Westinghouse Scientific Lecture2018

Dr. Freddie H. FuDistinguished Service Professor

David Silver Professor and ChairmanDepartment of Orthopaedic Surgery

University of Pittsburgh Head Team Physician

University of Pittsburgh Athletic Department

Medicine is an Art Based on Principle

Work with Nature1920 1940

1975

Historical South Side

University of Pittsburgh 1787

Medical School 1886

#5 in NIH Funding – $473M

• $19 Billion Enterprise

• 80,000 Employees

• 41 Hospitals

UPMC New $2 Billion Complex UPMCRooney Sports Performance Complex

UPMCRooney Sports Performance Complex

UPMC Freddie Fu Sports Medicine CenterNovember 9, 2018

UPMC Freddie Fu Sports Medicine CenterNovember 9, 2018

UPMCLemieux Sports Performance Complex

�Just do the right thing�

�Take good care of your patients and they will take good care of you�

Prof. Albert B. Ferguson, M.D.Chairman: 1953-1986

How Do You Tear The ACL?

How Do You Tear The ACL? How Do You Tear The ACL?

How Do You Tear The ACL? How Do You Tear The ACL?

Examination of a Torn ACL

AM

PL90º

What Does the ACL Look Like?

Arthroscopy Torn ACL

“Lucy” – 3.2 million years old

Lovejoy, Fu, et al

Lucy Modern Human

Dr. Owen Lovejoy

Bony Morphology ó ACL

Human knee Gorilla knee

Form Follows Function

Variation in Range of Motion Between Species

Lion Polar bear

TigerCotton top

Say what? you have 3 bundles?

§ 12 yr old male

§ Biting and pinching on left knee for several months§ Showing left knee to the zookeeper multiple times

Mandrill

Physical Examination■ Johnny is doing well■ No more biting and pinching of knee■ Good motion

After the Surgery

Curtis Martin

Dan Marino

Football2012 NFL Hall of Fame

Gordon Fu

Ice Hockey

Sydney Crosby

Medical Staff

Charles Smith

Suzie McConnellPittsburgh Panthers

Basketball

Dejuan Blair

Yao MingHouston Rockets 2002-2011

2002 2017

Basketball

Pelé

Roberto Baggio

Soccer

Zlatan IbrahimovicApril 21, 2017

Soccer

April 21, 2017

Torn ACL

Zlatan IbrahimovicZlatan Ibrahimovic

April 28, 2017

Zlatan Ibrahimovic

Zlatan Ibrahimovic

August 21, 2017

Zlatan Ibrahimovic

4 months Postoperative

December 20, 2017

7 months Postoperative

Zlatan Ibrahimovic

11 months Postoperative

Zlatan Ibrahimovic

16 months Postoperative

Zlatan Ibrahimovic

500th Career Goal!17 months Postoperative

Zlatan Ibrahimovic

Concussion

The Movie

The Hit

Steelers vs Bengals AFC Wildcard Game

Symptoms of Concussion

ImPACTImmediate Post-Concussion Assessment and Cognitive

TestingComputerized Neurocognitive Testing

24-72 Hours Day 5-10Concussion Beyond if necessary

20 days later4 days later

ImPACT Program to Evaluate Concussion

No Return to Sports Until ImPACT is Normal!

Concussion Recovery

Lazy Eyes

Rehabilitation Migraine

Genetics

PreviousConcussions

AdequateTreatment Innovation Is Good

The Victorian Revolution in Surgery

■Anesthesia■Antisepsis■X-rays

Important Clinical Innovations in Surgery

Connor, Science, 2004 Oxygen is Abundant in our Atmosphere

Michael Jackson

Is More Always Better?

Is Increased Oxygen Beneficial?

Evidence Based Triad

Individual Clinical

Expertise

Best Available Clinical Evidence

Patient Values and

Expectations Improved Patient

Outcomes

Famous Surgeon

Famous Athleteor

Wounded Warrior

NewTreatment

Dr. John Bergfeld

Orthopaedic Triad

Health Care Delivery?�We are making the same mistake in global health care that we make in the American system, believing that better

diagnostics and therapeutic tools will solve all problems. They won�t. They haven�t. We don�t measure results well enough�

Jim Yong Kim (President, World Bank; Former President, Dartmouth College)

USA Healthcare

Highest Cost in the World

90% of Opioid use in the World

White Coat Ceremony

Freddie H. Fu, MD, DSc (Hon),DPs(Hon) DC’74, MED ’75

Distinguished Service Professor,University of Pittsburgh

David Silver Professor and Chairman, Department of Orthopaedic Surgery,

University of Pittsburgh School of Medicine

Freddie H. Fu, MD, DSc (Hon),DPs(Hon) MED '77

Distinguished Service Professor,University of Pittsburgh

David Silver Professor and Chairman,

Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine

White Coat Ceremony

School of Medicine

Thoughts for

Young DoctorsFrom

Freddie H. Fu, Md

1. Do what you love2. Mentors3. You’ve got friends4. Talking without speaking: hearing without listening5. Focus versus multi-task6. IQ vs EQ7. Face time8. For better or for worse9. Does no difference really Mean no difference? 10. Is evidence based reallyevidence based?

11. Is the greatest alwaysthe greatest?12. Do the right thing13. Credibility and Integrity14. Patients come first15. Be a dreamer16. Don’t be a dinosaur17. The world is flat18. Terrible towel19. Home sweet home20. “I never dared to be radicalWhen young for fear it wouldMake me conservative when Old” – Robert Frost

Myron Cope

“Voice of the Steelers”

The Terrible Towel

The Terrible TowelThe Terrible Towel

& Giving Back§ Each one of us can give back

§ Own initiative and effort are more important thanmoney

THINGS WE ALL CAN DO IN OUR EVERYDAY LIFE

Learning Forever

University of Pittsburgh Cathedral of Learning