Bio

Bio


Native of Kalamazoo, Michigan. Undergraduate and medical education at the University of Michigan, Orthopaedic Surgery residency at Stanford. Dual-fellowship trained and now focused on injuries and deformity of the foot and ankle.

Specialties include sports injuries: osteochondral defects, Achilles ruptures and tendinitis, os trigonum syndrome, turf toe, plantar plate tears, ankle sprains; trauma injuries: ankle fractures, calcaneus fractures, talus fractures, metatarsal fractures; and arthritis of the ankle, subtalar joint, and midfoot. Fellowship trained in ankle arthroplasty.

Personal interests include outdoor activities, running, and travel.

Clinical Focus


  • Orthopaedic Surgery
  • Foot & Ankle Specialty
  • Sports Medicine

Academic Appointments


Administrative Appointments


  • Representative, Committee to Improve Patient Quality and Outcomes (2016 - Present)

Honors & Awards


  • Young Investigator Award for Research Excellence, Western Orthopaedic Association (2016)
  • John Joyce Award for Research Excellence, International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Injury (ISAKOS) (2013)
  • Nomination for the 2012 American Goldner Award, American Orthopaedic Foot and Ankle Society (AOFAS) (2012)
  • Glasgow-Rubin Achievement Citation, American Medical Womens Association (AMWA) (2009)
  • President of Alpha Omega Alpha, University of Michigan Medical School (2009)
  • Summa cum laude, University of Michigan (2004)
  • James B. Angell Scholar, University of Michigan (2003,4)

Boards, Advisory Committees, Professional Organizations


  • Member, Western Orthopaedic Association (2014 - Present)
  • Member, Ruth Jackson Orthopaedic Society (2013 - Present)
  • Member, American Foot and Ankle Orthopaedic Society (2013 - Present)
  • Member, American Academy of Orthopaedic Surgeons (2012 - Present)

Professional Education


  • Fellowship:Oakland Bone and Joint Specialists (2015) CA
  • Fellowship:The Flinders University of South Australia (2014) Australia
  • Residency:Stanford Hospital and Clinics - Dept of Orthopaedics (2014) CA
  • Internship:Stanford Hospital and Clinics - Dept of Orthopaedics (2010) CA
  • Medical Education:University of Michigan Medical School (2009) MI

Community and International Work


  • Wings of Hope Haiti, Haiti

    Topic

    Volunteer surgeon

    Populations Served

    Underserved

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

Research & Scholarship

Current Research and Scholarly Interests


Longterm follow up data of ankle arthroplasty

Projects


  • Appropriateness of Ankle MRI, Stanford University

    Determining the cost-benefit burden and current use trends of ankle MRIs

    Location

    Palo Alto, CA

  • STAR ankle: Patient results at 16 year follow-up, Stanford University

    Assessing long term outcomes of total ankle arthroplasty

    Location

    Palo Alto, CA

Publications

All Publications


  • The Effects of Limb Elevation on Muscle Oxygen Saturation: A Near-Infrared Spectroscopy Study in Humans PM&R Palanca, A. A., Yang, A., Bishop, J. A. 2016; 8 (3): 221-224
  • The Effects of Limb Elevation on Muscle Oxygen Saturation: A Near-Infrared Spectroscopy Study in Humans. PM & R : the journal of injury, function, and rehabilitation Palanca, A. A., Yang, A., Bishop, J. A. 2016; 8 (3): 221-224

    Abstract

    Orthopaedic and rehabilitation physicians often instruct patients to elevate a traumatized or postoperative lower extremity. Elevation is thought to improve patient comfort, as well as decrease swelling, wound complications, and the risk of compartment syndrome. Elevating a limb with increased compartment pressures, however, has been shown to reduce perfusion pressure and contribute to tissue ischemia. This investigation aims to advance our understanding of the tissue effects of limb elevation using a healthy patient model.To quantify the effects of elevation, experimentally induced ischemia, and immobilization on muscle oxygen saturation in the human leg using near-infrared spectroscopy (NIRS).Experimental crossover study.Orthopaedic Surgery research laboratory, Stanford Hospitals & Clinics.Twenty-six healthy volunteers.Using transcutaneous sensors, we measured muscle oxygen saturation of the anterior compartment of the left (control) leg at 0, 15, and 30 cm of elevation relative to the heart using NIRS. A standardized short leg splint and a thigh tourniquet inflated to 50 mmHg were then applied to the right (experimental) leg to simulate a traumatized state. NIRS measurements were then repeated, again at 0, 15, and 30 cm of elevation. Muscle oxygen saturation values at various degrees of elevation of the control and experimental limb were then compared and analyzed by the use of a crossover study design and mixed-effects regression.Muscle oxygen saturation at varying levels of elevation in both the (1) control leg and (2) experimental leg in a simulated traumatic state.Male (18) males and female (8) patients between 22 and 62 years of age (mean 29.8 years) were enrolled. Mean regional muscle oxygen saturation (rSO2) of the control limbs at 0, 15 and, 30 cm of elevation were 74.2%, 72.5%, and 70.6%, respectively, whereas mean rSO2 of the experimental limbs were 66.3%, 65.0%, and 63.3%. A statistically significant decrease of rSO2 was observed (mean 7.65%) in the experimental limbs compared with the control limbs. As elevation increased, there was a statistically significant decrease in rSO2 of 0.12% per centimeter of elevation. Elevation did not decrease the rSO2 in the experimental limb to a greater degree than in the control limb.Increasing levels of elevation in a human limb results in progressively compromised muscle oxygen saturation as measured by NIR.

    View details for DOI 10.1016/j.pmrj.2015.07.015

    View details for PubMedID 26261022

  • Antirotation Pins Improve Stability of the Compress Limb Salvage Implant: A Biomechanical Study CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Avedian, R. S., Chen, T., Lindsey, D., Palanca, A., Mohler, D. 2014; 472 (12): 3982-3986
  • Correlation of Intra-Articular Ankle Pathology With Cytokine Biomarkers and Matrix Degradation Products FOOT & ANKLE INTERNATIONAL Giovanni, T. P., Golish, S. R., Palanca, A., Hanna, L. S., Scuderi, G. J. 2012; 33 (8): 627-631

    Abstract

    Articular cartilage degeneration is mediated by inflammatory cytokines and fragments of structural matrix proteins. Few studies have examined the role of these biomarkers in intra-articular pathology of the ankle.Four groups of patients with increasing ankle pathology were enrolled. Group 1 included controls with no pain who underwent unrelated forefoot surgery. Group 2 included patients undergoing arthroscopy with intraoperative mild chondrosis. Group 3 included patients undergoing arthroscopy with moderate/severe chondrosis, osteochondral lesions, impingement, or loose bodies. Group 4 included positive controls with severe arthrosis undergoing ankle arthrodesis/arthroplasty. Ankle fluid was obtained by intra-articular aspiration and was assayed for IL-6, IFN-γ, MCP, MIP-1β, and fibronectin-aggrecan complex (FAC), a matrix-degradation marker. There were 36 patients total, 21 males and 15 females with a mean age 45 (±16; range 18 to 76) years and a mean VAS for pain of 4.7 (±3.5; range 0 to 9). In groups 1 through 4, there were 11, 6, 15 and 4 patients respectively.The mean values of MCP-1 were 49.8 (±8.0) for minimal pathology and 133.9 (±33.0) for substantial pathology (pg/ml). The mean values of the FAC were 2.83 (±1.16) for minimal pathology and 9.62 (±2.23) for substantial pathology (optical density at 450 nm). The groups differed significantly in age, preoperative VAS, FAC, IL-6, and MCP-1 (p<0.05).There are differences in FAC and MCP-1 with increasing grades of severity of intra-articular pathology.These tests may play a role in determining the necessity for arthroscopy or intra-articular procedures in equivocal candidates.

    View details for DOI 10.3113/FAI.2012.0627

    View details for Web of Science ID 000307418300002

    View details for PubMedID 22995228

  • Assessment of Compromised Fracture Healing JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS Bishop, J. A., Palanca, A. A., Bellino, M. J., Lowenberg, D. W. 2012; 20 (5): 273-282

    Abstract

    No standard criteria exist for diagnosing fracture nonunion, and studies suggest that assessment of fracture healing varies among orthopaedic surgeons. This variability can be problematic in both clinical and orthopaedic trauma research settings. An understanding of risk factors for nonunion and of diagnostic tests used to assess fracture healing can facilitate a systematic approach to evaluation and management. Risk factors for nonunion include medical comorbidities, age, and the characteristics of the injury. The method of fracture management also influences healing. Comprehensive evaluation includes an assessment of the patient's symptoms, signs, and immune and endocrine status as well as the biologic capacity of the fracture, presence of infection, and quality of reduction and fixation. Diagnostic tests include plain radiography, CT, ultrasonography, fluoroscopy, bone scan, MRI, and several laboratory tests, including assays for bone turnover markers in the peripheral circulation. A systematic approach to evaluating fracture union can help surgeons determine the timing and nature of interventions.

    View details for DOI 10.5435/JAAOS-20-05-273

    View details for Web of Science ID 000303366800003

    View details for PubMedID 22553099