Wednesday, July 21, 2010

CONTACT:
Gene Ford
317.962.4576 (office)
gford2@clarian.org 

Indianapolis surgeon receives national award for research on ACL reconstruction
K. Donald Shelbourne, M.D., is the only individual to receive the prestigious Hughston Award for the second time

INDIANAPOLIS – The Shelbourne Knee Center at Methodist Hospital and Clarian Human Motion are proud to announce that Indianapolis-based orthopedic surgeon K. Donald Shelbourne, M.D., received one of the American Orthopaedic Society of Sports Medicine’s (AOSSM) most prestigious awards for his study on the long-term effects of anterior cruciate ligament (ACL) reconstruction. Dr. Shelbourne accepted the AOSSM’s Hughston Award during a special ceremony that took place on Saturday, July 17, as part of the AOSSM’s annual meeting in Providence, Rhode Island.

The AOSSM, founded in 1972, is a national organization of orthopedic surgeons dedicated to sports medicine. Every year, the AOSSM gives the Hughston Award—named after the founder of The American Journal of Sports Medicine, Jack C. Hughston, M.D.—to the individual with the most outstanding research paper appearing in that journal in the year prior to the award. Dr. Shelbourne, a renowned expert in the treatment of ACL injuries who has performed more than 6,000 ACL reconstructions throughout his career, is the first person to receive the award for the second time.

“We are honored to see that Dr. Shelbourne and his organization have again been recognized on a national level,” says John Kohne, M.D., chief operations officer for Clarian’s Methodist Hospital. “This prestigious award for research testifies to their level of expertise and ensures that their patients have access to the most effective and up-to-date clinical treatments for their injuries.”

Dr. Shelbourne’s award-winning research paper titled, “Minimum 10-Year Results After ACL Reconstruction: How the loss of normal knee motion compounds other factors related to osteoarthritis after surgery,” is one of many research papers published in conjunction with a long-term follow-up study of ACL reconstruction being conducted at the Shelbourne Knee Center at Methodist Hospital.

The study found that, at an average of 15 years after ACL reconstruction, patients who had lost even a few degrees of normal knee extension had lower subjective scores and more signs of osteoarthritis than patients who achieved normal knee motion. The paper also shows the importance of proper rehabilitation to restore normal knee extension after surgery in order to reduce the incidence of symptoms of arthritis in young adults.   

Since launching his practice in 1982, Dr. Shelbourne has focused his research, partially funded by the Methodist Research Institute, toward advancing the surgical treatment and rehabilitation of anterior cruciate ligament (ACL) injuries. As a result of his ongoing research, Dr. Shelbourne and his team at the Shelbourne Knee Center at Methodist Hospital have been able to provide up-to-date treatment and rehabilitation methods enabling many of their patients to return to their favorite physical activities several months after surgery. 

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About the Shelbourne Knee Center at Methodist Hospital
The Shelbourne Knee Center at Methodist Hospital in Indianapolis, a partner of Clarian Human Motion, provides specialized, world-class care for knees. With a focus on continuing research and cutting-edge surgical and rehabilitation techniques, the staff at the Shelbourne Knee Center is committed to providing unsurpassed care to all patients, whether professional athletes or weekend warriors. The rehabilitation department specializes in the treatment of knee pain and knee injuries, providing patients with one-on-one care and education. Driven by research and evidence-based practices to provide the most up to date treatment and information, the Shelbourne Knee Center takes time to develop a treatment plan that meets your individual needs and helps you meet your goals. For more information, visit www.aclmd.com.

About Clarian Human Motion
Clarian Human Motion—Indiana’s only orthopedics program to be ranked among the 2010-11 edition of U.S.News & World Report’s “America’s Best Hospitals” —specializes in treating injured joints, bones, backs and muscles. As an evidence-based leader in musculoskeletal care, Clarian Human Motion offers a variety of services ranging from joint replacement and reconstruction, spine and sports medicine to pediatric orthopedics and rehabilitation services. For more information, visit www.clarian.org/hm.

Press Release Feb 25, 2009 "Getting back in the game"

July 8, 2009

Avoiding total knee replacement: Research from the Shelbourne Knee Center shows most patients improve with rehabilitation and are able to avoid surgery

Indianapolis – Research findings show that patients can significantly reduce their knee pain and improve their function with nonoperative treatment, allowing them to postpone or completely avoid total knee replacement surgery.  The study, conducted by Dr. K. Donald Shelbourne, was the first study to document the effectiveness of increasing range of motion in the treatment of deconditioned and arthritic knees. 

The study group included 50 patients (25 men, 25 women, mean age 53.2 years) with knee pain and range of motion loss compared to their opposite, normal knee.  Most patients (41/50) had osteoarthritis of the knee and had been told by other physicians that they should have a total knee replacement.  All patients underwent physical therapy including a daily home exercise program.  The focus of the rehabilitation program was to improve range of motion, specifically the ability to completely straighten the knee.  The goal was to restore symmetry compared to the opposite, normal knee. 

Results of the Study
All patients had improvement in knee extension (straightening) and all but 4 patients had improvement in knee flexion (bending).  As range of motion improved, International Knee Documentation Committee (IKDC) survey scores also improved, indicating lower levels of pain and disability. 

Of the 50 patients in this study, all but 8 of them achieved adequate symptom relief with rehabilitation and decided against having surgery.  The mean IKDC survey score at final follow up was comparable to what is considered a normal score for people aged 51 to 65.  Patients reported decreased pain severity and frequency following completion of this rehabilitation program. 

Components of the Treatment
Treatment involved a structured rehabilitation program focused on improving knee extension first, followed by knee flexion once progress on extension slowed.  The final phase of rehabilitation focused on improving strength through quadriceps exercises and low impact exercise on a stationary bike, elliptical, or stair climber machine.
 
The Elite Seat®, manufactured by Kneebourne Therapeutic, was used with many of these patients to improve knee extension.  This device can be used independently by the patient to provide a constant, prolonged stretch to the knee to improve extension and achieve hyperextension equal to the normal knee.  The Elite Seat is also useful for treating any knee condition associated with extension loss including osteoarthritis, postoperative knee stiffness, acute anterior cruciate ligament (ACL) tears, and arthrofibrosis. 

Summary
These findings highlight the efficacy of improving range of motion in patients with arthritic knees.  Preoperative rehabilitation before ACL reconstruction surgery is now considered standard-of-care, but very few surgeons require preoperative rehabilitation before total knee replacement.  Many patients are looking for ways to avoid having a knee replacement surgery, but are not given other options if medications fail to control their symptoms.  This study shows that by implementing preoperative total knee replacement rehabilitation, many patients may be able to avoid surgery.  For those patients who pursue the surgery, their recovery and outcome will be improved by maximizing the available range of motion before surgery. 

About Dr. Shelbourne 
K. Donald Shelbourne, M.D. began his Orthopaedic Sports Medicine career in 1982.  Dr. Shelbourne graduated from Wabash College in 1972 with a major in chemistry.  He completed Medical School and his Orthopaedic Residency at Indiana University Medical School from 1972 through 1981.  Dr. Shelbourne obtained additional training by doing a Sports Medicine Fellowship with Dr. Bill Clancy at the University of Wisconsin in 1981-82.

Dr. Shelbourne served as the team physician for the Indianapolis Colts from 1984 through 1998, and has been an orthopaedic consultant to Purdue University, Wabash College, and area high schools since 1982.  Dr. Shelbourne is an associate clinical professor at Indiana University School of Medicine at Indianapolis, Indiana.  He has performed over 5000 ACL reconstructions and is best known for his advancement of ACL rehabilitation. He has published over 200 journal articles and chapters in books, and he has presented his findings at national and international meetings. 

The Shelbourne Knee Center at Methodist Hospital in Indianapolis provides specialized, world-class care for knees. With a focus on continuing research and cutting-edge surgical and rehabilitation techniques, the staff at the Shelbourne Knee Center is committed to providing unsurpassed care to all patients, whether professional athletes or weekend warriors. The rehabilitation department specializes in the treatment of knee pain and knee injuries, providing patients with one-on-one care and education. Driven by research and evidence-based practices to provide the most up to date treatment and information, the Shelbourne Knee Center takes time to develop a treatment plan that meets your individual needs and helps you meet your goals. For more information, visit www.FixKnee.com.

July 8, 2009 "Avoiding total knee replacement"

EMBARGOED UNTIL WEDNESDAY, FEBRUARY 25

CONTACT:

Elizabeth Friedland

TrendyMinds

317.926.1727

efriedland@trendyminds.com

Getting back in the game: Shelbourne Knee Center releases ground-breaking ACL study

Findings show student athletes can safely return to full sports competition in as little as four months post-surgery

Indianapolis – Recent research findings released today show that student athletes recovering from ACL reconstruction surgery can return safely to competitive sports in as little as four months, questioning the widely held belief that patients should wait at least six months before returning to athletics. The study, conducted by Dr. Shelbourne and his partner Dr. Urch at the Shelbourne Knee Center at Methodist Hospital in Indianapolis , is being presented today at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) in Las Vegas . This is the first study to specifically examine the teenage athlete’s ability to return to high-level sports competition after ACL reconstruction surgery.

Among athletes of all ages, the measure of success of an ACL reconstruction is whether or not the athlete is able to return to their pre-injury level of competition; recovery time is especially important to student athletes. Most teenage athletes are now involved in year-round sports competition that includes the traditional school season and a travel team that is not affiliated with the school. Therefore, this age group also places priority on the amount of time needed for a full recovery to allow them to play at their pre-injury level of skill.

Dr. Shelbourne’s study focused on athletes who tore their ACL while competing in basketball or soccer, sports that are known for their high-risk of injury to the ACL. The study group included over 400 patients who were 17 years old or younger at the time of their surgery. All patients went through a directed rehabilitation program before and after their ACL reconstruction surgery. The main findings of the study were:

Return to Full Sports Competition

• 40% of patients were able to return in less than four months.
• 35% of patients were able to return in four to six months. (a total of 75% returned to sports in 6 mos or less)
• Only 25% of patients required more than 6 months to return.
• The mean time to return was just over five months in both basketball and soccer.

Incidence of Re-Injury

• Athletes who returned to sports competition at earlier times after surgery did not have a higher incidence of re-injury to the ACL than patients who returned at later times.

Ability to Return to High-Level Competition

• 20% of the patients went on to compete at the collegiate level (NCAA stats show that only 3-5% of all high school athletes continue to play at the collegiate level).
• There were no differences between sexes for the rate or time of return.

A widely accepted guideline among the orthopaedic community is that return to full sports competition should not be permitted until six months after ACL surgery. However, the findings of this study show that earlier return to sports does not increase the risk of re-injury to the ACL. Seventy-five percent of the patients

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SHELBOURNE ACL STUDY PAGE 2

included in this study were back to full sports competition in basketball or soccer at full capability in less than six months. In fact, 40% of the patients included in this study were back to full sports competition at full capability in less than four months.

These findings suggest that the traditional thinking – that patients should wait at least six months before resuming athletic activities – may be too conservative. The results support the philosophy that patients should not be restricted by physician-imposed timelines following ACL reconstruction surgery, but rather should dictate, to a greater extent, their own recovery timelines.

About Dr. Shelbourne

Dr. Shelbourne's specialties include orthopaedic and arthroscopic surgery, knee ligament reconstruction and rehabilitation. He also pioneered the contralateral ACL reconstruction for torn anterior cruciate ligaments and developed the accelerated ACL reconstruction rehabilitation protocol. Dr. Shelbourne's practice began in 1982 and includes clinic, surgery, therapy and a research department. He has focused his research toward advancing the surgical treatment and rehabilitation of anterior cruciate ligament (ACL) injuries. He has performed more than 5000 ACL reconstructions and closely monitors his patients' progress and results. This information is shared through the publication of over 150 journal articles and 40 book chapters.

Through his ongoing research, Dr. Shelbourne is able to provide up-to-date treatment and rehabilitation methods for patients world-wide. In 1994, Dr. Shelbourne began performing ACL reconstruction using the patellar tendon graft from the non-injured (contralateral) knee. This advancement in treatment offers patients the ability to rehabilitate their knee faster with more predictable results. Over 3000 patients have undergone this procedure and most athletes return to their desired sport by three months after surgery.

About Dr. Urch

Dr. Urch joined the Shelbourne Knee Center at Methodist Hospital in September 2006 after being in a sports medicine practice for 7 years in Virginia . Dr. Urch did his post-graduate fellowship under the direction of Dr. Shelbourne and was a co-investigator for the research on contralateral ACL reconstruction.

Dr. Urch has dedicated his practice solely to knee care including surgery and non-operative knee rehabilitation. He is currently involved with 6 ongoing research studies and has recently published several articles relating to the care of knee injuries. He is the team orthopedist for Wabash College and is an orthopaedic consultant for local area high schools.

Dr. Urch received his Bachelor of Arts degree in 1987 at the University of Virginia , where he also played football. After graduation, he played profession football before attending medical school. He received his medical degree from Temple University in Philadelphia , PA and then he returned to the University of Virginia to complete residency training.

The Shelbourne Knee Center at Methodist Hospital in Indianapolis provides specialized, world-class care for knees. With a focus on continuing research and cutting-edge surgical and rehabilitation techniques, the staff at the Shelbourne Knee Center is committed to providing unsurpassed care to all patients, whether professional athletes or weekend warriors. The rehabilitation department specializes in the treatment of knee pain and knee injuries, providing patients with one-on-one care and education. Driven by research and evidence-based practices to provide the most up to date treatment and information, the Shelbourne Knee Center takes time to develop a treatment plan that meets your individual needs and helps you meet your goals. For more information, visit www.aclmd.com.