Department of Orthopaedic Surgery

Kenneth L. Urish, MD, PhD

  • Associate Professor
  • Associate Medical Director, Magee Bone and Joint Center
  • Director, Arthritis and Arthroplasty Design Laboratory

Ken Urish, MD, PhD, is a fellowship trained Adult Reconstructive and Arthroplasty Orthopedic Surgeon. As an Associate Medical Director at the Magee Bone and Joint Center, his practice focuses on primary and revision hip and knee arthroplasty (joint replacement). He has extensive experience with minimally invasive techniques, robotic surgery, and managing complications from failed or painful hip and knee replacements.

Dr. Urish holds additional appointments with the University of Pittsburgh Department of Bioengineering, Clinical & Translational Science Institute, and Carnegie Mellon University Department of Biomedical Engineering.

 

Education & Training

  • MD, University of Pittsburgh School of Medicine, Medical Scientist Training Program (MSTP), Pittsburgh, PA
  • PhD, Bioengineering, University of Pittsburgh School of Engineering, Pittsburgh, PA
  • Residency: Penn State Milton S. Hershey Medical Center, Hershey, PA
  • Fellowship: Massachusetts General Hospital, Harvard Medical School, Boston, MA

Representative Publications

  1. Huang DB, Brothers KM, Mandell JB, Taguchi M, Alexander PG, Parker DM, Shinabarger D, Pillar C, Morrissey I, Hawser S, Ghahramani P, Dobbins D, Pachuda N, Montelaro R, Steckbeck JD, Urish KL. Engineered peptide PLG0206 overcomes limitations of a challenging antimicrobial drug class. Public Library of Science. 2022. [epub ahead of print]. PMID: 36112657
  2. Doub JB, Urish KL, Lee M, Fackler J. Impact of Bacterial Phenotypic Variation with Bacteriophage therapy: A Pilot Study with Prosthetic Joint Infection Isolates. International Journal of Infectious Disease. 2022. [epub ahead of print]. PMID: 35331932.
  3. Kundu S, Ashinsky BG, Bouhrara M, Spencer RG, Urish KL, Dam EB, Rohde GK. Enabling Early Detection of Osteoarthritis from Pre-Symptomatic Cartilage Texture Maps via Transport-Based Learning. Proceedings of the National Academy of Sciences. 2020 117(40):24709-24719. PMID: 32958644.
  4. Ma D, Mandell JB, Donegan NP, Cheung AL, Ma W, Rothenberger SD, Shanks RMQ, Richardson AR, Urish KL. The Toxin Antitoxin MazEF Drives Staphylococcus aureus Chronic Infection. mBio. 2019 10(6):e01658-19. PMID: 31772059.
  5. Shah NB, Hersh BL, Kreger A, Sayeed A, Bullock AG, Rothenberger SD, Klatt B, Hamlin B, Urish KL. Benefits and Adverse Events Associated with Extended Antibiotic Use in Total Knee Arthroplasty Periprosthetic Joint Infection. Clinical Infectious Disease. 2020 70(4):559-565. PMID: 30944931.

PubMed Link

Research Interests

Dr. Urish is Director of the Arthritis and Arthroplasty Design Laboratory. Funded by the National Institute of Health, the group’s focus is on early arthritis prevention and optimizing joint replacement outcomes.

1. Translational Therapies in Periprosthetic Joint Infection

Total knee and hip arthroplasty is the most common surgical procedure in the United States. The largest reason for failure is periprosthetic joint infection. The goal of this project is to develop new therapies to treat acute and chronic periprosthetic joint infection to improve treatment outcomes. These publications and clinical studies demonstrate the ability of our group to complete pre-IND development that informs and directs FDA clinical studies. This experience combined with the basic science, hypothesis driven work above resulted in our involvement with multiple FDA clinical studies (2 of 4 listed: FDA Phase I: Study in Patients Undergoing Debridement, Antibiotics, and Implant Retention (DAIR) for Treatment of a Periprosthetic Joint Infection (PJI) Occurring After Total Knee Arthroplasty (TKA) ClinicalTrials.gov: NCT05137314; FDA Phase II: Safety and Efficacy in Patients Treated for Hip or Knee PJI With Vancomycin and Tobramycin Joint Irrigation, ClinicalTrials.gov: NCT03721328) including the current parent FDA study with a pending clinical trial.gov number. 

2. Staphylococcus Pathogenesis and Biofilm Antibiotic Tolerance

Infection and biofilm antibiotic tolerance are one of the largest clinical challenges in orthopaedic surgery. The goal of this project is to demonstrate a mechanism behind the poor clinical results in the treatment of implant infection. These publications demonstrate the role of toxin-antitoxin systems in Staphylococcus aureus biofilm antibiotic tolerance and adhesion during orthopaedic infection. Combined, this work provides a basic mechanism to the observed poor clinical results in treatment of periprosthetic joint infection. Irrigation, debridement, and antibiotics are unable to sufficiently remove biofilm from arthroplasty implants. This serves as the foundation for current clinical studies we are completing to demonstrate the role of antibiotic tolerant biofilm and toxin-antitoxin systems in periprosthetic joint infections, and suggests new treatment strategies. apy with the co-PI of this proposal is in press.

3. Periprosthetic Joint Infection Clinical Studies

A series of clinical studies investigating outcomes with current standard of care, diagnosis, and improved treatment strategies with periprosthetic joint infection have been completed. These studies demonstrate our group’s ability to execute a well-designed, unbiased clinical study.

4. Arthritis and Total Knee Arthroplasty Outcomes: Robotics and Imaging

These manuscripts demonstrate my current work on new imaging modalities and robotic technologies. Radiographs are the gold standard in osteoarthritis imaging, but indirectly image cartilage. Quantitative MRI has the ability to directly image the molecular structure of cartilage. These publications demonstrate that T2 maps can be used to predict the development of osteoarthritis symptoms in patients with no symptoms or radiographic signs of arthritis. Robotic surgery has the potential to greatly improve outcomes. The expertise I developed with imaging led to my involvement with robotic surgery. My demonstrated expertise in complex registration, segmentation, and machine learning algorithms essential in the development of robotic technology served as the basis for the current ongoing clinical studies in robotic assisted surgery in total knee arthroplasty.

Research Grants

The Role of Teichoic Acid Glycosylation in Phage Activity and Selection in an Ongoing FDA Phase I/II Clinical Study of Bacteriophage Therapy in Chronic Periprosthetic Joint Infection
NIH/NIAMS R01 AR082167.
2022-2026.

Analysis of functional outcomes in arthroplasty using Navio robotic assisted surgery
Smith & Nephew Industry Grant.
Co-Investigator.
2017-2020.

The Role of Biofilm Formation in Antibiotic Tolerant Periprosthetic Joint Infection
NIH/NIAMS R03 AR077602.
Principle Investigator. 10% effort.
2021-2023.

A New Approach to Treat Prosthetic Joint Infections with a ClpP Activating Antibiotic
NIH/NIAID 5R44AI157081.
Site Principle Investigator. 5% effort.
2021-2024

FDA Phase III Clinical Study: APEX Study: Safety and Efficacy in Patients Treated for Hip or Knee PJI With Vancomycin and Tobramycin Joint Irrigation
Osteal. (ClinicalTrials.gov identifier: NCT03721328).
Site PI: Urish.
4/1/2023-12/30/2024

Biofilm Antibiotic Tolerance in Periprosthetic Joint Infection
NIH/NIAMS K08 AR071494.
Principle Investigator. 60% effort.
2017-2022.

Combating Antibiotic Resistant Bacteria (Carb-X) 04CARB-X0616: Preclinical Development of PLG0206 for Antimicrobial resistant Bacteria in Orthopaedic Infection
Site Principle Investigator. 15% effort.
2020-2026