Staff radiologist co-authors article published in medical journal

Dr. Ryan Grippo, radiologist at Blanchfield Army Community Hospital, performs a scan on a patient July 2017. Grippo co-authored a research article with Dr. Justin J. Ernat and Maj. (Dr.) Joseph W. Galvin that was recently published in the “Journal of Orthopaedics.”

Blanchfield Army Community Hospital is making strides in medical research and developing a deeper understanding of joint injuries thanks to a recent research article published by three orthopedic medical professionals.

The research, published in the “Journal of Orthopaedics,” was headed by Maj. (Dr.) Joseph W. Galvin, former orthopedic surgeon at BACH and current head of shoulder and elbow surgery at Madigan Army Medical Center, Tacoma, Washington.

“The study was designed to determine the normal pressure in the shoulder joint after injecting 10 milliliters of contrast dye during a shoulder X-ray in patients with unstable shoulders,” Galvin said. “We also compared them to a control group of patients without instability. The ultimate goal was to determine the ideal pressure in the shoulder joint so that in a subsequent study we could perform pressure limited X-rays in an effort to more uniformly evaluate MRI capsular measurements.”

Galvin reached out to Dr. Ryan Grippo, BACH staff radiologist; and Dr. Justin J. Ernat, former staff orthopedic surgeon at BACH who now serves as a sports medicine fellow at the Steadman Clinic, Vail, Colorado, to help him with the study. Ernat has expertise in sports medicine surgery, primarily arthroscopic knee and shoulder surgery.

“Dr. Galvin had the idea and came to me as we were both are interested in labral disorders of the shoulder,” Ernat said. “There are a lot of shoulder labral and instability injuries in the military and we thought this study could improve our diagnostic accuracy of such. Dr. Galvin initiated the project and then he PCSed (permanent change of station) so I took the project over in his absence. I participated in the actual administration of the testing, as well as writing the manuscript for publication.”

The team wanted to see if they could use the new technique to better understand shoulder instability and pathology, Ernat said.

Grippo has expertise in radiology and imaging of muscular cells and joints. He assisted Galvin and Ernat in conducting the testing, measuring the pressure, and collecting the data for the article. The research and writing of the article took more than a year, he said.

“Dr. Galvin approached me in 2017 to help with the study,” Grippo said. “He created a new way to measure the pressure in the joint with the standard equipment we have around the hospital. He showed me his idea and I thought it was something we could apply in our practices.”

The team had hopes their findings could be a direct benefit to the Fort Campbell community, specifically with Soldiers and retirees. They also see great potential in Army medical research innovations across the health spectrum.

“The U.S. Army has a young, healthy patient population where surgical outcomes are rarely, if ever, are effected by comorbidities,” Ernat said. “If they can make performing research more accessible to the treating physicians, I think they could have an impact on not only Soldier readiness, but also on the general population as it pertains to evidence-based medicine.”

Their findings have already inspired more in-depth research from sports medicine orthopedic surgeons because athletes and Soldiers are similar, Galvin said.

“The military orthopedic community has a unique advantage in studying musculoskeletal injuries in young athletes,” he said. “Almost all of our patients are active men and women 18 to 45 years old. This offers us the ability to study injury patterns, improve diagnostic techniques, and study the outcomes of orthopedic surgeries in order to better warrior/patient care. In the civilian sector, orthopedic surgeons don’t have the luxury of treating such a highly young, active and motivated population.”

Grippo believes BACH is a great place to not only provide excellent medical care, but to contribute to medical research and innovations.

“The patients at BACH receive great care,” Grippo said. “The potential for research that not only benefits our patients, but across the military and nation, is great. It’s an exciting place. There are a lot of great minds. This is just one step in the process of mutual improvement of medical care for patients and hopefully we can improve the care for our patients through general innovation and research.”