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Susan comes full-circle for her knee replacement at UW Health

Since she was a little girl, Susan Cowles had good reason to suspect that her knees may one day need medical attention. She was grateful for seven pain-free decades, but by her early 70s, a knee replacement became imminent.

Now 74, Susan was born with an extremely rare skeletal abnormality known as Schmid Metaphyseal Chondrodysplasia. It is typically characterized by short stature and a waddling gait.

As a child, Susan and her parents frequently traveled to Madison so she could receive care from UW specialists. While she built a life and career in medical social work in Milwaukee, Susan returned to Madison for care once again as an adult more than six decades later.

Susan as a young girl

Aside from her 4’5” stature and short, bowed legs, little else has gotten in Susan’s way. Once she reached her early 70s, however, Susan began experiencing serious knee arthritis.

“Genu Varum or ‘bowed legs’ is a common deformity with patients who have Schmid Metaphyseal Chondrodysplasia,” says Dr. Brian Nickel, Susan’s UW Health orthopedic surgeon. “Because Susan’s legs were not straight, extra pressure continued to mount, especially on the inside of her right knee,” he adds. “Her resiliency allowed her knees to last until her early 70s before the pain got bad enough on her right side to make her a candidate for a total knee replacement.”

Dr. Nickel, whose training included a fellowship at the #1 ranked Hospital for Special Surgery in New York City, has performed thousands of knee and hip replacements throughout his six years at UW Health. Susan’s case, he says, required far more preparation and planning than a more conventional patient would need.

Dr. Nickel’s most challenging knee surgery

“Every step of Susan’s surgery was different because of her short stature,” Dr. Nickel says. “This was the most challenging surgery I have done on a first-time knee replacement patient. At UW Health, one of the advantages for patients like Susan is that our team has frequent experience with complex cases. Not only do we provide the highest ranked care in the state for orthopedic surgery, but we also know how to deal with the so-called curve balls. This makes it all the more fulfilling to help patients like Susan get back to living a better life.”

Now with her surgery several months behind her, Susan is back to walking a mile every day supplemented with plenty of yoga stretching. She is incredibly pleased with her outcome.

Making Susan’s story even more compelling is the amount of time since she first traveled to Madison for care. Some 65 years ago, Susan’s parents were having a hard time getting answers about their daughter’s short stature.

“I was misdiagnosed twice as a child, leaving my parents stumped and discouraged,” Susan says. “Finally when I was about 9, our family doctor arranged for me to see a pediatric specialist at UW-Madison named David W. Smith.”

Dr. David Smith joined the UW faculty not long after the creation of the Department of Pediatrics in 1957. Although he would leave Madison within a decade, Dr. Smith would come to be known as a pioneer in the field of dysmorphology — the study of birth defects including growth abnormalities such as Susan’s.

Falling in love with Madison from an early age

“I just loved coming to Madison with my parents,” Susan says. “We would always make a day of it and spend time exploring the university campus. I remember thinking how much I wanted to go to college there, but coming from a strong Catholic family, my parents preferred that I go to a Catholic university in Milwaukee. I never lost my love for Madison, however.”

While being seen by Dr. Smith and a young doctor-in-training named Arlan Rosenbloom, Susan joined a trailblazing medical study that would lead to the establishment of Schmid Metaphyseal Chondrodysplasia as a unique form of inherited dwarfism. Because the field of genetics was in its infancy in the 1960s, Dr. Smith’s study, published in the Journal of Pediatrics in 1965, would later emerge as a seminal piece of clinical research.

“Dr. Smith and I drove across Wisconsin meeting with about two dozen children like Susan and their families,” recalls, Dr. Rosenbloom, the 89-year-old nationally distinguished expert in growth abnormalities. “We learned that the cells at the end of the shorter bones in these kids were disorganized, which disrupted the normal growth process.”

Fast forward to 2022, when the pain in Susan’s right knee was making life difficult.

“An orthopedic surgeon in Milwaukee asked me to have DNA testing to confirm that I truly had the Schmid form of metaphyseal dysplasia,” Susan says. “I started by calling a local genetics department but nobody called me back for two weeks. So I Googled the Genetics Department at UW. A genetics counselor named Peggy Modaff answered her phone directly and listened to my story.”

UW genetics counselor connected Susan with Dr. Nickel

Not only did Peggy send Susan the DNA test kit right away — the test confirmed Susan’s original Schmid diagnosis — but later Peggy provided Susan with recommendations for UW Health orthopedic surgeons.

“Peggy sent me the names of two UW orthopedic surgeons and one of those was Dr. Brian Nickel,” Susan says. “That’s how I first connected with him, so thanks to Peggy and her fast response, I was on my way.”

Peggy’s immediate willingness to listen to Susan’s phone call and then act swiftly left Susan extremely impressed.

“So many people say they’ll get back to you and never do,” Susan says. “Peggy was absolutely fabulous.”

Loving life and feeling free from debilitating knee pain, Susan is amazed at her good fortune, especially with two UW Health encounters spanning more than six decades.

“Everything good to me happens at UW,” she says.

This story originally appeared on

Tamara Scerpella to Become Chair of Orthopedics and Rehabilitation at UW

July 25, 2023 – Tamara A. Scerpella, MD, a nationally renowned orthopedic surgeon, academic leader, mentor, and researcher, becomes the next chair of the Department of Orthopedics and Rehabilitation at the University of Wisconsin School of Medicine and Public Health on July 30, 2023.

Scerpella has provided leadership for the clinical and academic programs in the department in prior roles, having served as chief of its Division of Sports Medicine, vice chair, senior vice chair, and interim chair. She has emphasized exceptional patient care while advancing the department’s residency and fellowship programs, research enterprise, and faculty development initiatives.

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Scott Crawford, PhD, receives ICTR KL2 Scholar Award

May 30, 2023 – Scott Crawford, PhD, an assistant professor in the University of Wisconsin Departments of Kinesiology at the School of Education and Orthopedics and Rehabilitation at the School of Medicine and Public Health, was recently awarded a KL2 Scholar Program grant; he will officially begin the program in July 2023. Funded by the NIH through the UW Institute for Clinical and Translational Research (ICTR), the KL2 Scholar Program supports “junior faculty at UW Madison pursuing and actively engaged in translational research and who are committed to developing an independent research program.” Crawford’s KL2 grant will provide him with two years of protected time for research and career development training – allowing him to delve into novel ideas and emerge as a leader in the field.

His current research project, “Neuroplasticity in Muscle Mechanics Following Hamstring Injury: A Combined fMRI and Ultrasound Study,” will investigate the neural changes that occur after hamstring injuries. Crawford says that, while we have gotten good at diagnosing and identifying the progression of hamstring injuries and returning athletes to their sport, “re-injury rates are still very high.” Most studies show as high as 1 in 3 will go on to re-injure – though some show re-injuries as high as 60% or more.

By examining muscle tissue mechanics using ultrasound and brain activity using fMRI, Crawford hopes to uncover if altered brain activity following a recent hamstring strain injury may be related to why re-injury rates for hamstring strains remain high, despite advancements in rehabilitation protocols. The study is still in the piloting stage, where Dr. Crawford and his team are refining their methodology before enrolling participants.

Before coming to UW, Dr. Crawford earned his Bachelor of Science in Mechanical Engineering from Cedarville University in Ohio and his Master’s and PhD in Biomedical Engineering from The Ohio State University. He joined the UW as an NIH-funded TL1 Post-Doctoral Trainee under Dr. Bryan Heiderscheit in January 2019 – later transitioning to a faculty position in the Kinesiology Department with a joint appointment in the Department of Orthopedics and Rehabilitation in August 2022.

Dr. Crawford’s educational background in biomedical engineering and biomechanics and his work in the Badger Athletics Performance Lab shaped his interdisciplinary approach to studying sport-related muscle injury. Further, as Dr. Crawford pursues the focused study afforded by his KL2 grant, he says that the symbiotic relationship between research investigators across different academic departments, clinicians, and surgeons at UW allows him to “collaborate with people like Dr. Heiderscheit, [the Badger Athletics Performance Program], and other orthopedic faculty members” and find “common ground” that will ultimately translate research findings into impactful treatments for patients.


UW Researchers Recruiting Participants to Test Novel Therapy for Painful Diabetic Peripheral Neuropathy

UW researchers are recruiting participants for a clinical trial exploring an innovative non-opioid therapy to treat painful diabetic peripheral neuropathy (PDPN). Nalini Sehgal, MD, Professor and Chair of the Division of Rehabilitation Medicine and the Director of the UW Interventional Pain Medicine Program and Pain Medicine Fellowship, is the study’s principal investigator (PI); Ali Zandieh, MD, and Collin Kreple, MD, of the UW Department of Neurology are the trial’s sub-PIs.

PDPN affects up to 30% of patients with diabetes, significantly decreasing the quality of life for those who experience the condition – causing numbness, tingling, and intense pain in the hands, feet, and lower limbs. Worse, current treatments provide little pain reduction and are frequently not well-tolerated for most PDPN patients.

A novel substance called NRD could hold the key to finding relief for these patients. NRD was discovered in a medicinal tea used in a village in Siberia to treat various illnesses and was identified as the substance in the tea most likely to result in pain reduction. Improved by researchers through chemical alterations and put into pill form, NRD was shown to be safe and well-tolerated in three Phase 1 trials. It was then tested for a Phase 2a trial, resulting in reduced pain.

To further test the safety and efficacy of NRD, the National Institutes of Health (NIH) is funding a multi-center initiative to conduct a phase 2, placebo-controlled clinical trial. Based at Massachusetts General Hospital, the study has 16 research sites nationwide – the UW School of Medicine and Public Health is the Wisconsin site. Investigators aim to recruit 122 participants from around the United States. To participate, individuals must meet the following criteria:

  • Are at least 18 years old and have had Type II diabetes with PDPN for at least six months;
  • Can stop other pain medications for 12 weeks, other than acetaminophen (Tylenol), as needed;
  • Don’t have a history of heart attacks, heart disease, or stroke.

Study volunteers must come in for eight to nine visits over 13 weeks and will receive up to $850 for their participation. For more information or to determine if you can participate, please contact Janelle Suriaga, Clinical Research Coordinator at (608) 265-2413 or by email.

This research is a part of the NIH-funded Early Phase Pain Investigation Clinical Network (EPPIC-Net), whose mission is to “enhance pain treatment and reduce reliance on opioids with early phase clinical trials of non-addictive pain therapeutics.”

Stephanie Kliethermes, PhD, organizes Research Summit on Health Disparities in Sports Medicine

Stephanie Kliethermes, PhD, was recently awarded an R13 Grant from the National Institute on Minority Health and Health Disparities to support an all-day Research Summit on health disparities in sports medicine. Dr. Kliethermes is is an Associate Professor in the UW Department of Orthopedics and Rehabilitation and currently serves as Research Director of the American Medical Society for Sports Medicine (AMSSM). She organized this event through the AMSSM.

Held on April 28, 2023, the Research Summit kicked off the AMSSM Annual Meeting in Phoenix, Arizona. The Summit focused on:

  • Identifying current knowledge gaps regarding the impact of health disparities in sports and exercise medicine and establishing appropriate priorities for targeted research in the space;

  • Providing evidence-based approaches and recommendations for research methodologies in sports and exercise medicine for researchers interested in conducting research in the space and/or conducting research through an equity lens.

Dr. Kliethermes described the Research Summit as a “tremendous success,” stating:

The energy and optimism in our ability to use research to make progress and create lasting change on health disparities in sports medicine was extremely high during the summit and in the days following. I’m looking forward to getting our Summit outcomes published over the course of the year and helping guide future research in this space.

For more information, please visit the Research Summit website

R13 Grants support scientific meetings, conferences, and workshops relevant to the NIH’s mission and scientific priorities.