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 Nitin Kukkar, M.D.
Division of orthopaedics
Special Interests:
- Bone and Soft tissue tumor surgery
- Minimally Invasive Spine Surgery
- Cervical and Lumbar Disc Arthroplasty
Research Interests:
- Deformity Correction via Minimally Invasive Spine Surgery
- Prevention of DVT via Mechanical Prophylaxis
Memberships:
- Indian Orthopaedic Association
- Orthopaedic Research Society
- Society for Minimally Invasive Spine Surgery
Education/Work Experience
Medical School(MBBS)
Sardar Patel Medical College, Bikaner, Rajasthan, India 09/1996 – 12/2001
Internship
Sardar Patel Medical College, Bikaner, Rajasthan, India 01/2001 – 12/2002
Residency(orthopaedics)
All India Institute of Medical Sciences (AIIMS), New Delhi, India 01/2003 – 12/2005
Senior Resident
( orthopaedics)All India Institute of Medical Sciences (AIIMS), New Delhi, India 01/2006 – 10/2007
Fellowship( Joint Reconstruction and Arthroplasty)
Columbia University Medical Center, NY, NY 10/2007 – 07/2008
Fellowship (Musculoskeletal Oncology)
Harvard Medical School/MGH, Boston, MA 08/2008 – 07/2009
Research
Mayo Clinic, Rochester, MN 08/2009 – 04/2010
Research
SIU SOM, Springfield, IL 05/2010 – 07/2010
Fellowship ( Spine Surgery)
SIU SOM, Springfield, IL
Credentialing Paperwork and Travel
SIU SOM, Springfield, IL 08/2011-present
I. Academics
- Rajasthan University Jaipur, India: Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.)
- Ist Prof: May 1998
- IInd Prof: May 2000
- Final Prof: September 2001
- Internship: December 2002
- All India Institute of Medical Sciences, India: Master of Surgery (M.S.) : orthopaedics
- Orthopeadic Surgery Residency: Dec 2005
- Certification
- USMLE Step 1 : 97 percentile
- USMLE Step 2: 95 percentile
- USMLE Step 3: 82 percentile
- ECFMG Certified: June 2007
II. Postdoctoral Training
- Year: 2006
Academic Title: Senior Resident
Specialty/Discipline: Orthopeadic Surgery
Place of Training: All India Institute of Medical Sciences, India
- Year: 2007-2008
Title: Clinical Fellow
Specialty/Discipline: Joint Replacement [Hip and Knee]
Place of Training: Center for Hip and Knee Replacement
New York Presbyterian Hospital
Columbia University Medical Center
New York 10032
- Year: 2008-2009
Title: Clinical Fellow
Specialty/Discipline: Musculoskeletal Oncology
Place of Training: Center for Sarcoma and Connective tissue Oncology
Massachusetts General Hospital – Harvard Medical School
55 Fruit St
Boston, MA 02145
- Year: 2010-2011
Title: Clinical Fellow
Specialty/Discipline: Spine Surgery
Place of Training: Division of orthopaedics and Rehabilitation
Memorial Medical Center – SIU School of Medicine
701 N First Street
Springfield, IL 62781
III. Licensure and Certification
Year: 2003
Type of License: Full License
Medical Council of India
Year: 2007
Type of License: Limited License
New York State Board of Medicine
Year: 2008
Type of License: Limited License
Commonwealth of Massachusetts Board of Licensure
Year: 2010
Type of License: Temporary License
State of Illinois Board of Licensure
Year: 2011
Type of License: Full License
State of Illinois Board of Licensure
IV. Professional Societies
- Member Indian Orthopeadic Association.
- Member of Orthopeadic Research Society, AIIMS.
- Member of Indian Association of Sports Medicine
- Member of Indian Federation of Sports Medicine.
- SMISS member (Society for Minimally Invasive Spine Surgery)
V. Workshops
- Basic Arthroscopy Workshop (14 December, 2004, Agra), 49th Annual Conference of Indian Orthopeadic Association.
- Advanced Arthroscopy Workshop (15 December, 2004, Agra), Annual Conference of Indian Orthopeadic Association
- Ethicon Suture Practum Course (23 September, 2001, Delhi).
VI. Educational Courses
- Hand Surgery Update 2003 (26-27 April, 2003, AIIMS, New Delhi)
- Current Concepts in Arthroplasty (20-21 September, AIIMS, New Delhi).
- National Symposium on Musculoskeletal Allografts (14 March, 2004, AIIMS, New Delhi).
- Current Concepts in ACL Reconstruction [11 March, 2006].
VII. Conferences Attended
- DOACON, 2003, Delhi
- ISICON, 2003, Delhi
- DOACON, 2004, Delhi
- IAOCON, 2004, Agra
- Current updates in arthroplasty ,2007, Mumbai
- SMISS, 2009, Las Vegas, NV
- Mayo international spine symposium, Hawaii, 2010
- NASS, Orlando, 2010
- SMISS, Miami, 2010
VIII. Clinical Experience
1. SPINE SURGERY
Cervical spine
- Posterior C 1-2 fixation with wiring and transarticular screws
- Posterior Occiput to Cervical spine plating
- Odontoid screws
- Anterior open mouth odontoidectomy
- Cervical Laminectomy and decompression
- ACDF
- Multilevel anterior decompression and corpectomy with allograft fusion and plating
- Cervicothoracic instrumentation with both Synthes and Depuy Mountaineer
- Cervical disk Arthroplasty
- Microsocpic laminoforminotomy
- Laminoplasty- open door
Thoracic spine
- DLIF for deformity and disk excision
- Extracavitary corpectomy and decompression
- Extracavitary corpectomy through Quadrant MIS technique
- Posterior percutaneous Medtronic longitude fixation for trauma and deformity
- Percutaneous facetectomy for deformity and decompression
- Thoracoplasty
- Thoracoscopic assisted decompression
- Primary and metastatic tumor excision and stabilization
Lumbar spine
- ALIF with Synthes antegra and allograft
- ALIF with Medtronic pyramid and peek cage
- Medtronic convergance system
- Lumbar disc arthroplasty with synthes prodisk L
- Revision lumbar disk arthroplsty
- Posterior interspinous device and revision for X stop device
- Minimally invasive TLIF
- Microsocpic decompression with MetrX and Quadrant system
- Deformity correction with MIS and DLIF and PEEK cage
- XLIF
- XLIF for revision decompression
- PLIF
- Percutaneous fixation
- Cages and expandable cages
- Lumbar corpectomy for tumor resection and trauma
2. TUMOURS
Sacrum
- Partial and total sacrectomy for tumor resection
Pelvic tumors
- Periacetabular tumors and Saddle prosthesis.
- Hemipelviectomy
Malignant tumors around knee and resection arthroplasty.
Scapulectomy and scapular prosthesis
GCT distal radius resection and Fibular grafting
Soft tissue tumor resection
Vertebral tumor resection
3. ARTHROPLASTY
Total knee arthroplasty
- CR and PS TKA
Partial total knee arthroplasty
Total hip arthroplasty
Hip resurfacing
Revision total knee arthroplasty
Revision total hip arthroplasty
Patellar resurfacing
Bicondylar knee arthroplasty
Active participant of the Arthroplasty team at CUMC in my fellowship and AIIMS in my residency.
Assisted in more than three hundred total knee and total hip arthroplasties [both primary and revision].
Firsthand experience in Surface Replacement arthroplasty of Hip, Metal on Metal Hip arthroplasty ,Ceramic Hip arthroplasty
Thesis on total knee arthroplasty under guidance of Prof. Bhan.
Actively involved in postoperative care and rehabilitation of patients.
4. POLYTRAUMA AND EMERGENCY MEDICINE
Associated with AIIMS for last four years.
In this apex tertiary center, I had extensive experience in polytrauma, complex and neglected orthopaedic trauma.
Actively involved in planning and implementation, during expansion of emergency services in AIIMS.
Experience of ATLS protocol and procedures in polytrauma patients and have taught and supervised the house-surgeons, postgraduates, undergraduates and nursing staff in department and seminars.
Taking trauma conference of postgraduates.
5. MICROSURGERY, REPLANTATION AND HAND INJURIES
- Microsurgery training at AIIMS.
- Members of ‘Replantation team’ of AIIMS and have experience in replantation.
- Experience in microvascular repair and venous grafts.
- Active member of team on call for management of “Hand injuries”.
- Assisted in soft tissue coverage [rotation flaps, pedicled flaps (posterior interosseous flap, Chinese flap), neurovascular flaps, free flaps (lateral forearm, lat dorsii flap], Groin and abdominal flap etc] in hand injuries.
- Experience in nerve repairs (epineural, perineural, sural nerve grafting and digital nerve repairs).
- Experience of vascularized bone grafting (free fibula, pedicled rib grafts and dorsal, volar radius based grafts).
- Experience of free gracialis muscle transfer.
- Extensive experience in hand fixation using mini fragment titanium screws and plates.
- Experience of ligament repairs in hand (especially using anchor sutures).
- Experience of dorsal percutaneous scaphoid fixations and vascularized bone grafting into scaphoid.
- Experience of flexor tendon repairs (especially zone II and FPL repairs) and extensor tendon repairs (especially central and lateral slip repairs).
- Experience in pulley reconstruction techniques, sialistic rods (in two stage procedures) and tendon grafting.
6. TEACHING IN HAND SURGERY
Active member of ‘Hand Clinic’ of AIIMS.
Participated in preoperative assessment and post-surgery rehabilitation.
Educated postgraduates and house-surgeons about proper recognition and management of hand injuries (which are commonly mismanaged).
7. COMPLEX TRAUMA
Pelvis
- Active interest and experience in managing acetabular and pelvis injuries. I have experience of following techniques :
- Emergency external fixation of pelvis
- Anterior symphysis pubis plating
- Anterior, intrapelvic sacroiliac joint fixation by double plating
- Posterior percutaneous illiosacral screw fixation for sacroiliac joint dislocation and sacrum fractures
- Ingenious cannulated illiosacral bars for SI joint dislocation
- Transacral plating for sacral fractures
- Acetabulum
Technical Experience
- Illioinguinal approach (14 cases)
- Stoppa’s approach
- Illiofemoral approach
- Kocher-Langenbach’s approach
- Digastric anterior flip trochanteric osteotomy (six cases)
- Combined approaches
- Management of complex fracture pattern (Transverse, T-type and bicolumnar fractures)
- Quadrilateral plate fixation
- Spring plates
- Surgery in delayed and neglected acetabular fractures
Elbow
- Extensive case series on TRAP approach and Mayo’s technique (22 cases) for intercondylar fracture of humerus
- Radial head fracture fixation
- Percutaneous supracondylar fracture humerus fixation
- Radial and ulnar ligament repairs and reconstructions
- Vascular repairs in elbow injuries
- Experience in elbow arthrolysis
- Self-designed dynamic elbow mobolization splint and active interest in elbow rehabilitation following trauma and arthrolysis
- I have taught my postgraduates about elbow surgery and its rehabilitation aspects
Wrist
- Composite fixation in distal end radius fractures (using newer implants such as locking plates, titanium screws, radial styloid and dorsal plates, injectable bone cement) and also arthroscopic assisted reduction
- New and delayed carpal dislocations’ surgeries
- Scaphoid (volar and dorsal fixation)
SHOULDER
Scapula
- Six cases of posterior approach to scapula fractures
Clavicle
- Use of locking plate in clavicle fractures (12 cases) – largest in India
Acromioclavicular joint dislocation
- ORIF and ligament reconstruction
Proximal humerus
- Percutaneous screw and plates for two and three part fractures
- HRA in delayed four part fraction and dislocations.
KNEE
Tibial plateau
- Fixation of posteromedial and posterolateral fragments using posterior approaches
- Hybrid fixator
- Arthroscopic assisted reduction
Distal femur
- Experience of Hoffa fracture.
- Osteochondral fixation by Herbert screws
- Swashbuckler approach in distal femur.
ANKLE
Pilon fracture
- Hybrid fixator
Calcaneum
- Extensive experience in lateral extensile approach
Talus
- Anteromedial and anterloateral exposures
- Dome fixation and mosaic arthroplasty.
FOOT
- Experience in Lis-Franc dislocations.
8. EXPERIENCE IN TRAUMA CARE AND REHABILITATION
• Actively taught about these sick patients and have taken active interest on rehabilitation (especially elbow wrist and hand rehabilitation).
9. ARTHROSCOPY
• Assisted in ACL, PCL, PLC knee arthroscopy surgeries.
• Assisted in shoulder arthroscopy.
• Extensive experience in physiotherapy and postoperative rehabilitation of patients with sports related injuries.
10. PAEDIATRIC orthopaedics
• Experience in CTEV – Ponsetti and conventional treatment
• CDH- open reduction, closed reduction, salters osteotomy, pelvic support osteotomy
• Perthes disease;
• Pediatric trauma- epiphseal injuries, NOF, neglected dislocations; congenital anamolies- pseudoarthrosis, club hand, syndactyly etc.
IX. Research
1. Research Contributions.
- Thesis: Evaluation of the Effect of Alteration in Joint Line and Patellar Height on Range of Movement and Stability after Total Knee Arthroplasty in Severely Degenerated Knees.
- Report of Current Research Activities other than those mentioned above (bench research, clinical trials, outcome studies, efficacy studies as applicable)
- Pre op radiation and wound healing in tumors of axial skeleton and pelvis - a retrospective study. Kukkar N, Hornicek FJ, Raskin K, Springfield D.
- Clinical outcome and radiological fusion results for axial lumbar interbody fusion: Kukkar N, Freitag P (Primary outcome- Axial lumbar interbody fusion is an effective minimally invasive procedure at achieving fusion at the lumbosacral junction; Secondary outcome- Axial lumbar interbody fusion can substitute anterior lumbar interbody fusion for long spine constructs.
- Chronic back pain: evaluation of serum 25 OH vitamin D and their correlation with dual energy X-ray absorptiometry- Kukkar N, Milbrandt JC, Freitag P (Primary outcome- Low vitamin D levels have a high correlation with chronic axial back pain; Secondary outcome- Reduced instrumentation failure and increased fusion rates with optimized vitamin D levels in patients.
- Adult degenerative scoliosis surgery: trends of utilization using National Inpatient Sample database- Kukkar N, Beck RT, Banerjee D, Freitag P (Primary outcome- Age and preoperative functional status correlate to quality of life postoperatively; Secondary outcome- Use of bone morphogenetic proteins and total surgical expenditure does not justify surgical outcome as measured by quality adjusted life years.
- Chronic axial skeletal pain: evaluation of a single institution's referral patterns- Mai MC, Kukkar N, Milbrandt JC, Freitag P. Primary outcome- Primary care physicians become aware of their noncompliance to referral guidelines concerning chronic axial back pain. Secondary outcome- Education of primary care providers will result in appropriate referrals for chronic axial back pain patients.
- Does axial lumbar interbody fusion result in an increase in foraminal height, width, and disc height through indirectly decompressing vertebral nerve root? Kukkar N, Mai MC, Beck RT, Sullivan DN, Freitag P. Primary outcome- Axial lumbar interbody fusion provides an increase in foraminal area and disc height via indirection decompression. Secondary outcome- 5-year follow-up will demonstrate fusion and/or subsidence and their effect on neuroforaminal area.
- Transforaminal lumbar interbody fusion versus axial lumbar interbody fusion, operative room time, fluoroscopy radiation dose/time and blood loss analysis. Kukkar N, Mai MC, Beck RT, Freitag P.
- Correlation of vitamin D levels with dual energy X-ray absorptiometry scan in institutionalized subjects. Kukkar N, Mai MC, Freitag P
- Bilateral Flexor Digitorum Accessorius Longus – a rare case report of 2 cases presenting as Tarsal tunnel syndrome. Kukkar N, Idusuyi OB.
X. PUBLICATION
- Cervicomedullary compression at the craniovertebral junction by clivus hyperplasia. Nitin Kukkar, Devin V. Amin, Ryan Beck, Neru Bedi, Per Freitag,. Accepted at JBJS (A).
- Mayo International Spine Symposium 2010. Nitin Kukkar, Neru Bedi and Abhijit Kanthala. Expert Review of Neurotherapeutics, May 2010, Vol. 10, No. 5, Pages 677-681.
- Role of Intra-Articular Hyaluronic Acid in Management of Periarthritis Shoulder: An Indian Experience. Archives of Physical Medicine and Rehabilitation, Volume 88, Issue 9, Pages E47-E47 N. Goel, S. Yadav, U. Singh, N. Kukkar, S. Vishwajit.
- Sagittal alignment following multilevel axial lumbar interbody fusion: Submitted to “Eur Spine Journal” -Mai MC, Kukkar N, Froelich JM, Milbrandt JC, Freitag P. Primary outcome: Significant change in lumbar lordosis with one and two level AxiaLIF.
- Avoiding early complication after MOMHR: The technical and conceptual aspects of “Bailing-Out” to THA. Geller JA, Kukkar N, Fink LA, Macaulay WB. Operative Techniques in orthopaedics, Volume 19, Issue 3, Pages 169- 175 (July 2009).
- Immunohistochemical Analysis of Chordoma Targeting B7HS and HMW-MAA. Andrew J. Schoenfeld, MD; G. Petur Nielsen, MD; Andrew E. Rosenberg, MD; Thomas F. Delaney, MD; Andrzej Niemierko, PhD; Wendy Kobayashi, MS; Frank X. Pedlow, Jr, MD; Hennock Wolde-Semait, MD; Nitin Kukkar, MD; Kevin A. Raskin, MD; Dempsey Springfield, MD; Henry J. Mankin, MD; Francis J. Hornicek, MD PhD; Soldano Ferrone, MD PhD; Joseph H. Schwab, MD MS. The Orthopaedic Journal at Harvard Medical School.
XI. POSTERS
- Evaluation of Quality of life in unilateral vs bilateral amputees using prosthesis-- Indian perspective, Canadian Association of PM&R.
- Sagittal alignment following multilevel axial lumbar interbody fusion. SMISS Nov 2010, Miami, FL.
- Does axial lumbar interbody fusion result in an increase in foraminal height, width, and disc height through indirectly decompressing vertebral nerve root? SMISS Nov 2010, Miami, FL.
- Chronic Axial Skeletal Pain: Evaluation of a Single Institutional Referral Patterns. Special Emphasis Poster, 124th Annual Meeting, American Orthopaedic Association, Boston, MA, June 22-25, 2011.
- Alterations in Disc Height, Foraminal Height and Foraminal Width Following One- and Two-Level AxiaLIF: A Radiological Analysis. SAS11 in Las Vegas, Nevada - April 26 - 29, 2011.
- Chronic Axial Skeletal Pain: Evaluation of a Single Institution’s Referral Patterns. Mai MC, Kukkar N, Milbrandt JC, Freitag P. COA annual meeting on July 7-9, 2011 in St. John's Newfoundland, Canada.
XII. PRESENTATIONS
- Moderator Orthopeadic self assessment examination , Mayo international spine symposium, Hawaii 2010.
- Sagittal alignment following multilevel axial lumbar interbody fusion: SIU Resident Research Day 2010; upcoming at Mid-American Orthopaedic Association 2010.
- Chronic axial skeletal pain: evaluation of a single institution's referral patterns. Mai MC, Kukkar N, Milbrandt JC, Freitag P. Presented at SIU Resident Research Day 2010.
- Alterations in Disc Height, Foraminal Height and Foraminal Width Following One- and Two-Level AxiaLIF: A Radiological Analysis. Kukkar N, Beck RT, Mai MC, Sullivan DN, Milbrandt JC, Freitag P. COA annual meeting on July 7-9, 2011 in St. John's Newfoundland, Canada.
- Sagittal alignment following single and multi-level axial lumbar interbody fusion. Mai MC, Froelich JM, Beck RT, Milbrandt JC, Freitag P. COA annual meeting on July 7-9, 2011 in St. John's Newfoundland, Canada.
- MIS TLIF vs. AxiaLIF: Comparison of radiographic outcome and operative data. Nitin Kukkar, Devraj Banerjee, Ryan T. Beck, Per Freitag. Lumbar Spine Research Society, Chicago, April, 2011.
XIII. GRANTS
- Prospective randomized controlled trial for a comparison between ACDF and posterior foraminotomy in degenerative cervical radiculopathy. To be submitted to NASS.
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