Grant D. Shifflett, M.D. and Alexis E. Dixon, M.D. have joined California’s DISC Sports & Spine Center (DISC). As indicated in the September 7, 2016 news release, Dr. Shifflett completed a residency at Hospital for Special Surgery, then did a spine fellowship at Rush University in Chicago; he also completed a traveling fellowship in Japan. An orthopedic foot and ankle surgeon, Dr. Dixon joins DISC after the completion of a residency at the Los Angeles County + USC Medical Center, followed by a fellowship at the Baylor University Medical Center in Dallas, Texas.
Grant D. Shifflett, M.D. and Alexis E. Dixon, M.D. Join DISC

“I chose DISC for the same reasons I elected to do my fellowship at Rush University Medical Center, ” said Dr. Shifflett. “Both are known and respected for pioneering microsurgical spine techniques, and I knew that by joining the team at DISC, I would be working alongside some of the most talented physicians in the country within a uniquely patient-centric, innovative environment.”
Dr. Shifflett told OTW, “DISC has built an incredible model for the delivery of efficient, high-quality outpatient spine surgery. The next step is to share this success with the spine surgery community. I hope to use my research background to build a patient outcomes database that will facilitate this exchange as we work to improve the delivery of care for our patients.”
Dr. Dixon told OTW, “Foot and ankle naturally complements the care for the athletes, as these are a portion of the foot and ankle patients generally seen in practice. I believe I will bring a broader patient base, including a greater number of dancers, which is also a popular activity in Los Angeles. I will also continue to bring in active middle-aged patients with arthritis and chronic injuries, as DISC sees now as well. As an orthopaedic foot and ankle specialist, I am also qualified to treat inherited and developmental foot deformities that are less common in other areas of orthopaedics, like high-arched feet or flat feet, that can both be painful on their own or can lead to further injury. There are relatively few surgeons in the area well-trained in the use of total ankle replacements, which is a very complex but powerful operation, and it’s exciting to bring this treatment as an option in this area. Foot and ankle is a unique field in that a very high percentage of injuries and conditions can be treated nonoperatively, and I will be utilizing expertise of others in a team approach in the form of therapy, orthotics, and other modalities, in addition to surgery. I also believe it is important to educate the public on injury prevention, as well as when an injury is so severe as to require intervention from an orthopaedic foot and ankle surgeon. I am reaching out to athletic groups in the area to hear what are the common concerns and how I can best educate their members. I also have reached out to primary care physicians in the area to learn more about the common complaints seen in this neighborhood.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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