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Category Archives: Research & Innovation

Scottish Rite Hospital: The Leader in Treating Hand Disorders

From a child’s hands, imagination becomes creation. Through their hands, children explore the world around them. For thousands of children with hand and upper limb disorders, Texas Scottish Rite Hospital for Children has been a source of hope and healing.

The Center for Excellence in Hand delivers a setting for both patient care and clinical research focused on the treatment for pediatric patients with hand and upper limb disorders, says Scott Oishi, M.D., the center’s director. “Our clinical practice [treats] a variety of children who are either born with congenital hand differences or upper extremity differences, or patients who have had trauma or something happen to them after they’re born,” he says. “There are a lot of patients who come through here and get no surgery at all because all they really need is a lot of encouragement and ability to grow and expand their horizons.”

Oishi and staff hand surgeon Christopher M. Stutz, M.D., have the privilege of seeing many of their pediatric patients from the time they’re a few days old until the time they become 18 years old. “We’re able to keep a database of our patients as far as what type of diagnosis they have, what type of surgeries they underwent, and what their outcomes were, based on very good outcome measures,” Oishi says.

The doctors of the Center for Excellence in Hand are able to understand the best form of treatment for each child through their dedication to research. One of the research studies in the center focuses on the impact of participating in Hand Camp has on school-aged children with a congenital hand difference. Our doctors and researchers evaluate a child’s self-esteem, function and participation in activities, as well as their relationship with peers before and after attending Hand Camp. From treating children with congenital hand abnormalities, such as webbed fingers, reconstructing children’s hands with extra digits, or changing the position of fingers on hands, the center strives to give children back their childhood through the hospital’s world-renowned patient care and groundbreaking research. The Center for Excellence in Hand is committed to helping children with congenital hand anomalies become active, happy, productive, and independent adults.

 

Scottish Rite Hospital’s Movement Science Lab: Experts in Analyzing How Children Move

The Movement Science Laboratory at Scottish Rite Hospital is an integrated part to the treatment of our patients. The team uses leading-edge technology to evaluate and identify movement to help our doctors make decisions about the best treatment options for the child.

The Movement Science Lab (MSL), also known as the gait lab, has two main focuses: clinical evaluations and research. Clinically, our MSL team works directly with our orthopedic doctors to help provide options to determine the best course of treatment for each child. Doctors are provided with a detailed analysis of their patient’s walking ability including how the joints move, when the muscles are firing, and the power generated through their legs.

Scottish Rite Hospital is one of the few institutions in the area to have a premier movement science lab. During a Movement Science appointment, small reflective markers are placed on the child’s body and special high speed motion capture cameras record the child’s movement in three dimensions while performing certain tasks (walking, running, squatting, etc.). This equipment is the same technology used to make animations, video games, and movie special effects. MSL staff processes and summaries the data so doctors can analyze and help create their treatment plan.

Other tools utilized in the lab include a special plate that is in the floor, which allows the team to measure and evaluate the patient’s footprint as they walk. It shows exactly where and how high the pressure is under different areas of the foot. This device helps with the assessment of children with specific foot problems. Other equipment in the lab measures muscle strength or how efficiently the body uses oxygen with every breath.

The other focus of the Movement Science Lab is research. As an integrated part of the hospital’s mission, the research conducted allows the team to better understand and measure how well the treatment plans our doctors provide to our patients improve their function. The lab will see patients before and after treatment in order to measure the effectiveness of the care. The purpose of the research is to compare patient outcomes following different surgical procedures, assess a specific treatment across varying types of patients, define the improvements of the child’s conditions following physical and occupational therapy, and evaluate the effectiveness of various orthoses and prosthetic limb components. The research continues to educate our staff and allows the team to provide the best possible care to each patient.

Overall, our Movement Science Lab gives our doctors a more in-depth analysis of how a patient’s body moves. Whether it is the child’s hips, knees or ankles, the equipment our lab uses guides our doctors in providing the best treatment plan. It is through the clinical evaluations and dedication to research that our movement science lab is world-renowned.

Psychology Staff Present Groundbreaking Research at Annual Conference

Texas Scottish Rite Hospital for Children is world-renowned for its groundbreaking research. Our doctors and staff travel around the country to share innovation and collaborate with other medical professionals. This week, members of our psychology team are attending the Society for Pediatric Psychology Annual Conference (SPPAC) in Portland, Oregon.

Pediatric psychologists specialize in the psychological aspects of medical conditions and the promotion of health with children, adolescents, and families in a pediatric healthcare setting. SPPAC is an annual meeting to advance the science, collaboration, research, and practice of pediatric psychologists in various medical sub-specialties.

Scottish Rite Hospital psychologist, Heather Richard, Psy.D., will be presenting recent research titled, “Integrated Team Approach to Adolescents Treated with Hip Preservation Surgery.” This collaborative study is the first to analyze an integrated team approach with adolescents undergoing hip preservation surgery. It evaluated the impact of required, pre-operative, psychological interventions as part of the team and the potential positive impacts to patient care. The team learned that patients treated with the integrated care model reported significantly reduced pain and stayed in the hospital fewer days after surgery. “This is an untapped area in pediatric psychology,” says Dr. Richard. “We are pioneering psychology as part of an integrated team in pediatric orthopedics. This is important work, as it is our mission to treat the whole child.”

It is the hospital’s dedication to ongoing research that continues to guide and help define the treatment plans for our patients now and in the future. Scottish Rite Hospital is honored to have the opportunity to present their work and collaborate with fellow medical professionals to provide the best care to every patient.

Q&A: Perthes Disease

What causes Perthes disease? The cause is unknown and the disease is not inherited in most patients. A very small number of patients have another family member with Perthes.

Should I expect a lot of complaints of pain? Pain generally suggests that there is hip joint inflammation, which can be caused by too much activity. The amount of pain experienced by a child with Perthes disease varies from patient to patient. Some patients complain of activity-related pain or night pain only. Your child may complain of groin, thigh or knee pain. They may have restricted movement and a mild limp. You and your child’s doctor will discuss how to manage pain.

What is the time frame of Perthes? Perthes disease has four stages. In general, it may take three to five years for a patient to go from the initial stage to the healed stage of the disease. The length of each stage can vary.

What activities can my child do? Your child’s doctor will help you determine the activities that are safe. The answer will depend on the stage of the disease, symptoms and hip joint stiffness.

What are long-term effects of Perthes disease? Most children have occasional periods of increased pain and stiffness for six months to two years. Most children will return to typical activities and sports once healed. However, some children may be at risk for developing arthritis as adults. Children’s hips that grow back irregularly will have more symptoms, such as pain and hip stiffness, and a greater risk of arthritis later in life.

Will my child be able to participate in physical activities? Even with a deformed femoral head, most patients can perform daily activities and sports’ activities once the hip has healed.

Is hip replacement an option? Hip replacement is not a surgery for children. Only when a patient develops painful degenerative arthritis later in adulthood is the surgery recommended.

Developmental-Behavioral Pediatrics: Topics for Primary Care was March 3, 2017

Developmental-Behavioral Pediatrics: Topics for Primary Care was held March 3, 2017 in the T. Boone Pickens Training and Conference Center at Texas Scottish Rite Hospital. The 18th annual seminar for pediatricians, family practitioners, advanced practice nurses, physician assistants and health care professionals providing direct care to children attracted 215 attendees from across the state of Texas as well as individuals from Alabama, Oklahoma, New Mexico, Minnesota, Michigan, Georgia and New York.

Conference presentation topics included behavioral health: practical psychology and psychiatry for the primary care provider, ADHD: practical tips to improve outcomes, Fragile X: diagnosis and treatment, childhood onset psychiatric disorders, neuromotor development in infants and children and the challenges of the autistic adolescent. This activity was provided jointly by UT Southwestern Medical Center and Texas Scottish Rite Hospital for Children.

For more information, visit community.tsrhc.org/dbp.

Scottish Rite Hospital Doctors Attend the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting

Last week, several doctors from Scottish Rite Hospital attended the American Academy of Orthopaedic Surgeons (AAOS) annual meeting in San Diego, California. AAOS was founded in 1933 and has grown to be the world’s largest medical association, serving more than 39,000 members worldwide. This association provides practice management and education for orthopedic surgeons and allied health professionals.

The five-day conference included exhibits, presentations and instructional courses covering a full range of topics in orthopedics. Our staff made presentations on various research areas including hip dysplasia, sports medicine, musculoskeletal infection, fractures, Perthes Disease, and scoliosis. It was a great opportunity for the doctors to showcase their work and collaborate with medical professionals from around the world.

On the final day of AAOS, the meeting concluded with Specialty Day. This includes sixteen Specialty Societies that feature the latest research in their areas of expertise. Members of each society are selected to present on a topic associated with their specialty. Director of Research, Harry Kim, M.D., and staff orthopedists, Christine Ho, M.D., and Lawson Copley, M.D. each made presentations on topics regarding pediatric orthopedics. This section of the meeting allows members to be a part of a concentrated program to expand their discussions and highlight their expertise.

Scottish Rite Hospital has consistently had a strong presence at AAOS each year. It is an honor that our doctors are members of this established group and are selected to present their research on an international stage. The Academy allows our staff to learn and grow as surgeons to ultimately bring better care to our patients.

Scottish Rite Hospital Hosts Inaugural Genomics Conference

Texas Scottish Rite Hospital for Children is hosting an inaugural international conference titled, “Genomic Approaches to Understanding and Treating Scoliosis.” The three-day meeting unites two distinct groups who are dedicated to scoliosis genetics research, the International Consortium for Vertebral Anomalies and Scoliosis (ICVAS) and the International Consortium for Scoliosis Genetics (ICSG). A primary goal of the conference is to promote interdisciplinary research to solve the underlying basis of scoliosis, a complex and poorly understood disorder that is common in children. The conference has attracted basic science researchers and clinicians at the faculty level, as well as fellows, graduate students, and other trainees who are focused on scoliosis and genomics. Funding for the meeting is provided by grants awarded by the National Institutes of Health, the Scoliosis Research Society, Fondation Yves Cotrel, and the Globus, Medtronic, and Nuvasive companies.

The conference includes paper presentations from various attendees and lectures from seven international keynote speakers from the United States, the United Kingdom, Japan, and Australia. These presenters represent distinct specialties including developmental biology, orthopedic surgery, clinical genetics, and human genetics. The topics will provide the audience with a diverse and insightful program.

Carol Wise, Ph.D., Director of Molecular Genetics and Basic Research at Scottish Rite Hospital, is an organizer of the conference. She views this meeting as an exciting opportunity to encourage collaborations and to bring new ideas to the treatment of the various complex forms of scoliosis. “It is a privilege to host specialists in scoliosis and scoliosis genetics from around the world here at the hospital,” says Wise. “This conference will generate a roadmap for collaborative research that will create future scientific breakthroughs. Importantly, this meeting also provides a forum for mentoring the next generation of researchers in the field.”

Continuing education for professionals and trainees is a cornerstone of the Scottish Rite Hospital mission. It is an honor to host this and other conferences to promote groundbreaking research and better care for our patients.

L. Ray Lawson, M.D., International Spine Fellowship: Educating Medical Professionals from Around the World

At Texas Scottish Rite Hospital for Children, we are dedicated to education. The hospital offers several fellowship programs to provide a well-rounded experience for medical professionals interested in pediatric orthopedics. As an institution, it is a privilege for our doctors to have the opportunity to train individuals from all over the world.

One of the renowned programs at Scottish Rite Hospital is the L. Ray Lawson, M.D., International Spine Fellowship. This fellowship is in honor of L. Ray Lawson, M.D., for his many years of commitment and dedication to the treatment of pediatric spine disorders. This program is available to postgraduate surgeons who have completed an orthopedic residency. It provides the recipient the opportunity to rotate and observe our orthopedic surgeons and work on a spine-related research project.

Recently, a recipient of the L. Ray Lawson, M.D., International Spine Fellowship has completed his time at Scottish Rite Hospital. Ali Parsa, M.D., traveled to Dallas, Texas from Mashhad, Iran to spend six months learning from the best in pediatric orthopedics. He worked closely with Chief of Staff, Dan Sucato, M.D. and Stephen Sparagana, M.D, and the spine research team on a neuromonitoring study for Adolescent Idiopathic Scoliosis (AIS). “This program allows the fellow to receive comprehensive training in spinal disorders”, says Assistant Chief of Staff Karl Rathjen, M.D. “It is an honor to have medical professionals traveling from around the world to train at Scottish Rite Hospital – the exchange of ideas enriches all of us and extends the reach of the cutting edge knowledge developed here in Dallas.”

Although Scottish Rite Hospital was a short stop for Dr. Parsa in his medical career, he will be able to take what he has learned back to Iran to continue his research and develop innovative techniques to treating spine disorders. It is an honor to educate physicians like Dr. Parsa, and all of the past and future recipients of this fellowship, to bring better care to children all over the world.

Let’s Talk Concussions

Scottish Rite Hospital experts are often on the road to share their research findings and experiences in caring for children. One example is our pediatric sports medicine physician Shane M. Miller, M.D. He has a passion for concussion education and it is evident in the frequent invitation he receives to speak on the topic. Here are a few examples:

    • Pediatricians studying for board certification, Philadelphia, PA
    • UT Southwestern Medical School Family Medicine Grand Rounds, Dallas, TX
    • Plano parent and coaches @ Prestonwood Sports Organization Soccer Coaches Meeting
    • Community event at Sci-Tech Discovery Center, Frisco, TX
    • School Nurses at the Episcopal School of Dallas, Dallas, TX
    • Frisco Soccer Association Coaches Meeting, Frisco, TX
    • McKinney ISD school nurses, McKinney, TX
    • National and international sports medicine specialists at Pediatric Research in Sports Medicine Annual Meeting, Dallas, TX
    • Local pediatricians at Pediatric Society of Greater Dallas quarterly meeting, Dallas, TX
    • Pediatricians and healthcare providers at Pediatric Orthopedic Education Series, Dallas, TX
    • Dallas community through interview and publication in Dallas Child Magazine
    • Physical Therapists and Athletic Trainers at DFW Sports Symposium, Southlake, TX

UntitledThis week Dr. Miller is at the NCAA Headquarters in Indianapolis at the Youth Sports Safety Summit.

The multi-disciplinary Youth Sports Safety Alliance hosts this annual event bringing together advocates for young athletes from across the country. Made up of athletic trainers, orthopedic surgeons, physicians, and school and youth sports organization administrators share lessons learned and collaborate to identify ways to make youth sports safer. Dr. Miller will be talking about the importance of immediate removal from play after a suspected sports-related concussion. He will highlight results from a recent study of his patients showing that 4/10 go back to play or continue playing on the day of their injury. He emphasizes the phrase “when in doubt, sit them out.”

If you have a group that would like to learn more about sports-related concussions or another pediatric sports medicine topic, please email lindsay.linteman@tsrh.org.

For information about injury prevention and pediatric sports medicine, please visit our website at scottishritehospital.org/sports.

Molecular Genetics Team Awarded National Institutes of Health Grants

Texas Scottish Rite Hospital for Children is world-renowned for its patient care, research and education. Over the years, our physicians and researchers have made groundbreaking discoveries that have enlightened our understanding of medical conditions to improve our patient care. In particular, the Division of Molecular Genetics has made innovative contributions to the hospital’s scoliosis research.

Genetics Lab 2017 _15Carol Wise, Ph.D., Director of Molecular Genetics and Basic Science Research, has led this division of the hospital in the discovery of several genetic factors associated with idiopathic scoliosis, the most common spinal deformity in children. Since that breakthrough, Dr. Wise and her team have continued their commitment to understand this complex disease through various research efforts.

Recently, Dr. Wise and Jonathan Rios, Ph.D., also a member of Scottish Rite Hospital’s Molecular Genetics team, were awarded three NIH (National Institutes of Health) grants, totaling over $7 million to fund research in idiopathic scoliosis. Two awards were received from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The first grant will fund a program titled “Developmental Mechanisms of Human Idiopathic Scoliosis”. It will be shared with two other investigators at two other institutions including, Liliana Solnica-Krezel, Ph.D., at Washington University, and Nadav Ahituv, Ph.D., at the University of California, San Francisco over a span of five years. The goal of this research is to identify genetic risk factors in idiopathic scoliosis and to define the mechanisms by which these factors predispose children to spinal deformity.

The second grant awarded to Dr. Wise will fund an international meeting that will be held at Scottish Rite Hospital in March. The “Genomic Approaches to Understanding and Treating Scoliosis” conference will bring together physicians and researchers from across the world to present and synthesize latest discoveries in scoliosis research.

The third grant was awarded to Dr. Rios from the Gabriella Miller Kids First Pediatric Research Program. This grant funds the project “Genomics of Orthopaedic Disease (GOOD for Kids).” The project will use next-generation genomic technologies to discover genetic causes of adolescent idiopathic scoliosis (AIS).

These highly competitive awards provide researchers at Scottish Rite Hospital the opportunity to continue groundbreaking research that will lead to better care for the children we treat.

Carol Wise, Ph.D., and Jonathan Rios, Ph.D., are professors at the University of Texas Southwestern Medical Center (UTSW). Dr. Wise is a Professor in the McDermott Center for Human Growth and Development, Pediatrics, and Orthopedic Surgery and Dr. Rios is an Associate Professor of Pediatrics and Orthopedic Surgery.