Matthew Dilisio, MD, an orthopedic surgeon with CHI Health and assistant professor of orthopedic surgery in the School of Medicine, claims that most surgeons in his field have a similar story. “Most of us were athletes at one point who were injured,” Dilisio says. “When an orthopedic surgeon could get you back on the field, it was amazing that they could do that.” Dilisio has known for a long time that he wanted to be able to return the favor to the next generation of athletes.
In his case, the surgeon that got Dilisio back on the field was also his high school rugby coach. He repaired Dilisio’s injured hand and had him back on the field in no time – probably too soon, Dilisio admits, but at the time, all that mattered was getting back out there with his teammates. Dilisio also played high school football and then college rugby at St. Louis University.
Now, as an orthopedic surgeon, he helps many high school and college athletes that resemble his younger self. “I love what I do,” Dilisio says. His patients run the gamut from high school athletes injured in contact sports to grandmothers with a broken shoulder. An orthopedic surgeon sees and evaluates people with musculoskeletal issues – fixing broken bones, replacing joints and repairing torn tendons, Dilisio explains. His specialty: shoulders and the tendons that help them function.
There is another side to patient care that not all clinical faculty choose to tackle: research. For Dilisio, research provides a means to investigate more effective treatments for patients. Beyond applying the current body of knowledge to patient cases, he wants to advance the field he loves. His current research examines the causes of tendon disorders of the shoulder and possible new treatments to enhance healing.
Explaining the Unexplained
Anyone who has gone to a physician to seek pain relief knows the frustration when a barrage of tests yields no explanation. Dilisio shared the frustration of his patients who complained of shoulder pain for which he couldn’t identify a clinical explanation. He set out to “explain the unexplained,” he says, through research. His team “discovered new ways that the tendon degenerates that are invisible to other testing modalities,” Dilisio says. In other words, they found an explanation for pain that standard tests couldn’t detect, finally opening the door to treatment options for patients.
Dilisio completed years of extensive training and studied with eminent surgeons – in France and Switzerland, and at Harvard Medical School, after graduating with distinction in research from medical school at St. Louis University. He also has experience in biomechanics research, and the complexities of the human body require a broad range of expertise. One problem in orthopedics that isn’t well understood yet is fatty infiltration of the shoulder. After shoulder surgery, instead of regaining muscle tissue, sometimes fat invades the tendon area instead, preventing healing, Dilisio explains. If the rotator cuff can’t heal after surgery, it’s as though “you’ve just changed the tires on a car with no motor,” Dilisio explains.
Synergy for Success
To better understand and address this challenge, Dilisio sought out experts in Creighton’s Department of Clinical and Translational Science, which applies scientific research methods to clinical problems identified by physicians. When scientists and physicians work together, patients benefit directly. Devendra Agrawal, PhD, a professor in clinical and translational science with extensive experience in cardiovascular sciences, has studied how fat can have negative inflammatory effects on cardiac tissue. Naturally, Dilisio teamed up with Agrawal to investigate ways to limit the fatty infiltration of the shoulder, which Dilisio can then use to inform patient treatments. Along with post-doctoral researcher Finosh Thankam, they published their findings on the mechanisms of this phenomenon in Molecular and Cellular Biochemistry.
Not long after coming to Creighton, Dilisio earned an intramural grant from the Dr. George Haddix Faculty Research Fund for $15,000 to explore a possible link between vitamin D deficiency and shoulder tendon problems. Dilisio calls this 2015 award the “springboard” for his research momentum, helping him build a dynamic team with Agrawal. He has since earned a $120,000 grant through the Department of Clinical and Translational Science, from LB 692 funds for biomedical research to advance health care in Nebraska. This funding will allow him to dive deeper in understanding inflammation and shoulder tendons.
For Every Answer, Ten Questions
No matter how decisive the findings from a line of research, “every project opens up 10 more questions,” Dilisio says. Even momentary disappointment from an unexpected research outcome may reveal new paths for inquiry. This provides plenty of opportunities to continue collaborating with Agrawal and undergraduate and graduate students and post-doctoral researchers. How do students make meaningful contributions to such complex work? Dilisio explains that first he educates students on the nature of the research project, and together they find an unanswered question within the project that a student can dive into. This lets students take the lead on specific topics on which they can become an expert. Then they look at tissue and gather data, with help from Dilisio and other mentors.
Medical students enjoy working with Dilisio on research so much that one of them, Andrew Hasebroock, MD’17, helped create a competitive program to open the opportunity to more students. Hasebroock says, “Dr. Dilisio has been a fantastic educator, physician and role model. With his help, we formed the M1 Orthopedic Surgery Summer Academy, a program designed to immerse first-year medical students in the world of orthopedic surgery, from staffing the clinic to scrubbing in to getting a research project done over the summer. Now, he takes on two students each summer to participate in the accredited program, teaching them and guiding them through their research. For him to go above and beyond like that is truly a testament to how dedicated he is as a physician.” Participating in research helps medical students land their ideal residency and understand what they want to do in the future, Dilisio explains.
After creating a strong research program in only a few years at Creighton, what does the future hold? Busy as he may be, Dilisio says, “I don’t want to take my foot off the gas.” He and his team just submitted a $2.5 million grant to the National Institutes of Health, and he says he is “confident that everything we’ve built is going to put our orthopedic department on the map.”
Learn more about Dilisio’s scholarly background.
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Learn more about clinical and translational science degree and certificate programs.