Daniel L Latt

Interests

Teaching

Teaching - Dr. Latt has been active as a teacher in every part of his work. He has utilized a variety different teaching methods, including: informal teaching during clinic, didactic teaching through medical grand rounds and engineering course lectures, and mentorship of students in the lab.Clinical teaching – Dr. Latt has worked with medical students, orthopaedic surgery residents, family medicine residents and emergency medicine residents in both the clinic and in the operating room since starting in practice. Over the past 5 years, he has trained 15 orthopaedic residents and approximately 4 times as many primary care residents on the sports medicine rotation. During these informal teaching sessions he has focused on critical thinking and on the application of basic principles of anatomy and biomechanics to the diagnosis and treatment decision making for musculoskeletal disorders.Didactic teaching – Dr. Latt has also engaged in formal teaching through grand rounds, biomedical engineering lectures, and public colloquia. Over the past 5 years, he has given 15 orthopaedic, rheumatology, and emergency medicine grand rounds lectures covering clinical topics in foot and ankle surgery and sports medicine. He has also given 7 lectures for biomedical engineering undergraduate and graduate students including BME 295C-Challenges in biomedical engineering, BME 497G- clinical topics in biomedical engineering, and BME 566 - biomechanics. Finally, He has given 10 public talks covering a wide variety of topics from ankle arthritis, to overuse injuries in cycling, to training for a career as a clinician-scientist. He has made these lectures engaging and interactive.Research mentorship - Over the past 3 years, he has had the privilege of teaching the students in his lab about research design, research methodology, musculoskeletal anatomy and orthopaedic biomechanics. Over 60 graduate and undergraduate students from biomedical engineering, mechanical engineering, systems and industrial engineering, honors physiology, and nursing students have participated in his lab. He particularly enjoys providing career mentoring for a number of physiology and biomedical engineering undergraduate students who have gone on to medical school. He has on the masters thesis committee for 5 engineering students and on the doctoral dissertation committee for 2 engineering students.

Research

Dr. Latt's research interest is in using the principles of biomechanics to solve clinical problems in orthopaedics. He has four major research areas (1) Degenerative disease of tendons (tendinosis), (2) The role of alignment in the health and disease of the lower extremity, (3) Movement analysis as a functional outcome measure, and (4) Optimization of medical workflow using task analysis and modeling.

Courses

Scholarly Contributions

Journals/Publications

• Latt, D. L. (2019). Gait alterations in acquired flatfoot with posterior tibial tendonitis: a systematic review and meta-analysis. Gait Posture, 76, 28-38.
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  Wang J, Siddicky SF, Mannen EM, Lee JM, Latt LD. Gait alterations in acquired flatfoot with posterior tibial tendonitis: a systematic review and meta-analysis. Gait Posture. 2019 Nov 4;76:28-38.
• Latt, D. L. (2019). Peer Reviewed Abstract: Assessing Outcomes with a National Foot and Ankle Outcomes Registry. Western Orthopaedic Association (WOA) 83rd Annual Meeting.
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  Hunt K, Latt LD. Assessing Outcomes with a National Foot and Ankle Outcomes Registry. Abstract. Western Orthopaedic Association (WOA) 83rd Annual Meeting, July 31-Aug 3, 2019, Monterey, CA.
• Latt, D. L. (2019). Surgical Management of Lateral Ankle Instability in Athletes. Journal of Athletic Training, 54(6), 639-649.
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  Camacho LD, Roward ZT, Deng Y, Latt LD. Surgical Management of Lateral Ankle Instability in Athletes. Journal of Athletic Training. 2019 Jun;54(6):639-649.
• Latt, L. D., Smith, K. E., & Dupont, K. M. (2016). Revision Tibiotalocalcaneal Arthrodesis With a Pseudoelastic Intramedullary Nail: A Case Study. Foot & Ankle Specialist.
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  Hindfoot (tibiotalocalcaneal or TTC) arthrodesis is commonly used to treat concomitant arthritis of the ankle and subtalar joints. Simultaneous fusion of both joints can be difficult to achieve especially in patients with impaired healing due to smoking, diabetes mellitus, or Charcot neuroarthropathy. Conventional intramedullary fixation devices allow for compression to be applied at the time of surgery, but this compression can be lost due to bone resorption or settling, leading to impaired healing. In contrast, the novel pseudoelastic intramedullary nail is designed to maintain compression at the arthrodesis sites throughout the healing process by the use of an internal pseudoelastic element. We present 2 cases of revision TTC arthrodesis using the pseudoelastic intramedullary nail. In the first case, an 80-year-old diabetic man with previous ankle and failed subtalar fusion with screws underwent revision TTC arthrodesis. In the second case, a 66-year-old man with Charcot neuroarthropathy and a failed TTC arthrodesis with a static intramedullary nail underwent revision tibiotalar arthrodesis. In both cases, computed tomography scan demonstrated successful union and patients were allowed full weight bearing by 3 months after surgery. These cases provide early evidence that sustained compression via an intramedullary nail can lead to rapid successful hindfoot fusion when standard approaches have failed.
• Gao, L., Yuan, J. S., Heden, G. J., Szivek, J. A., Taljanovic, M. S., Latt, L. D., & Witte, R. S. (2015). Ultrasound elasticity imaging for determining the mechanical properties of human posterior tibial tendon: a cadaveric study. IEEE Transactions on Biomedical Engineering, 62(4), 1179-84.
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  Posterior tibial tendon dysfunction (PTTD) is a common degenerative condition leading to a severe impairment of gait. There is currently no effective method to determine whether a patient with advanced PTTD would benefit from several months of bracing and physical therapy or ultimately require surgery. Tendon degeneration is closely associated with irreversible degradation of its collagen structure, leading to changes to its mechanical properties. If these properties could be monitored in vivo, they could be used to quantify the severity of tendonosis and help determine the appropriate treatment. The goal of this cadaveric study was, therefore, to develop and validate ultrasound elasticity imaging (UEI) as a potentially noninvasive technique for quantifying tendon mechanical properties. Five human cadaver feet were mounted in a materials testing system (MTS), while the posterior tibial tendon (PTT) was attached to a force actuator. A portable ultrasound scanner collected 2-D data during loading cycles. Young's modulus was calculated from the strain, loading force, and cross-sectional area of the PTT. Average Young's modulus for the five tendons was (0.45 ± 0.16 GPa) using UEI, which was consistent with simultaneous measurements made by the MTS across the whole tendon (0.52 ± 0.18 GPa). We also calculated the scaling factor (0.12 ± 0.01) between the load on the PTT and the inversion force at the forefoot, a measurable quantity in vivo. This study suggests that UEI could be a reliable in vivo technique for estimating the mechanical properties of the PTT, and as a clinical tool, help guide treatment decisions for advanced PTTD and other tendinopathies.
• Latt, D. L. (2015). Advances in Lower Extremity Ultrasound. Current Radiology Reports, 3(6), 1-12.
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  Taljanovic MS, Melville DM, Klauser AS, Latt LD, Arif-Tiwari H, Gao L, Witte RS (2015) Advances in Lower Extremity Ultrasound. Current Radiology Reports. 2015;3(6):1-12
• Latt, D. L. (2015). Chronic plantar fasciitis is mediated by local hemodynamics: implications for emerging therapies.. North American Journal of Medical Sciences, 7(1), 1-5.
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  17. Miller L, Harris R, Latt LD. Chronic plantar fasciitis is mediated by local hemodynamics: implications for emerging therapies. N Am J Med Sci. 2015: 7(1): 1-5.
• Latt, L. D., Glisson, R. R., Adams, S. B., Schuh, R., Narron, J. A., & Easley, M. E. (2015). Biomechanical Comparison of External Fixation and Compression Screws for Transverse Tarsal Joint Arthrodesis. Foot & Ankle International, 36(10), 1235-42.
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  Transverse tarsal joint arthrodesis is commonly performed in the operative treatment of hindfoot arthritis and acquired flatfoot deformity. While fixation is typically achieved using screws, failure to obtain and maintain joint compression sometimes occurs, potentially leading to nonunion. External fixation is an alternate method of achieving arthrodesis site compression and has the advantage of allowing postoperative compression adjustment when necessary. However, its performance relative to standard screw fixation has not been quantified in this application. We hypothesized that external fixation could provide transverse tarsal joint compression exceeding that possible with screw fixation.
• Taljanovic, M. S., Alcala, J. N., Gimber, L. H., Rieke, J. D., Chilvers, M. M., & Latt, L. D. (2015). High-resolution US and MR imaging of peroneal tendon injuries--erratum. Radiographics : a review publication of the Radiological Society of North America, Inc, 35(2), 651.

Presentations

• Latt, D. L. (2020, Jan). Oral Presentation: Quantification of Bone Viscoelasticity With Lag Screw in Hindfoot Arthrodesis. 2020 Western Medical Research Conference. Carmel, CA: Western Medical Research Conference.
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  Johnson BW, Rugg AL, Requist MR, Alvarez A, Son MM, Latt LD. Quantification of Bone Viscoelasticity With Lag Screw in Hindfoot Arthrodesis. Oral presentation at the 2020 Western Medical Research Conference, January 23-25, 2020, Carmel, CA.
• Latt, D. L. (2019, Feb). Podium/Slide Presentation: Postural stability in patients with posterior tibial tendon dysfunction during walking.. 2019 Mid-South Biomechanics Conference at the University of Memphis,. Memphis, TN: Mid-South Biomechanics Conference at the University of Memphis,.
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  Wang J, Bowers K, Fatsje C, Latt LD. “Postural stability in patients with posterior tibial tendon dysfunction during walking. Podium/Slide Presentation. 2019 Mid-South Biomechanics Conference at the University of Memphis, February 21-22, 2019, Memphis, TN.
• Gimber, L. H., Latt, D. L., Caruso, C., Nuncio Zuniga, A. A., Krupinski, E. A., Chadaz, T., & Taljanovic, M. (2018, March). Ultrasound shear wave elastography of the lateral ankle ligaments in healthy subjects at rest and stress. Society of Skeletal Radiology Annual Meeting. Austin, Texas: SSR.
• Taljanovic, M., Chadaz, T., Krupinski, E. A., Nuncio Zuniga, A. A., Caruso, C., Latt, D. L., & Gimber, L. H. (2018, Spring). Ultrasound shear wave elastography of the lateral ankle ligaments in healthy subjects at rest and stress. SSR 2018.
• Latt, D. L., Latt, D. L., Gao, L., Gao, L., Taljanovic, M., Taljanovic, M., Szivek, J. A., Szivek, J. A., Guerra, J. D., Guerra, J. D., Klewer, J. A., Klewer, J. A., Witte, R. S., & Witte, R. S. (2016, March). In Vivo Ultrasound Elasticity Imaging Differentiates Healthy From Diseased Tendons. Orthopaedic Research Society 2016 Annual Meeting. Orlando, Florida.
• Latt, D. L., Witte, R. S., Klewer, J. A., Gao, L., Guerra, J. D., Taljanovic, M., Szivek, J. A., Szivek, J. A., Guerra, J. D., Taljanovic, M., Gao, L., Klewer, J. A., Witte, R. S., & Latt, D. L. (2016, March). In Vivo Ultrasound Elasticity Imaging Differentiates Healthy From Diseased Tendons. ORS 2016 Annual Meeting. Orlando, Florida.
• Taljanovic, M., Latt, D. L., Gao, L., & Witte, R. S. (2016, March). In Vivo Ultrasound Tension Elastography Differentiates Healthy From Diseased Posterior Tibialis tendon. 39th Annual Meeting of the Society of Skeletal Radiology (SSR). New Orleans, LA: Society of Skeletal Radiology.

Poster Presentations

• Latt, D. L. (2019, Feb). In Vivo Ultrasound Elastography of Material Properties of Healthy and Diseased Human Posterior Tibial Tendon. ORS 2019 Annual Meeting, February 2-5, 2019, Austin, TX.. Austin, TX: ORS.
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  Latt LD, Zuniga AN, Schmitz HA, Lim AE, Roussas A, Tang Y, Klewer JA, Taljanovic MS, Witte RS. . In Vivo Ultrasound Elastography of Material Properties of Healthy and Diseased Human Posterior Tibial Tendon. Poster Presentation (Tendon & Ligament – Diseases & Disorders Category). ORS 2019 Annual Meeting, February 2-5, 2019, Austin, TX.
• Latt, D. L. (2019, March). ePoster: Ultrasound shear wave elastography (SWE) of the tibialis posterior tendon (PTT) and tibiospring/spring ligaments at rest and stress in normal feet compared to asymptomatic and symptomatic acquired flatfoot deformity.. 42nd Annual Meeting of the Society of Skeletal Radiology. Scottsdale, AZ: SSR.
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  Taljanovic MS, Kim W, Caruso CC, Krupinski EA, Nuncio A, Latt LD. Ultrasound shear wave elastography (SWE) of the tibialis posterior tendon (PTT) and tibiospring/spring ligaments at rest and stress in normal feet compared to asymptomatic and symptomatic acquired flatfoot deformity. ePoster. 42nd Annual Meeting of the Society of Skeletal Radiology, March 10-13, 2019. Scottsdale, AZ.
• Latt, D. L. (2019, Nov). Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. American Medical Association EXPO. Carmel, CA: AMA.
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  Rugg AL, Requist MR, Johnson BW, Alvarez A, Son MM, Latt LD. Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. Poster presentation at the American Medical Association EXPO, November 15, 2019, Carmel, CA.
• Latt, D. L. (2019, Oct). Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. American College of Physicians – Arizona Chapter 2019 Annual Meeting Poster Competition. Phoenix, AZ: American College of Physicians.
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  Rugg AL, Requist MR, Johnson BW, Alvarez A, Son MM, Latt LD. Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. Poster presentation at the American College of Physicians – Arizona Chapter 2019 Annual Meeting Poster Competition, October 19, 2019, Phoenix, AZ.
• Latt, D. L. (2019, Oct). Self-reported injuries and treatments in collegiate dancers. International Association for Dance Medicine & Science Annual Conference. Montreal, Quebec: International Association for Dance Medicine & Science.
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  Paulsen K, Latt LD. Self-reported injuries and treatments in collegiate dancers. Poster presentation at the International Association for Dance Medicine & Science Annual Conference, October 24-27, 2019, Montreal, Quebec, Canada.
• Latt, D. L. (2019, Sept). Hindfoot Bone Viscoelasticity and Stress Relaxation.. AOFAS Annual Meeting, September 12-15, 2019. Chicago, IL: AOFAS.
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  Son M, Johnson B, Latt LD. Hindfoot Bone Viscoelasticity and Stress Relaxation. Poster presentation at the AOFAS Annual Meeting, September 12-15, 2019, Chicago, IL.
• Schmitz, H., Witte, R. S., Gao, L., Latt, D. L., Ingram, C. P., Taljanovic, M., Klewer, J., Szivek, J. A., Klewer, J., Szivek, J. A., Ingram, C. P., Taljanovic, M., Gao, L., Latt, D. L., Schmitz, H., & Witte, R. S. (2016, January). Ultrasound Elasticity Imaging of the Posterior Tibial Tendon using FOCUS Simulation Software. 27th Annual Undergraduate Biology Research Program Conference. Tucson, AZ.