Marshall Health/Marshall Orthopaedic Research Program
The Department of Orthopaedic Surgery at Marshall University has an active and robust research initiative because it provides an excellent foundation for the development of compassionate, patient-centered care. By serving as a regional and national leader for advancements in orthopaedic science, we are helping to develop and provide novel treatment modalities that will provide cutting edge technology to our patients for the 21st century and beyond.
Going to a research oriented department like ours can yield the following benefits:
- Research and evidence based practices have been shown to improve health outcomes;
- Research and evidence based practices have been shown to reduce healthcare expenditures;
- Research and evidence based practices have been shown to improve patient satisfaction.
Our research program is integral to our overall award-winning mission of providing compassionate, patient-centered care. We are a center of excellence and hope that you consider us for your Orthopaedic care.
Franklin D. Shuler MD, PhD
Director, Orthopaedic Research
International Congress for Joint Reconstruction - How We Manage Periprosthetic TKA Fractures
Periprosthetic fractures have an incidence of 0.3-2.5% after a primary total knee arthroplasty (TKA) and 1.6-38% following revision TKA.  Because the number of TKAs is expected to increase by 673% by 2030, the incidence of this complication is expected to rise as well. 
Osteoporosis is the single most important contributor to periprosthetic fractures around the knee. [5-7] The most common mechanism of injury is a fall onto the knee, but other causes include motor vehicle accidents, seizures, and forced manipulation for a stiff knee.
Periprosthetic supracondylar femur fractures are defined as occurring 15 cm above a TKA joint line and are the most common type of periprosthetic fracture around the knee. For short-stemmed implants, supracondylar femur fractures were previously defined as within 5 cm of the proximal end of the stem. 
This brief article highlights surgical management of periprosthetic fractures. Many patient factors will guide the choice of treatment, including:
- The general medical health of the patient
- Pre-fracture ambulatory status
- Stability of knee prosthesis
- Fracture pattern
- Quality of bone stock
- Type of knee prosthesis (open vs closed box)
The main goal of treatment should be fracture healing, pain-free function, and early functional mobility.
West Virginia Medical Journal - Smartphone Medical Applications Useful for the Rural Practitioner
Like other similarly situated rural states, West Virginia’s patients and practitioners often experience access barriers to current medical expertise for multiple disciplines. This article was generated to help bridge this gap and highlights the
best-rated mobile medical applications (Apps) for smartphone use. From finding drug interactions and dosing schedules to
discussing patients in HIPAA-compliant formats, Apps arebecoming integral to the practice of 21st Century medicine. The
increased use of these Apps by physicians-in-training and established practitioners highlights the shift from reliance upon
the medical library to the easy to use mobile-based technology platforms. This article provides our practitioners, physician
extenders, medical trainees, and office staff a guide to access and assess the utility of some of the best rated medical and HIPAA compliant App.
Antibiotic-Like Actions of Vitamin D
Background of the study
I have collected outcome data on patients with fractures who received vitamin D supplementation postoperatively. For three years in a busy surgical practice, there was not one patient that developed a postoperative infection when receiving high dose vitamin D. This caused us to further look into the “antibiotic like actions of vitamin D”.
Orthopaedic Trauma Association Member, Dr. Franklin Shuler, awarded $293,000 NIH Grant
HUNTINGTON, W.Va. – Dr. Jingwei Xie, a senior scientist at the Marshall Institute for Interdisciplinary Research (MIIR), has been awarded a $293,000 grant from the National Institutes of Health to lead a project to develop a technique that may improve surgical repair of rotator cuff injuries.
The project will combine the expertise of two research groups at Marshall University. Xie, who is an expert in bone growth and development, and his team at MIIR will be working with Dr. Franklin D. Shuler, associate professor and vice chair of research in the Department of Orthopaedic Surgery at the university's Joan C. Edwards School of Medicine.
Dr. Shuler stated “We are very proud of this success and are excited to strengthen our collaborative, multidisciplinary approach to Orthopaedic translational research.”
Orthopod - Vitamin D Recommendations for Athletes
You wouldn't think athletes with their strong bones and muscles would need any Vitamin D supplementation. But according to this group of researchers, there are sports health benefits to taking Vitamin D supplements. Some of those benefits actually come in the form of prevention. That is -- preventing the musculoskeletal events that can occur when someone is Vitamin D deficient (e.g., bone fractures, musculoskeletal pain, frequent illness).
Sports Health - Traumatic Laryngeal Fracture in a Collegiate Basketball Player
Laryngotracheal trauma is a rare condition that accounts for less than 1% of blunt trauma. Laryngotracheal fractures are uncommon in sports, even in settings where athletes are more vulnerable, including football, basketball, and hockey. If a laryngeal injury is suspected, immediate evaluation is required to avoid a delay in the diagnosis of a potentially life-threatening injury. A collegiate basketball player sustained an unusual fracture involving the cricoid and thyroid cartilage during practice. This case illustrates the importance of rapid identification and early management of patients with blunt laryngotracheal trauma in sports.
West Virginia Medical Journal - Antibiotic-Like Actions of Vitamin D
Vitamin D is a secosteroid hormone that has expanding importance for a healthy lifestyle and disease prevention. multitude of studies have highlighted that vitamin D acts not only in bone and calcium homeostasis but is critically important for human immunity. The discovery that the storage form of vitamin D (25-hydroxyvitamin D3) can be locally converted to the active form (1,25-hydroxyvitamin D3) in immune cells, epithelial cells and numerous other non-renal tissues highlights the importance of maintaining sufficient stores. When responding to a specific external stimulus, like bacterial invasion, intracrine synthesis of active vitamin D has the ability to regulate gene expression providing a specific response and directing cellular actions. These responses include the generation of antimicrobial peptides with production of these peptides dependent on vitamin D status. Vitamin D deficiency is associated with an increased rate of infection. This paper highlights the antibiotic like actions of vitamin D and importance of vitamin D sufficiency.
MU Orthopaedics to be a TRUST Clinical trial site
Can ultrasound help leg fractures heal faster? That is the question that researchers in the top rated Orthopaedic practice in WV will be trying to answer.
MU Orthopaedics is one of 25 multinational sites invited to participate in the TRUST Clinical Research Trial (Trial to evaluate Ultrasound in the treatment of Tibial fractures).
This FDA-approved study will include 500 patients from the US and Canada. The goal of this research protocol is to produce Level I data directing physicians on the utility of ultrasonic stimulation for fracture healing. Previous reports in the literature have suggested that ultrasonic stimulation of fractures improves the fracture healing process.
Patients enrolled into this study have acute tibia fractures surgically stabilized with intra-medullary fixation. If the patient consents to participation, an ultrasound unit will be provided at no cost to the patient. Patient outcomes including time to fracture healing will be assessed by clinical and radiographic evaluation.
The Principal Investigator for the project is Franklin D. Shuler MD, PhD. He will be assisted by Amber Simmons, RN; Clinical Manager and Research Coordinator. Participation in this study is part of MU Orthopaedic's push for translational research programs.
"We are excited to be one of the centers of excellence included in the TRUST research protocol,” said Dr. Shuler, who is the Director of Orthopaedic Research. “The addition of quality clinical research to our award winning excellence in patient care will help improve the care of our patients for the 21st century and beyond."