Donald D Anderson

Donald D Anderson
University of Iowa | UI · Department of Orthopaedics and Rehabilitation

PhD

About

185
Publications
12,951
Reads
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3,902
Citations
Introduction
Dr. Anderson’s primary research focus is articular joint biomechanics, with an eye toward better understanding the mechanical relationships between joint injury and the development of post-traumatic osteoarthritis. This work involves nurturing interactions between a growing inter-disciplinary group of clinicians, engineers, and biologists. Much of his work has involved computational modeling. The Whitaker Foundation, the NFL, the Arthritis Foundation, and the NIH have funded his research.
Additional affiliations
July 2016 - present
University of Iowa
Position
  • Professor
October 2010 - July 2016
University of Iowa
Position
  • Professor (Associate)
Education
January 1987 - December 1989
University of Iowa
Field of study
  • Mechanical Engineering (Biomechanics)
June 1985 - December 1986
University of Iowa
Field of study
  • Mechanical Engineering (Biomechanics)
August 1981 - May 1985
University of Iowa
Field of study
  • Biomedical Engineering

Publications

Publications (185)
Article
Even with current treatments of acute joint injuries, more than 40% of people who suffer significant ligament or meniscus tears, or articular surface injuries, will develop osteoarthritis (OA). Correspondingly, 12% or more of all patients with lower extremity OA have a history of joint injury. Recent research suggests that acute joint damage that o...
Article
Full-text available
Many intra-articular fracture patients eventually experience significant functional deficits, pain, and stiffness from post-traumatic osteoarthritis (PTOA). Over the last several decades, continued refinement of surgical reconstruction techniques has failed to markedly improve patient outcomes. New treatment paradigms are needed - ideally, bio/phar...
Article
Highly comminuted intra-articular fractures are complex and difficult injuries to treat. Once emergent care is rendered, the definitive treatment objective is to restore the original anatomy while minimizing surgically induced trauma. Operations that use limited or percutaneous approaches help preserve tissue vitality, but reduced visibility makes...
Preprint
Osteoarthritis (OA) is a common musculoskeletal disease that leads to deterioration of articular cartilage, joint pain, and decreased quality of life. When OA develops after a joint injury, it is designated as post-traumatic OA (PTOA). The etiology of PTOA remains poorly understood, but it is known that proteoglycan (PG) loss, cell dysfunction, and...
Article
Articular fracture malreduction increases post‐traumatic osteoarthritis (PTOA) risk by elevating joint contact stress.A new Biomechanical Guidance System (BGS) that providesintra‐operative assessment of articular fracture reduction and joint contact stressbasedsolely on a pre‐operative CT and intra‐operative fluoroscopymayfacilitatebetter fracture...
Article
Background: Reverse shoulder arthroplasty (RSA) is associated with high rates of midterm complications including scapular notching, implant wear, and mechanical impingement. Scapulo-humeral rhythm (SHR), described by Codman in the 1920's, is defined as the ratio of glenohumeral motion to scapulothoracic motion. SHR is used as an indicator of shoul...
Article
Full-text available
Category Ankle Arthritis; Ankle; Trauma Introduction/Purpose Ankle osteoarthritis (AO) is an incapacitating condition for patients and a substantial burden for medical assistance. It is well known that the vast majority of AO occurs as a sequela of previous trauma. However, it is currently unknown what types of injuries of the foot and ankle most...
Article
Category Hindfoot; Midfoot/Forefoot Introduction/Purpose Peritalar subluxation (PTS) of the hindfoot is a critical finding in Progressive Collapsing Foot Deformity (PCFD). Subluxation of the middle facet and sinus tarsi recently been shown to represent essential markers of pronounced and potentially progressive deformity. Weightbearing CT (WBCT) i...
Article
Skill assessment in orthopedics has traditionally relied on subjective impressions from a supervising surgeon. The feedback derived from these tools may be limited by bias and practical issues. Objective analysis of intraoperative fluoroscopic images offers an inexpensive and easily repeatable assessment strategy without bias. Despite the advantage...
Article
Full-text available
Category: Basic Sciences/Biologics; Hindfoot Introduction/Purpose: Implant-related artifact (IRA) represents an important limitation in Computed Tomography (CT) assessment of osteotomy and fracture healing, bone-implant integration, and success of fusion procedures. Metallic implants are the most used in foot and ankle surgery and are recognized as...
Article
Full-text available
Category: Basic Sciences/Biologics; Hindfoot; Midfoot/Forefoot Introduction/Purpose: Progressive collapsing foot deformity (PCFD), formerly termed Adult-Acquired Flatfoot Deformity (AAFD), is a complex 3D deformity characterized by peritalar subluxation (PTS) of the hindfoot through the triple joint complex. In this context, adjacent structures may...
Article
Full-text available
Category: Ankle Introduction/Purpose: Recently, weightbearing computed tomography (WBCT) has been utilized to provide more comprehensive and accurate assessment of complex foot and ankle deformities, notably to diagnose and stage Progressive Collapsing Foot Deformity (PCFD). The 3D data provided by WBCT has enabled the developed of novel tools like...
Article
INTRODUCTION Radiography is the current standard for assessing osseous structural knee OA, but it is a 2D image of a 3D structure and superimposition of bone impairs ability to sensitively detect changes. Weight-bearing CT (WBCT) allows improved visualization of OA features, shows greater correlation with central medial cartilage damage on MRI and...
Article
Introduction: Arthroscopy simulation is increasingly used in orthopaedic residency training. The implementation of a curriculum to accommodate these new training tools is a point of interest. We assessed the use of a high-fidelity arthroscopy simulator in a strictly voluntary curriculum to gauge resident interest and educational return. Methods:...
Conference Paper
Introduction/Purpose: Improving the diagnosis of subtle syndesmotic instability (SSI) represents one of the most challenging missions in orthopedic surgery, because undi-agnosed instability frequently leads to posttraumatic ankle arthritis. Stressed conventional radiographs, ultrasonogra-phy, and bilateral comparative conventional computed tomograp...
Conference Paper
Introduction/Purpose: Recently, weightbearing computed tomography (WBCT) has been utilized to provide more com-prehensive and accurate assessment of complex foot and ankle deformities, notably to diagnose and stage Progressive Collapsing Foot Deformity (PCFD). The 3D data provided by WBCT have enabled the development of novel tools like distance ma...
Article
Objective: Determine whether tibiofemoral contact stress predicts risk for worsening knee pain over 84-months in adults aged 50-79 years with or at elevated risk for knee osteoarthritis. Design: Baseline tibiofemoral contact stress was estimated using discrete element analysis. Other baseline measures included weight, height, hip-knee-ankle (HKA...
Article
BACKGROUND Repair of the subscapularis following reverse shoulder arthroplasty (RSA) remains a controversial topic among surgeons. Poor rotator cuff muscle quality is associated with increased musculotendinous stiffness, and the subsequent effect of compromised tissue repair on RSA functional outcomes remains unclear. The objective was to investiga...
Conference Paper
Medical simulation has risen in popularity as a method of improving surgical outcomes for less experienced practitioners. In orthopedic surgery, haptic feedback is an essential element of simulation. In the case of Kirschner wire navigation, for example, a steel pin is drilled through cortical bone and into cancellous bone. Currently, many orthoped...
Conference Paper
Simulation training provides an opportunity for surgeons to learn key skills in a safe environment. This is especially important for surgical procedures where mistakes have high consequences, such as working near the spinal cord. Wire navigation is a common orthopedic skill that spans many procedures. This paper presents the design steps taken to m...
Article
Background: To advance orthopaedic surgical skills training and assessment, more rigorous and objective performance measures are needed. In hip fracture repair, the tip-apex distance is a commonly used summative performance metric with clear clinical relevance, but it does not capture the skill exercised during the process of achieving the final i...
Article
Full-text available
Category Ankle; Ankle Arthritis; Arthroscopy; Sports Introduction/Purpose Chronic subtle distal tibiofibular syndesmotic instability (DTFSI) is relatively common, and consequences of undiagnosed injuries can be devastating. Diagnosing acute and chronic injuries is challenging, and the most commonly used diagnostic tools are physical exams, convent...
Article
Background Instability following reverse shoulder arthroplasty is influenced by various factors such as component design, component positioning, and soft tissue tensioning. Patients may achieve glenohumeral motion beyond initial scapular impingement during activities of daily living which could further compound instability. However, instability/sub...
Article
Background: Posttraumatic osteoarthritis (PTOA) of the subtalar joint is a serious, disabling, and frequent complication following intra-articular calcaneal fractures (IACFs). Using plain radiographs to assess the subtalar joint for PTOA is imprecise and insensitive, hindering progress toward improving treatment and assessing outcomes. This study...
Conference Paper
Trainees in orthopedic surgery are required to receive dedicated laboratory-based surgical skills training in their first year of residency. Simulators are often used in this training. Our group previously developed a hip fracture wire navigation simulator to train and assess skill in placing a K-wire within a femur bone surrogate using synthetic f...
Article
Background: Posttraumatic osteoarthritis (PTOA) is a common and early sequela of tibial pilon fractures resulting in substantial long-term disability. New approaches are needed to objectively and reliably quantify early disease progression in order to critically assess the impact of interventions aimed at preventing or mitigating PTOA. Weight-bear...
Article
Background: Many orthopedic surgeries involve the challenging integration of fluoroscopic image interpretation with skillful tool manipulation to enable procedures to be performed through less invasive approaches. Simulation has proved beneficial for teaching and improving these skills for residents, but similar benefits have not yet been realized...
Article
Full-text available
Limitations of plain radiographs may contribute to poor sensitivity in the detection of knee osteoarthritis and poor correlation with pain and physical function. 3D joint space width, measured from weight bearing CT images, may yield a more accurate correlation with patients' symptoms. We assessed the cross‐sectional association between 3D joint sp...
Article
Full-text available
Simulation-based surgical skills training is recognized as a valuable method to improve trainees’ performance and broadly perceived as essential for the establishment of a comprehensive curriculum in surgical education. However, there needs to be improvement in several areas for meaningful integration of simulation into surgical education. The purp...
Article
Background: Skills training and simulation play an increasingly important role in orthopaedic surgical education. The intent of simulation is to improve performance in the operating room (OR), a trait known as transfer validity. No prior studies have explored how simulator-based wire navigation training can transfer to higher-level tasks. Addition...
Article
The demand for simulation-based skills training in orthopaedics is steadily growing. Wire navigation, or the ability to use 2D images to place an implant through a specified path in bone, is an area of training that has been difficult to simulate given its reliance on radiation based fluoroscopy. Our group previously presented on the development of...
Article
Objectives: To quantify fracture severity for a series of displaced intra-articular calcaneal fractures (DIACFs) and correlate it with Sanders classification, post traumatic osteoarthritis (PTOA), and patient outcomes. Design: Retrospective review and fracture severity analysis SETTING:: The University of Iowa Hospitals and Clinics is a level 1...
Article
Background: The primary indication for reverse shoulder arthroplasty (RSA) is rotator cuff arthropathy caused by a deficient rotator cuff. Cuff deficiency in patients is highly variable in its distribution and extent, with mechanical implications that may significantly affect post-operative recovery. This study investigated the effects of variable...
Conference Paper
The American Board of Orthopaedic Surgery has mandated dedicated skills training for first-year orthopedic surgical residents.1 Most residency programs address this requirement with training exercises with cadavers and plastic foam bones. Some programs incorporate one or more simulators in their skills training, including several sophisticated virt...
Article
Background: Women are at higher risk for knee osteoarthritis and numerous other lower limb musculoskeletal disorders. Arch drop during pregnancy and the resultant excessive pronation of the feet may alter loading patterns and contribute to the higher prevalence of knee osteoarthritis in women. Objective: To determine the effect of arch drop on t...
Article
An unbiased, repeatable process for assessing operating room performance is an important step toward quantifying the relationship between surgical training and performance. Hip fracture surgeries offer a promising first target in orthopedic trauma because they are common and they offer quantitative performance metrics that can be assessed from vide...
Article
Evaluation of abnormalities in joint contact stress that develop after inaccurate reduction of an acetabular fracture may provide a potential means for predicting the risk of developing post-traumatic osteoarthritis. Discrete element analysis (DEA) is a computational technique for calculating intra-articular contact stress distributions in a fracti...
Article
Purpose: To quantify arthroscopic accessibility of the talar dome with predefined ankle positions through anterior and posterior approaches. Methods: Fourteen below-knee cadaver specimens underwent preoperative range of motion assessments. A 30° 2.7-mm arthroscopic camera was used to mark accessible areas at varying ankle positions. Accessible r...
Article
Full-text available
Background: Osteochondral lesions of the tibial plafond (OLTPs) can lead to chronic ankle pain and disability. It is not known how limited ankle motion or joint distraction affects arthroscopic accessibility of these lesions. The purpose of this study was to determine the effects of different fixed flexion angles and distraction on accessibility o...
Article
Background: A previously validated finite element modeling approach was used to determine how changes in glenoid component version and polyethylene liner rotation within the humeral component affect the arm abduction angle at which impingement between the inferior glenoid and the polyethylene liner occurs as well as the amount of subluxation gener...
Conference Paper
Orthopaedic resident training has been, and continues to be, in a state of flux. Initially, there were limits placed on the number of hours a resident could work in a week [1]. Later, residency programs were required to provide laboratory-based training in basic surgical skill for first year residents [2]. Now there is a push towards a competency-b...
Article
Background: Injury severity may be the most important factor in determining outcome after articular fractures, but there is a surprising paucity of clinical evidence to support this assertion. The purpose of this study was to utilize a new method for rank ordering a group of patient radiographs to assess the effect of injury severity and quality o...
Article
Full-text available
Objective To determine the test–retest reliability of knee joint space width (JSW) measurements made using standing CT (SCT) imaging. Subjects and methodsThis prospective two-visit study included 50 knees from 30 subjects (66% female; mean ± SD age 58.2 ± 11.3 years; BMI 29.1 ± 5.6 kg/m2; 38% KL grade 0–1). Tibiofemoral geometry was obtained from b...
Article
Biomathematical models offer a powerful method of clarifying complex temporal interactions and the relationships among multiple variables in a system. We present a coupled in silico biomathematical model of articular cartilage degeneration in response to impact and/or aberrant loading such as would be associated with injury to an articular joint. T...
Article
The objective of this project was to determine the relationship between medial tibiofemoral joint space width measured on fixed-flexion radiographs and the three-dimensional joint space width distribution on low-dose, standing CT (SCT) imaging. At the 84-month visit of the Multicenter Osteoarthritis Study, 20 participants were recruited. A commerci...
Article
Two categories of joint overloading cause post-traumatic osteoarthritis (PTOA): single acute traumatic loads/impactions and repetitive overloading due to incongruity/instability. We developed and refined three classes of complementary models to define relationships between overloading and progressive cartilage loss across the spectrum of acute inju...
Article
Patients with tibial pilon fractures have a higher incidence of post-traumatic osteoarthritis than those with fractures of the tibial plateau. This may indicate that pilon fractures present a greater mechanical insult to the joint than do plateau fractures. We tested the hypothesis that fracture energy and articular fracture edge length, two indepe...
Article
Cadaveric experiments were undertaken to validate a finite element (FE) modeling approach for studying impingement-related scapular notching in reverse shoulder arthroplasty (RSA). The specific focus of the validation was contact at the site of impingement between the humeral polyethylene component and the inferior aspect of the scapula during an a...
Article
Objective: There are no widely accepted, objective, and reliable tools for measuring surgical skill in the operating room (OR). Ubiquitous video and imaging technology provide opportunities to develop metrics that meet this need. Hip fracture surgery is a promising area in which to develop these measures because hip fractures are common, the surge...
Article
Objectives: Determine the agreement between subjective assessments of fracture severity and an objective CT-based metric of fracture energy in tibial plateau fractures. Methods: Six fellowship-trained orthopaedic trauma surgeons independently rank-ordered 20 tibial plateau fractures in terms of severity based upon AP and lateral knee radiographs...
Article
Full-text available
Background: Interpreting two-dimensional radiographs to ascertain the three-dimensional (3D) position and orientation of fracture planes and bone fragments is an important component of orthopedic diagnosis and clinical management. This skill, however, has not been thoroughly explored and measured. Our primary research question is to determine if 3...
Article
Objective: To assess whether medial tibiofemoral joint space width (JSW) on 3D standing CT (SCT) correlates more closely with MRI cartilage morphology (CM) and meniscal scores than does radiographic 2D JSW. Methods: Participants in the Multicenter Osteoarthritis Study (MOST), who had standing fixed-flexion PA knee radiographs, were recruited. Me...
Article
Background: Mechanotransduction is theorized to influence fracture-healing, but optimal fracture-site motion is poorly defined. We hypothesized that three-dimensional (3-D) fracture-site motion as estimated by finite element (FE) analysis would influence callus formation for a clinical series of supracondylar femoral fractures treated with locking...
Article
Background: Post-traumatic osteoarthritis (PTOA) is common after intra-articular fractures of the tibial plafond. An objective CT-based measure of fracture severity was previously found to reliably predict whether PTOA developed following surgical treatment of such fractures. However, the extended time required obtaining the fracture energy metric...
Article
Background: Orthopedic surgical education is evolving as educators search for new ways to enhance surgical skills training. Orthopedic educators should seek new methods and technologies to augment and add value to real-time orthopedic surgical experience. This paper describes a protocol whereby we have started to capture and evaluate specific orth...
Article
Background: Performance assessment in skills training is ideally based on objective, reliable, and clinically relevant indicators of success. The Objective Structured Assessment of Technical Skill (OSATS) is a reliable and valid tool that has been increasingly used in orthopaedic skills training. It uses a global rating approach to structure exper...
Article
Scapular notching in reverse shoulder arthroplasty occurs in up to 97% of patients. Notching is associated with decreased strength and reduced motion and may lead to long-term failure due to polyethylene wear. Many implant systems lateralize the glenosphere to address scapular notching, but the mechanical tradeoffs of lateralization have not been r...
Article
Surgical simulation is an increasingly important method to facilitate the acquiring of surgical skills. Simulation can be helpful in developing hip fracture fixation skills because it is a common procedure for which performance can be objectively assessed (i.e., the tip-apex distance). The procedure requires fluoroscopic guidance to drill a wire al...