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Orthopaedic hero

Caring for every patient, every step of the way.


Musculoskeletal Research

The scientist/clinician partnership at Geisinger facilitates research in discovering the best applications of, improvements to and innovations for the latest orthopaedic technologies in development. The basic research and clinical trials aim to develop the best implants, finest biomaterials and cutting-edge pharmaceuticals for musculoskeletal patient care.

"We are a dynamic orthopaedic translational research center," says Michael Suk, MD, JD, MPH, MBA, FACS, chairman, department of orthopaedic surgery at Geisinger. "Our affiliation with various groups prove that Geisinger is a major contributor to orthopaedic research."


September 2022 Cohort Representative

Alexander Bachir




Foot and ankle research

Comparative Study of Injectable Human Amniotic Allograft (ReNu) versus Corticosteroids for Plantar Fasciitis: A Prospective, Randomized, Blinded Study

PI, Gerard Cush, MD

The aim of this study is to evaluate both the safety and efficacy of the ReNu injection on pain and inflammation in subjects diagnosed with plantar fasciitis.

Liposomal Bupivacaine Versus Peripheral Nerve Block

PI, Gerard Cush, MD

This is a prospective, randomized trial to investigate whether there is a difference in pain score, opioid consumption, patient satisfaction, functional outcomes, complication rates and unscheduled contact associated with local liposomal bupivacaine infiltration versus peripheral nerve block in patients undergoing elective ankle and hindfoot surgery.

Geographic Distribution of Foot and Ankle Orthopaedic Surgeons Throughout the United States

PI, Gerard Cush, MD

The aim of this study is to determine the geographic distribution of foot and ankle orthopaedic surgeons throughout the United States with the goal of using this data to determine the density of providers as an assessment of foot and ankle surgical care.

Comparison of Fixation Methods in Isolated Subtalar Fusions

PI, Nicole Branning, DPM

This study will retrospectively assess the outcomes associated with rearfoot arthritis correction surgery. The purpose is to find out which fixation technique achieves better outcomes. We will compare the parallel screw fixation versus all other types of screw fixations.

Incidence of Deep Vein Thrombosis in Total Contact Casting

PI, Ellianne Nasser, DPM

This retrospective study aims to fill gaps in the current knowledge of the incidence of deep vein thrombosis with serial total contact casting. This knowledge will help practitioners be more cognizant of complications during total contact casting and better educate patients and families.

Comparison of Postoperative Pain Following Neuroma Excision in Patients with Preoperative Local Injection Nerve Blockade Versus Those Without 

PI, Ellianne Nasser, DPM

The aim of this study is to compare preoperative versus postoperative pain in patients with and without a preoperative nerve blockade following neuroma excision surgery. The goal is to determine if a preoperative local anesthetic block significantly reduces the amount of pain a patient experiences following the neuroma excision procedure, both in the short and long term.

Operative Ankle Fractures in Diabetic Patients: Is There a Synergistic Relationship Between Prolonged Non-weightbearing Status and the Rigidity of Internal Fixation with Respect to Ankle Fractures?

 PI, Ellianne Nasser, DPM

The purpose of this study is to establish a standard of care by which to fixate ankle fractures in diabetic patients and determine a post-operative protocol for weightbearing. It is hypothesized that patients with prolonged non-weightbearing longer than 8 weeks with more than 2 syndesmotic screws will have fewer complications and better outcomes when compared to early weightbearing and less than 2 syndesmotic screws.

Relationship of White Blood Count and Proximal Amputations Following Emergency Department Visit in Diabetic Patients 

PI, Ellianne Nasser, DPM

This study aims to assess the relationship between diabetic patients who have gone to the emergency room with foot ulcers and have had proximal amputations as a result. If we can isolate variables that have more predictive value for proximal amputation, we may be better able to control those variables and delay or prevent amputation.

Surgical Treatment Option (Fusion) for Middle Facet Tarsal Coalitions and Their Outcomes: A Retrospective Study

PI, Ellianne Nasser, DPM

The purpose of this study is to examine surgical interventions for middle facet tarsal coalition and the outcomes measured in terms of reoperation rate and pain relief.

Surgical Outcomes Following Lapidus Procedure for Treatment of Adolescent Hallux Abducto Valgus 

PI, Ellianne Nasser, DPM

The purpose of the study is to retrospectively analyze the use of the lapidus procedure for the correction of hallux abductovalgus deformity in patients 20 years of age old and younger. 

Hip and knee research

Safety and Effectiveness of Utilizing Virtual Reality for Total Knee Arthroplasty (TKA) for the Reduction of Acute Postoperative Pain and Opioid Use

PI, Michael Suk, MD

This randomized controlled study will study the effects of a virtual reality-based pain management program in helping to reduce acute postoperative pain and opioid use after orthopaedic total knee arthroplasty (TKA) surgery. After surgery, participants wear a pair of goggles to create the sensation of being transported into immersive, 3D worlds. The goal is to limit the patients’ processing of pain signals, thereby reducing pain and associated opioid use.

Periprosthetic Joint Infection Causative Organisms and Their Infecting and Antibiotic Susceptibility Patterns

PI, David Maish, MD

The aim of this study is to establish infection patterns in patients who were diagnosed with periprosthetic joint infections after arthroplasty, and to identify antimicrobial susceptibility and the evolution of resistance that may have occurred over time from 2008 to 2020 in a rural health system.

The Impact of Robotic-Assisted Technology on Knee Arthroplasty Healthcare Costs and Utilization

PI, David Kolessar, MD

Robotic-assisted knee arthroplasty (rKA) has been associated with improved clinical, radiographic and patient-reported outcomes. The aim of this study is to evaluate healthcare utilization and costs associated with manual knee arthroplasty (mKA) versus rKA. This study also examines the influence of rKA technology on surgeons’ practice patterns.

An Overview of Indications, Complications, and Outcomes Following Girdlestone Arthroplasty in the Year 2020: A Retrospective Review

PI, James Murphy, MD

Resection (Girdlestone) hip arthroplasty (GRA) has historically been used as a treatment for severe, unreconstructable hip disease; however, this procedure is rarely used in modern times. This study reviews the indications and results of a large series of GRA in the current arthroplasty environment with specific attention to chronic antibiotic usage.

Diagnostic Accuracy of the New Definition of Periprosthetic Joint Infection Versus 2014 Musculoskeletal Infection Society (MSIS) Criteria

PI, David Maish, MD

Periprosthetic joint infection (PJI) is a serious complication following total joint arthroplasty. The new 2018 scoring system for diagnosing PJI demonstrated a higher sensitivity and specificity than 2014 Musculoskeletal Infection Society (MSIS) criteria. The purpose of this study is to compare the accuracy of the 2018 criteria to the 2014 MSIS criteria for the diagnosis of periprosthetic hip/knee joint infection. 

Genotype and Phenotype Associations of Developmental Dysplasia of the Hip

PI, Steven Lietman, MD

Developmental dysplasia of the hip (DDH) describes a wide spectrum of disorders ranging from minor acetabular dysplasia to irreducible dislocation of the hip. Modern medicine is still lacking a solid foundation to guide DDH screening and describe potential genetic predispositions. Early detection of DDH may help prevent further disability and improve the psychological health and quality of life of these children. The aim of our study is to establish a genetic etiology for this condition.

Can the Lateral Approach to Knee Replacement Surgery Decrease Infrapatellar Saphenous Nerve Damage and Improve Kneeling and Squatting Function?

PI, Steven Lietman, MD

Lateral approach to knee replacement may lead to lower risk of nerve damage to the anterior knee and better kneeling and squatting function than the standard medial parapatellar approach. This study will compare 12-month postoperative kneeling and squatting function between patients who had the medial parapatellar approach with anterolateral skin incision and patients who have undergone surgery using a lateral approach with anterolateral skin incision.

Aseptic Loosening in a Novel Total Knee Arthroplasty System.

PI, David Kolessar, MD

Several studies have described good short-term outcomes using a novel total knee arthroplasty (TKA) implant system. However, there have been reports of early failures with aseptic loosening of the tibial component, specifically at the implant-cement interface. The purpose of this study is to describe the causes and rates of revision in patients who underwent TKA surgery with this novel system and identify factors associated with aseptic loosening.

Triathlon Titanium Knee Outcomes Study: A Prospective, Post-market, Multicenter Study of the Outcomes of the Triathlon Titanium Knee System

PI, Thomas Bowen, MD

The Triathlon Knee System, a predecessor to the Triathlon Tritanium Knee System, is designed to provide patients with more natural motion and the potential for greater implant longevity. The primary objective of this prospective, non-randomized, post-market, multicenter study is to evaluate the success rate of cementless primary total knee replacement with the Triathlon Tritanium Tibial Baseplate and Triathlon Tritanium Patella.

SWIFT Trial: Surgical Weight Loss to Improve Functional Status Trajectories following Total Knee Arthroplasty

PI, Christopher Still, DO

The purpose of this study is to determine whether weight-loss surgery prior to total knee replacement surgery reduces risk and improves long-term orthopaedic outcomes including knee range of motion, knee pain, and physical function.

Secur-Fit Advanced Outcomes: A Prospective, Post-market, Multicenter Evaluation of the Clinical Outcomes of the Secur-Fit Advanced Hip Stem

PI, Thomas Bowen, MD

The purpose of this prospective, post-market study is to evaluate and determine the success rate of the Secur-Fit Advanced Hip Stem and compare it with those reported for other primary hip stems in the scientific literature.

Pediatric orthopaedic research

Computational Modeling of Pediatric High Femoral Anteversion and Knee Biomechanics

PI, Mark Seeley, MD

The goal of this work is to study the effect of a morphological condition known as miserable malalignment syndrome on anterior knee pain in children. Knee pain in the adolescent population can be a significant detriment to everyday life and is often a precursor to more debilitating conditions such as osteoarthritis. If physical therapy proves ineffective, surgery is generally recommended and conducted to correct hard and soft tissue morphology, yet there is a lack of standardization regarding surgical intervention. We hypothesize that using a patient-specific computational approach to aid in selecting specific surgical procedures can broadly improve patient outcomes.

Does Chlorhexidine and/or Betadine Prep Thoroughly Clean the Surgical Sites and Fingernails in Pediatric Arm Surgery Following Trauma?

PI, Mark Seeley, MD

This study is a prospective design in which a cohort of 20 pediatric patients who are undergoing upper extremity surgery will be enrolled to determine if patients are being adequately prepped for surgery. We will collect culture specimens before surgically prepping the patient with either chlorhexidine or betadine, post their surgical prep, and post-operation. We will compare the results of the culture specimens within and between the different surgical prep cohorts.

Primary ACL Reconstruction in Pediatric and Adolescent Patients

PI, Mark Seeley, MD

The purpose of this retrospective study is to determine the overall re-operation rate of anterior cruciate ligament (ACL) injuries in children when compared to their adult controls. Secondary outcomes will include ACL re-rupture rate, contralateral ACL tear following ACL reconstruction, and identification of risk factors for re-injury or re-operation.

Effect of Pre-contoured Spinal Implant Rods on Sagittal Correction in Adolescent Idiopathic Scoliosis

PI, Meagan Fernandez, DO

The purpose of this study is to determine if pre-contoured spinal rods deform after implantation. The degree of deformation will be measured by the maximal deflection and the Cobb angle of the implanted rods on postoperative X-rays. The postoperative rod measurements will be compared with preoperative measurements. The difference between pre and post implantation Cobb angle and maximal deflection will be analyzed for statistical significance.

Physical medicine & rehabilitation research

A Study on Brain-Computer-Interface-based Robotic Rehabilitation of Post-Stroke Upper Limb Neuromuscular Impairment

PI, Chulhyun Ahn, MD

Stroke is one of the leading causes of functional impairment that can lead to loss of independence and quality of life of the stroke survivor. Robotic technology can be used for functional training in the upper extremity of post-stroke patients. In this prospective randomized controlled study, we will compare robotic therapy guided by Brain-Computer-Interface (BCI) technology with robotic therapy without BCI to determine whether incorporation of BCI can enhance the functional outcome of robotic rehabilitation.

Safety and Effectiveness of Virtual Reality Utilizing EaseVRx for the Reduction of Chronic Pain and Opioid Use

PI, Chulhyun Ahn, MD

This prospective randomized blinded controlled study will investigate the effects of using a virtual reality (VR) headset in decreasing pain, reducing opioid use and improving quality of life for individuals being treated for chronic low back pain. During this 8-week, at-home program, patients will either be assigned to use either a 3D or 2D VR headset, and we will compare the outcomes between these two groups.

Orthopaedic spine research

Blunt Cerebrovascular Injury in Cervical Trauma Patients

PI, Michael Haak, MD

The purpose of this study is to determine the incidence of vertebral artery injury in cervical spine injuries and assess neurological outcomes in patients with cervical spine fractures diagnosed with asymptomatic blunt cerebral vascular injury. All patients who sustain a cervical spine injury receive a Computed Tomography Angiogram (CTA) per Geisinger Clinic protocol. Often patients are diagnosed with a Blunt Cerebral Vascular Injury (BCVI) based on imaging with no accompanying neurologic symptoms. The literature is limited on neurologic outcomes of patients with asymptomatic positive CTA imaging for BCVI. 

Preoperative or Pre-injury Opioid Use as a Predictor of Functional Outcomes and Chronic Opioid Use Following Spine Surgery or Trauma

PI, Michael Haak, MD

This study aims to identify preoperative and postoperative opioid use to determine which factors may increase the risk of chronic opioid use and poor outcomes postoperatively. 

Incidence of Infection and Complications After Spinal Cord Stimulator Implantation: A Single Center, Retrospective Review

PI, Michael Haak, MD

This study is a single center, retrospective review of the incidence of infection and complications after spinal cord stimulator implantation.

Sports medicine

Injuries in Female Collegiate Athletes with Polycystic Ovary Syndrome (PCOS)

PI, Matthew McElroy, DO

Polycystic Ovary Syndrome (PCOS) is a common problem in women of reproductive age. PCOS is a major risk factor for metabolic syndrome, and women with metabolic syndrome have higher rates of Type 2 diabetes, heart disease and infertility. The identification and treatment of PCOS at an early age can help delay or prevent progression to metabolic syndrome. This study will identify female athletes with PCOS and determine if they are more prone to injury, inflammation, malnutrition and insulin resistance.

Reduction of Concussion Symptoms Through the Use of Osteopathic Manipulative Therapy: A Prospective Study

PI, Matthew McElroy, DO

Concussion incidence in high school and collegiate sports is high, especially in football. These injuries have become the focus of the sports world, as coaches, trainers and medical personnel are more vigilant than ever in screening for concussions. Once diagnosed, return to play is dependent on recovery from symptoms followed by a specific protocol for clearance; the sooner the symptoms subside the sooner the protocol is initiated. Osteopathic Manipulative Therapy (OMT) is a low-risk procedure that has minimal side effects and has been used to decrease both headache intensity and frequency. We are investigating whether OMT decreases symptom duration and severity of headache in concussion management.

Perception of Exercise Prescriptions in Patients Presenting with Musculoskeletal Complaints

PI, David Ross, MD

Exercise is an important part of fitness and overall well-being. Current trends in healthcare place an emphasis on encouraging patients to take a proactive role in their care. Our goal is to evaluate perspectives of exercise prescriptions among patients presenting with musculoskeletal complaints. We hope to use this data to evaluate our strategies as providers in encouraging patients to take a proactive role in their recoveries.

Trauma research

Three-Dimensional Computed-Tomography (CT) Reconstruction for the Classification of Acetabular Fractures

PI, Michael Suk, MD

Fractures of the acetabulum require careful consideration in order to ensure maintenance of natural motion and prevention of early post-traumatic arthritis. Fractures involving significant portions of the articular surface and/or that render the joint unstable are typically addressed surgically whereas stable fractures with little/no-articular involvement are treated non-operatively. This distinction is made with radiographic studies. This study is being conducted to compare the reliability and accuracy of classifying acetabular fractures by using 3D CT images versus using plain radiographs and 2D CT images.

Braking Force After Orthopaedic Trauma

PI, Daniel Horwitz, MD

The ability to operate a motor vehicle is an essential part of everyday life. Consequently, the return to driving is a genuine concern for patients who are recovering from orthopaedic trauma. Using a driving simulator created at Bucknell University, we are conducting a prospective study to learn more about patients’ abilities to effectively drive following orthopaedic trauma injuries with a focus on braking force.

Outcomes in Orthopaedic Trauma Surgery Patients with a History of Pre-injury Narcotic Use

PI, Daniel Horwitz, MD

The purpose of this study is to review the existing data in the Pennsylvania Department of Health's Prescription Drug Monitoring Program online database to evaluate trends in opioid use in orthopaedic trauma surgery. We hypothesize that outcomes following orthopaedic trauma surgery will be worse in patients who have taken opioid pain medications during the six months preceding the injury necessitating their surgery.  

Safe International Normalized Ratio (INR) for Patients Undergoing a Hemiarthroplasty for Treatment of Intracapsular Hip Fracture

PI, Daniel Horwitz, MD

Approximately 5-10% of hip fracture patients are chronically anticoagulated with warfarin pre-fracture. The purpose of this study is to evaluate the effect of preoperative INR on the incidence of thromboembolic and bleeding complications in patients undergoing a hemiarthroplasty for an intracapsular hip fracture.

Treatment of Ankle Fractures in Patients with Peripheral Neuropathy Using Retrograde Hindfoot Nail

PI, Daniel Horwitz, MD

Among diabetics, patients with peripheral neuropathy have the highest risk of complications following treatment of ankle fractures. We hypothesize that insertion of a retrograde nail for the treatment of an acute ankle fracture is an effective and safe treatment for diabetic patients with peripheral neuropathy.

Thromboprophylaxis in Patients with Acetabular Fractures

PI, Daniel Horwitz, MD

The purpose of this study is to evaluate whether the time from last dose of low molecular weight heparin to surgery affects the incidence of bleeding or thromboembolic complications in patients undergoing surgical treatment for acetabular fractures.

Hematoma Block vs Bier Block: Radiographic Outcomes after Closed Reduction of Distal Radius Fractures Using Different Anaesthesia Techniques

PI, Daniel Horwitz, MD

This study compares the bier block and the hematoma block in terms of quality of reduction, outcomes and complications in acute distal radius fractures.

Assessment of Quality and Adverse Events of Hip Fracture Repair After an Operative Night on Call at the Orthopaedic Attending Level

PI, Daniel Horwitz, MD

The purpose of this study is to assess the quality of hip fracture repair after an operative on call night among attending physicians. We hypothesize there will be no difference in the quality or complication rate of hip fractures performed by an orthopaedic attending after a night during which he/she was on call.

Effect of Obesity on Outcomes After Fracture of the Humerus 

PI, Daniel Horwitz, MD

The purpose of this study is to compare the incidence of perioperative complications in obese and non-obese patients undergoing surgical treatment of humeral shaft fractures.

Analysis of Contralateral Hip Fractures

PI, Daniel Horwitz, MD

The purpose of this study is to compare the complication rate, length of stay, transfusions and mortality among patients’ first hip fracture and subsequent contralateral hip fractures.

Upper extremity research

Magnetic Resonance Imaging (MRI) Evaluation After Endoscopic Carpal Tunnel Release

PI, Joel Klena, MD

This study investigates whether there is a clear division of the flexor retinaculum visible on MRI immediately after and six weeks following Endoscopic Carpal Tunnel Release compared to preoperative MRI, and if morphological changes are maintained at intermediate follow-up.

The Use of Preoperative Dynamic Ultrasound to Predict Ulnar Nerve Instability Following In Situ Decompression for Cubital Tunnel Syndrome

PI, Joel Klena, MD

This study aims to identify if preoperative dynamic ultrasound can be used to accurately predict the degree of ulnar nerve instability following in situ decompression for Cubital Tunnel Syndrome.

Demographics of Orthopaedic Post-Graduate Training Program Faculty

PI, Joel Klena, MD

The aim of this study is to evaluate the baseline demographics and characteristics including gender and subspecialty training for all orthopaedic residency and fellowship program faculty in the United States.

Determinants of Outcomes After Distal Radius/Ulna Fractures

PI, Joel Klena, MD

There are scarce studies evaluating the role of radiographic imaging during the late follow-up of patients treated for distal radius fractures. We hypothesize that once the fracture has clinically and radiographically healed, the role of further routine X-rays is negligible and that limiting X-ray imaging in these patients would help reduce unnecessary expenditures to the health system.

Telemedicine After Upper Extremity Surgery: A Prospective Study of Program Implementation

PI, L. Christopher Grandizio, DO

The purpose of this study is to evaluate the implementation of a postoperative hand and upper extremity telemedicine program. We aim to compare travel burden, visit time and patient satisfaction between an initial postoperative telemedicine visit and a second conventional in-clinic visit.

Surgical Dressings After Endoscopic Carpal Tunnel Release: A Randomized Controlled Trial

PI, L. Christopher Grandizio, DO

This prospective, randomized trial is being conducted to determine if there is a difference in pain scores, outcomes and complications for patients treated with a conventional bulky soft tissue dressing versus those treated with a band-aid after endoscopic carpal tunnel release.

Demographic and Genetic Associations of Dupuytren’s Disease

PI, L. Christopher Grandizio, DO

This study will examine both the incidence/prevalence of Dupuytren’s Disease as well as the demographics of patients with this condition. We aim to create a matched cohort study of patients with and without Dupuytren’s Disease to evaluate the significance of previously investigated genes as well as potential new genetic associations. 

Shoulder Arthroplasty: A Retrospective Analysis of Outcomes

PI, L. Christopher Grandizio, DO

The aim of this study is to evaluate shoulder arthroplasties to better understand the clinical outcomes of the shoulder arthroplasty procedure.

Glucocorticoid Administration in the Treatment of Adult Distal Radius Fractures: A Randomized Controlled Trial

PI, Liam Dwyer, MD

The purpose of this study is to compare functional outcome measures and range of motion for patients receiving glucocorticoid (GC) injections versus those not receiving GCs for the treatment of distal radius fractures. In addition, we aim to determine if there is a difference in rates of complications and postoperative pain control between the GC and non-GC groups.

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