Orthopedic Research

Our team is actively involved in orthopedic research studies designed to lead to better outcomes for pediatric patients.

High quality clinical research is a top priority for Children’s Orthopedics and Sports Medicine Program. With more than 100 years of expertise in orthopedics, our team’s orthopedic research studies are designed to lead to better outcomes for our patients, including lower infection rates, shorter lengths of hospital stay than the national average, and lower rates of reinjury after surgery. In addition to conducting ongoing research in spine, sports medicine, hip, limb difference and other areas, our Orthopedics Program performs more orthopedic surgeries than any other pediatric hospital in the country*.

Research Highlight

Children’s Cerebral Palsy Study Shows ERAS Protocol Reduces PICU Admissions

Orthopedic surgeon Nicholas Fletcher, MD, led a study demonstrating most cerebral palsy patients undergoing posterior spinal fusion for neuromuscular scoliosis can be managed post operatively on the hospital room floor, instead of the PICU, using an enhanced recovery after surgery (ERAS) pathway.

read the study
Research Highlight

Research Demonstrates Patellar Stabilization Knee Surgery is Highly Effective

A retrospective analysis of the outcomes of medial patellofemoral ligament reconstruction of the knee with or without tibial tubercle osteotomy surgery in adolescents led by orthopedic surgeon Crystal Perkins, MD, first author, shows patellar stabilization surgery had excellent revision-free outcomes in 95% of patients.

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Research Highlight

Study Shows Multi-Ligament Knee Reconstruction (MLKR) Yields High Return to Sport

With contributions from Children’s orthopedic surgeons Clifton Willimon, MD, and Crystal Perkins, MD, this retrospective analysis of MLKR in adolescents shows low rates of secondary surgery, few complications, good knee function, and high rates of return to sport.

read the study

Regional anesthesia as an alternative to procedural sedation for forearm fracture reductions in the pediatric emergency department. Sulton CD, Fletcher N, Murphy J, Gillespie S, Burger RK. Pediatr Emerg Care. 2024 Feb 1.

Bony remodeling of adolescent displaced clavicle fractures: A FACTS study. Pennock AT, Bastrom TP, Perkins CP, Willimon SC, Busch MT, et al. Am J Sports Med. 2023 March.

Variability in Evaluation and Treatment of Tibial Tubercle Fractures Amongst Pediatric Orthopaedic Surgeons. Fields MW, Kaushal NK, Patel NM, McCormick SK, Eberson CP, Schmitz ML, Swarup I, Blanco JS, Crawford LM, Edobor-Osula OF. J Pediatr Orthop B. 2022 Mar 1.

Flexible intramedullary nailing of pediatric femoral fractures. JBJS Essential Surgical Techniques. Murphy, J.S., Koehler, K., Johnson, M., Hosseinzadeh, P. JBJS Essential Surgical Techniques. March 2021.

Descriptive epidemiology of adolescent clavicle fractures: results from the FACTS prospective multicenter cohort study. Ellis, H.B., Li, Y., Bae, D.S., Willimon, S.C., Heyworth, B.E., et al. Orthop J Sports Med. 2020.

 

Do Weightbearing restrictions cause excess weight gain in children with Legg-Calve-Perthes Disease? Novotny SA, Hailer YD, Laine JC, Schrader T, et al. J Pediatr Orthop. 2023 Jan 1.

Slipped capital femoral epiphysis associated with endocrinopathy: a narrative review. Shaw KA, Shiver AL, Oakes T, Fletcher ND. JBJS Rev. 2022 Feb 7.

Controversies in the management of unstable slipped capital femoral epiphysis. Davey S, Fisher T, Schrader T. Orthop Clin North Am. 2022 Jan.

Slipped Capital Femoral Epiphysis Associated with Endocrinopathy: A Narrative Review. Shaw, K.A., Shiver, A.L., Oakes, T., Fletcher, N.D., et al. JBJS Rev. 2022 Feb 7.

Reliability and Validity of Visual Estimation of Femoral Head Hypoperfusion on Perfusion MRI in Legg-Calve-Perthes Disease. International Perthes Study Group, including, Schrader, T. J Pediatr Orthop. 2021 Oct.

Hip Morphology in Early-stage LCPD: Is There an Argument for Anatomic-specific Containment? International Perthes Study Group, including, Schrader, T. J Pediatr Orthop. 2021.

Tractionless hip arthroscopy for septic arthritis in children. Ellis, H., Copley, L., Pennock, A.T., Nepple, J.J., Willimon, S.C., Mayer, S., Yen, Y. Arthroscopy Techniques. 2021 Feb 19.

Validation of pediatric self-report patient-reported outcomes measurement information system (PROMIS) measures in different stages of Legg-Calve-Perthes Disease. Matsumoto, H., Hyman, J.E., Shah, H.H., Sankar, W.N., Laine, J.C., Mehlman, C.T., Schrader, T., Kelly, D.M., Rosenfeld, S.B., Janicki, J.A., Thacker, M.M., Trupia, E., Mcguire, M.F., Kim, H.K.W., International Perthes Study Group. J Pediatr Orthop. 2020 May.

Increased hip intracapsular pressure decreases perfusion of the capital femoral epiphysis in a skeletally immature porcine model. Upasani V.V., Badrinath R, Farnsworth C.L., Jeffords M.E., Hallare J.A., Ahmed S.I., Schrader T.S. J Pediatr Orthop. 2020 Apr.

Prospective Multi-Center Preliminary Validation of Limb Deformity-Modified Scoliosis Instruments in Pediatric Patients with Limb Deformity. Moon T, Carnita E, Amakoutou K, Jasty N, Sachwani N, Flanagan JC, Liu RW. J Pediatr Orthop. 2024 Mar 1.

Scientific, technological, surgical, and prosthetic advances in pediatric limb deficiency. Schmitz ML, Hernandez R. Atlas of Amputations and Limb Deficiencies (5th ed.). Wolters Kluwer Health. 2023.

Limb Deficiencies and Amputations. Coulter C, Hernandez R, Giavedoni B, Stanger M, Campbell SK, Palisano RJ, Orlin M, Schreiber J, eds. Physical Therapy for Children. 2023.

Physical Therapy Management in Children with Congenital and Acquired Limb Differences. Coulter C, Cannoy J, Krajibich I, Pinzur M. Potter B, and Stevens P. Atlas of Amputations and Limb Deficiencies. American Academy of Orthopedic Surgeons. 2023.

Walking kinematics in young children with limb loss using early versus traditional prosthetic knee prescription protocols. Geil MD, Safaeepour Z, Giavedoni B, Coulter CP. PLoS ONE. 2020.

Descriptive epidemiology of upper extremity septic arthritis in children – review of a retrospective multicenter database. Li Y, Snaborn RM, Cook D, CORTICES Study Group (Murphy, McLaughlin), et al. J Pediatr Orthop. 2023 Jan 1.

Age and CRP associated with improved tissue pathogen identification in children with blood culture negative osteomyelitis: results from the CORTICES multicenter database. Burns JD, Upasani VV, Bastrom TP, CORTICES study group (Murphy, McLaughlin). J Pediatr Orthop. 2023 Sep 1. Epub ahead of print.

Access to care among patients with osteogenesis imperfecta during the COVID-19 pandemic. Malina SN, Flanagan JC, Loechner KJ, Wu M. Arch Osteoporos. 2023 Nov 28.

Osteogenesis imperfecta patients wish orthopedic surgeons had better strategies to help with… -Results of a patient and parent-oriented survey. Flanagan J, Tosi L, Carter E, Hart T, Franzone J, Wallace M. Children (Basel). 2023 Aug 4.

Intraoperative Hardware Failure of the Fassier-Duval Rescue System in a Pediatric Patient with Osteogenesis Imperfecta. Kahan ME, Angerett NR, and Flanagan JC. Case Reports in Pediatrics. 2021.

Minimize Implants Maximize Outcomes Study Group. The effect of implant density on adolescent idiopathic scoliosis fusion: The results of the minimize implants maximize outcomes randomized clinical trial. Larson AN, Polly DW, Sponseller PD, Kelly MP, Richards BS, Garg S, Parent S, Shah SA, Weinstein SL, Crawford CH, Sanders JO, Blakemore LC, Oetgen ME, Fletcher ND, Kremers WK, Marks MC, Brearley AM, Aubin CE, Sucato DJ, Labelle H, Erickson MA. J Bone Joint Surg Am. 2024 Feb 7.

Prospective multicenter preliminary validation of limb deformity-modified scoliosis instruments in pediatric patients with limb deformity. Moon TJ, Canitia E, Amakoutou K, Jasty N, Sachwani N, Flanagan JC, Liu RW. J Pedatr Orthop. 2023 Dec 22.

Breaking the Rules in Three Dimensions: What to Expect After a Thoracic-only Fusion With Structural Thoracic and Thoracolumbar Curves. Catanzano A, Upasani VV, Bryan TP, Yaszay B, Newton PO; Harms Study Group (Fletcher ND). J Pediatr Orthop. 2023 Dec 8.

Pregnancy and childbirth after spinal fusion for adolescent idiopathic scoliosis. Landrum M, Nocka HR, Ashebo L, Hilmara D, MacAlpine E, Flynn JM, Ho M, Newton PO, Sponseller PD, Lonner BS, Cahill PJ; Harms Study Group (Fletcher ND). J Pediatr Orthop. 2023 Dec 1.

BrAIST-Calc: Prediction of individualized benefit from bracing for adolescent idiopathic scoliosis. Dolan LA, Weinstein SL, Dobbs MB, Flynn JMJ, Green DW, Halsey MF, Hresko MT, Krengel WF 3rd, Mehlman CT, Milbrandt TA, Newton PO, Price N, Sanders JO, Schmitz ML, Schwend RM, Shah SA, Song K, Talwalkar V. Spine (Phila Pa 1976). 2023 Nov 23.

Pain medication use two years after adolescent idiopathic scoliosis fusion surgery. Bastrom TP, Kelly MP, Upasani VV, Newton PO; Harms Study Group (Fletcher ND). Spine (Phila Pa 1976). 2023 Aug 15.

Consensus-based best practice guidelines for the management of spinal deformity and associated tumors in pediatric neurofibromatosis type 1: screening and surveillance, surgical intervention, and medical therapy. Xu AL, Suresh KV, Murphy JS, Pediatric Spine Study Group, et al. J Pediatr Orthop. 2023 Aug 1; online ahead of print.

SRS-22r self-image after surgery for adolescent idiopathic scoliosis at 10-year follow-up. Stone LE, Upasani VV, Pahys JM, Fletcher ND, et al. Spine (Phila Pa 1976). 2023 May 15.

Avoiding PICU admission following PSF for neuromuscular scoliosis in non-ambulatory cerebral palsy managed with ERAS protocol. Shaw KA, Harris H, Sachwani N, Ruska T, Murphy JS, Fletcher ND. Spine Deform. 2023 May 11.

Accuracy of rod contouring to desired angles with and without a template: Implications for achieving desired spinal alignment and outcomes. Sardi JP, Ames CP, Coffey S, Good C, Dahl B, Kraemer P, Gum J, Devito D, Brayda-Bruno M, Lee R, Bell CP, Bess S, Smith JS. Global Spine J. 2023 Mar.

Drain options after vertebral body tethering. Haber L, Starring H, Newcomb N, Larson AN, Desai B, Roybal J, Fant W, Milbrandt T, Boeyer M, Marks M, Newton P, Samdani A, Miyanji F, Hoernschemeyer D; Harms Study Group Investigators (Fletcher ND). Spine Deform. 2023 Mar.

Effects of distraction-based distal fixation on pelvic parameter development in early onset scoliosis. Shaw KA, Fletcher N, West J, Sachwani N, Romine M, El-Hawary R, Murphy J. Spine Deformity. 2023 Mar.

Operative differences for posterior spinal fusion after vertebral body tethering: Are we fusing more levels in the end? Boeyer ME, Groneck A, Alanay A, Neal KM, Larson AN, Parent S, Newton P, Miyanji F, Haber L; Harms Study Group (Fletcher, ND), Hoernschemeyer DG. Eur Spine J. 2023 Feb.

The reliability of the AO spine upper cervical classification system in children: results of a multi-center study. O’Neill NP, Mo AZ, Fletcher ND, et al. J Pediatr Ortho. 2023 April.

Machine learning for benchmarking adolescent idiopathic scoliosis surgery outcomes. Gupta A, Oh IY, Kim S, Fletcher ND, HARMS study group, et al. Spine. 2023 May.

Risk factors for the development of DJK in AIS patients undergoing posterior spinal instrumentation and fusion. Segal DN, Ball J, Fletcher ND, et al. Spine Deform. 2022 Mar.

1- vs 2-year follow-up after posterior spinal fusion for AIS: what additional information is gained. Shaw KA, Orland K, Fletcher ND. Spine Deform. 2022 Nov.

Continued increase in cost of care despite decrease in stay after posterior spinal fusion for adolescent idiopathic scoliosis. Shaw KA, Ange B, George V, Murphy JS, Fletcher ND. J AAOS Glob Res Rev. 2022 Mar.

To tether or fuse? Significant equipoise remains in treatment recommendations for idiopathic scoliosis. Shaw KA, Welborn, Murphy JS, et al. Spine Deform. 2022 July.

Complications following posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective cohort study using the modified Clavien-Dindo-Sink system. Keil LG, Himmelberg SM, Fletcher ND, et al. Spine Deform. 2022 May.

Ten-year follow-up of lenke 5 curves treated with spinal fixation. Fletcher ND, Bastrotime wim TP, Larson NA, et al. Spine Deform. 2022 Sept.

Complications following surgical treatment of adolescent idiopathic scoliosis: a 10-year prospective follow-up study. Hariharan AR, Shah SA, Harms Study Group (Fletcher ND), et al. Spine Deform. 2022 Sept.

Blood loss estimation during posterior spinal fusion for adolescent idiopathic scoliosis. Fletcher ND, Gilbertson LE, Bruce RW, et al. Spine Deform. 2022 May.

Modified clavien-dindo-sink classification system for adolescent idiopathic scoliosis. Guisse NF, Stone JD, Fletcher ND, et al. Spine Deform. 2022 Jan.

Continued increase in cost of care despite decrease in stay after posterior spinal fusion for adolescent idiopathic scoliosis. Shaw, K.A., Ange, B., George, V., Murphy, J.S., Fletcher, N.D. J Am Acad Orthop Surg Glob Res Rev. 2022 Mar.

Absent baseline intraoperative neuromonitoring signals part I: Adolescent idiopathic scoliosis. Spitzer, A., Patel, R., Hasan, S., Blas, D., Floccari, L., Glotzbecker, M., Murphy, J.S., Fletcher, N.D., Gomez, J. JPOSNA. 2022 Jan.

Absent baseline intraoperative neuromonitoring signals part 2: Neuromuscular scoliosis. Spitzer, A., Patel, R., Hasan, S., Blas, D., Floccari, L., Glotzbecker, M., Murphy, J.S., Fletcher, N.D., Gomez, J. JPOSNA. 2022 Jan.

Blood loss estimation during posterior spinal fusion for adolescent idiopathic scoliosis. Fletcher, N.D., Gilbertson, L.E., Bruce, R.W. Jr., Lewis, M., Lam, H., Austin, T.M. Spine Deform. 2021 Nov.

Risk factors for the development of DJK in AIS patients undergoing posterior spinal instrumentation and fusion. Harms Study Group, including, Fletcher, N.D. Spine Deform. 2021 Sept.

Power pedicle tract preparation and screw placement: A multicenter study of early adopters. Skaggs, D.L., Compton, E., Andras, L., Illingworth, K., Vitale, M.G., Stone, J., Fletcher, N.D., Keil, L., Garg, S., Martinez, R., Kim, E., Harris, H. Spine Deform. 2021 Sept.

Surgical outcomes of obese patients with adolescent idiopathic scoliosis from endemic areas of obesity in the United States. McDonald, T.C., Heffernan, M.J., Ramo, B., Haber, L., Sheffer, B., Murphy, J.S., Murphy, R., Fletcher, N.D., Coyne, K., Lubicky, J., Bumpass, D.B., Crawford, C. 3rd, Carreon, L., Toner, S., Stafford, W.H., Poppino, K., Adams, T., Song, B.M., Gidwani, S., Taillac, H., Cornaghie, M., Sukkarieh, H., Wright, P.B., Conklin, M., Gilbert, S., Thimothee, J., Bhanat, E., Brooks, J.T. J Pediatr Orthop. 2021 Aug.

Modified Clavien-Dindo-Sink classification system for adolescent idiopathic scoliosis. Guisse, N.F., Stone, J.D., Keil, L.G., Bastrom, T.P., Erickson, M.A., Yaszay, B., Cahill, P.J., Parent, S., Gabos, P.G., Newton, P.O., Glotzbecker, M.P., Kelly, M.P., Pahys, J.M., Fletcher, N.D. Spine Deform. 2021 Aug.

Current concept review: Gastrostomy tubes in children with non-ambulatory cerebral palsy and neuromuscular scoliosis: An enemy or an ally? Shiver, A.L., Shaw, K.A., Murphy, J.S., Fletcher, N.D. JPOSNA. 2021 July.

Indications for lumbar fusion in the skeletally mature athlete: How to address oblique takeoff and leg length discrepancy. Li, Y., Fletcher, N.D. J Pediatr Orthop. 2021 July.

Shoulder balance in patients with Lenke type 1 and 2 idiopathic scoliosis appears satisfactory at 2 years following anterior vertebral body tethering of the spine. Miyanji, F., Fields, M.W., Murphy, J.S., Matsumoto, H., Fano, A.N., Roye, B.D., Skaggs, D., El-Hawary, R., Vitale, M.G., Parent, S.; Pediatric Spine Study Group (PSSG). Spine Deform. 2021 June.

Comparative cost-utility analysis of postoperative discharge pathways following posterior spinal fusion for scoliosis in non-ambulatory cerebral palsy patients. Shaw, K.A., Heboyan, V., Fletcher, N.D., Murphy, J.S. Spine Deformity Journal. 2021 May.

Does body mass index affect outcomes after vertebral body tethering surgery? Mishreky, A., Parent, S., Miyojni, F., Murphy, J.S., El Hawary, R. Canadian Undergraduate Conference on Healthcare Journal. 2021 Apr.

Risk of early complication following anterior vertebral body tethering for idiopathic scoliosis. Abdullah, A., Parent, S., Miyanji, F., Smit, K., Murphy, J.S., Skaggs, D., Gupta, P., Vitale, M., et al. Spine Deformity Journal. 2021 Apr.

In-hospital opioid usage following posterior spinal fusion for adolescent idiopathic scoliosis: Does methadone offer an advantage when used with an ERAS pathway? Shaw, K.A., Fletcher, N.D., Devito, D.P., Schmitz, M.L., Fabregas, J.A., Gidwani, S., Chhatbar, P., Murphy, J.S. Spine Deformity Journal. 2021 Mar.

Risk factors for gastrointestinal complications after spinal fusion in children with cerebral palsy. Verhofste, B.P., Berry, J.G., Miller, P.E., Crofton, C.N., Garrity, B.M., Fletcher, N.D., Marks, M.C., Shah, S.A., Newton, P.O., Samdani, A.F., Abel, M.F., Sponseller, P.D., Harms Study Group, Glotzbecker, M.P. Spine Deformity Journal. 2021 Mar.

Application of a halo fixator for the treatment of pediatric spinal deformity. Shaw, K.A., Griffith, M., Schmitz, M.L., Brahma, B., Fletcher, N.D., Murphy, J.S. JBJS Essential Surgical Techniques. 2021 Mar.

Short-term outcomes of an enhanced recovery after surgery (ERAS) pathway versus a traditional discharge pathway after posterior spinal fusion for adolescent idiopathic scoliosis. Fletcher, N.D., Murphy, J.S., Austin, T.M., Bruce, R.W., Harris, H., Bush, P., Yu, A., Kusumoto, H., Schmitz, M.L., Devito, D.P., Fabregas, J.A., Miyanji, F. Spine Deformity Journal. 2021 Jan.

The reliability of the AOSpine thoracolumbar classification system in children: Results of a multicenter study. Mo, A.Z., Miller, P.E., Glotzbecker, M.P., Li Y., Fletcher, N.D., Upasani V.V., Riccio, A.I., Hresko, M.T., Krengel, W.F., Spence, D., Garg S., Hedequist, D.J. J Pediatr Orthop. 2020 Feb.

Fusions ending above the sagittal stable vertebrae in adolescent idiopathic scoliosis: does it matter? Segal, D.N., Orland, K.J., Yoon, E., Bastrom, T., Fletcher, N.D., Harms Study Group. Spine Deform. 2020 May.

Single-stage multiligament reconstruction in adoelscdents: outcomes of anatomic reconstruction and early range of motion. Willimon SC, Kim J, Perkins CA. Orthop J Sports Med. 2024.

Medial patellofemoral ligament reconstruction with or without tibial tubercle osteotomy in carefully selected patients results in a 5% revision rate: a preliminary analysis. Perkins CA, Egger AC, Busch MT, Murata A, Willimon SC. J Pediatr Orthop. 2024.

Arthroscopic Bankart repair for adolescent anterior shoulder instability: clinical and imaging predictors of revision surgery and recurrence. Egger AC, Willimon SC, Busch MT, Broida S, Perkins CA. Am J Sports Med. 2023.

Intrarater and interrater reliability of radiographic characteristics in skeletally immature patients with anterior cruciate ligament tears: a PLUTO study group reliability study. Perkins CA, Coene RP, Anderson CN, Busch MT, Willimon SC, PLUTO Study group et al. J Pediatr Orthop. 2023.

Opioid use in pediatric patients after common orthopedic surgeries. Perkins, CA, Murata A, Kim J, Willimon SC. J Pediatr Orthop. 2023.

Pediatric and Adolescent Medial Collateral Ligament Injuries. Pearce SS, Bangley RM, McHorse K, Dale K, Lopreiato NP, Schlecter J, Pennock A, Vandenberg C, Pierce L, Perkins, CA, Koehler R, Ellington M. JPOSNA. 2023.

Perioperative complications of pediatric orthopedic surgery in sickle cell disease. Lorenzana D, Perkins CA, Willimon SC. J Pediatr Orthop. 2023.

Pigmented villonodular synovitis/giant cell tumor in the knee. Chipman DE, Perkins CA, Lijesen E, Green DW. Curr Opin Pediatr. 2023.

Transosseous meniscus root repair in pediatric patients and association with durable midterm outcomes and high rates of return to sports. Willimon SC, Busch MT, Murata A, Perkins CA. Am J Sports Med. 2022.

Traumatic hip dislocations in the pediatric patient: injury patterns, need for axial imaging, outcomes, and selective hip arthroscopy. Willimon SC, Egger AC, Perkins CA. JPOSNA. 2022.

Descriptive epidemiology from the research in osteochondritis dissecans of the knee (ROCK) prospective cohort. Nissen CW, Abright CN, ROCK Group (Busch MT, Perkins CA, Willimon SC), et al. Am J Sports Med. 2022.

Multiligament Knee Injuries in Young Athletes. Perkins CA, Willimon SC. Clin Sports Med. 2022.

Transosseous repair of patellar sleeve fractures: a case series and surgical technique guide. Perkins CA, Egger AC, Willimon SC. J Knee Surg. 2022. 

Two-Year Functional Outcomes of Operative vs Non-operative Treatment of Completely Displaced Midshaft Clavicle Fractures in Adoelscents: Results from the Prospective Multicenter FACTS Study Group. Heyworth BE, Pennock AT, Li Y, Liotta ES, Dragonetti B, Williams D, Ellis HB, Nepple JJ, Spence D, Willimon SC, Perkins CA, Pandya NK, Kocher MS, Edmonds EW, Wilson PL, Busch MT, Sabatini CS, Farley F, Bae DS. Am J Sports Med. 2022 Sept.

Navicular stress fractures in adolescent athletes: injury characteristics and outcomes of surgical fixation. Egger AC, Ramirez M, Willimon SC, Perkins, CA. JPOSNA. 2022.

Acute management of pediatric knee dislocations. Ellington M, Pearce SS, Dale K, McHorse K, Paterno M, Ryan C, Vanderberg C, Perkins CA. JPOSNA. 2022.

Traumatic hip dislocations in the pediatric patient: Injury patterns, need for axial imaging, outcomes, and selective hip arthroscopy. Willimon, S.C., Egger, A.C., Perkins, C.A. JPOSNA. April 2022.

Descriptive epidemiology from the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort. ROCK Group, including, Perkins, C.A., Willimon, S.C., Busch, M.T., et al. American Journal of Sports Medicine. 2022 Jan.

Early operative versus delayed operative versus nonoperative treatment of pediatric and adolescent anterior cruciate ligament injuries. PLUTO Study Group, including, Perkins, C.A., Willimon, S.C., Busch, M.T., et al. American Journal of Sports Medicine. 2021 Dec.

Assessment of skeletal maturity and post-operative growth disturbance after anterior cruciate ligament reconstruction in skeletally immature patients: A systematic review. PLUTO Study Group, including, Perkins, C.A., Willimon, S.C., Busch, M.T., et al. American Journal of Sports Medicine. 2021 May.

Rates of concomitant meniscal tears in pediatric patients with anterior cruciate ligament injuries increase with age and body mass index. Perkins, C.A., Christino, M.A., Busch, M.T., Murata, A., Egger, A.C., Kelleman, M., Willimon, S.C. Orthopaedic Journal of Sports Medicine. 2021 Mar.

Transosseous repair of patellar sleeve fractures: A case series and surgical technique guide. Perkins, C.A., Egger, A.C., Willimon, S.C. Journal of Knee Surgery. 2021 Feb.

Saucerization and repair of discoid lateral menisci with peripheral rim instability: intermediate term outcomes in children and adolescents. Perkins, C.A., Busch, M.T., Christino, M., Willimon, S.C. J Pediatr Orthop. 2021 Jan.

Surgical Technique: Arthroscopic Treatment of Pigmented Villonodular Synovitis. Willimon S.C., Perkins C.A. Hip Arthroscopy and Hip Joint Preservation Surgery. 2021. https://doi.org/10.1007/978-1-4614-7321-3_166-1

In 2017, Children’s Healthcare of Atlanta established the Orthopedic and Sports Medicine Outcomes Center. Crystal Perkins, MD, an Orthopedic Surgeon, serves as Medical Director for Orthopedic Quality and Outcomes at Children's.

We participate in several multicenter prospective study groups with other leading pediatric centers across the country, including:

Hip

International Perthes Study Group

The International Perthes Study Group is a group of specialists and researchers with a common goal of advancing knowledge and care of patients with Legg-Calve-Perthes disease. Tim Schrader, MD, an Orthopedic Surgeon at Children’s, was a founding member of this group and is actively involved in collaborative studies with researchers across the world.

Spine

Children's Spine Foundation and Study Group

The Children’s Spine Foundation is a community dedicated to improving the quality of care and outcomes for patients and families dealing with chest wall and spine deformities. Our team works with the Spine Study Group on research projects to help improve patient outcomes. Michael Schmitz, MD; Nicholas Fletcher, MD; and Joshua Murphy, MD, all orthopedic surgeons at Children’s, are actively involved in this collaboration on behalf of Children’s.

Harms Study Group

We are one of only 25 centers that participate in this invitation-only research group. In an effort to standardize postoperative spinal fusion care, our team has provided research and data collection from the Children’s spinal fusion postoperative pathway. Our research helps to guide best practices nationwide with the goal of improving spinal fusion patient outcomes. Dr. Fletcher provides leadership on behalf of Children’s in this collaboration with the Harms Study Group.

Sports medicine

Research in Osteochondritis Dissecans of the Knee (ROCK)

The Research in Osteochondritis Dissecans of the Knee (ROCK) group is committed to developing improved methods for the diagnosis, evaluation and treatment of osteochondritis dissecans. Our team works closely with other members of this group to identify better treatment plans for patients. Michael Busch, MD; S. Clifton Willimon, MD; and Dr. Perkins represent Children’s through research efforts in this group.

Function After Adolescent Clavicle Trauma and Surgery (FACTS) Multicenter Study Group

Children’s is one of eight centers nationwide that participate in the FACTS Study Group. These centers represent the highest-volume pediatric hospitals in the country that are combining their clinical experience to determine treatment outcomes for teenagers who have displaced clavicle fractures. Drs. Busch, Willimon and Perkins contribute to this group.

Pediatric ACL: Understanding Treatment Options (PLUTO)

PLUTO is a national study group investigating the safety and effectiveness of treatment of pediatric anterior cruciate ligament (ACL) injuries, specifically in children with open growth plates. Children’s sports medicine surgeons, including Drs. Busch, Willimon and Perkins, are active members of this group.

Pediatric Research in Sports Medicine (PRiSM)

PRiSM is devoted to the care of pediatric and adolescent athletes. Many pediatric sports injuries and conditions are unique to young athletes and do not occur in other age groups. By combining research across multiple centers and different practitioners, the group aims to increase the impact of research. Drs. Busch, Willimon, Perkins and Egger participate in this study group and lead research interest groups studying complex knee injuries and shoulder instability.

Limb deformity

Multicenter Pin Site Infection Study

Jill Flanagan, MD, an Orthopedic Surgeon at Children’s, is actively involved in the Multicenter Pin Site Infection Study led by British Columbia Children’s Hospital. It aims to measure and document pin site infection rate and pin site care across Canada, the U.S. and United Kingdom through a multicenter pin site infection database. By identifying the factors contributing to pin site infections, this study will take another step toward improving clinical care for children in external fixation devices.

Multicenter Study Group for Pediatric Limb Deformity

This study group, led by University Hospitals Cleveland Medical Center, is committed to establishing a multicenter prospective study group to define the appropriate indications and expected outcomes in children treated for pediatric limb deformity. The establishment of this large coalition, including Dr. Flanagan, will offer substantial improvements to the current literature and ultimately make a significant impact in our care of children with these conditions.

Trauma

CORTICES Trauma and Infection Study Group

CORTICES is a collaboration of pediatric orthopedic surgeons dedicated to improving quality, safety and value in the management of emergent orthopedic conditions through education, research and development of optimal care guidelines. Drs. Fletcher, Murphy and McLaughlin help lead research efforts on behalf of Children’s in this group.

POSNA 2023 Annual Meeting

Our orthopaedic surgeons shared research spanning sports medicine, spine and fracture during the POSNA 2023 Annual Meeting. Dr. Nicolas Fletcher, Medical Director of the Spine Program, served as the Program Chair of the POSNA 2023 Annual Meeting.

  • Nicholas Fletcher, MD: Regional Anesthesia as an Alternative to Procedural Sedation for Forearm Fracture Reductions
  • Nicholas Fletcher, MD: Is shorter really better? Results of selective vs. nonselective thoracic fusion in adolescent idiopathic scoliosis patients at minimum 10-year follow-up
  • Joshua Murphy, MD: Why are we giving additional parenteral antibiotics to non-ambulatory cerebral palsy patients with isolated acute post-operative fevers following posterior spinal fusion?
  • Crystal Perkins, MD: Sports Medicine Scientific Program (moderator)

Ongoing throughout the conference

  • Crystal Perkins, MD: Traumatic Adolescent Knee Dislocations: Beware of the KDIII Injury Pattern (ePoster 67)
  • Michael Schmitz, MD; Jessica King, PA: Growing Your Practice with APPs (part of POPs Virtual Symposia Program)

POSNA Annual Meeting

Our orthopaedic surgeons presented research spanning sports medicine, spine, hip and bone health during the POSNA 2022 Annual Meeting.

  • Cliff Willimon, MD: What Not To Do: Complications in Pediatric Sports Complications and unexpected events happen to every surgeon
  • Nicholas Fletcher, MD: Roids are the Rage: Postoperative Steroids in Patients with Severe Neuromuscular Scoliosis Undergoing Posterior Spinal Fusion Reduced Opioid Usage by 70%
  • Cliff Willimon, MD: Introduction to Revision Sports Medicine Surgery
    • Discussion included Crystal Perkins, MD: Revision Shoulder Stabilization: Whats Next After a Failed Arthroscopic Bankart? When to Latarjet?
  • Tim Schrader, MD: How to Determine with Diagnostics if a SCFE Is Alive or Dead–Pre, During, and After
  • Jill Flanagan, MD: Adolescent Blount’s Disease...When to Guide and When to Cut 
  • Nicholas Fletcher, MD: Spinal Fusion in Pediatric Patients with Down Syndrome

PRiSM Annual Meeting

Our sports medicine physicians were proud to host the following sessions and presentations at the 2022 Pediatric Research in Sports Medicine Society Annual Meeting. 

  • Cliff Willimon, MD and Crystal Perkins, MD: Hot off the Press- Top 5 in 60
  • Crystal Perkins, MD: Poster: Does Shortening Change in the First 2 Weeks Following Completely Displaced Adolescent Clavicle Fractures?

Key presenters at 2021 Scoliosis Research Society (SRS) Annual Meeting

Dr. Fletcher presented his research and represented our Spine Program at the 2021 SRS Annual Meeting. 

  • Nicholas Fletcher, MD: 10-Year Follow Up of Lenke V Curves in Patients with Adolescent Idiopathic Scoliosis
  • Nicholas Fletcher, MD: Lowest Instrumented Vertebral Discordance in Adolescent Idiopathic Scoliosis: When Coronal and Sagittal Parameters Conflict

Key presenters at 2021 Pediatric Orthopaedic Society of North American (POSNA) Annual Meeting

Children’s Healthcare of Atlanta was honored to have many orthopaedic surgeons among the presenters and speakers for POSNA 2021.

  • Nicholas Fletcher, MD: Saving Yourself and Others From Bad Meetings
  • Nicholas Fletcher, MD: 10-Year Follow Up of Lenke V Curves in Patients with Adolescent Idiopathic Scoliosis
  • S. Clifton Willimon, MD: Opiod Use in Children and Adolescents Following Common Orthopaedic Surgeries
  • Robert Bruce, MD: Perioperative Steroid Use in Patients Undergoing Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
  • Nicholas Fletcher, MD: Establishing a Gold Standard for Estimation of Blood Loss During Spine Surgery

e-Poster

  • Crystal Perkins, MD: Osteochondral Lesions of the Talus: Factors Predictive of Cartilage Integrity
  • Nicholas Fletcher, MD: Evaluation of the AOSpine Injury Classification in the Pediatric Population: Results of a Multi-Center POSNA Grant

Key presenters at 2020 PRiSM

A number of our pediatric orthopedic surgeons—Drs. Busch, Willimon and Perkins—are key members of Pediatric Research in Sports Medicine (PRiSM) and recently presented on several topics at the 2020 annual meeting in Glendale, Ariz. Dr. Willimon was also elected Chair of the PRiSM Research Committee, which oversees 13 different research interests.

Presentations by our pediatric orthopedic experts for the 2020 annual meeting included:

Rehabilitation Pearls for Multi-Ligament Knee Injuries

  • Dr. Perkins shared updates on the Multi-Ligament Knee Injury Research Group in which she is the leader for 2020 and Dr. Willimon is a member.

Multi-Ligament Knee Injury: Anatomy and Diagnosis

  • Dr. Willimon

Autologous Chondrocyte Implantation To Manage Unsalvageable Osteochondritis Dissecans

  • Dr. Willimon

Osteochondral Lesions of the Talus: Factors Predictive of Cartilage Integrity

Podium presentation: Research on the Children’s cartilage imaging in the ankle

  • Asahi Murata, MPH

*Pediatric Health Information System (2021), as prepared by the Children’s Hospital Association. This report compares clinical data annually for more than 49 pediatric hospitals in the U.S.

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