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Bio

Bio

Dr. Kleimeyer specializes in orthopaedic spine surgery, treating cervical, thoracic and lumbar spine disorders including disc herniations, stenosis, myelopathy, fractures, scoliosis and more. Prior to coming to the Stanford Department of Orthopaedic Surgery and the Stanford Spine Center, Dr. Kleimeyer completed his residency in orthopaedic surgery at Stanford University where he was elected to the Alpha Omega Alpha honor society. He then completed his spine fellowship at the renowned Emory University Spine Center.

Dr. Kleimeyer has received honors and recognition for his research in the fields of orthopaedic surgery and spine surgery. He participates in national and international specialty societies and as a journal reviewer. His research interests include improving clinical outcomes of surgical and nonsurgical care, the genetics of orthopaedic and spine disorders, and cost efficacy. Dr. Kleimeyer has published over 20 journal articles in addition to other reviews and textbook chapters.

Clinical Focus

  • Orthopaedic Surgery
  • Spine Surgery

Academic Appointments

Professional Education

  • Fellowship: Emory University Orthopaedic Spine Surgery Fellowship (2019) GA
  • Residency: Stanford University Orthopaedic Surgery Residency (2018) CA
  • Internship: Stanford University General Surgery Residency (2014) CA
  • Medical Education: Weill Cornell Medical College (2013) NY

Contact

  • Tammy Brown Administrative Assistant
    • Tel: 650-736-6205
  • Stanford Orthopedic Surgery at Pleasanton 5725 W Las Positas Blvd Ste 200 Pleasanton, CA 94588
    • Tel: (925) 272-2860
    Fax: (925) 263-5700

Links

Publications

All Publications

  • Cervical Epidural Steroid Injections: Incidence and Determinants of Subsequent Surgery. The spine journal : official journal of the North American Spine Society Kleimeyer, J. P., Koltsov, J. C., Smuck, M. W., Wood, K. B., Cheng, I., Hu, S. S. 2020

    Abstract

    BACKGROUND CONTEXT: Cervical epidural steroid injections (CESIs) are sometimes used in the management of cervical radicular pain in order to delay or avoid surgery. However, the rate and determinants of surgery following CESIs remain uncertain.PURPOSE: This study sought to determine: 1) the proportion of patients having surgery following CESI, and 2) the timing of and factors associated with subsequent surgery.STUDY DESIGN: Retrospective analysis of a large, national administrative claims database.PATIENT SAMPLE: The study included 192,777 CESI patients (age 50.9±11.3 years, 55.2% female) who underwent CESI for imaging-based diagnoses of cervical disc herniation or stenosis, a clinical diagnosis of radiculopathy, or a combination thereof.OUTCOME MEASURES: The primary outcome was the time from index CESI to surgery.METHODS: Inclusion criteria were CESI for cervical disc herniation, stenosis, or radiculopathy, age ?18, and active enrollment for 1 year prior to CESI to screen for exclusions. Patients were followed until they underwent cervical surgery, or their enrollment lapsed. Rates of surgery were assessed with Kaplan-Meier survival curves and 99% confidence intervals. Factors associated with subsequent surgery were assessed with multivariable Cox proportional hazard models.RESULTS: Within 6 months of CESI, 11.2% of patients underwent surgery, increasing to 14.5% by 1 year and 22.3% by 5 years. Male patients and those aged 35-54 had an increased likelihood of subsequent surgery. Patients with radiculopathy were less likely to undergo surgery following CESI than those with stenosis or herniation, while patients with multiple diagnoses were more likely. Patients with comorbidities including CHF, other cardiac comorbidities or chronic pain were less likely to undergo surgery, as were patients in the northeast US region. Some 33.5% of patients underwent >1 CESI, with 84.6% of these occurring within 1 year. Additional injections were associated with reduced rates of subsequent surgery.CONCLUSIONS: Following CESI, over one in five patients underwent surgery within 5 years. Multiple patient-specific risk factors for subsequent surgery were identified, and patients undergoing repeated injections were at lower risk. Determining which patients may progress to surgery can be used to improve resource utilization and to inform shared decision-making.

    View details for DOI 10.1016/j.spinee.2020.06.012

    View details for PubMedID 32565316

  • Development of a Reproducible Upper Limb Swelling Model. The journal of hand surgery Asian-Pacific volume Muraoka, K., Kleimeyer, J., Yao, J. 2019; 24 (4): 452?55

    Abstract

    Background: The purpose of this study was to develop a reproducible upper limb swelling model and quantify the efficacy of changing elevation posture in swelling reduction using this model. Methods: A manual sphygmomanometer was applied to healthy volunteers' upper arms while in a dependent position for 25 minutes to create venous congestion and swelling. Seven different levels of pressure (250, 120, 100, 80, 50, 40 and 30 mmHg) were tested. Every 5 minutes, the level of swelling was measured using the volumetric method. Any complications were recorded. We then compared the swelling reduction potential among 3 limb postures (arm on head, elevation brace, and simple sling). The significance level was set at p < .05. Results: Thirty to forty milliliters of swelling was created for all pressure levels except the 250 and 30 mmHg. All complications including transient nerve palsy, pain and petechiae were severe at 250 and 120 mmHg, less severe at 100 mmHg, mild at 80 mmHg, and absent below 40 mmHg. Both the on head and elevated brace limb postures markedly and significantly decreased swelling greater than the simple sling posture. Conclusions: We found that 20 ml or greater swelling can be reliably created with a blood pressure cuff inflated to 40 mmHg on the upper limb. The on head and elevated brace postures demonstrated a greater degree of swelling reduction than the simple sling posture.

    View details for DOI 10.1142/S2424835519500589

    View details for PubMedID 31690206

  • A Structured Review Instrument Improves the Quality of Orthopaedic Journal Club JOURNAL OF SURGICAL EDUCATION Campbell, S. T., Kleimeyer, J. P., Young, J. L., Gardner, M. J., Wood, K. B., Bishop, J. A. 2019; 76 (1): 294?300

    View details for DOI 10.1016/j.jsurg.2018.06.017

    View details for Web of Science ID 000456356300036

  • Agreement and Reliability of Lateral Patellar Tilt and Displacement following Total Knee Arthroplasty with Patellar Resurfacing. The journal of knee surgery Kleimeyer, J. P., McQuillan, T. J., Arsoy, D. n., Aggarwal, V. K., Amanatullah, D. F. 2019

    Abstract

    Patellar position and alignment may be measured on routine axial radiographs by various techniques; however, the agreement and reliability of such measurements with a resurfaced patella remain unknown. This study evaluated the range and reliability of lateral patellar tilt and lateral patellar displacement following total knee arthroplasty (TKA) with a resurfaced patella among three observers on 45° Merchant view in 139 TKAs. Intraclass correlation coefficient (ICCs) were used to evaluate intraobserver agreement (IOA) and inter-rater reliability (IRR). IRR was high between each of the observers for lateral patellar tilt (ICC?=?0.8) and lateral patellar displacement (ICC?=?0.87). IOA was also high upon repeat measurement for the same observer for lateral patellar tilt (ICC???0.90) and lateral patellar displacement (ICC???0.86). Therefore, lateral patellar tilt and lateral patellar displacement are reproducible measurements of patellar position on a Merchant axial radiograph following a well-functioning TKA with a resurfaced patella.

    View details for DOI 10.1055/s-0039-1700843

    View details for PubMedID 31698498

  • Incidence and Risk Factors for Postoperative Hypothermia After Orthopaedic Surgery JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS Kleimeyer, J. P., Harris, A. S., Sanford, J., Maloney, W. J., Kadry, B., Bishop, J. A. 2018; 26 (24): E497?E503

    View details for DOI 10.5435/JAAOS-D-16-00742

    View details for Web of Science ID 000462410600001

  • Improved biomechanics of two alternative kyphoplasty cementation methods limit vertebral recollapse JOURNAL OF ORTHOPAEDIC RESEARCH Alamin, T., Kleimeyer, J. P., Woodall, J. R., Agarwal, V., Don, A., Lindsey, D. 2018; 36 (12): 3225?30

    View details for DOI 10.1002/jor.24127

    View details for Web of Science ID 000454861000016

  • Does the Watson-Jones or Modified Smith-Petersen Approach Provide Superior Exposure for Femoral Neck Fracture Fixation? CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Lichstein, P. M., Kleimeyer, J. P., Githens, M., Vorhies, J. S., Gardner, M. J., Bellino, M., Bishop, J. 2018; 476 (7): 1468?76

    View details for DOI 10.1097/01.blo.0000533627.07650.bb

    View details for Web of Science ID 000438532900019

  • Functionally Graded, Bone- and Tendon-Like Polyurethane for Rotator Cuff Repair ADVANCED FUNCTIONAL MATERIALS Ker, D., Wang, D., Behn, A., Wang, E., Zhang, X., Zhou, B., Mercado-Pagan, A., Kim, S., Kleimeyer, J., Gharaibeh, B., Shanjani, Y., Nelson, D., Safran, M., Cheung, E., Campbell, P., Yang, Y. 2018; 28 (20)

    Abstract

    Critical considerations in engineering biomaterials for rotator cuff repair include bone-tendon-like mechanical properties to support physiological loading and biophysicochemical attributes that stabilize the repair site over the long-term. In this study, UV-crosslinkable polyurethane based on quadrol (Q), hexamethylene diisocyante (H), and methacrylic anhydride (M; QHM polymers), which are free of solvent, catalyst, and photoinitiator, is developed. Mechanical characterization studies demonstrate that QHM polymers possesses phototunable bone- and tendon-like tensile and compressive properties (12-74 MPa tensile strength, 0.6-2.7 GPa tensile modulus, 58-121 MPa compressive strength, and 1.5-3.0 GPa compressive modulus), including the capability to withstand 10 000 cycles of physiological tensile loading and reduce stress concentrations via stiffness gradients. Biophysicochemical studies demonstrate that QHM polymers have clinically favorable attributes vital to rotator cuff repair stability, including slow degradation profiles (5-30% mass loss after 8 weeks) with little-to-no cytotoxicity in vitro, exceptional suture retention ex vivo (2.79-3.56-fold less suture migration relative to a clinically available graft), and competent tensile properties (similar ultimate load but higher normalized tensile stiffness relative to a clinically available graft) as well as good biocompatibility for augmenting rat supraspinatus tendon repair in vivo. This work demonstrates functionally graded, bone-tendon-like biomaterials for interfacial tissue engineering.

    View details for PubMedID 29785178

  • Two Genetic Variants Associated with Plantar Fascial Disorders INTERNATIONAL JOURNAL OF SPORTS MEDICINE Kim, S. K., Ioannidis, J. A., Ahmed, M. A., Avins, A. L., Kleimeyer, J. P., Fredericson, M., Dragoo, J. L. 2018; 39 (4): 314?21

    Abstract

    Plantar fascial disorder is comprised of plantar fasciitis and plantar fibromatosis. Plantar fasciitis is the most common cause of heel pain, especially for athletes involved in running and jumping sports. Plantar fibromatosis is a rare fibrous hyperproliferation of the deep connective tissue of the foot. To identify genetic loci associated with plantar fascial disorders, a genome-wide association screen was performed using publically available data from the Research Program in Genes, Environment and Health including 21,624 cases of plantar fascial disorders and 80,879 controls. One indel (chr5:118704153:D) and one SNP (rs62051384) showed an association with plantar fascial disorders at genome-wide significance (p<5×10-8) with small effects (odds ratios=0.93 and 1.07 per allele, respectively). The indel chr5:118704153:D is located within TNFAIP8 (encodes a protein induced by TNF alpha) and rs62051384 is located within WWP2 (which is involved in proteasomal degradation). These DNA variants may be informative in explaining why some individuals are at higher risk for plantar fascial disorders than others.

    View details for PubMedID 29534260

  • Does the Watson-Jones or Modified Smith-Petersen Approach Provide Superior Exposure for Femoral Neck Fracture Fixation? Clinical orthopaedics and related research Lichstein, P. M., Kleimeyer, J. P., Githens, M. n., Vorhies, J. S., Gardner, M. J., Bellino, M. n., Bishop, J. n. 2018

    Abstract

    A well-reduced femoral neck fracture is more likely to heal than a poorly reduced one, and increasing the quality of the surgical exposure makes it easier to achieve anatomic fracture reduction. Two open approaches are in common use for femoral neck fractures, the modified Smith-Petersen and Watson-Jones; however, to our knowledge, the quality of exposure of the femoral neck exposure provided by each approach has not been investigated.(1) What is the respective area of exposed femoral neck afforded by the Watson-Jones and modified Smith-Petersen approaches? (2) Is there a difference in the ability to visualize and/or palpate important anatomic landmarks provided by the Watson-Jones and modified Smith-Petersen approaches?Ten fresh-frozen human pelvi underwent both modified Smith-Petersen (utilizing the caudal extent of the standard Smith-Petersen interval distal to the anterosuperior iliac spine and parallel to the palpable interval between the tensor fascia lata and the sartorius) and Watson-Jones approaches. Dissections were performed by three fellowship-trained orthopaedic traumatologists with extensive experience in both approaches. Exposure (in cm) was quantified with calibrated digital photographs and specialized software. Modified Smith-Petersen approaches were analyzed before and after rectus femoris tenotomy. The ability to visualize and palpate seven clinically relevant anatomic structures (the labrum, femoral head, subcapital femoral neck, basicervical femoral neck, greater trochanter, lesser trochanter, and medial femoral neck) was also recorded. The quantified area of the exposed proximal femur was utilized to compare which approach afforded the largest field of view of the femoral neck and articular surface for assessment of femoral neck fracture and associated femoral head injury. The ability to visualize and palpate surrounding structures was assessed so that we could better understand which approach afforded the ability to assess structures that are relevant to femoral neck fracture reduction and fixation.After controlling for age, body mass index, height, and sex, we found the modified Smith-Petersen approach provided a mean of 2.36 cm (95% confidence interval [CI], 0.45-4.28 cm; p = 0.015) additional exposure without rectus femoris tenotomy (p = 0.015) and 3.33 cm (95% CI, 1.42-5.24 cm; p = 0.001) additional exposure with a tenotomy compared with the Watson-Jones approach. The labrum, femoral head, subcapital femoral neck, basicervical femoral neck, and greater trochanter were reliably visible and palpable in both approaches. The lesser trochanter was palpable in all of the modified Smith-Petersen and none of the Watson-Jones approaches (p < 0.001). All modified Smith-Petersen approaches (10 of 10) provided visualization and palpation of the medial femoral neck, whereas visualization of the medial femoral neck was only possible in one of 10 Watson-Jones approaches (p < 0.001) and palpation was possible in eight of 10 Watson-Jones versus all 10 modified Smith-Petersen approaches (p = 0.470).In the hands of surgeons experienced with both surgical approaches to the femoral neck, the modified Smith-Petersen approach, with or without rectus femoris tenotomy, provides superior exposure of the femoral neck and articular surface as well as visualization and palpation of clinically relevant proximal femoral anatomic landmarks compared with the Watson-Jones approach.Open reduction and internal fixation of a femoral neck fracture is typically performed in a young patient (< 60 years old) with the objective of obtaining anatomic reduction that would not be possible by closed manipulation, thus enhancing healing potential. In the hands of surgeons experienced in both approaches, the modified Smith-Petersen approach offers improved direct access for reduction and fixation. Higher quality reductions and fixation are expected to translate to improved healing potential and outcomes. Although our experimental results are promising, further clinical studies are needed to verify if this larger exposure area imparts increased quality of reduction, healing, and improved outcomes compared with other approaches. The learning curve for the exposure is unclear, but the approach has broad applications and is frequently used in other subspecialties such as for direct anterior THA and pediatric septic hip drainage. Surgeons treating femoral neck fractures with open reduction and fixation should familiarize themselves with the modified Smith-Petersen approach.

    View details for PubMedID 29698292

  • Genome-wide association study identifies a locus associated with rotator cuff injury PLOS ONE Roos, T. R., Roos, A. K., Avins, A. L., Ahmed, M. A., Kleimeyer, J. P., Fredericson, M., Ioannidis, J. A., Dragoo, J. L., Kim, S. K. 2017; 12 (12): e0189317

    Abstract

    Rotator cuff tears are common, especially in the fifth and sixth decades of life, but can also occur in the competitive athlete. Genetic differences may contribute to overall injury risk. Identifying genetic loci associated with rotator cuff injury could shed light on the etiology of this injury. We performed a genome-wide association screen using publically available data from the Research Program in Genes, Environment and Health including 8,357 cases of rotator cuff injury and 94,622 controls. We found rs71404070 to show a genome-wide significant association with rotator cuff injury with p = 2.31x10-8 and an odds ratio of 1.25 per allele. This SNP is located next to cadherin8, which encodes a protein involved in cell adhesion. We also attempted to validate previous gene association studies that had reported a total of 18 SNPs showing a significant association with rotator cuff injury. However, none of the 18 SNPs were validated in our dataset. rs71404070 may be informative in explaining why some individuals are more susceptible to rotator cuff injury than others.

    View details for PubMedID 29228018

  • International journal of sports medicine Kim, S., Kleimeyer, J. P., Ahmed, M. A., Avins, A. L., Fredericson, M., Dragoo, J. L., Ioannidis, J. P. 2017

    Abstract

    Shoulder dislocations are common shoulder injuries associated with athletic activity in contact sports, such as football, rugby, wrestling, and hockey. Identifying genetic loci associated with shoulder dislocation could shed light on underlying mechanisms for injury and identify predictive genetic markers. To identify DNA polymorphisms associated with shoulder dislocation, a genome-wide association screen was performed using publically available data from the Research Program in Genes, Environment and Health including 662 cases of shoulder dislocation and 82?602 controls from the European ancestry group. rs12913965 showed an association with shoulder dislocation at genome-wide significance (p=9.7×10(-9); odds ratio=1.6) from the European ancestry group. Individuals carrying one copy of the risk allele (T) at rs12913965 showed a 69% increased risk for shoulder dislocation in our cohort. rs12913965 is located within an intron of the TICRR gene, which encodes TOPBP1 interacting checkpoint and replication regulator involved in the cell cycle. rs12913965 is also associated with changes in expression of the ISG20 gene, which encodes an antiviral nuclease induced by interferons. This genetic marker may one day be used to identify athletes with a higher genetic risk for shoulder dislocation. It will be important to replicate this finding in future studies.

    View details for DOI 10.1055/s-0043-106190

    View details for PubMedID 28521375

  • Two Genetic Loci associated with Medial Collateral Ligament Injury. International journal of sports medicine Roos, A. K., Avins, A. L., Ahmed, M. A., Kleimeyer, J. P., Roos, T. R., Fredericson, M., Ioannidis, J. P., Dragoo, J. L., Kim, S. 2017

    Abstract

    Medial collateral ligament (MCL) injuries are a common knee injury, especially in competitive athletes. Identifying genetic loci associated with MCL injury could shed light on its etiology. A genome-wide association screen was performed using data from the Research Program in Genes, Environment and Health (RPGEH) including 1?572 cases of MCL injury and 100?931 controls. 2 SNPs (rs80351309 and rs6083471) showed an association with MCL injury at genome-wide significance (p<5×10(-8)) with moderate effects (odds ratios=2.12 and 1.57, respectively). For rs80351309, the genotypes were imputed with only moderate accuracy, so this SNP should be viewed with caution until its association with MCL injury can be validated. The SNPs rs80351309 and rs6083471 show a statistically significant association with MCL injury. It will be important to replicate this finding in future studies.

    View details for DOI 10.1055/s-0043-104853

    View details for PubMedID 28482362

  • Genome-wide association screens for Achilles tendon and ACL tears and tendinopathy PLOS ONE Kim, S. K., Roos, T. R., Roos, A. K., Kleimeyer, J. P., Ahmed, M. A., Goodlin, G. T., Fredericson, M., Ioannidis, J. P., Avins, A. L., Dragoo, J. L. 2017; 12 (3)

    Abstract

    Achilles tendinopathy or rupture and anterior cruciate ligament (ACL) rupture are substantial injuries affecting athletes, associated with delayed recovery or inability to return to competition. To identify genetic markers that might be used to predict risk for these injuries, we performed genome-wide association screens for these injuries using data from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort consisting of 102,979 individuals. We did not find any single nucleotide polymorphisms (SNPs) associated with either of these injuries with a p-value that was genome-wide significant (p<5x10-8). We found, however, four and three polymorphisms with p-values that were borderline significant (p<10-6) for Achilles tendon injury and ACL rupture, respectively. We then tested SNPs previously reported to be associated with either Achilles tendon injury or ACL rupture. None showed an association in our cohort with a false discovery rate of less than 5%. We obtained, however, moderate to weak evidence for replication in one case; specifically, rs4919510 in MIR608 had a p-value of 5.1x10-3 for association with Achilles tendon injury, corresponding to a 7% chance of false replication. Finally, we tested 2855 SNPs in 90 candidate genes for musculoskeletal injury, but did not find any that showed a significant association below a false discovery rate of 5%. We provide data containing summary statistics for the entire genome, which will be useful for future genetic studies on these injuries.

    View details for DOI 10.1371/journal.pone.0170422

    View details for Web of Science ID 000399174800001

    View details for PubMedID 28358823

  • Genome-wide association screens for Achilles tendon and ACL tears and tendinopathy PLOS ONE Kim, S. K., Roos, T. R., Roos, A. K., Kleimeyer, J. P., Ahmed, M. A., Goodlin, G. T., Fredericson, M., Ioannidis, J. P., Avins, A. L., Dragoo, J. L. 2017; 12 (3)

    Abstract

    Achilles tendinopathy or rupture and anterior cruciate ligament (ACL) rupture are substantial injuries affecting athletes, associated with delayed recovery or inability to return to competition. To identify genetic markers that might be used to predict risk for these injuries, we performed genome-wide association screens for these injuries using data from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort consisting of 102,979 individuals. We did not find any single nucleotide polymorphisms (SNPs) associated with either of these injuries with a p-value that was genome-wide significant (p<5x10-8). We found, however, four and three polymorphisms with p-values that were borderline significant (p<10-6) for Achilles tendon injury and ACL rupture, respectively. We then tested SNPs previously reported to be associated with either Achilles tendon injury or ACL rupture. None showed an association in our cohort with a false discovery rate of less than 5%. We obtained, however, moderate to weak evidence for replication in one case; specifically, rs4919510 in MIR608 had a p-value of 5.1x10-3 for association with Achilles tendon injury, corresponding to a 7% chance of false replication. Finally, we tested 2855 SNPs in 90 candidate genes for musculoskeletal injury, but did not find any that showed a significant association below a false discovery rate of 5%. We provide data containing summary statistics for the entire genome, which will be useful for future genetic studies on these injuries.

    View details for DOI 10.1371/journal.pone.0170422

    View details for PubMedID 28358823

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