SHORT ANSWER ORTHOPEDICS
AAP Recognizes Bariatric Surgery for Adolescents
BARIATRIC SURGERY
Recent data report the prevalence of severe obesity in youth has nearly doubled since 1999 and affects about 4.5 million children in the United States . In an effort to combat this rising public health concern , the American Academy of Pediatrics now recognizes bariatric surgery as a viable treatment option for severely obese adolescents .
The AAP ’ s release of its stance and best practice guidelines is
A Passion That ’ s Bone-Deep
ENDOCRINOLOGY
Pediatric endocrinologist Nina S . Ma , MD , CCD , will lead a new Bone and Mineral Metabolism Program at Children ’ s Hospital Colorado as the Ed and Jeannette Kerr Family Endowed Chair in Endocrinology . Dr . Ma , whose clinical expertise is in pediatric osteoporosis and nutritional and genetic forms of rickets , came to Children ’ s Colorado from Boston Children ’ s Hospital , where she directed the Bone Health due , in part , to findings from the multicenter clinical study Teen Longitudinal Assessment of Bariatric Surgery , or Teen-LABS , led by Thomas H . Inge , MD , PhD , associate surgeon-in-chief at Children ’ s Hospital Colorado . When compared to older adults , the study found adolescents who undergo bariatric surgery have higher rates of remission of hypertension and type 2 diabetes . •
Program and DXA Center from 2012 to 2019 .
Dr . Ma is shaping the new program to be comprehensive and multidisciplinary , focusing not only on the evaluation and treatment of pediatric bone conditions , but also on research and education . “ These aspects are crucial ,” she says . “ We need to be amassing our scientific knowledge , while also educating the next generation of doctors and researchers , so that we are perpetually helping these children .”
To that end , Dr . Ma has approval to begin two research studies in children with achondroplasia : one on the natural history of the condition and the other an interventional drug trial to help improve bone growth . Both are part of larger , multicenter studies with participating sites around the world . •
Joint Venture
What is postoperative life like for a kid who undergoes a total joint replacement ?
Outside of solid tumors , a total joint replacement is a rare surgery for adolescents . There isn ’ t a lot of information on surgical outcomes for this age group , so researchers at Children ’ s Hospital Colorado are starting to collect it .
As a pain control surgery , a total joint replacement is ideal for a person who is later in life — someone who likely won ’ t have to worry about replacing the replacement . That ’ s not the case for a kid , says orthopedic surgeon Nathan Donaldson , DO , because it won ’ t last their whole life . And each time the device is replaced , there ’ s a catch .
“ The patient loses function ,” Dr . Donaldson says . “ Less bone and muscle , more scar tissue . It makes it harder on the surgeon and the patient .”
Other methods to control the pain are preferable , but when those methods fail , a total joint replacement can offer relief .
But because it isn ’ t a common surgery for kids , there isn ’ t much data to show what postoperative life is like after one , let alone several over a lifetime . What is their pain level ? Are they physically doing well ? What about mentally ?
Dr . Donaldson and affiliate researcher Nathan Rogers , MPH , are surveying a cohort of about 140 kids who ’ ve already undergone a total joint replacement at Children ’ s Colorado in the last 16 years to start collecting those answers .
6 | CHILDREN ’ S HOSPITAL COLORADO