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John Claude Elfar, M.D.

Orthopaedics & Rehabilitation

Contact Information

Phone Numbers

Appointment: (585) 276-3000

Biography

Dr. Elfar specializes in the treatment of sports and hand, wrist, elbow, and shoulder problems for patients of all ages. His clinical interests include all aspects of upper extremity trauma and reconstruction as well as injuries in the competitive and recreational athlete. He has special expertise in arthroscopy including the arthroscopic treatment of hand and upper extremity problems including the rotator cuff of the shoulder and elbow. He also has special expertise in joint reconstructive and salvage procedures for the hand, wrist, shoulder, and elbow including joint replacements, peripheral nerve surgery, and vascular surgery.

Dr. Elfar is a graduate of both Johns Hopkins University (Double Bachelors Degrees) and Harvard Medical School (Medical Doctorate). His Orthopaedic Surgery Residency training was with URMC Orthopaedics. Then, he completed an Advanced Upper Extremity Trauma Fellowship with the AO International (a Swiss organization dedicated to trauma care). He also completed advanced fellowship training in Surgery of the Hand and Upper Extremity, including shoulder and elbow reconstruction at the Cincinnati Hand Surgery Center under the directorship of Peter Stern, MD. He is board certified in orthopaedic surgery and holds Dual Certificates of Added Qualification in Sports and Hand and Upper Extremity Surgery. Dr. Elfar joined URMC Orthopaedics specializing in hand, wrist, shoulder, and elbow surgery in 2008.

If surgery is required, Dr. Elfar uses multiple surgery centers and can accommodate most patient needs using outpatient surgical procedures when possible.

Research

My laboratory is a group of approximately six to ten people people working in three distinct areas: Pharmaco-aduvant therapy for orthopaedic neurotrauma; trauma outcomes assessment, and biomechanical assessments of cartilage relaxation. We are currently engaged in multiple research projects in the clinical, translational, and basic science realms. We have an approach that allows multiple teams to approach distinct projects in neuroregeneration, large-scale population studies of orthopaedic outcomes and basic biomechanics.

Our neuro-scientific research is centered on the effect of erythropoietin (EPO) and 4-aminopyridine (4AP) on regenerating peripheral nerve function after severe peripheral nerve trauma. Our work is motivated by the potent effect which EPO and 4AP have on injured nerves. These effects include the promotion of myelin production, a holy-grail in peripheral nerve injury science. We have found potent and lasting effects on the structure of the nerve at the sites of injury, which are coupled with demonstrable changes in limb function. So far, we have demonstrated that a potentially large group of agents, already approved for use in humans by the Food and Drug Administration (FDA), may hold the potential to accellerate recovery after neurotrauma. In the case of several of these agents, translation to the clinic is currently underway using Investigational New Drug approval which we have been granted from the FDA. If successful, these agents will offer some of the only treatments for peripheral neurotrauma available. Our efforts are therefore directed on further study on mechanistic detail of neuroregenerative, myeloprotective, and functionally supportive treatments while at the same time conducting first-ever clinical trials on these same agents in humans.

In parallel with our translational work, my group has grown to include several members of the surgical community interested in examining surgical and trauma outcomes. We have focussed on approaches that combine large-scale big-data with small scale local chart-based validation. Thus far, we have been able to contribute studies on orthopaedic trauma outcomes centered on the quintessential hip-fracture. What grew out of a team diversion has become a full-fledged Center for Orthopedic Population Studies (COPS), which has used large database programming to produce several critical manuscripts documenting key elements underpinning cost, length of stay, and mortality after trauma.

Finally, we have delved into preliminary work on biomechanics analysis of joint reaction force measurements using the novel method of cartilage relaxation (technique, CRT). We have shown that measurements of the minute forces required to relax small and even large cartilage surfaces in joints can be measured, even in the absence of disruptive interposition of sensors. The dissection of stabilizing soft tissue to interpose such sensors alters the same forces which are to be measured. Using principles from the science of non-destructive evaluation derived from engineering methods, we have endeavored to accurately measure these minute forces without destructive interposition of sensor material - a key limitation of current methods. Thus far, this program has produced several significant contributions that center on measurements in small joints, where the dissection to interpose tissue would naturally yield spurious results.

Each of these programs has been built through collaboration with co-investigators and has garnered significant extramural funding. Each also represents a collaboration where, my role has been founding and also fostering a group which shares ownership and responsibility for funding applications, publications, successes and failures. The process of beginning and supporting independent, programmatically funded research programs is the primary interest which has fueled my work.

Credentials

Specialties

  • Orthopaedic Surgery - American Board of Surgery
  • Sports Medicine - American Board of Orthopedic Surgery
  • Surgery of the Hand - American Board of Surgery

Education

1996
Bachelor's Degree | Johns Hopkins University
Biomedical Engineering

1996
Bachelor's Degree | Johns Hopkins University
Electrical and Computer Engineering

2002
MD | Harvard Medical School

Post-doctoral Training & Residency

07/01/2007 - 07/31/2008
Fellowship in Hand Surgery at Cincinnati Children's Hospital

10/01/2006 - 11/01/2006
Fellowship in Orthopaedics at Massachusetts General Hospital

06/26/2003 - 06/25/2007
Residency in Orthopaedic Surgery at University of Rochester School of Medicine & Dentistry

06/25/2002 - 06/30/2003
Internship in General Surgery at University of Rochester School of Medicine & Dentistry

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Awards

2013 - 2018
ASSH Hand Surgeon Scientist Award - NIH K Award 5 Year Support
Sponsor: American Society for Surgery of the Hand AFSH/PSF

2011 - 2011
25 Sports Medicine Physicians Honored-American Orthopaedic Society / North American Traveling Fellowship

2011
American Orthopaedic Association North American Traveling Fellowship
Sponsor: American Orthopaedic Association

2009
Julian Bruner Award American Society for Surgery of the Hand
Sponsor: American Society for Surgery of the Hand

2008 - Present
Emerging Leader - American Orthopaedic Association
Sponsor: American Orthopaedic Association

2008 - Present
Young Leader - American Society for Surgery of the Hand
Sponsor: American Society for Surgery of the Hand

2007
Kenneth E DeHaven Award for Outstanding Orthopaedic Research
Sponsor: Plato Schwartz Lectureship-Dept of Orthopaedic Surgery
Location: University of Rochester Medical Center

2007
Resident Leader Program (Zimmer- American Orthopaedic Association)
Sponsor: American Orthopaedic Association

2007
Clinician Scientist Training Program
Sponsor: American Academy of Orthopaedic Surgeons

2002
Efforts in Diversity Award
Sponsor: Harvard Medical School

2000
National Research Service Award
Sponsor: NIH

1999 - 2000
Traveling Fellowship
Sponsor: Society for Neuroscience

1998
Richard Allen Williams Fellowship
Sponsor: American Board of Cardiology

1998
Research Fellowship
Sponsor: DuPont Merck Harvard Medical School

1996 - 1999
Medical Scientist Training Program Award Recipient

1996
Academic All American
Sponsor: USA TODAY

1995 - 1996
National Torchbearer Award
Sponsor: NSBE

1995 - 1996
Faculty for the Future Fellowship
Sponsor: General Electric Foundation

1995
Howard Hughes Undergraduate Fellowship (declined)

1995
The John Hopkins University Biomedical Engineering Research Award

1995
Whitaker Foundation Undergraduate Fellowship

1995
Baylor College of Medicine/Rice University Premedical Academy
Sponsor: MMEP

1992 - 1996
OMSA Academic Honor Award
Sponsor: John Hopkins University

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Publications

Journal Articles

11/2018
Schreck MJ, Kelly M, Lander S, Kaushik A, Smith H, Bell S, Raman V, Olles D, Geigel J, Olles M, Elfar JC. "Dynamic Functional Assessment of Hand Motion Using an Animation Glove: The Effect of Stenosing Tenosynovitis." Hand : official journal of the American Association for Hand Surgery.. 2018 Nov 0; 13(6):695-704. Epub 2017 Oct 06.

9/2018
Childs S, McVicker Z, Trombetta R, Awad H, Elfar J, Giordano B. "Patient-Specific 3-Dimensional Modeling and Its Use for Preoperative Counseling of Patients Undergoing Hip Arthroscopy." Orthopaedic journal of sports medicine.. 2018 Sep 0; 6(9):2325967118794645. Epub 2018 Sep 11.

1/2018
Schreck MJ, Kelly M, Canham CD, Elfar JC. "Techniques of Force and Pressure Measurement in the Small Joints of the Wrist." Hand : official journal of the American Association for Hand Surgery.. 2018 Jan 0; 13(1):23-32. Epub 2017 Feb 06.

Books & Chapters

2014
Chapter Title: Distal Radius Fractures
Book Title: Encyclopedia of Trauma Care
Author List: Elfar JC; Richardson, WL
Published By: Springer 2014

2010
Chapter Title: Nerve
Book Title: ASSH Manual of Hand Surgery
Author List: Boyer, Bozentka, Calfee, Elfar JC, Hammert
Published By: ASSH 2010

2009
Chapter Title: Hand and Wrist Arthritis
Book Title: Principles of Hand Surgery and Therapy
Author List: Peter Stern, John Elfar
Edited By: Ghazy Rayan, Jefferey Budoff, Mark Baratz, Thomas Trumble
Published By: Saunders, Elsevier 2009 in Philadelphia

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