Specialty: Hip and Knee
College: B.Sc. Tufts University
Medical School: M.D. McGill University Faculty of Medicine
Internship: St. Luke's/Roosevelt Hospital Center, New York, NY, 1991-1993
Residency: McGill University, Montreal, QC, 1993-1996
Fellowships: Shriners Fellow, Orthopedic Research, Joint Diseases Laboratory, Shriners Hospital for Children, Montreal Unit 1996-1997
Fellowship - Adult Reconstruction and Joint Replacement, University of Pittsburgh Medical Center, Pittsburgh, PA 1997-1998
Board Certification: Board Certified
UW Medicine Bio: http://www.uwmedicine.org/bios/paul-manner
About Dr. Manner
Many patients express interest in minimally invasive approaches to hip and knee surgery. I believe that this type of surgery, though technically challenging, offers many benefits to the patient, including less tissue injury, less post-operative pain, faster rehabilitation, and a shorter hospital stay.
My major interests relate to the care and treatment of osteoarthritis. My aim is to conduct clinical research that has a significant impact on the field while raising the clinical standards for optimal patient care. I want to reduce morbidity and improve outcomes in these patients not only through research but also by establishing a model of care that can be universally applied, easily adapted to both academic and community groups and led by outstanding trainees who can influence care throughout the world.
OSTEOARTHRITIS OF THE HIP
Firefighter Kenneth Knott’s job relies on his ability to move heavy equipment and carry injured patients down stairs and through rough terrain. Also a member of the Mercer Island SCUBA rescue team, Ken performs rescue dives. Outside of his heavily physical job, Ken is an avid outdoorsman and participant in multiple sports.
Four years ago, Ken began experiencing pain in his hips. He first noticed discomfort while walking. "Over the course of the first year, I continued to have more pain, to the point that I was unsure if I could continue to work,” he remembers. Eventually, Ken’s hip pain progressed to the point where it was interfering with his job. “I continued to work but had to find new ways to do my job to mitigate the pain. I often had to depend on my fellow workers to take some of the workload because I was unable to move in certain directions and had pain on a number of movements."
Eventually, Ken made an appointment with Paul Manner, MD, an orthopaedic surgeon at the University of Washington Orthopaedics and Sports Medicine clinic. Dr. Manner, who specializes in adult reconstruction and joint replacements, took x-rays of Ken’s hips and diagnosed him with osteoarthritis of the hip.
Osteoarthritis, also known as "wear and tear" arthritis, is a common condition where the cartilage on the ends of the bones wears thin. Articular cartilage helps joints, like the hips, glide smoothly. Osteoarthritis is degenerative, and often progresses rapidly, creating painful bone-on-bone contact. About ten million Americans suffer from osteoarthritis.
Ken was informed that his only option was total hip replacement. However, because of his age, Dr. Manner recommended that he postpone the surgery until he was older. Eventually, Ken’s pain progressed to a point where he was unable to work, had difficulty walking, and was unable to exercise to stay in shape. He was looking toward his future with little hope for improvement.
In December of 2010, Dr. Manner performed a hip resurfacing procedure on Ken’s left hip, a more conservative approach to total hip replacement which leaves the femur bone intact. With hip resurfacing surgery, if a revision procedure is required, there is bone remaining for the stem of a total hip replacement implant.
Ken felt relief almost immediately. He was able to fully return to his job functions after five weeks of physical therapy. A little over one year later, in January of 2012, Dr. Manner resurfaced Ken’s right hip. "After having both hips resurfaced, I have no pain," Ken says with pride. "I am able to do my job at the level I was prior to the first symptoms. Without this surgery I would not have able to continue working in the career that I love and providing for the citizens that depend on our services."
Ken aspires to serve his state and his country as a firefighter for the next ten years. He aims to live life to the fullest and has already started biking again. He intends to return to snow skiing and water skiing this year.
"I hope to get 20+ years from the implants and at that time, I hope to be able to replace them with full replacements," he says. Advancements in research have already enabled Ken and others suffering from osteoarthritis. Ken hopes to see further advancements in the diagnosis and treatment of degenerative joint disease. "This surgery has truly changed my life."
*Posted with permission of Kenneth Knott and AAOS
In the News
- Resident Teaching Award, Department of Orthopedic Surgery, The George Washington University Washington, DC, 2002-2003
Leadership Fellows Program, American Academy of Orthopedic Surgeons, 2005-2006
Fellow of the Royal College of Surgeons - Canada
Fellow American Academy of Orthopedic Surgeons
American Association of Hip and Knee Surgeons
Orthopedic Research Society
Washington Orthopedic Society
Canadian Orthopedic Association
Submitted on: 10/05/2014
Clinical Orthopaedics and Related Research: Editorial or governing board
JointMetrix Medical: Employee
Surgeries & Diagnosis
- Minimally invasive total hip replacement
- Total hip replacement
- Minimally-invasive partial knee replacement (unicompartmental)
- Knee osteotomy
- Total knee replacement
- Hemiresurfacing arthroplasty of the hip (partial hip replacement)
- Hemiarthroplasty for hip fracture
- Open reduction internal fixation (repair) of hip fractures
- Knee arthroscopy
- Osteoarthritis (hip/knee)
- Rheumatoid arthritis (hip/knee)
- Avascular necrosis (osteonecrosis of the femoral head)
- Developmental dysplasia of the hip
- Metastatic disease to the hip/pelvis/knee
- Hip fracture
- Meniscus tears in the knee
Williams SL, Bachison C, Michelson JD, Manner PA Component position in 2-incision minimally invasive total hip arthroplasty compared to standard total hip arthroplasty. The Journal of arthroplasty 2008 Feb; 23; 2; 197-202
Birmingham P, Helm JM, Manner PA, Tuan RS Simulated joint infection assessment by rapid detection of live bacteria with real-time reverse transcription polymerase chain reaction. The Journal of bone and joint surgery. American volume 2008 Mar; 90; 3; 602-8
Manner PA Universal health care and the single-payer system. Orthopedics 2007 Aug; 30; 8; 601, 604
Okafor CC, Haleem-Smith H, Laqueriere P, Manner PA, Tuan RS Particulate endocytosis mediates biological responses of human mesenchymal stem cells to titanium wear debris. Journal of orthopaedic research : official publication of the Orthopaedic Research Society 2006 Mar; 24; 3; 461-73
Wang X, Manner PA, Horner A, Shum L, Tuan RS, Nuckolls GH Regulation of MMP-13 expression by RUNX2 and FGF2 in osteoarthritic cartilage.Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society 2004 Dec; 12; 12; 963-73
- Improve our understanding of cartilage biology, in particular the role of artificial matrix constructs to replace or augment diseased cartilage,
- Apply this understanding to development of new treatments relevant to joint diseases, and
- Introduce new techniques into clinical use, thus translating laboratory findings into practical treatment for life-impairing joint disorders.
In terms of clinical practice, I have been active in attempting to address perioperative morbidity and complications by the use of minimally invasive techniques for hip and knee replacement. In January 2003, I performed the first two-incision total hip arthroplasty in Washington, DC, after approximately one year of utilizing mini-incision approaches, which modified existing standard techniques. These techniques are now being applied in similar fashion to total knee arthroplasty. Clinical assessment studies are now ongoing for these techniques.
Since my arrival at the University of Washington, I have continued to collaborate with the Cartilage Biology and Orthopaedics Branch, and form new collaborations with groups at the University of Washington. My most active project of this type involves translational research in conjunction with Buddy Ratner, PhD of the University of Washington Engineered Biomaterials group.
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3100 Northup Way
Bellevue, WA 98008
Seattle, WA 98133