- Brian Grisez 2016-2017
- Phillip Bostian 2015-2016
- Jonathan Karnes 2014-2015
- Andrew Hanselman 2013-2014
- Karim Boukhemis 2012- 2013
A Year in the Lab
During my research year I was involved in many different projects. Some of which I came up with on my own and others to which I contributed. The thing that stood out to me the most about my research year was the autonomy I was given in the lab. I was given the freedom and the resources to explore my own research questions. This gave me valuable experience in creating a research project from start to finish. This included creating a project proposal, obtaining funding through grants, gaining approval from review boards, and carrying out the investigation. I feel that overall, this experience will serve me well in the future in whatever career path I choose.
The project that I chose to focus on primarily involved the study of orthopaedic hardware infections. I created an in vitro model for the study of S. aureus biofilm in co-culture with K12 osteosarcoma cells on common orthopaedic biomaterials. I studied their interactions both qualitatively and quantitatively using colony forming units (CFU’s), cell counts, and scanning electron microscopy (SEM). I hope to use this model in the future to test nano-coatings imbedded with anti-bacterial peptides that will inhibit biofilm formation and promote tissue cell attachment and proliferation.
I was also involved in studies being carried out by our Ph.D. faculty, Dr. Ming Pei and Dr. Bing Li that inovled animal models. Dr. Pei received an NIH grant to investigate adipose stem cells and bone regeneration in rat calvarial defects. With the help of Dr. Pei and our research assistants, Nina Clovis and Suzanne Smith, we designed a surgical model to create the rat calvarial defects and implant the adimpose stem cells and stem cell matrix. With Dr. Li, I was involved in using a rat open femur fracture model designed by Dr. Brock Lindsey, a former research resident and current lab director, to investigate bioluminescent bacteria. These projects gave me valuable experience in micro-surgery which will serve me well as I complete the remainder of my residency training.
Overall, I felt my year in the lab was very worthwhile. I would encourage anyone, regardless of research background to apply. Our lab personnel including Nina Clovis, Sheila Rye, and Suzanne Smith along with our lab director Dr. Brock Lindsey are ready and willing to work with you in directing your research interests and helping you produce a finished product by the end of your lab year.
My research year was a positive experience. Our lab staff is phenomenal; it includes lab manager Nina Clovis and Suzanne Smith who provides grant writing and editing support. Our clinical research support person is Sheila Rye and engineering and basic science support comes from Vince Kish and Jabeen Noore. The lab year is truly unique because it allows us to be completely free from clinical duties, which gives us plenty of time to read and work continuously on various projects, as well as the ability to moonlight. I also had a number of opportunities to work on microsurgery skills with Nina Clovis, which positively impacted my microscope skills upon my return to clinical rotations.
During the year, I participated in an ongoing study with Dr. Bingyun Li, which was started by a previous research resident, Dr. Brock Lindsey. Dr. Lindsey developed a fracture infection model using rats. The animals were anesthetized and underwent a femur fracture, which was infected with Staphylococcus aureus and then fixed using a Kirschner wire as an intramedullary device. The animals had a blood draw and x-rays at 10 days and, ultimately, fracture healing and presence of infection were assessed. We operated on several groups of rats using differing combinations of bacteria, microcapsules, and immunomodulators to assess the efficacy of various interventions on infection rates. Previous data in this area have been encouraging.
My primary clinical research project involved testing the self-application of various tourniquets, one of which is currently used by the US Army. Dr. David Hubbard is the primary investigator of this study. Subjects were trained in the application of three tourniquets in the same fashion as military recruits and were then timed in the application of each of these tourniquets individually. Also, we tested a combination of two tourniquets simulating tourniquet failure. There is currently no model in the literature for tourniquet failure so we created a model where the first tourniquet applied was loosened to allow blood flow. The tourniquet combination applications were timed and effectiveness of stopping blood flow was determined using Doppler. The data analysis is ongoing and we will be submitting the results for presentation later this year.
I worked on a variety of manuscripts and smaller projects this year as well. Currently, I have two articles accepted for publication. One is regarding surgical treatment of adolescent idiopathic scoliosis which is accepted to Spine, written with Dr. Scott Daffner. The second article involves a retrograde femoral nail with Dr. Frank Shuler, accepted to the Journal of Trauma. Finally, I participated in chart reviews on proximal humerus fractures with Dr. Kelly Bal, Wagner stem follow-up with Dr. Brian Hamlin, isthmic spondylolisthesis with Dr. John France, pediatric trampoline injuries with Dr. Frank Shuler, and ATV accidents with Dr. Sanford Emery.
In conclusion, I feel my lab year helped me grow as a clinician and a researcher, giving me skills in basic science research, scientific decision making and manuscript preparation that will serve me well in the years to come.
As you may know from reviewing some of the materials about our residency program, one of the three incoming residents each year spends an extra year in the Musculoskeletal Research lab between the first and second year. As the second resident to complete the research year, I completely agree with Brock that the experience has been a very positive one.
First of all, I want to stress the phenomenal support from Dr. Emery and the department for pursuing your research goals. The Musculoskeletal research lab is rapidly growing with new personnel and projects starting all of the time. The research year is fully “protected”, meaning you take no call for the entire year, and you are not pulled out of the lab to go help cover clinic or other clinical duties. As the research resident, you have complete freedom in choosing which project you want to spend your time working on. You may join in one of the several already open projects or develop your own idea for a project, and Dr. Emery, the department, and the lab personnel will do whatever they can to help get your project running. The lab facilities are excellent for whatever you may need. We have a fully functional OR for animal surgeries, a microsurgery room with two operating microscopes, an arthroscopy wet lab, and an anatomy room with readily available cadaver material for dissection or to practice surgical approaches/procedures. We have our own x-ray equipment and developer. We also have dedicated areas for Histology preparation, microbiology, and cell culture. Our department has a great working relationship with several other departments in the School of Medicine including Immunology, Histology, Cardiology, and Pathology that can be invaluable collaborators on various projects. So, overall, the infrastructure is there for whatever research idea you may have.
My decision to spend an extra year working in the lab was based on two objectives; first, I wanted to gain a better understanding of the process of developing and carrying out orthopaedic related research projects, and second, I wanted to work on developing some critical reasoning, analytical, and surgical skills that would benefit me for the rest of my career. I did not really have much of a research background coming into this year, but that was not a problem. There is plenty of support and help available to answer any question or problem you may encounter. Additionally, I feel like I have been able to develop valuable skills in developing research projects, analyzing pertinent orthopaedic and scientific literature, surgical planning, and microsurgical skills that will benefit me through the remainder of my residency and should help me to secure a more competitive fellowship spot.
As I have mentioned, the support staff in the lab is always more than willing to help out with any questions or problems that may come up. They are a very dedicated and hard working group and have the experience necessary to make everything seem to run smoothly. Need help designing or performing surgical procedures on cadaver material or test animals? Nina and Suzanne can help first assist and circulate. Need help building a particular device or machine for one of your projects? Vince can help design and build it. Need assistance with writing and proofreading study design protocols or grant proposals? Nina, Suzanne, and Susan have their red pens ready. Need help with preparing tissue for histology, Flo Cytometry, or running ELISA’s, or have another basic science related question? Sydha has the answer.
During my lab year, I have been involved in a number of different projects, from basic science to clinical research. The main project I have been working on is looking at the effect of the cytokine Interleukin-12 on infection reduction using an infected open fracture model in rat femurs that Brock designed and developed last year. We operate on the rat femurs under the operating microscope, which has certainly helped improve my microsurgical skills. But, I also have gained knowledge in the areas of immunology, microbiology, histology, and orthopaedic basic science through this project. Additionally, I have developed a clinical project looking at potential falsely elevated Troponins in Spine fusion patients. I have worked on a cadaver project looking at different x-rays views of the distal radius. Also, I have helped collaborate on a number of tissue engineering projects with meniscal grafts and articular cartilage in different animal models with Dr. Pei, and have been working with Dr. Li on using IL-12 nanocoatings on orthopaedics implants for infection prevention in the same rat model above.
My year in the lab has been a very positive one. In addition to getting a good research background and developing some very interesting projects, my schedule has been much more flexible, leaving more time for academic reading and free time. Additionally, the research resident is allowed to moonlight, which is a great way to make a little extra money but also to have some clinical interaction with patients and to develop some of the vital clinical reasoning and decision making skills that many second year residents do not have a chance to develop fully while working under an attending physician.
Hopefully, I have helped shed some light on the lab year for those of you that may be interested in pursuing that option.
Brandon M Boyce, M.D.
I am writing this little blurb to those of you who may be looking into coming to West Virginia University for your orthopaedic residency. Since being at WVU for residency, I have been extremely pleased with my program both from a professional and social aspect. I find myself surrounded by great people both in the faculty, my fellow residents and support staff as well. Specifically I want to tell you about doing the six-year research track here at WVU. The infrastructure and facilities for doing orthopaedic research are exceptional in my experience. The lab staff are extremely good people, easy to work with, hard working and fun to be around as well. The great thing about them is if we don’t have it, they know someone who does or they can build it for you (not joking). I also have found other departments in the Health Sciences Center very helpful as well, especially the Immunology/Microbiology and Pathology Departments.
I am currently working on several projects that cross several specialties. The first project involved Open Fracture Infection Prevention Using Interleukin-12 Therapy in a Rat Model. This project is based on the fact that in the murine/rat model, a traumatic injury causes a form of immunosuppression that may lead to an increase in infection rats after being subjected to these injuries. The project specifically is trying to restore the immune system to its full strength by using interleukin supplementation. I have been able to perform multiple microsurgeries for rat femur fixation and learn more than I ever thought possible about immunology/microbiology. I also learned how to write an animal care and use protocol (IRB for animals) and grants. During my year in the lab, I have been awarded two grants, one from the Orthopaedic Research and Education Foundation and one from the Orthopaedic Trauma Association. Many of these skills have been directly learned from the lab staff which they have great experience with. The second major study involves Vertebral Disc Repair for Disc Herniation Using Porcine Small Intestine Submucosa in a Rabbit Model. This has been an excellent study for me surgically. I have been able to work closely with Dr. Emery doing laminotomies on rabbit spines under the operative microscope. This has been very helpful in learning how to manage epidural vein bleeding while maintaining a good view of the intervertebral disc and getting experience using many of the same instruments that we use in humans. Another project involved T2-mapping to measure articular cartilage wear in collegiate athletes. This project has taught me a lot about MRI’s and statistics. I also am working on three or four other projects that involve LISS plates, arthrotomies, rotator cuff repairs and the RIA system.
The education that I am getting both through actual experience and reading (there is much more time for this during research than in your clinical years) is invaluable especially since I plan on doing academic medicine. The other up side has been the ability to do some other things with my free time as well. I have been moonlighting at a local Fast Track to pay some extraneous bills and I have been able to snowboard, kayak and mountain bike a little more this year.
The freedom and support that Dr. Emery has allowed me has been exceptional. Once again, I cannot stress the importance of working with good people and the orthopaedic lab has some great ones. Thanks for your time and consideration.
Brock Lindsey, MD