Interview with David Lowenberg - OTCF President

David Lowenberg is the current president of the OTC Foundation. He is a Clinical Professor in the Department of Orthopaedic Surgery at Stanford University School of Medicine, where he has served in the past as Chief of the Division of Orhtopaedic Trauma. We talked to him about his involvement with the OTCF and his opinion on the future of surgery techniques and osteosynthesis education.

What are your fields of subspecialty?

David Lowenberg: They are particularly in the treatment of nonunions, osteomyelitis, and limb deformity. I practice them as a Clinical Professor at Stanford Medical Center. It is an American College of Surgeons accredited Level 1 Trauma Center for both Adult and Pediatric Trauma.


Since when have you been an OTC member?

I have been a member of the Foundation for Orthopaedic Trauma (FOT) since its founding and inception probably 14 years ago.  Therefore, I have been a member of the OTC since the FOT was incorporated into it.


What is your personal motivation to get involved with the OTC Foundation?

The OTC Foundation represents probably the largest and most diverse group of orthopaedic traumatolgists in the world. It is structured in a way that there is no avenue for any financial gain for anyone to be a member, so its purpose remains purely altruistic. Its roughly 4,500 members worldwide represent an amazing group of physicians to use as a resource for the exchange of knowledge and information. This represents an incredible resource for any orthopaedic traumatolgist wishing to expand his/her breadth of knowledge. It has also been a wonderful resource for me in meeting some incredible people and making some life-long friends from around the world.


Where do you see the general benefit of the OTC Foundation?

I like to believe that the general benefit of the OTC Foundation mirrors my personal motivations for being involved. The OTCF provides a venue unlike few others for opportunity to expand your education and knowledge in an international fashion. Also, it serves as an open resource to apply for funding in basic science and applicable clinical research endeavors.


How can you personally benefit from your commitment or activities at the OTC Foundation?

One can personally benefit in being a member of the OTCF by the ways I have outlined before.  This is especially true for members from smaller or more isolated orthopaedic communities, where resources or knowledge base in a subspecialty area are lacking. I routinely receive emails from colleagues and friends from OTC chapters around the world for advice or consultation on cases of osteomyelitis or nonunion care. The relationships and friendships one can garnish from this are invaluable.


You are currently holding the presidency of the OTC Foundation until the end of June 2019. What are your goals for your presidential year? 

My goals for the rest of my presidential year are several-fold. They include the creation of several more OTC chapters throughout the world. This way, we try to further expand the influence and presence of the OTC internationally. I also hope that the education programs can be further expanded.  Currently, the OTCF and its chapters put on nearly 80 courses in the field of orthopaedic traumatology yearly around the world. I am hopeful that this number will continue to rise each year. We have recently released our new website. I am hopeful that it will continue to evolve and improve. Chapters are presently involved in converting over to this website look and format. I am optimistically hopeful that over the next year the majority of chapters will have converted over to this website look and format.
Lastly, it is my hope that we as an organization can improve on our diversification for sources of funding for the organization, as this represents a healthier formula for perpetual success of such an important and diverse education and research-centric group.


In the coming years, where do you expect the biggest advances in osteosynthesis and trauma care in terms of surgery techniques, aids and post-operative care?

Strides in orthopaedic trauma care will come from innovations developed via improved surgical techniques, improved understanding of disease states (i.e. mechanisms of the shock response in hypovolemia and trauma), and continued development of new biological products to help in the healing of bone and soft tissue defects and injuries. I was fortunate enough to be in training during the outbreak of the AIDS epidemic. I was in training at San Francisco General Hospital where in the mid-1980’s 50% of all admissions to there were for AIDS. Virtually, all but a handful of these patients died. The country understood the need for extreme resources to find a cure for this disease, and large amounts of money were diverted to the scientific community to find a cure. In a matter of a decade, treatments were found, all because of the money allocated, to find a treatment that dramatically altered the course of this disease. This represented one of the true miracles I experienced in my medical career. I feel with the appropriate resources, the same can occur for traumatic injuries.


Where do you expect the biggest changes in osteosynthesis training and education?

I am hopeful that the greatest changes in the next decade in the training and education of orthopaedic trauma care will involve the improvement in “dry lab” and “virtual surgery” techniques for the education of our surgeons-in-training. Unfortunately, I feel we are still a far way from being there. It will take a great deal of monetary resources before we get to a point where these training techniques can compare to those learned in direct experience in the operating room and in cadaver labs. The cadaver lab training has also faced further impediments. This is due to ethical issues being raised as well as the cost of fresh-frozen cadaver specimens. Improvements in computer graphics, 3D virtual reality, and microchip speed will hopefully lead to great strides being made here.