Overview
The primary focus of the Division of Orthopaedics at Cincinnati Children's Hospital Medical Center is the management of congenital and acquired musculoskeletal problems in children. The division's clinical research efforts continue with the goal of improving patient care, while our basic science has continued to expand.
The spine research program has focused on understanding the anatomy, biomechanics and biology of the spine and how this may be used to improve the clinical practice of spine surgery. Development of innovative treatment methods, the mechanobiology of growth, the biomechanical function of spine ligaments, and biomechanics of instrumentation insertion have been recently investigated.
New collaborative basic science research program between the Division of Orthopaedic Surgery and the Department of Developmental Biology on the "Regulation of Skeletal Growth Plate" has been started at Cincinnati Children's. This program is designed to study the physiological physical growth and subsequently study the patterns of abnormal skeletal growth as a result of breaks in this regulation pathway.
A crucial difference between pediatric and adult orthopaedic biomechanics is growth. Therefore, the mechanobiology of growth is a primary research interest, especially as it impacts the clinical treatment of skeletal deformities. We have designed and fabricated a spine staple based on the premise that some scoliosis may be surgically arrested or corrected much less invasively by modifying spine growth. The initial work was published in Spine (May 20, 2005). A joint company, SpineForm LLC, was created to develop and test the staple. Patents have been issued in Australia, South Korea, and the USA; and are pending in Europe and Japan. With the help of a Cincinnati Children's Trustee Grant, we began in vivo studies to define the pressure levels that arrest spine growth. A grant was submitted to the Scoliosis Research Society, and an award was granted to develop and test novel micro-electro-mechanical (MEMS) stress sensors. We are also quantifying structural features of spine growth plate tissues from scoliosis patients. With these tissues, we have determined that growth activity remains in the spine even in patients with severe deformities. In addition, orthopaedic clinical fellow, Gerard Librodo MD, was awarded a University of Cincinnati Orthopaedic Research and Education Foundation (UOREF) grant to determine how the location of a cortical wall breach affects pull-out strength of pedicle screw spine fixation.
Congenital and traumatic orthopaedic problems of the lower limbs are emerging as biomechanical research themes. Comparisons in strength and stiffness of different fracture fixation techniques have been the subject of three experiments. Limb length discrepancy is another area of emerging interest. Dr. VonStein has begun development of an in vivo animal model and assessment methods to test the potential of improvements in distraction osteogenesis techniques.
