The Orthopedic Center at CHOP is one of the largest and most established pediatric programs in the world dedicated to treating orthopedic and sports medicine conditions in children and adolescents. A core part of our mission is to improve children's lives through research. Our staff investigate a wide spectrum of topics including bone and joint disorders, congenital anomalies and injuries. Below are some highlights of publications from 2025 authored by our orthopedic and sports medicine staff.
How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis?
Safe alternatives to posterior spinal fusion (PSF) to treat idiopathic scoliosis have long been sought, and anterior vertebral body tethering (AVBT) has shown quite promising results. AVBT has been gaining popularity as the procedure allows for spinal growth and functional activities. In this FDA clinical trial led by Patrick J. Cahill, MD, the study team evaluated the surgical and health quality of life outcomes of PSF and AVBT. The study team found that PSF had better surgical outcomes and lower complication rates than AVBT. AVBT patients had shorter hospital stays and fewer spinal levels treated but had higher device-related complications including tether breakage and revision surgeries. AVBT might be better suited among kids who don’t respond well to bracing. Overall, while AVBT offers certain benefits, it carries higher complication rates and less reliable correction compared with PSF. Read the publication.
Lott C, Capraro A, Qiu C, Talwar D, Gordon J, Flynn JM, Anari JB, Cahill PJ. How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis? A Nonrandomized Clinical Trial. Clinical Orthopaedics and Related Research.
Partial Avulsion Patterns in the Pediatric Humeral Medial Epicondyle
In a study led by J. Todd Lawrence, MD, PhD, the study team described the fracture patterns with differential avulsion of the ulnar collateral ligament (UCL) and flexor pronator mass (FPM) attachment sites. The team identified two distinct fracture patterns: the proximal UCL avulsion fracture and the cortical sleeve avulsion. The incidence of these partial avulsion injuries were approximately 16% of all medial epicondyle fracture in our study. While these fracture types may theoretically respond to operative reduction and fixation differently, a classification system based on this schema may be clinically useful and help understand the natural history of these injuries. Read the publication.
Lee RC, Syed AN, Bowen MA, Lawrence JTR. Partial Avulsion Patterns in the Pediatric Humeral Medial Epicondyle. The American Journal of Sports Medicine.
Do Cerebral Palsy Scoliosis Patients With Postoperative Complications Have Worse CPCHILD Scores Two Years After Surgery?
Children with cerebral palsy (CP) often require surgical intervention to correct scoliosis, which, unfortunately, is associated with higher postoperative complications. In this collaborative study with Harms study group and Patrick J. Cahill, MD along with CHOP spine surgeons, researchers aimed to assess whether CP kids who experienced complications after spinal fusion surgery had worse health quality-of-life outcomes (HRQOL). This was measured using validated questionnaire CPCHILD. The study team found that there were no differences among HRQOL scores at two years postoperatively when compared between the patients who had postoperative complications versus those who didn’t. These results should reassure surgeons that as long as postoperative complications were timely identified and managed, patients still achieved their long-term HRQOL outcomes. Read the publication.
Desai VM, Coleman T, Stelzer JW, Bowen M, Anari JB, Flynn JM, Yaszay B, Sponseller P, Abel M, Cahill PJ, Harms Study Group. Do Cerebral Palsy Scoliosis Patients With Postoperative Complications Have Worse CPCHILD Scores 2 Years After Surgery? Journal of Pediatric Orthopaedics.
Morphological Risk Factors for Pediatric Anterior Cruciate Ligament Tears and Tibial Spine Fractures
In a study led by Theodore J. Ganley, MD, in a national collaboration with ASTEROID group, the study authors aimed to identify risk factors that cause pediatric anterior cruciate ligament (ACL) tears and tibial spine fractures (TSF) MRI. Researchers matched patients with ACL tears and TSF with those who had uninjured knee with pain on basis of sex and age. Articular lateral tibial slope was a risk factor for both ACL tears and TSF while high notch width index was a protective factor against ACL tears but not TSF. Study results can help inform clinicians for better risk counseling. Read the publication.
Shin CH, Syed AN, Swanson ME, Lawrence JT, Baghdadi S, Cruz Jr AI, Ellis Jr HB, Fabricant PD, Green DW, Kerrigan A, Kirby J, Shea KG, Ganley TJ. Morphological Risk Factors for Pediatric Anterior Cruciate Ligament Tears and Tibial Spine Fractures. The American Journal of Sports Medicine.
Loss of Reduction in Pediatric Distal Radius Fractures: Risk Factors from a Prospective Multicenter Registry
In this POSNA grant-funded study where CHOP researchers, including Apurva S. Shah, MD, MBA, collaborated with three other tertiary-referral academic children's hospitals in the Northeast and Midwest regions, the study team aimed to identify rates and risk factors of radiographic loss of reduction (LOR) of pediatric distal radius fractures. Among 616 children included in this study, the rate for radiographic LOR was 44%, and about 11% had 20 degrees or more shift in angulation. Approximately 8% had repeat closed reduction or surgery. Fractures with bicortical metaphyseal patterns, prereduction fracture translation >=51% of the radial shaft width, and nonanatomic closed reductions were at highest risk. The study findings highlight the importance of minimizing fracture translation at the time of closed reduction, so as to reduce the risk of redisplacement. Read the publication.
Shah AS, Belardo ZE, Miller ML, Willey MC, Mahan ST, Talwar D, Bae DS. Loss of Reduction in Pediatric Distal Radius Fractures: Risk Factors from a Prospective Multicenter Registry. Journal of the Pediatric Orthopaedic Society of North America.
Nerve Recovery in Pediatric Supracondylar Humeral Fractures: Assessing the Impact of Time to Surgery
Nerve injuries in pediatric supracondylar humeral (SCH) fractures occur in 2% to 35% of patients. Previous research has suggested that isolated anterior interosseous nerve injuries are not influenced by the time to surgery; however, little is known about other nerve injuries or mixed, motor and sensory injuries. With this study, the researchers, including J. Todd Lawrence, MD, PhD, examined the impact of time to surgery on nerve recovery in patients with traumatic nerve injuries associated with SCH fractures. Read the publication.
Syed, A.N., Isaacs, D., Ashebo, L., Talwar, D., Anari, J.B. and Lawrence, J.T.R., 2021. Nerve Recovery in Pediatric Supracondylar Humeral Fractures: Assessing the Impact of Time to Surgery. The Journal of Bone and Joint Surgery, pp. 10-2106.
Epiphyseal Morphology Following Successful Modified Dunn Procedure for SCFE
This study, led by Wudbhav N. Sankar, MD, along with seven other surgeons from four centers, evaluated the growth and developmental outcomes for modified Dunn procedure to treat serious hip condition, slipped capital femoral epiphysis (SCFE). The study results found that even when the procedure for modified Dunn surgery was successful, most hips were aspherical and did not improve over time. During subsequent follow-ups, narrowing of joint space was observed, which can impact long-term joint health. The findings suggest that while the surgery helps with SCFE, the hip may still not return to a completely “normal” spherical shape. Read the publication.
Sankar, W.N., Anderson, T., Novais, E., Kim, Y.J., Millis, M.B., Sucato, D.J., Podeszwa, D. and Zaltz, I., 2025. Epiphyseal Morphology Following Successful Modified Dunn Procedure for SCFE. Journal of Pediatric Orthopaedics, 45(10), pp. e916-e920.
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The Orthopedic Center at CHOP is one of the largest and most established pediatric programs in the world dedicated to treating orthopedic and sports medicine conditions in children and adolescents. A core part of our mission is to improve children's lives through research. Our staff investigate a wide spectrum of topics including bone and joint disorders, congenital anomalies and injuries. Below are some highlights of publications from 2025 authored by our orthopedic and sports medicine staff.
How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis?
Safe alternatives to posterior spinal fusion (PSF) to treat idiopathic scoliosis have long been sought, and anterior vertebral body tethering (AVBT) has shown quite promising results. AVBT has been gaining popularity as the procedure allows for spinal growth and functional activities. In this FDA clinical trial led by Patrick J. Cahill, MD, the study team evaluated the surgical and health quality of life outcomes of PSF and AVBT. The study team found that PSF had better surgical outcomes and lower complication rates than AVBT. AVBT patients had shorter hospital stays and fewer spinal levels treated but had higher device-related complications including tether breakage and revision surgeries. AVBT might be better suited among kids who don’t respond well to bracing. Overall, while AVBT offers certain benefits, it carries higher complication rates and less reliable correction compared with PSF. Read the publication.
Lott C, Capraro A, Qiu C, Talwar D, Gordon J, Flynn JM, Anari JB, Cahill PJ. How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis? A Nonrandomized Clinical Trial. Clinical Orthopaedics and Related Research.
Partial Avulsion Patterns in the Pediatric Humeral Medial Epicondyle
In a study led by J. Todd Lawrence, MD, PhD, the study team described the fracture patterns with differential avulsion of the ulnar collateral ligament (UCL) and flexor pronator mass (FPM) attachment sites. The team identified two distinct fracture patterns: the proximal UCL avulsion fracture and the cortical sleeve avulsion. The incidence of these partial avulsion injuries were approximately 16% of all medial epicondyle fracture in our study. While these fracture types may theoretically respond to operative reduction and fixation differently, a classification system based on this schema may be clinically useful and help understand the natural history of these injuries. Read the publication.
Lee RC, Syed AN, Bowen MA, Lawrence JTR. Partial Avulsion Patterns in the Pediatric Humeral Medial Epicondyle. The American Journal of Sports Medicine.
Do Cerebral Palsy Scoliosis Patients With Postoperative Complications Have Worse CPCHILD Scores Two Years After Surgery?
Children with cerebral palsy (CP) often require surgical intervention to correct scoliosis, which, unfortunately, is associated with higher postoperative complications. In this collaborative study with Harms study group and Patrick J. Cahill, MD along with CHOP spine surgeons, researchers aimed to assess whether CP kids who experienced complications after spinal fusion surgery had worse health quality-of-life outcomes (HRQOL). This was measured using validated questionnaire CPCHILD. The study team found that there were no differences among HRQOL scores at two years postoperatively when compared between the patients who had postoperative complications versus those who didn’t. These results should reassure surgeons that as long as postoperative complications were timely identified and managed, patients still achieved their long-term HRQOL outcomes. Read the publication.
Desai VM, Coleman T, Stelzer JW, Bowen M, Anari JB, Flynn JM, Yaszay B, Sponseller P, Abel M, Cahill PJ, Harms Study Group. Do Cerebral Palsy Scoliosis Patients With Postoperative Complications Have Worse CPCHILD Scores 2 Years After Surgery? Journal of Pediatric Orthopaedics.
Morphological Risk Factors for Pediatric Anterior Cruciate Ligament Tears and Tibial Spine Fractures
In a study led by Theodore J. Ganley, MD, in a national collaboration with ASTEROID group, the study authors aimed to identify risk factors that cause pediatric anterior cruciate ligament (ACL) tears and tibial spine fractures (TSF) MRI. Researchers matched patients with ACL tears and TSF with those who had uninjured knee with pain on basis of sex and age. Articular lateral tibial slope was a risk factor for both ACL tears and TSF while high notch width index was a protective factor against ACL tears but not TSF. Study results can help inform clinicians for better risk counseling. Read the publication.
Shin CH, Syed AN, Swanson ME, Lawrence JT, Baghdadi S, Cruz Jr AI, Ellis Jr HB, Fabricant PD, Green DW, Kerrigan A, Kirby J, Shea KG, Ganley TJ. Morphological Risk Factors for Pediatric Anterior Cruciate Ligament Tears and Tibial Spine Fractures. The American Journal of Sports Medicine.
Loss of Reduction in Pediatric Distal Radius Fractures: Risk Factors from a Prospective Multicenter Registry
In this POSNA grant-funded study where CHOP researchers, including Apurva S. Shah, MD, MBA, collaborated with three other tertiary-referral academic children's hospitals in the Northeast and Midwest regions, the study team aimed to identify rates and risk factors of radiographic loss of reduction (LOR) of pediatric distal radius fractures. Among 616 children included in this study, the rate for radiographic LOR was 44%, and about 11% had 20 degrees or more shift in angulation. Approximately 8% had repeat closed reduction or surgery. Fractures with bicortical metaphyseal patterns, prereduction fracture translation >=51% of the radial shaft width, and nonanatomic closed reductions were at highest risk. The study findings highlight the importance of minimizing fracture translation at the time of closed reduction, so as to reduce the risk of redisplacement. Read the publication.
Shah AS, Belardo ZE, Miller ML, Willey MC, Mahan ST, Talwar D, Bae DS. Loss of Reduction in Pediatric Distal Radius Fractures: Risk Factors from a Prospective Multicenter Registry. Journal of the Pediatric Orthopaedic Society of North America.
Nerve Recovery in Pediatric Supracondylar Humeral Fractures: Assessing the Impact of Time to Surgery
Nerve injuries in pediatric supracondylar humeral (SCH) fractures occur in 2% to 35% of patients. Previous research has suggested that isolated anterior interosseous nerve injuries are not influenced by the time to surgery; however, little is known about other nerve injuries or mixed, motor and sensory injuries. With this study, the researchers, including J. Todd Lawrence, MD, PhD, examined the impact of time to surgery on nerve recovery in patients with traumatic nerve injuries associated with SCH fractures. Read the publication.
Syed, A.N., Isaacs, D., Ashebo, L., Talwar, D., Anari, J.B. and Lawrence, J.T.R., 2021. Nerve Recovery in Pediatric Supracondylar Humeral Fractures: Assessing the Impact of Time to Surgery. The Journal of Bone and Joint Surgery, pp. 10-2106.
Epiphyseal Morphology Following Successful Modified Dunn Procedure for SCFE
This study, led by Wudbhav N. Sankar, MD, along with seven other surgeons from four centers, evaluated the growth and developmental outcomes for modified Dunn procedure to treat serious hip condition, slipped capital femoral epiphysis (SCFE). The study results found that even when the procedure for modified Dunn surgery was successful, most hips were aspherical and did not improve over time. During subsequent follow-ups, narrowing of joint space was observed, which can impact long-term joint health. The findings suggest that while the surgery helps with SCFE, the hip may still not return to a completely “normal” spherical shape. Read the publication.
Sankar, W.N., Anderson, T., Novais, E., Kim, Y.J., Millis, M.B., Sucato, D.J., Podeszwa, D. and Zaltz, I., 2025. Epiphyseal Morphology Following Successful Modified Dunn Procedure for SCFE. Journal of Pediatric Orthopaedics, 45(10), pp. e916-e920.
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