Beth Paterson Smith, Ph.D., Associate Professor
In 1971, Dr. Smith received a BA in Microbiology from the University of Texas at Austin and a PhD in toxicology in 1974 from Texas A & M University. From 1974 to 1978, she completed a postdoctoral fellowship in pathology at the Bowman Gray School of Medicine. In 1987, the Department of Orthopaedic Surgery committed to support clinical and basic science research within the department. She joined the faculty to assist in the development of the department's research capabilities. As a result of the initiative to provide expanded research opportunities, faculty members, orthopaedic residents, medical students, and graduate students have been able to participate in a wide variety of research projects. Dr. Smith's role in this initiative is to support all research projects by providing the basic services, infrastructure, and assistance with scientific design necessary to enable the faculty and residents in a busy clinical department to achieve their research goals. As part of the departmental research plan, the department has focused on several areas in order to develop, expand, and implement a nationally-recognized program in orthopaedic research. Faculty and residents have been successfully involved in the development of animal models, the use of outcome studies to follow the orthopaedic management of various patient groups, and most recently, the development of nanotechnology and regenerative medicine approaches to orthopaedic pathologies.

SYNOPSIS OF AREA OF INTEREST: Areas of research are clinical outcome studies evaluating various treatments of orthopaedic conditions, and the use of botulinum toxin in the management of orthopaedic conditions including spasticity, tendon repair, and post-operative pain relief.

DETAILED AREA OF INTEREST: Dr. Smith's main area of research interest involves the use of chemodenervation to manage various orthopaedic conditions. Since 1988, she has been collaborating with L. Andrew Koman, MD to evaluate the safety and efficacy of intramuscular injections of botulinum toxin in the management of muscle spasticity associated with pediatric cerebral palsy. They have participated in several clinic trials evaluating the use of botulinum toxin injections to improve upper and lower extremity function and joint range of motion. Each spring, Dr. Koman and the Department of Orthopaedic Surgery sponsor a Spasticity Management Workshop designed to train other health professionals in the use of various spasticity management techniques. They are currently exploring the use of chemodenervation as an adjunct to treatment for other orthopaedic conditions including rotator cuff repair surgery and idiopathic toe walking. They are also studying the basic science of the chemodenervation effected by intramuscular toxin injections. Recently, they have begun collaborations with the Wake Forest Institute for Regenerative Medicine in order to develop new treatment paradigms for orthopaedic cartilage, bone, nerve, tendon, and meniscus pathologies. Dr. Smith's other research areas include orthopaedic clinical outcome studies, health-related quality of life, and health economics. She is also involved in teaching and mentoring orthopaedic residents in research as it relates to orthopaedic issues.

PUBLICATIONS:

Koman LA, Smith BP, Balkrishnan R: Spasticity associated with cerebral palsy in children: Guidelines for the use of botulinum A toxin. Pediatr Drugs 2003;5:11-23.

Koman LA, Smith BP, Shilt JS: Cerebral Palsy. The Lancet 2004;363:1619-1632.

Poehling GG, Curl WW, Lee CA, Ginn TA, Rushing JT, Naughton MJ, Holden MB, Martin DF, Smith BP: Analysis of outcomes of anterior cruciate ligament repair with two-year follow-up: Allograft versus autograft. Arthroscopy 2005;21(7):774-785.

Cole DW, Ginn TA, Chen GJ, Smith BP, Curl WW, Martin DF, Poehling GG: Cost comparison of anterior cruciate ligament reconstruction autograft versus allograft. Arthroscopy 2005;21(7):786-790.

Ma J, Shen J, Lee CA, Elsaidi GA, Smith TL, Walker FO, Rushing JT, Tan KH, Koman LA, Smith BP: Gene expression of nAChR, SNAP-25 and GAP-43 in skeletal muscles following botulinum toxin A injection: a study in rats. J Orthop Res 2005;23(2):302-309.

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