Ferguson Lab Spotlight: Christopher Como, MD

Pittsburgh native and current Ferguson Laboratory for Orthopaedic and Spine Research trainee, Christopher Como, MD, is currently second year of resident in the University of Pittsburgh Department of Orthopaedic Surgery’s six-year research track.

Dr. Como earned an undergraduate degree in biomedical engineering at the University of Michigan, and then returned to his hometown of Pittsburgh where he earned his medical degree from the University of Pittsburgh.

“Pitt was my top choice for medical school because of prior experience doing volunteer work as an undergrad, its high quality and vast number of opportunities,” says Dr. Como. “Being close to home and family is another bonus.”

Dr. Como’s experiences as an undergrad and as a medical school student at Pitt ultimately led him to orthopaedic surgery, research, and the research track residency program at Pitt.

“Studying biomedical engineering as an undergrad led me to several exciting, informative, and career-shaping opportunities during summers volunteering in several of the Department of Orthopaedic Surgery’s labs,” says Dr. Como. “There’s a very robust biomedical engineering component in the Department and that’s how I got my initial exposure to medicine, orthopaedic surgery, and medical research.”

Early Work in Orthopaedics at the ORL and Biodynamics Labs

Dr. Como spent several summers as an undergrad working in the Orthopaedic Robotics Lab (ORL) co-directed by Richard Debski, PhD, and Volker Musahl, MD.

During his first summer at the ORL, Dr. Como collaborated with a graduate student on a challenging project to revamp the STAR-IV, a shoulder and knee testing apparatus that was originally designed and built by the Department’s late chair Freddie Fu, MD, more than two decades ago. The testing apparatus, designed for examining joint mechanics, had become outdated and dysfunctional. Dr. Como's work involved extensive mechanical repairs and coding, leading to the successful restoration of this important research tool by the end of the summer.

“Every time I go over to the lab, I see that rekindled device in operation,” says Dr. Como. “It’s immensely satisfying to have been a part of rehabilitating something Dr. Fu built and used for research.”

In his second stint working in the ORL, Dr. Como took part in a study focusing on ACL fixation.

“We were analyzing different sizes of interference screws in cadaveric distal femurs, correlating bone mineral density with insertion torque and load to failure,” says Dr. Como. This study was particularly relevant for patients with conditions like osteoporosis, indicating that larger screws could improve surgical outcomes.

During medical school, Dr. Como took a year off between his third and fourth year of study to take part in a year-long internship if the Orthopaedic Surgery Department’s Biodynamics Laboratory (BDL), which is directed by William Anderst, PhD.

Dr. Como’s main project involved tracking hip and spine data for patients who underwent total hip arthroplasty. The study focused on analyzing changes in patients' movements and pain levels before and after the surgery, particularly in the context of hip-spine syndrome, a phenomenon where hip surgery alleviates concurrent low back pain. The research led to published findings about spinal alignment changes post-surgery.

Alongside this work, Dr. Como collaborated on a trapeziectomy study that involved tracking wrist and hand motion in cadavers, which at the time was a first for the lab. Additionally, he worked on clinical projects involving reverse shoulder arthroplasty and orthopaedic surgeon physician burnout with Albert Lin, MD.

Residency Research in the BDL and the Ferguson Lab

For his residency research year, Dr. Como matched into the Ferguson Lab and the Biodynamics Lab. The labs are frequent collaborators on spinal research.

In the BDL, Dr. Como is working on several studies, one of which entails tracking and analyzing the motion between the occiput and C1 and C2 vertebrae. "We're focusing on tracking the skull base and the upper cervical spine, particularly the movements at the atlantoocciptal (occiput-C1) joint. Our study involves 20 healthy participants performing head flexion/extension, lateral bending, and axial rotation to understand these motions better, especially in the context of upper cervical spine trauma and other complex cervical spine pathologies,” says Dr. Como.

For his residency research in the Ferguson Lab, Dr. Como is primarily focused on a project involving a rat model for spine instability that is being led by Ferguson Lab co-director Nam Vo, PhD and principal investigator Peter Alexander, PhD, as study which is related to spinal stenosis. The central aspect of this study is to understand the causes of ligamentum flavum hypertrophy (LFH), a significant contributor to spinal stenosis characterized by increased fibrosis and sclerosis of the ligamentum flavum. This study is exploring the theory that spinal instability in degenerative diseases cause inflammation, ultimately leading to LFH.

“We’re using MRI and histology to assess changes in the ligamentum flavum pre- and post-operatively to develop a reproducible model of spine instability that can be used to study LFH,” says Dr. Como. “If successful, this model could be used to test different treatments, such as injectables, to see if they can prevent or reduce hypertrophy in the ligamentum flavum. The creation of a reliable model that causes instability without significant harm is a primary objective.”

About Being in the Ferguson Lab

As Dr. Como explains, there’s an undercurrent of enthusiasm, collaboration, and mentorship at work in the Ferguson Lab.

“There’s so much going on in the lab – basic science, cutting edge technologies, so many studies occurring simultaneously, but the atmosphere and the attitude of everyone here is just so collegial and helpful,” says Dr. Como. “And its one that’s really focused on the end goal of improving care for patients. It’s a tremendous place to study and grow.”