IN THE SPOTLIGHT: Dr. Amir Misaghi

Earlier this year, orthopaedic surgeon Dr. Amir Misaghi joined the CHOC Children’s Orthopaedics Institute. A member of CHOC’s sarcoma team, his special clinical interests range from bone and soft tissue tumors to limb deformities. He shared with us why he decided to become a doctor, new developments in his field, his hobbies outside of work and more.

Dr. Amir Misaghi
Dr. Amirhossein Misaghi, CHOC Children’s orthopaedic surgeon

What is your education and training?

I completed my undergraduate, medical school and orthopaedic surgery residency all at the University of California, San Diego, followed by a pediatric orthopaedic fellowship at Children’s Hospital of Philadelphia and an orthopaedic oncology fellowship at Mayo Clinic in Rochester, Minn.

What are your special clinical interests?

My clinical interests are bone and soft tissue tumors, trauma, hip disorders, limb deformities and other standard pediatric orthopaedic conditions. The vast majority of tumors in kids are benign but can still be complicated. Tumors can be found in difficult-to-operate areas, or be benign but hard to eradicate, so having both a pediatric orthopaedic and an orthopaedic oncology background helps me manage these complexities.

Why did you decide to become a doctor?

I love working with and helping others, and I was drawn to orthopaedics because I’ve always enjoyed using my hands to build and repair things. I also like working in pediatrics because I find kids fun and fascinating to be around. Oftentimes, especially when working with pediatric cancer patients, some very difficult situations and decisions arise, but I feel privileged to partner with families and navigate these challenges alongside them. Kids tend to do remarkably well and have incredible resilience, and I have encountered very powerful moments working in this field. It is an amazing feeling to witness my patients growing up and thriving.

What are some new programs or developments within your specialty?

CHOC is an amazing place with a fantastic pediatric orthopaedic department and cancer center.

Pediatric orthopaedics and pediatric orthopaedic oncology have changed with advances in growing type prosthesis for limb salvage surgery, as well as advances in lengthening limbs and restoring function after major trauma or cancer treatment. We have access to many exciting new pediatric-focused technologies at CHOC.

CHOC also has a great sarcoma team, and it is incredibly rewarding to be part of this multidisciplinary group. We take care of complex patients with the shared goal of providing the best care and getting them back to living happy, healthy lives. I love being able to work closely with Dr. Elyssa Rubin, medical oncologist, and Dr. Raj Vyas, plastic surgeon, to grow our limb salvage and musculoskeletal oncology/sarcoma program. We also have fantastic pediatric interventional radiology with Dr. Tamman Beydoun, and an amazing pathology department with Dr. Aaron Sassoon and Dr. Ali Nael.

What would you most like referring providers to know about you or your division at CHOC?

I want providers to feel confident referring patients to us. We are set up to take care of all benign and malignant bone and soft tissue tumors with a comprehensive team. The oncology program at CHOC is a dedicated group of multidisciplinary providers, including oncology, pediatric surgery, radiation oncology, interventional radiology, radiology and pathology. We meet weekly at our oncology tumor board meeting to discuss complex cases, ensuring we can provide up-to-date, cutting-edge treatment. We are fully equipped as a sarcoma team to manage all malignant bone and soft tissue tumors, and we all focus specifically on pediatrics.

What inspires you most about the care being delivered here at CHOC?

The various providers and patients inspire me. I am constantly impressed by the dedication of the nurses, physicians, child life specialists and countless other staff who work so hard. Taking care of pediatric patients, seeing their strength and witnessing them overcome their challenges is incredible.

If you weren’t a physician, what would you be and why?

I would open a small restaurant – I have always loved cooking, especially outdoors. One of the things I love most about my current job is talking to and getting to know my patients and their families. I think that the restaurant world might offer similar rewarding interactions with people, like chatting with regulars over the years, all while making delicious food.

What are your hobbies and interests outside of work?

I enjoy outdoor activities like camping and fishing, and have recently been trying to interest my kids, ages 3 and 7, in these hobbies as well. We’ve also taken up gardening as a family, and we are always ready for a good barbecue or soccer match.

What have you learned from your patients?

I’ve learned that life is a marathon, not a sprint. It is a joy to watch kids heal after surgery, and to then see them months or years later recovered and back to life. They have also taught me some practical things to keep me plugged in to what is cool and trendy. Recently I was educated about TikTok and some of its popular personalities – one patient suggested I even make a TikTok profile and start showing off some of my dance moves.

Refer a patient to the CHOC Children’s Orthopaedic Institute.

CHOC recognized as one of nation’s best children’s hospitals

CHOC Children’s is one of a select group of pediatric facilities nationwide to have been ranked today as a best children’s hospital by U.S. News & World Report.

The following CHOC specialties are honored in the 2020-21 Best Children’s Hospitals rankings: neonatology; cancer; diabetes and endocrinology; neurology and neurosurgery; orthopaedics; pulmonology; and urology. Both orthopaedics and diabetes and endocrinology earned a “Top 20” spot.

“At CHOC, we are committed to the highest standards of care, safety and service – and this honor reflects that unwavering dedication,” said Dr. James Cappon, CHOC’s vice president, chief quality and patient safety officer and interim chief medical officer. “Not only does this recognition of our excellence in these subspecialties, including two on the top 20 lists, validate our efforts, but it also offers our patients and families additional assurance of our commitment to their health and safety.”

The Best Children’s Hospitals rankings were introduced by U.S. News in 2007 to help families of children with rare or life-threatening diseases find the best medical care available. Only the nation’s top 50 pediatric facilities are distinguished in 10 pediatric specialties, based on survival rates, nurse staffing, procedure and patient volumes, reputation and additional outcomes data. The availability of clinical resources, infection rates and compliance with best practices are also factored into the rankings.

The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices.

Learn more about Best Children’s Hospitals rankings.

How QR codes could improve cast care for pediatric patients

Scrawled get-well messages, doodles and friends’ autographs might be common sights on children’s casts following a bone fracture, but what about QR codes?

It turns out that quick response (QR) codes – those ubiquitous boxes with pixelated lines that lead smart phones to web pages – could be an effective way to communicate at-home cast care instructions to patients and families, according to a new study co-authored by a CHOC Children’s orthopaedic surgeon.

A QR code that leads to a website spelling out care instructions can be accessed on-demand and supplement details provided by the physician in the clinic, said study co-author Dr. John Schlechter. Use of this technology could help enhance the retention of care instructions, possibly leading to improved outcomes and reducing emergency department visits.

A QR code leading to the CHOC Children’s Orthopaedic Institute’s website

“At CHOC, we know how stressful and scary a child’s injury can be,” Dr. Schlechter said. “In these cases, it can be difficult for parents to retain information and instructions. For parents who are faced with a child who has a broken or fractured bone, simple technology like a QR code can help bring added confidence and peace of mind that they can provide quality follow-up care at home.”

Released as part of the American Academy of Orthopaedic Surgeons’ (AAOS) recent Virtual Education Experience, QR Codes – Alternative Methods for Cast Care Instructions in Children tracked 88 children with fractures who didn’t require surgery and had a family member with a smart phone. A waterproof QR code was secured to the child’s cast, allowing a family member to scan the code with their phone.

Dr. John Schlechter. orthopaedic surgeon, CHOC Children’s Orthopaedic Institute

Among other factors, researchers monitored cast complications, the number of times the QR code was scanned, treatment satisfaction, and whether the code helped prevent a call to the physician.

Finding that 60 families used the code, researchers also noted:

  • The QR code was scanned an average of 1.6 times, though participants believed they scanned it an average of 2.4 times.
  • Seventy-four percent of patients were very satisfied with the convenience.
  • Ninety percent of the patients found the QR code convenient and useful.
  • Thirty-seven participants reported that the information on the website the QR code led them to kept them from needing to contact a physician to ask a question.
  • Some reported problems with the QR code, including it not scanning, falling off, being unable to find the code on the cast, and the code not working after the first scan.
  • Eleven cast complications – including eight wet casts – were reported among participants.

“Our data shows that the use of a QR code for a non-surgical pediatric fracture has a high level of patient and family success and satisfaction and can reduce the number of phone calls to an attending physician,” Dr. Schlechter said.

Learn more about the CHOC Children’s Orthopaedic Institute.

CHOC Children’s Names New Orthopaedic Institute Director

Bringing a wealth of clinical and administrative knowledge and experience, Dr. Lucy Morizio has been named director of the CHOC Children’s Orthopaedic Institute.

Dr. Lucy Morizio is director of the CHOC Children's Orthopaedic Institute

In her new administrative leadership role, Dr. Morizio will partner with CHOC leadership to accomplish the Orthopaedic Institute’s strategic and operational goals, including developing the institute as a destination location for pediatric orthopedic services. She begins her new duties Oct. 22.

“I am excited to collaborate with clinicians, employees and executive leadership at CHOC Children’s to help grow its orthopedic services,” Dr. Morizio said. “My goal is to build upon the Orthopeadic Institute’s already top-notch care and outcomes to further enhance and improve how we serve children in Orange County and beyond.”

The Orthopaedic Institute consistently ranks among the Best Children’s Hospitals by U.S. News & World Report for orthopedics.

Dr. Morizio joined CHOC in 2016 as part of its population health efforts, first serving as a quality improvement specialist and later becoming manager of population health-quality.

Previously, Dr. Morizio had a private practice while working with the California’s Newborn Screening Program for 16 years.

Dr. Morizio graduated with a Bachelor of Science degree from UC Irvine and earned a doctorate in podiatric medicine from Samuel Merritt University. She completed her surgical residency in Rancho Mirage, Calif.

Dr. Francois Lalonde Discusses Pediatric Orthopaedics

Stretching before activity as well as at home, and alternating between sports are key to prevent sports-related injuries, Dr. Francois Lalonde, a pediatric orthopaedic surgeon and chief of the department of surgery at CHOC Children’s, tells “American Health Journal.”

Children interested in a specific sport should spend three to four months each year participating in an activity that utilizes other muscle groups and movements as not to incur repetitive-use injuries, says Dr. Lalonde.

Learn more about pediatric orthopaedics, including common sports injuries, in “American Health Journal,” a television program that airs on PBS and other national network affiliates that reach more than 30 million households.

Each 30-minute episode features six segments with a diverse range of medical specialists discussing a full spectrum of health topics. For more information, visit www.discoverhealth.tv.

More About Dr. Lalonde

Francois Lalonde, M.D., is the chair of the department of surgery at CHOC Children’s. Dr. Lalonde graduated from the University of Toronto. He completed his internship in pediatrics at the Montreal Children’s Hospital/McGill University in Montreal and his residency in orthopedic surgery at the University of Ottawa in Ontario.

Learn more about CHOC’s Orthopaedic Institute, by clicking here: http://www.choc.org/orthopaedics/