spine. Spine. May 2016.
Gregory Grabowski, MD, Caroline Clark PA, J. Benjamin Jackson, III, MD, Alexis Pilato, MD HIV in Orthopaedic Surgery. Journal of the American Academy of Orthopaedic Surgeons. (Accepted) April 2016.
Gabriella Ode, J. Benjamin Jackson, III, MD, Rachel Seymour, Edward N. Hanley, Jr. Coccygectomy: A Prospective, Observational Study of 98 Patients. Bone and Joint Journal. April 2016.
Ryan Robertson, MD, Gregory Grabowski, MD Blunt Cerebrovascular Injury in Cervical Spine Fractures: Are More-Liberal Screening Criteria Warranted? Global Spine Journal. January 2016.
Matthew Pollack, MD Extensor Tendon Repair. In: Mayeaux EJ. Ed. My Essential Guide to Primary Care, 2nd Ed. Philadelphia, PA. June 2015.
J. Benjamin Jackson, III, MD, Scot Youngblood MD, Robert Anderson MD, Kent Ellington MD, Bruce Cohen MD, Carroll Jones MD, W. Hodges Davis MD. Global Ankle Instability – Clinical and Functional Assessment at Average 26-month Follow-up. REVISTA ABTPé. June 2015.
OBESITY 90% PREVENTABLE
HEART DISEASE 80% PREVENTABLE
STROKE 80% PREVENTABLE
DIABETES 80% PREVENTABLE
CANCER 80% PREVENTABLE
• Cardiovascular prescription (per ACSM guidelines)• Corrective exercise prescription (per American Physical
Therapy Association guidelines) • Twice weekly supervised exercise sessions (per ACSM
guidelines) with exercise physiologist • Once weekly nutrition consults including behavior
modification, recipes, and menu planning with a registered dietitian nutritionist (per Academy of Nutrition and Dietetic guidelines)
• Ending assessment, progress note, and lifestyle prescription
Rationale - MedFit12 was developed with one single premise:
70% of all healthcare expenses are from chronic conditions (CDC). 75% of these are preventable:
Research has demonstrated overwhelmingly that traditional medical protocols, such as prescription medications and surgery, are ineffective, expensive and dangerous. None of these approaches addresses the underlying pathophysiology and none offer hope of a cure.
Research has proven that the aforementioned lifestyle-mediated conditions can be prevented and reversed by comprehensive lifestyle intervention. Expected clinical outcomes include:• Weight loss • Reduced abdominal fat• Improved cardiopulmonary fitness • Improved musculoskeletal strength, balance, and mobility• Improved blood pressure (systolic and diastolic)
CASTING AND ORTHOPEDIC SERVICES
Orthopedic technicians work in each clinic to provide orthopedic services to ensure patients are prepared with the orthopedic equipment they need to properly recover from injury. These services include wound care, splinting, casting, bracing and adjustments of equipment. They also are available to provide education on how to use and care for walkers, canes and crutches.
CONVENIENT CARE
Convenient Care is an orthopedic walk-in clinic that offers access to orthopedic specialty care during the day, after normal business hours and on weekends. This service caters to the working professional who has sustained an injury or other orthopedic condition, but may not be able to leave work. Convenient Care also offers access to athletes, children and adolescents who sustain weekend injuries,
without having to wait until Monday morning to be seen. No appointment is required and most insurance plans are accepted without a referral. Common injuries seen at Convenient Care are fractures, dislocations, strains, sprains and lacerations.
Convenient Care is currently open in one location, Monday-Saturday 8 a.m.-8 p.m. The facility is open six days a week, 12 hours a day to meet the ever growing need of the community.
IMAGING
Patients of Palmetto Health-USC Medical Group Orthopedics have access to some of the most advanced imaging services available. Imaging conveniently is done on-site to help with diagnosis and treatment. Types of imaging offered include: digital radiography, magnetic resonance imaging (MRI), extremity MRI, and ultrasound. Physicians also utilize in-office fluoroscopic interventional radiography and ultrasound to help perform procedures such as epidural steroid injections, sacroiliac joint injections, selective nerve root blocks, radiofrequency oblations and arthrograms. The imaging technologists on staff are licensed and registered through the American Registry of Radiologic Technologists and the South Carolina Radiation Quality Standards Association. Further, the facilities that offer imaging services are registered through the South Carolina Department of Health and Environmental Control, the American College of Radiology, and the Joint Review Committee on Education in Radiologic Technology.
WELLNESS
Overview
Palmetto Health-USC Medical Group Orthopedics offers a comprehensive medical wellness program designed to empower participants to lose weight, prevent and/or reverse morbidities like diabetes, and improve fitness, energy, and whole body health.
The program, MedFit12, is three months in duration and includes nutrition counseling, supervised exercise sessions, and behavior modification. MedFit12 is evidenced based and meets the recommendations of the American College of Sports Medicine (ACSM), American Medical Association, and the National Institute of Health. The MedFit12 protocol:
• Physical assessment including, review of past medical history and family medical history, measurement of biometrics including blood pressure, heart rate, oxygen saturation, BMI, body fat, waist circumference, and sub-maximal cardiovascular fitness test
• Lifestyle and nutrition assessment and screening
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Continuum of Care
Ryan HallVice President of Orthopedic Services
HOW DO YOU SEE PALMETTO HEALTH-USC MEDICAL GROUP ORTHOPEDICS IMPACTING THE COMMUNITY IN THE YEARS TO COME?
I believe the new orthopedic group will impact the community for years to come in three key ways:
A. First and foremost, I believe we will help shape the future of orthopedic care in our area by using clinical evidence to assure each patient receives personalized care in the correct setting.
B. Second, our group is committed to treating the whole person, not just the orthopedic injury. There is a clear focus on general wellness and injury prevention.
C. Lastly, our group, through research, will help define value for the consumer in orthopedic care. The focus on improving outcomes for each patient is a cornerstone of the group. Also, understanding the need to contain costs and reduce costs, where possible, by improving processes, procedures and the overall patient experience.
WHERE DO YOU SEE THE GROUP GROWING IN THE UPCOMING YEAR?
When I think of growth I believe that this has two aspects. We want to grow to meet the needs of the community and grow in our understanding of how to meet the needs of our patients. We believe it is our role to serve our neighbors with innovation and world class medical care and to grow as the needs of our community do. We currently are assessing the community’s orthopedic needs. Once the needs are completely understood, we will lead the way to ensure that they are meet.
In order to better understand our patients, our group also will demonstrate growth in the coming year by collecting patient reported outcome measures in a cohesive and meaningful manner. This information will help us define how we are meeting the needs of the individual patient. We will utilize what we learn from our patients to continually improve the care that we provide.
WHAT ARE SOME EXAMPLES OF HOW THE PRACTICE IS LEADING IN ORTHOPEDIC MEDICINE?
We plan to lead changes in orthopedic medicine from the front. We believe that our commitment to serve the whole patient differentiates us from others. We want to have our patients experience exemplary care from beginning to end. We start by being committed to providing timely access throughout the community to each subspecialty, ensuring that each patient receives the best care as quickly as possible. During a patient’s care, we believe that assessing the outcome of operative and non-operative management of orthopedic conditions is critical. We believe this will allow us to improve the patient experience and get them back to their pre-condition state of health as quickly as possible.
We also believe that wellness and the general health of patients of all ages is just as important as the treatment of the orthopedic injury. That is why we have developed a wellness program and training program that has a focus on nutrition, exercise, injury prevention and overall improvement of an individual’s level of fitness. Our specific patient-focused approach, combined with the patient reported outcomes, will allow us to pinpoint where we are in terms of serving our patient and give us the best roadmap toward where we can lead orthopedic health care in the future. We aim to lead the transformation of patient care and redefine what best medical practice is in the future.
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Continuum of Care
• Improved lipid panel (reduced LDL, VLDL, and triglycerides; increased HDL)
• Improved glucose levels and reduced hemoglobin A1C• Documented reversed coronary artery disease, type 2
diabetes, and sleep apnea• Improved orthopedic issues such as shoulder, back, hip,
and knee pathologies • Improved energy and well-being
The wellness program was developed initially to assist orthopedic patients before surgery in reducing risk factors like obesity and diabetes in order to reduce the risk of post-surgical complications and improve outcomes. The clinical application of MedFit12 has expanded to include all patients within the Palmetto Health USC Medical Group network with lifestyle-mediated risk factors including:• Overweight and obesity • Pre-diabetes and diabetes• Cardiology (coronary artery disease, hypertension,
hyperlipidemia, etc.)• Orthopedic issues improved by weight loss (back, hip,
and knee pathologies)
Clinical Pathway includes:• Primary care physical including full lab work-up• Risk stratification identifying high risk patients• Traditional intervention where indicated• Referral of high risk patients to Palmetto Health’s
MedFit12 program• Progress notes during and after program for physician
review• Physician re-evaluation upon program completion to
determine efficacy • Monitoring disease management for long term tracking,
compliance, education, and encouragement
ORTHOPEDIC WELLNESS
The Palmetto Health Orthopedics Wellness team led by Medical Director, Dr. Jeffrey Hopkins, includes experts in the fields of nutrition, exercise physiology, biomechanics and functional anatomy, and physical therapy. With over fifty years combined experience, Palmetto Health-USC Medical Group Orthopedics offers South Carolina’s only fully integrated orthopedic wellness program which treats the whole person over the entire cycle of care.
RESEARCH INITIATIVES
Research is currently underway to document clinical outcomes of MedFit12 to establish efficacy. The goal is to re-engineer the delivery of care for patients with chronic conditions like obesity, diabetes, and coronary heart disease to maximize outcomes as well as to establish third party reimbursement.
FUTURE DIRECTIONS
The future application of the wellness program will include collaboration with APEX Athletic Performance as well as the entire Palmetto Health USC Medical Group provider network to offer healthcare programs which focus on prevention. These innovative applications will include:
• Medical – including preventive cardiology, medical weight management and diabetes. This could also include Concierge Medicine where wellness functions are an added value and the need for recurring physician visits are reduced.
• Corporate – comprehensive corporate programs including on-site or near site medical clinics with urgent care, primary care, major medical, pharmacy, occupational medicine, and workers compensation. The wellness program would be fully integrated with the medical clinic or could be purchased separately and look like:
• HRA high deductible, lower premium wellness program:• Physical• Labs• PHA• Aggregate reports with strategic intervention• On-line portal for employees with summary report and
recommendations• Health Coaching• Work-site wellness programs• 12-week wellness program for high-risk employees• Disease management for 12 week wellness graduates
Leadership
HOW CAN YOU REFER A PATIENT TO US?
The orthopedics department of Palmetto Health-USC Medical Group is growing in resources and providers. Each subspecialty and physician is working closely together to ensure patients are receiving fast, quality orthopedic care. The teams will continue to merge and operate as one practice. For more information on providers and locations, please visit www.phuscmg.org
To make a referral to one of the orthopedic physicians, please reference the contact information below:
CALL 803-434-6812 FOR:
Guillaume D. Dumont, MD, Sports MedicineGregory Grabowski, MD, SpineJeffrey A. Guy, MD, Sports MedicineJeffrey P. Holloway, MD, Sports MedicineJ. Benjamin Jackson III, MD, Foot and AnkleDavid E. Koon Jr., MD, Joint ReplacementChristopher G. Mazoué, MD, Sports MedicineAndrew T. McGown, MD, Non-operative JointTenley E. Murphy, MD, Sports MedicineMatthew R. Pollack, MD, Sports MedicineFrank R. Voss, MD, Joint ReplacementJohn J. Walsh IV, MD, Upper Extremity
CALL 803-296-9200 FOR:
Kim J. Chillag, MD, Joint ReplacementJohn Clavet, MD, Interventional MedicineP. Douglas deHoll, MD, SpineWilliam T. Felmly, MD, SpineDavid B. Fulton, MD, Upper ExtremityS. Wendell Holmes Jr., MD, Sports MedicineMichael P. Horan, MD, MS, Pediatric OrthopedicsJeffrey S. Hopkins, MD, Joint ReplacementChristopher R. Hydorn, MD, Pediatric OrthopedicsThomas M. Jones, MD, TraumaMark D. Locke, MD, Pediatric OrthopedicsEarl B. McFadden Jr., MD, Upper ExtremityPranitha R. Nallu, MD, Interventional Medicine
Frank K. Noojin III, MD, Sports MedicineJ. Talley Parrott, MD, SpineMichael W. Peelle, MD, MHA, SpineMickey F. Plymale, MD, Sports MedicineBradley P. Presnal, MD, Joint ReplacementRyan M. Putnam, MD, Foot and AnkleDavid A. Scott, MD, Sports MedicineW. Bret Smith, DO, MS, Foot and AnkleMichael C. Tucker, MD, TraumaW. Alaric Van Dam, MD, Interventional MedicineMae E. Young, MD, Upper Extremity
CALL 803-774-7621 FOR:
Danny H. Ford, MDKurt T. Stroebel, MDRyan C. Zitzke, MD
PRACTICE LOCATIONS
2 Medical Park Rd., Suite L-9Columbia, SC 29203
2 Medical Park Rd., Suite 104 Columbia, SC 29203
3 Medical Park, Suite 330Columbia, SC 29203
14 Richland Medical Park Dr., Suite 200Columbia, SC 29203
100 Palmetto Health Pkwy., Suite 320Columbia, SC 29212
300 Palmetto Health Pkwy., Suite 200Columbia, SC 29212
104 Saluda Pointe Dr.Lexington, SC 29072
101 Business Park Blvd., Suite 200Columbia, SC 29223
100 North Sumter St., Suite 200Sumter, SC 29150
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Patient Referral
