MoMentuMMoMentuMThe Campbell FoundaTion

Enhancing Quality of Life Through the Science of Orthopaedic Medicine • Summer 2007

Two Campbell CliniC surgeons are Trained To implanT a groundbreaking new deviCe ThaT Can mean a longer, beTTer life for Children wiTh sColiosis.

Implant will grow as Evonte grows

Young scoliosis patient walks taller after VEPTR surgery

On the first day of the new school year, his teachers and classmates at White Station Elementary were especially happy to welcome back Evonte Cathey.

The quiet fourth grader missed the last two months of school last spring, when he was home- bound following surgery. During a lengthy operation, two Campbell Clinic surgeons performed a procedure that is certain to make a big difference in Evonte’s life this school year and all of his years to come.

In the surgery, Dr. Jeffrey Sawyer and Dr. Bill Warner implanted a Vertical Expandable Prosthetic Titanium Rib (VEPTR) in Evonte’s body. The VEPTR device is a curved rod made of titanium that is attached to the ribs near the spine. Drs. Sawyer and Warner were trained to implant the device by Dr. Robert Campbell, VEPTR’s inventor and an expert in the field. They are among the first pediatric orthopaedic surgeons in the nation trained to implant the device.

“You can see a difference in the way he sits and he walks,” said Yolanda Cathey, Evonte’s mother. “He’s sitting up straighter and walking taller. He looks really good.”

Last year, Evonte made the Honor Roll and earned Good Conduct citations. His mother thinks this school year will be even better.

“He’s been doing great ever since the surgery,” Yolanda Cathey said. “At his sister’s birthday party this summer, he was jumping on the Spacewalker and mixing it up with the other kids. I had to keep telling him ‘No flips!’ or he would have probably tried that too.”

Scoliosis since birthEvonte was born with scoliosis, a lateral (sideways)

curvature of the spine. While one out of every 10 people has some degree of curving in the spine, Evonte’s spine was curved more than 50 degrees. Evonte also had hearing loss, a condition unrelated to the scoliosis.

Due to his scoliosis and fused ribs, Evonte’s lung capacity was small. As his scoliosis progressed, problems with lung capacity grew worse.

“For someone with the physical problems he had, Evonte was a pretty active child,” said Yolanda Cathey. “The scoliosis didn’t really cause him pain. He wasn’t sick a lot, like you might think.”

Evonte is small for his age. He did not walk until he was two years old. But, his mother said, he rides a bike, shoots baskets in the family’s back yard, and enjoys playing outside with other children. “Having three brothers and a sister has probably helped him adjust as well as he has,” said Ms. Cathey.

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vepTr paTienT, evonTe CaThey, wiTh Campbell CliniC surgeon dr. Jeffrey sawyer

The VETPR device helps mechanically stabilize the spine and separate the ribs so that the lungs can grow.

A promising development

Due to the rapid progression of his scoliosis, Evonte underwent spinal fusion surgery at age three. In the surgery, the abnormally-shaped bones in his spine that were causing it to curve were prevented from growing and further deforming his spine. Following the surgery, Evonte wore a back brace for six months.

While spinal fusion surgery was successful in halting the rapid progression of Evonte’s spinal curvature, it did not allow his lungs to grow as he grew. The VETPR device allows pediatric spine surgeons to not only halt the progression of the curvature but, in some cases, decrease the amount of curvature. Most significantly, the device allows the patient’s lungs to grow and develop.

According to Dr. Sawyer, children whose lungs are too small can have a wide variety of medical problems including fatigue, poor growth and weight gain, frequent respiratory infections and, in severe cases, even death.

Children develop half of their lung volume by the age of six and the second half of lung volume between age six and maturity. Any condition that affects the chest and spine of a young, growing child can cause a permanent decrease in adult lung size and function.

“The VEPTR device has revolutionized the way spinal surgeons think about spinal deformity,” Dr. Sawyer said. “The work of Dr. Robert Campbell and others has taught us that correcting spinal deformity in a way that allows growth enables us to dramatically improve both the length and quality of life for severely affected children.”

dr. Jeffrey sawyer

dr. bill warner

dr. sawyer shows evonTe his xrays and explains The progress ThaT has been aChieved

©Synthes

“We feel really blessed and have a lot of hope for the future.” — Yolanda Cathey, mother of Evonte

The expansion advantage

Studies have shown that children who are treated with a VEPTR device can resume near-normal lung growth. “The device is lengthened every six months, essentially growing as the child grows,” Dr. Sawyer said. “The lengthening process is accomplished through a 45-minute surgical procedure and an overnight stay in the hospital.”

Dr. Sawyer and Dr. Warner are hopeful that the VEPTR device will assist in enabling Evonte’s lungs to continue growing and will allow him to be more active, as well as increase his final adult lung size. At the end of his active growth, Evonte will need one final spinal surgery to stabilize his spine and maintain the correction and growth that VEPTR facilitated.

“VEPTR is the type procedure that requires a lot of teamwork between the surgeons, the patient, and the patient’s family,” Dr. Sawyer said. “It is most successful with a well-informed and involved parent, such as Ms. Cathey. She has been actively involved in making complex medical decisions for Evonte, which has been very helpful.”

Hope for the future

“Watching a child grow and thrive after implantation of the VEPTR device, seeing a child be able to do the things his or her peers are doing, and seeing a child gain self-esteem, is one of the most rewarding aspects of being a pediatric surgeon,” Dr. Sawyer said.

Ms. Cathey praised Drs. Sawyer and Warner for their personal as well as surgical skills. “They’ve both been wonderful with Evonte, and they’ve been so patient explaining

everything to me,” she said. “I had a lot of questions, and they answered them one by one. I think this is going to be really good for Evonte. We feel really blessed and have a lot of hope for the future.”

Approximately one out of every 10 people has some degree

of curvature of the spine.

Scoliosis affects approximately two percent of the total

population.

Scoliosis tends to run in families. If one person in a family

has scoliosis, the likelihood of an incidence in another

family member is approximately 20 percent higher.

Scoliosis usually develops during middle or late childhood,

before puberty. It is seen more often in girls than boys.

Scoliosis can also occur in adults. When scoliosis is first

diagnosed in an adult, it may represent a condition that

started out as a slight curvature in childhood and has

progressed, due to the absence of treatment. In other

instances, adult scoliosis may be caused by degenerative

changes of the spine or spinal deformities associated with

osteoporosis.

If allowed to progress, severe cases of scoliosis can lead

to chronic back pain, deformity, and difficulty breathing.

SOURCE: American Academy of Orthopaedic Surgeons

Scoliosis facts

SOURCE: American Academy of Orthopaedic Surgeons

uneven shoulders prominent shoulder blade or

shoulder blades

uneven waist elevated hips leaning to one side

Scoliosis: Tips for parents

Scoliosis can go unnoticed in a child because it is rarely painful in the formative years. Parents should watch for the following signs, beginning when a child is about eight years old:

Any one of these signs warrants an examination by the family physician, pediatrician, or orthopaedist.

evonTe CaThey

Welcome to the Resident Class of 2012The Campbell Foundation is pleased to welcome eight outstanding new residents to our training program this year. They are a diverse group, coming to us from as near as the University of Tennessee and as far away as the University of Nevada, but all share a background of academic excellence and a commitment to orthopaedics.

Paul Balthrop, M.D., a graduate of the University of Louisville School of Medicine

Tim Bert, M.D., from Loyola University of Chicago Stritch School of Medicine

Craig Denlinger, M.D., a graduate of Tulane University School of Medicine

Ben Grear, M.D., from the University of Tennessee Health Science Center

Adam Kennedy, M.D., a graduate of Louisiana State University School of Medicine

Brian Perkinson, M.D., from the University of Tennessee Health Science Center

Nick Rachel, M.D., a graduate of the Univer- sity of South Alabama College of Medicine

Travis Torngren, M.D., a graduate of the University of Nevada School of Medicine

“During their five years here, we expect the Campbell Clinic Resident Class of 2012 to become exceptionally competent and caring orthopaedic surgeons.”

— Dr. Fred Azar

Four join the Campbell Fellowship ProgramFour distinguished resident graduates will join The Campbell Foundation’s fellowship program for 2007-2008:

Adam Fosnaugh, M.D., a graduate of Ohio State University School of Medicine; completed an orthopaedic residency at Tulane University, with a year at the University of Mississippi Medical Center due to Hurricane Katrina; Sports Medicine Fellowship, sponsored by Smith & Nephew Endoscopy

Mark Parrella, M.D., received his medical degree from Georgetown University School of Medicine, completed his residency at Drexel University School of Medicine; 2007 Synthes Trauma Fellow

Annette Smith, M.D., a graduate of Marshall University School of Medicine; completed a general surgery residency at LAC/USC Medical Center and an orthopaedic surgery residency at Kingsbrook Jewish Medical Center; Spine Fellowship

John Womack, M.D., received his medical degree from Medical University of South Carolina; recently completed his residency at the University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery; E. Greer Richardson, M.D. Hand and Foot Fellowship, sponsored by DePuy Orthopaedics

“Excellence in Surgery” AwardsBaptist Memorial Health Care Foundation presented the “Excellence

in Orthopaedic Surgery” Awards, named in honor of Campbell Clinic’s distinguished retired physicians, to this year’s senior residents. The Campbell Foundation recognized Baptist for its continued generous support of the resident education program.

Seated (l-r): Scott Fountain, Senior VP and Chief Development Officer, Baptist Memorial Health Care Foundation; Allen Edmonson, M.D.; Rocco Calandruccio, M.D.; Lee Milford, M.D.; Robert Tooms, M.D.; and Richard Drewry, M.D., VP and Chief Medical Officer, Baptist Memorial Health Care

Standing (l-r): Senior residents Judd Cummings, M.D.; John Babb, M.D.; Jay Womack, M.D.; Duane Belongie, M.D.; and Paul Whatley, M.D.

Not pictured: John Balbas, M.D.; Dan Fletcher, M.D.; Matt Mayfield, M.D.; and Mark Pierce, M.D.

e d u C a T i o n n e w s

dr. fred azar

direCTor of residenT eduCaTion

The Campbell foundaTion

The surgiCal Team used Two sTainless sTeel plaTes and 26 sCrews To align and immobilize The femur.

Campbell Clinic surgeon Dr. Edward Perez has set hundreds of femur fractures, but he’s never had a patient like Cranbeary, a 600-pound female polar bear he helped treat last spring.

A star attraction at the Memphis Zoo, Cranbeary broke the femur in her left hind leg in two places in February, the result of a 14-foot fall. When the veterinarian leading Cranbeary’s medical team contacted Smith & Nephew about using a plate designed for humans to repair the break in Cranbeary’s leg, Smith & Nephew recommended Dr. Perez because of his expertise and experience.

“I was very familiar with Cranbeary when I received the call,” said Dr. Perez. “She and the other polar bears are my children’s favorite animals at the zoo.”

There were no complications during the surgery, Dr. Perez said, but Cranbeary’s girth made it difficult to take detailed X-rays before the operation. The surgical team used two stainless steel

“I was happy to participate in the surgery for such a marvelous animal.”

— Dr. Edward Perez

Dr. Perez’s surgical skills help restore beary unusual patient

dr. edward perez

plates and 26 screws to align and immobilize the femur.

After recuperating in the zoo’s hospital for 10 weeks, Cranbeary returned to the polar bear exhibit on June 1. During her recovery, the beloved bear received more than 300 cards and 650 e-mails wishing her a speedy recovery.

“I was happy to participate in the surgery for such a marvelous animal,” Dr. Perez said. “After Cranbeary was back in her pool, the zoo held a private party for her medical team, and my children were able to attend also. They were proud of my role in Cranbeary’s recovery. It was really a great experience.”

Interns experience “thrill of discovery”Danielle Helton, a junior at Baylor University, and Erica Turse, a senior at the University of Florida, were chosen from 64 applicants for the first Kappa Delta Orthopaedic Research Internship launched this summer by the UT-Campbell Clinic Department of Orthopaedic Surgery.

The coeds spent eight weeks engaged in research under the direction of Dr. Karen Hasty, Dr. Jinsong Huang, and Dr. Richard Smith. Both students are members of Kappa Delta, a national social sorority.

“Women are under-represented in orthopaedics,” Dr. Hasty said, “and Kappa Delta has sponsored a significant national award for orthopaedic research for more than 50 years. It seemed appropriate to offer this opportunity to Kappa Delta members. And the response was terrific.”

Erica, who plans to become an ortho- paedic surgeon, worked on projects related to the early detection of osteoarthritis. Danielle, who plans a career in orthopaedic research, worked on research involving longevity issues related to artificial knee implants.

“We’ve both spent many hours in classroom labs, but the work we did this summer was more like real-world research,” Danielle said. “We experienced the thrill of discovery that real scientists experience. It was a great learning opportunity.”

danielle helTon, fronT lefT, and eriCa Turse, baCk lefT, winners of uT-Campbell CliniC’s firsT kappa delTa orThopaediC researCh inTernship, are piCTured wiTh (fronT righT) uT-memphis mediCal sTudenT sCoTT CasTle, reCipienT of an nih researCh fellowship, and dr. Jinsong huang, insTruCTor, uT-Campbell CliniC.

“There must be a better way...”That notion, often the mother of invention, has

led a third-year Campbell Clinic resident to create a more efficient way for residents working at The Med to record and share patients’ medical information.

The result, third-year resident Matt Busbee believes, could improve patient care as well as enable residents to make smarter use of their time during their trauma rotation.

“The way residents at The Med have been collecting, recording and sharing patient information has been not just a duplication but a triplication of efforts,” said Matt, who began planning the project last fall and completed it in early spring 2007.

Before, a resident wrote out a patient’s medical history and account information in longhand for the Consult sheet that stays with a patient’s chart. The resident then entered the same information in the PDA that he or she carries at the hospital. In a third step, each resident entered the information again in a PowerPoint presentation, downloading a patient’s x-rays into the presentation so that other residents could review the record when they came on duty.

Each Campbell Clinic resident must complete a research project during his or her residency, and Matt decided to tackle the record-keeping boondoggle as his project. “My goal,” he said, “was to create a process so that residents could enter the information one time, and everything else could be generated from the original input.”

His research adviser was Campbell Clinic surgeon Dr. George Wood, who provided numerous sugges- tions and constant encouragement, according to Matt.

“I had to learn Visual Basic computer programming, and I’d never done programming before,” Matt said.

“I literally started with Microsoft Access for Dummies. I created a template based on the Campbell Clinic Health History form, and I programmed in standard codes for diagnoses and procedures. Setting up the codes was the most time-consuming.” In total, Matt estimates he spent hundreds of hours on the project in a three-month period.

Residents at The Med began using the new system April 1, 2007. Information for the Consult sheet, PDA and PowerPoint are all generated as the result of one data entry session.

“There’s a learning curve, but we’ve had a lot of positive response,” Matt said. “The case managers, nurses, doctors and others on a patient’s case like the fact that everything is typed instead of handwritten, and that standard codes are used. It helps us communicate better with each other, and you can find the information you are looking for more quickly.”

The new records system can also improve doctor-patient communication, Matt said. When The Med’s newly-purchased server is working fully, the system will allow a resident to take a laptop into a patient’s room, pull up x-rays and other information, and have a bedside discussion.

As an additional benefit, residents conducting research in the future will be able to search the database by patient diagnosis or outcome, rather than having to manually search patient files, Matt said.

“Residents will also be able to ‘crunch’ the data, looking at all the cases during a time period,” said Matt. “It will help us understand what we did well and see where we need to improve, which is important for quality control.”

r e s e a r C h n e w s

Resident’s research will increase doctors’ efficiency, help patients

dr. maTT busbee

new daTabase sCreens developed by dr. maTT busbee for his residenCy researCh proJeCT will help save Time and improve CommuniCaTion for Trauma residenTs.

The new records system … will allow a resident to take a laptop into a patient’s room, pull up x-rays and other information, and have a bedside discussion.

They come from South America, Japan, Iran, Trinidad, Albania and other countries around the globe. Their goal: Learn all you can from Campbell Clinic surgeons, then take your knowledge back and apply it for the benefit of patients in your homeland.

International participants in the Campbell Foundation-sponsored Observership Program are grateful for the opportunity to meet and witness the work of surgeons they have come to admire, according to Rosemary Graham, the Foundation’s fellowship coordinator.

“Many Campbell Clinic surgeons are famous in the home countries of participants,” she said. “They have read the surgeons’ articles in the Campbell’s Operative Orthopaedics textbook and are familiar with their research. Our doctors are celebrities to them.”

The Observership Program enables doctors to observe Campbell Clinic surgeons as they meet with patients, perform surgery, and discuss cases with other medical professionals. Observers do not participate in surgery or patient care. The visiting doctors pay their own transportation and living expenses during the Observership.

Although the program is not solely for international doctors, many participants are from other countries.

Kay Daugherty, Campbell’s medical editor and a 30-year employee, said international doctors have visited Campbell Clinic to observe surgeons at work since Dr. Willis Campbell’s time. “There are records of visitors in the 1940s and ‘50s from places as diverse as China, England, and Mexico,” Kay said.

The number of observers varies each year. “We’ve had about 15 observers during the last two years,” said

Rosemary. The country with the largest number of participants is Brazil. Sports Medicine and Trauma are the specialties that draw the greatest number of participants.

Participants in the Observership Program are invited to attend Campbell educational conferences and use the clinic’s library while participating. At the end of their observership, participants receive a Certificate of Training.

“This program has also been a wonderful learning opportunity for us,” said Dr. Harkess. “It’s frankly an honor for the Campbell Clinic and for me personally to have someone of the caliber of Dr. Soichi Tsuji coming to visit for a year.”

“Many of our visitors are already accomplished orthopaedic surgeons and educators in their home countries. It’s very gratifying to learn their solutions to complex musculoskeletal problems.” — Dr. James Harkess

World’s doctors watch, learn in observership program

dr. soiChi TsuJi (righT) from sT. luke’s inTernaTional mediCal CenTer, Tokyo, Japan, is in memphis for one year To observe dr. James harkess, Campbell CliniC ToTal JoinT surgeon.

Charles C. gerber

dr. Jeffrey r. sawyer

Joseph C. weller

An outstanding team of physicians, business executives and community leaders guides The Campbell Foundation’s Board of Trustees, contributing insight and vision to realize the Foundation’s mission of improving quality of life for present and future generations. We welcome to the Board three Trustees, each with a distinguished record of accomplishments and service:

Mr. Charles C. Gerber is an investment advisor; founder and partner of Gerber/Taylor Associates; and founder of Gerber/Taylor Management Company, which specializes in alternative assets such as private equity/venture capital and hedge funds. Mr. Gerber is a graduate

of the University of Tennessee and serves on numerous civic boards.

Dr. Jeffrey R. Sawyer is on staff at Campbell Clinic and specializes in pediatric orthopaedics. Dr. Sawyer completed his residency at the Hospital of the University of Pennsylvania and his fellowship at Campbell Clinic. He is a member of several professional societies including the American Academy of Orthopaedic Surgeons, American Board of Orthopaedic Surgeons, Pediatric Orthopaedic Society of North America, Scoliosis Research Society, and American Academy for Cerebral Palsy and Developmental Medicine.

Mr. Joseph C. Weller,Vice Chairman and Executive Managing Director of Morgan Keegan, was one of the firm's founding members in 1969 and has served as Morgan Keegan's Chief Financial Officer. A graduate of the University of Mississippi with a BBA, he has served in various industry positions including president of the Financial Executives International. Mr. Weller is an active supporter of the arts. He has also served as trustee of the University of Mississippi Loyalty Healthcare Foundation.

Distinguished Additions to the Foundation’s Board

f o u n d a T i o n n e w s

Campbell Clinic celebrates 100 years in 2009Dr. Willis C. Campbell opened his practice in Memphis in 1909 and for the next 15 years made a lasting impact on the field of orthopaedic medicine. The following year Dr. Campbell organized the Department of Orthopaedic Surgery at the University of Tennessee School of Medicine in Memphis. With a passion for caring for all patients regardless of ability to pay, he opened the Crippled Children’s Hospital in 1919 and the Hospital for Crippled Adults in 1923. He also established the orthopaedic residency training program in 1924. Dr. Campbell laid the foundation for generations of Campbell Clinic physicians to continue his important work of surgeon training and community healthcare.

dr. willis C. Campbell

Mark your calendars for the Campbell Club

Triennial — The Centennial Meeting

in Memphis, April 23 - 26, 2009

The Campbell Club Triennial

Mission statementOur mission is to restore quality of life through the science of orthopaedic medicine worldwide. Since 1946, we have been committed to advancing orthopaedic healthcare, research, and surgeon education.

How you can helpYour tax-deductible gift will:

Educate the next generation of outstanding orthopaedic surgeons through our distinguished residency and fellowship programs.

Support promising research to discover new solutions in areas such as osteoarthritis, joint replacement, cartilage regeneration, spinal disorders, trauma care, and children’s bone and joint diseases.

Provide orthopaedic care to children and adults, regardless of their financial circumstances, through our community outreach clinics.

Consider making a gift... to The Campbell Foundation in your will or other estate plans and you will be making a difference in the lives

of others for generations to come. Donors who remember The Campbell Foundation through their bequests will be recognized and honored as members of the Campbell Legacy Society.

For more information Carol KirbyDirector of Leadership Gifts1400 S. Germantown RoadGermantown, TN 38138(901) 759-5490ckirby@campbell-foundation.org

Ca m p b e l l fo u n d aT i o n

For a fuller life. For a better future. Support The Campbell Foundation.

The Campbell Foundation www.campbell-foundation.org

O r t h O p a e d i c r e s e a r c h • s u r g e O n e d u c a t i O n • c O m m u n i t y h e a l t h c a r e