Faculty

Faculty Bios

Andrew
  • Andrew Howard MD, FRCSC, MSc

  • Chief, Division of Orthopaedics
  • Senior Scientist, Child Health and Evaluative Sciences
  • Director, University Office of International Surgery
  • From: High Prairie, Alberta, Canada
  • Medicine: Queen’s University, Kingston
  • Residency: Queen’s University, Kingston
  • Graduate: University of Ottawa
  • Fellowship:

  • Paediatric Orthopaedics:
  • The Hospital for Sick Children,Toronto
  • Clinical Practice:

  • Skeletal dysplasias
  • Childhood osteoporosis
  • Lower extremity deformity
  • Spinal deformity
  • Complex trauma
  • Research:

  • Injury prevention
  • International surgery
  • Clinical epidemiology
“I operate on all regions of the axial and appendicular skeleton, both acutely and for reconstruction or deformity correction. Deformities from trauma, osteogenesis imperfecta and skeletal dysplasias form a large part of my elective practice. When working with me the fellow will teach the residents how to operate on common fractures, and will learn to operate on complex fractures and deformities.”
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Sevan
  • Sevan Hopyan MD, PhD, FRCSC

  • Assistant Professor, Division of Orthopaedic Surgery
  • Scientist, Developmental and Stem Cell Biology
  • From: Toronto, Canada
  • Medicine: University of Toronto
  • Residency: University of Toronto
  • Graduate:University of Toronto
  • Fellowship:

  • Paediatric Orthopaedics:
  • The Royal Children’s Hospital, Melbourne, Australia
  • Orthopaedic Oncology:
  • St. Vincent’s Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia
  • Clinical Practice:

  • Orthopaedic oncology
  • Brachial plexus palsy sequela reconstruction
  • Congenital anomalies
  • Research:

  • Early limb bud development
  • Limb salvage outcomes
  • Upper extremity outcomes
“Working with me, fellows will learn a contemporary approach to benign and malignant tumours, as well as to brachial plexus birth palsy. They will practice dissection skills, perform intralesional and wide resection, and undertake reconstruction using biologic and endoprosthetic techniques specific to children.”
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Jim
  • James G. Wright MD, MPH, FRCSC

  • Chief of Perioperative Services and Surgeon-in-Chief
  • Robert B. Salter Chair
  • Senior Scientist, Research Institute
  • Professor of Surgery and Health Policy, Management, and Evaluation
  • University of Toronto
  • From: Nova Scotia, Canada
  • Medicine: Dalhousie University, Halifax
  • Residency: University of Toronto
  • Fellowship:

  • Paediatric Orthopaedics:
  • The Royal Children’s Hospital, Melbourne, Australia
  • Healthcare Leadership:
  • Robert Wood Johnson Clinical Scholars Program
  • Yale University, Connecticut
  • Clinical Practice:

  • Primary and recurrent clubfeet
  • Other foot disorders
  • Spina bifida
  • Neuromuscular disorders
  • Scoliosis
  • Research:

  • Clinical epidemiology
  • Surgical safety
  • Reducing surgical wait times
  • Unmet need and disparity in health care
  • Patient-specific outcome measures
“Working with me, fellows will systematically deconstruct multi-segmental foot deformities and learn to undertake corrective osteotomies and soft tissue reconstruction. Fellows will also learn all the rare procedures performed for spina bifida.”
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Simon
  • Simon Kelley MBChB, FRCS (Tr and Orth)

  • Assistant Professor, Division of Orthopaedic Surgery
  • Project Investigator, Developmental
  • and Stem Cell Biology
    • From: Bath, UK
    • Medicine: University of Birmingham, UK
    • Residency: Leeds and Bristol, UK
    • Fellowship:

    • Limb Reconstruction:
    • The Royal Children’s Hospital,
    • Melbourne, Australia
    • Trans-Canada Paediatric Orthopaedics:
    • The Hospital for Sick Children, Toronto
    • Shriners Hospital for Children, Montreal
    • BC Children’s Hospital, Vancouver

    • Clinical Practice:
    • Congenital limb deficiencies
    • Hip surgery
    • Skeletal dysplasias
    • Post-traumatic limb deformity
    • Trauma
    • Research:

    • Bone regeneration
    • Limb reconstruction outcomes
    • Hip dysplasia outcomes
    • “Working with me, fellows will learn about all aspects of limb reconstruction including modern analysis techniques and operative reconstruction with circular, monolateral and implantable devices. They will also be exposed to a large volume of hip pathology and surgery including the full range of femoral and pelvic osteotomies including hip dislocation and articulated hip distraction.”
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Reinhart
  • Reinhard Zeller MD, FRCSC

  • Associate Professor, Division of Orthopaedic Surgery
  • Head, Spine Program
  • From: Paris, France
  • Medicine: University of Paris
  • Residency: University Hospitals of Paris
  • Fellowship:

  • Paediatric Spine Surgery:
  • Saint Vincent de Paul Hospital, Paris, France
  • Paediatric Orthopaedics:
  • Texas Scottish Rite Hospital for Children, Dallas, Texas
  • Clinical Practice:

  • Complex spine surgery in children
  • Early onset and late onset scoliosis
  • Complex congenital scoliosis
  • High grade spondylolisthesis
  • Research:

  • Spine deformity correction outcomes
  • 3D spinal deformity analysis
“When working with me fellows will learn how to safely and efficiently treat complex spinal deformities, to understand and analyse three dimensional aspects of scoliotic deformity. They will also acquire the technical skills to carry out successful spinal deformity correction.”
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John
  • John Wedge OC, mD, FRCSC

    • Professor, Division of Orthopaedic Surgery
      Faculty of Medicine, University of Toronto
  • From: Saskatoon, Canada
  • Medicine: University of Saskatchewan
  • Residency: McGill University, Montreal
  • and University of Saskatchewan, Saskatoon
  • Fellowship:

  • Paediatric Orthopaedics:
  • The Hospital for Sick Children, Toronto
  • Clinical Practice:

  • Hip reconstruction in children and young adults
  • Cerebral palsy
  • Surgical education
  • Research:

  • Hip reconstruction outcomes
  • Developmental dysplasia of the hip
  • Avascular necrosis of the proximal femur
“When working with me, the fellow will see and discuss the full range of hip pathology. In the operating room they will learn the classic open reduction and innominate osteotomy. They will also learn the surgical management of hip conditions such as Perthes disease, SCFE, Coxa Vara and neuromuscular disease.”
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Steve
  • Stephen Lewis MD, MSc, FRCSC

  • Associate Professor, Division of Orthopaedic Surgery
  • The Hospital for Sick Children and The Toronto Western Hospital
  • From: Montreal, Canada
  • Medicine: McGill University, Montreal
  • Residency: University of Toronto
  • Graduate: University of Toronto
  • Fellowship:

  • Adult Spine and Trauma:
  • St. Michael’s Hospital, Toronto
  • Spinal Deformity:
  • Washington University, St. Louis
  • Clinical Practice:

  • Spinal deformity in children and young adults
  • High grade spondylolisthesis
  • Complex congenital scoliosis
  • Spinal osteotomies
  • Research:

  • Spine deformity correction outcomes
  • Surgical skill acquisition
  • “When working with me, the fellow will experience a wide variety of spinal deformities. They will learn to become comfortable with a range of spinal instrumentation techniques and perform advanced procedures such as pedicle subtraction osteotomies, Smith-Peterson osteotomies and vertebral column resection.”
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Lucas
  • Lucas Murnaghan MD, MEd, FRCSC

  • Assistant Professor, Division of Orthopaedic Surgery
  • Educator Researcher, The Wilson Centre
  • Surgical Director, MacIntosh Sports Medicine Clinic
  • From: Ottawa, Canada
  • Medicine: Queen’s University, Kingston
  • Residency: University of British Columbia
  • Graduate: University of British Columbia
  • Fellowship:

  • Arthroscopy and Athletic Injuries:
  • University of British Columbia
  • Paediatric Orthopaedics:
  • The Royal Children’s Hospital, Melbourne, Australia
  • Texas Scottish Rite Hospital for Children, Dallas, Texas
  • Clinical Practice:

  • Sports medicine and arthroscopy in children and young adults
  • Paediatric orthopaedics and Trauma
  • Research:

  • Surgical education
  • Children’s minimally invasive surgery outcomes
“Working with me, the fellow will develop surgical skills specific to the treatment of acute and chronic injuries in the growing athlete. This will include a broad experience in arthroscopy of the shoulder, elbow, hip, knee and ankle.”
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Unni
  • Unni G. Narayanan MBBS, MSc, FRCSC

  • Associate Professor, Division of Orthopaedic Surgery
  • Child Health Evaluative Sciences Program
  • Scientist, Bloorview Research Institute
  • From: Madras, India
  • Medicine: Madras Medical College, India
  • Residency: University of Minnesota, Minneapolis
    • Fellowship:

  • Cerebral Palsy and Gait Analysis:
  • Gillette Children’s Hospital
  • University of Minnesota, St. Paul, MN, USA.
  • Paediatric Orthopaedics:
  • The Hospital for Sick Children, Toronto
  • AAOS/OREF Health Services Research Fellowship:
  • University of Toronto
  • Clinical Practice:

  • Cerebral Palsy
  • Lower limb length discrepancy and complex deformity correction
  • Clubfeet and other foot disorders
  • Trauma
  • Research:

  • Patient Priorities and Outcome Measurement
  • Clinical Trials and Epidemiology
  • Outcomes Research
“Working with me, fellows will learn a goal based approach to decision making and surgical management of ambulatory and non-ambulatory children with chronic developmental disabilities, especially cerebral palsy. The fellow will learn how to plan for, and execute the surgical management of a broad spectrum of congenital, developmental and acquired limb deformities and limb length inequalities.”
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Selected Faculty Publications 2012–2013




  1. SELECT FACULTY PUBLICATIONS IN 2012–2013

  2. Ho L, Ali SA, Al-Jazrawe M, Kandel R, Wunder JS, Alman BA. Primary cilia attenuate hedgehog signaling in neoplastic chondrocytes. Oncogene. 2012 Dec 17. doi: 10.1038.
  3. Jones KB, Ferguson PC, Lam B, Biau DJ, Hopyan S, Deheshi B, Griffin AM, White LM, Wunder JS. Effects of neoadjuvant chemotherapy on image-directed planning of surgical resection for distal femoral osteosarcoma. The Journal of Bone and Joint Surgery. 2012 Aug 1;94(15):1399-405.
  4. Jarvis JG, Strantzas S, Lipkus M, Holmes LM, Dear T, Magana S, Lebel DE, Lewis SJ. Responding to neuromonitoring changes in 3-column posterior spinal osteotomies for rigid pediatric spinaldeformities. Spine. 2013 Apr 15;(8): E493-503.
  5. Gunton MJ, Carey JL, Shaw CR, Murnaghan ML. Drilling juvenile osteochondritis dissecans: retro- or transarticular? Clinical Orthopaedics and Related Research. 2013 Apr;471(4):1144-51.
  6. Leung A, Luu S, Regehr G, Murnaghan ML, Gallinger S, Moulton CA. “First, do no harm”: balancing competing priorities in surgical practice. Academic Medicine. 2012 Oct;87(10):1368-74.
  7. Bae DS, Howard AW. Distal radius fractures: what is the evidence? Journal Pediatric Orthopedics. 2012 Sep;32 Suppl 2:S128-30.
  8. Mehlman CT, Howard AW. Medial epicondyle fractures in children: clinical decision making in the face of uncertainty. Journal Pediatric Orthopedics. 2012 Sep;32 Suppl 2:S135-42.
  9. Narayanan UG. Management of children with ambulatory cerebral palsy: an evidence-based review. Journal of Pediatric Orthopedics. 2012 Sep;32 Suppl 2:S172-81.
  10. Kelley SP, Wedge JH. Management of Hip Instability in Trisomy 21. J Paediatr Orthop 2013 Jul-aug;33 suppl 1:S33-8.
  11. Heng M, Wright JG. Dedicated operating room for emergency surgery improves access and efficiency. Canadian Journal of Surgery. 2013 Jun;56(3):167-74.

Special Procedure

Special procedure: All Epiphyseal ACL

By Dr. Lucas Murnaghan

With the increased participation of growing athletes in organized sport, pediatric ACL injuries are becoming more common. Recent literature has demonstrated that early and reliable stabilization of the rotational and translational instability of the knee is crucial for the preservation of meniscal and articular cartilage integrity. The surgical management of ACL injuries in the growing athlete requires special consideration. Traditional ACL reconstructions cross the open growth plates about the knee: distal femur and proximal tibia. Growth disturbance following such reconstructions has been reported and presents a concern due to the percentage of overall growth of the lower extremity that these growth plates contribute. In response to this, Allen Anderson from Nashville, TN described an all-epiphyseal ACL reconstruction. His technique allows for an anatomic reconstruction that spares thephysis. My preferred technique is a modification of his original description and keeps not only the femoral and tibial tunnels within the physis, but also the fixation of the graft. My indication for this procedure is a patient with greater than three years of growth remaining.

Technical Steps

Using this technique, my standard ACL set-up provides all of the equipment necessary. I use mini C-arm fluoroscopy for visualization of the epiphysis and ensuring that my tunnels are accurately placed. I begin with harvesting the tendons of gracilis and semitendinosus and prepare the graft on the back table to form a quadrupled hamstring graft. Knee arthroscopy follows with management of meniscal or cartilage pathology. I use fluoroscopy to achieve a perfect lateral of the distal femur in order to place the guide wire for the femoral tunnel. The position is confirmed arthroscopically and over-reamed to the size of the graft. Similarly, the tibial tunnel is drilled using fluoroscopic guidance.

Rehab

I use a knee immobilizer for 2 weeks post operatively for comfort and begin early work on regaining full extension. I use a closely supervised goal-based physiotherapy protocol post-operatively with return to sport at 6 months once return to sport criteria have been met. I follow my patients with annual clinical examinations and radiographs until skeletal maturity.

Fixation

Once the tunnels are prepared, the graft is passed from proximal to distal and the Endobutton Direct is flipped on the anterior cortex of the tibia. The graft is tensioned in 20 degrees of flexion and the femoral side fixated with an interference screw. Stability and knee range are confirmed and surgical sites closed.

All Epiphyseal ACL ACL Infographic

Faculty Publications and Impact Factors 2013

Faculty

*Hover over the names or the circles for more details.

Faculty Presentations and Courses 2012–2013

  1. Academy of Pediatrics National Conference and Exhibition
  2. Alberta Children’s Hospital
  3. AOSpine
  4. Broad Water 22nd Annual Dr. Tom Lowe Spine Symposium
  5. Childhood Cancer Awareness Symposium, London Health Sciences Centre
  6. Children’s Hospital, British Columbia
  7. Chilean Orthopaedic Association
  8. Department of Orthopaedics, University of Cincinatti
  9. Department of Orthopaedics, University of Western Ontario
  10. Developmental Biology Division, Cincinnatti Children’s Hospital
  11. Division of Orthopaedics, Cincinnatti Children’s Hospital
  12. European Paediatric Orthopedic Society
  13. Gordon Research Conference on Cartilage Biology & Pathology
  14. Gordon Research Conference on Musculoskeletal Biology and Bioengineering
  15. International Cerebral Palsy Conference
  16. International Hip Dysplasia Institute
  17. International Paediatric Orthopaedic Symposium
  18. International Pediatric Orthopedic Think Tank
  19. Orthopaedic Sports Medicine and FIFA
  20. Lady Davis Institute for Medical Research
  21. Medtronic
  22. OA Spine
  23. Ontario Stem Cell Initiative, Stem Cell Rounds 2012
  1. Orthopaedic Research Society
  2. Osteoarthritis Research Society International (OARSI)
  3. POSNA
  4. Rocky Mountain Hospital for Children, POSNA, AOSSM
  5. Rolanette and Berdon Lawrence Bone Disease Program of Texas
  6. Scoliosis Research Society
  7. Society for Developmental Biology
  8. St. Justine Paediatric Orthopaedic Review Course
  9. Stryker
  10. The Canadian Orthopaedic Association
  11. The Canadian Orthopaedic Residents Association
  12. The Desmoid Tumor Research Foundation
  13. The Hospital for Sick Children
  14. The Hospital for Sick Children, Department of Interventional Radiology
  15. The Hospital for Sick Children, Perioperative Services and the Department of Surgery
  16. The Pediatric Orthopaedic Practitioners Society
  17. The Wilson Centre
  18. University of Pennsylvania
  19. University of Toronto, Department of Surgery
  20. University of Toronto, Spine Program
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“It is hard to express what the SickKids experience has meant to me. I have been stretched in so many different ways. If I had to pick out one thing it would be the approach to tackling difficult problems. There is no way to see everything in a fellowship that one will encounter throughout an individual’s lifetime. However, SickKids has provided me with a principle-based approach to clinical problem solving that I greatly appreciate. It is one of the many benefits of training at a program with such a wide array of staff and fellows with different educational backgrounds. This is a special place.”
— Brant Sachleben (Alumnus 2013)