B. Sonny Bal, MD, MBA
Associate Professor of Orthopaedic Surgery
Joint Replacement of the Hip and Knee

Clinical Interests: Ceramic bearing surfaces in total hip and total knee replacements.

Research Interests: Macrophage response to ceramic wear debris, material properties of ceramic components in joint replacement surgery.

Board Certification:

Certified by the American Board of Orthopaedic Surgery

Education:

MD: Cornell University Medical College
Residency: University of California-San Francisco, University of Missouri-Kansas City
Fellowship: Massachusetts General Hospital, Harvard Medical School

Honors and Awards:

• Honors In Research with M.D. degree, Cornell University Medical College (1987)
• Department of Orthopaedic Surgery Prize, University of Missouri-Kansas City School of Medicine (1990, 1991, 1992, and 1993)
• Rex L. Diveley Orthopaedic Research Award, University of Missouri-Kansas City School of Medicine (1990, 1992, and 1993)
• Richard H. Kiene Orthopaedic Award, University of Missouri-Kansas City School of Medicine (1990, 1991, and 1992)

Academic Appointments:

1999 - 2007: Assistant Professor of Orthopaedic Surgery, University of Missouri-Columbia
2007 - Present: Associate Professor of Orthopaedic Surgery, University of Missouri-Columbia
2005 - Present: Adjunct Professor of Materials Science, University of Missouri-Rolla

Peer-reviewed journal articles:

1. Fantini GA, Shiono S, Bal BS and Shires GT: Adrenergic Mechanism Contribute to Alterations in Regional Perfusion during Normotensive E. Coli Bacteremia. J Trauma 29:1251-1257, 1989.
2. Bal BS and Gurba DM: Coumadin-Induced Necrosis of the Skin after Total Knee Replacement. A Case Report. J Bone Joint Surg 73A:129-130, 1991.
3. Chen Y, Bal BS and Gorski JP: Calcium and Collagen Binding Properties of Osteopontin, Bone Sialoprotein, and Bone Acidic Glycoprotein-75 from Bone. J Biochem 267:24871-24878, 1992.
4. Bal BS and Jones L, Jr: Arthroscopic Resection of a Chondroblatoma in the Knee. A Case Report. J Arthroscopy and Related Surg 11:216-219, 1995.
5. Bal BS, Sampath SAC and Burke DW: A Technique for Cementing the Patella Component in Total Knee Arthroplasty. Am J Orthop 24:358, 1995.
6. Bal BS. A Technique for Comparison of Leg Lengths during Total Hip Arthroplasty. Am J Orthop 25(1):61-2, 1996.
7. McGrory BJ, Bal BS, Harris WH. Current Concepts of Six Trochanteric Osteotomies for Total Hip Arthroplasty. J Am Acad Orthop Surgeons 4:258-267, 1996.
8. Bal BS, Sandow T. Bilateral Femoral Neck Fractures with Negative Bone Scans. A Case Report. Orthopaedics 19(11):974-6, 1996
9. Bal BS , Jiranek W and Harris WH: Periprosthetic Osteolysis Around an Uncemented Endoprosthesis. A Case Report. J Arthroplasty 12(3):346-9, 1997.
10. Bal BS, Maurer B, Harris W. Trochanteric Union Following Revision Total Hip Arthroplasty. J Arthroplasty 13(1):29-33, 1998.
11. Bal BS, Vandelune D, Gurba DM and Harris WH. Polyethylene Wear in Cases Using Femoral Stems of Similar Geometry, but Different Metals, Porous Layer, and Modularity. J Arthroplasty 13: 492-499, 1998.
12. Bal BS, Maurer T, Harris W. Revision of the Acetabular Component without Cement After a Previous Acetabular Reconstruction with Use of a Bulk Femoral Heal Graft in Patients Who Had Congenital Dislocation or Dysplasia. J Bone Joint Surg 81A(12): 1703-1706, 1999.
13. Ray A, Kuroki K, Cook JL, Bal BS, Kenter K, Aust G, Ray BK. Induction of matrix metalloproteinase 1 gene expression is regulated by inflammation-responsive transcription factor SAF-1 in osteoarthritis. Arthritis Rheum. 2003 Jan;48(1):134-45.
14. Oonishi H, Kim SC, Clarke I, Asano T, Bal BS, Kyomoto M, Masuda S. Retrieved Ceramic Total Knee Prosthesis in Clinical Use for 23 Years. Key Engineering Materials Vols. 240-242, pp. 797-800, 2003.
15. Keshavan H, Bal BS, Morsi K. Preliminary investigation into the production of grain-size functionally gradient materials for artificial hip implant applications, TMS Annual Meeting, Symposium: Surface Engineering: In Materials Science II, Mar 2-6 2003, San Diego, CA, United States, 2003, p 233-241.
16. Morsi K, Keshavan H, Bal BS. Processing of grain-size functionally gradient bioceramics for implant applications. Journal of Materials Science: Materials in Medicine 15: 191-197, 2004.
17. Cook JL, Kuroki K, Kenter K, Marberry K, Brawner T, Geiger T, Jayabalan P, Bal BS. Bipolar and monopolar radiofrequency treatment of osteoarthritic knee articular cartilage: acute and temporal effects on cartilage compressive stiffness, permeability, cell synthesis, and extracellular matrix composition. J Knee Surg 2004 Apr;17(2):99-108.
18. Yagil-Kelmer E, Kazmier P, Rahaman MN, Bal BS, Tessman RK, Estes DM. Comparison of the response of primary human blood monocytes and the U937 human monocytic cell line to two different sizes of alumina ceramic particles. J Orthop Res. 2004 Jul;22(4):832-8.
19. Morsi K, Keshavan H, Bal BS: Hot Pressing of Graded Ultrafine-Grained Alumina
    Bioceramics. Materials Science and Engineering A 386: 384-389, September 2004.
20. Ray A, Bal BS, Ray BK. Transcriptional Induction of Matrix Metalloproteinase-9 in the Chondrocyte and Synoviocyte Cells Is Regulated via a Novel Mechanism: Evidence for Functional Cooperation between Serum Amyloid A-Activating Factor-1 and AP-1. J Immunol. 2005 Sep 15;175(6):4039-48.  
21. Bal BS, Aleto TJ, Garino JP, Toni A, Hendricks K. Ceramic-on-Ceramic versus Ceramic-on-Polyethylene Bearings in Total Hip Arthroplasty: Results of a Multicenter Prospective Randomized Study and Update of Modern Ceramic Total Hip Trials in the U.S. Hip International July-September 2005, 15:129-135.
22. Aleto T, Garino JP, Hendricks KJ, Bal BS. A Comparison of Ceramic-on-Ceramic with Ceramic-on-Polyethylene Bearings in Total Hip Arthroplasty: Early Results of a Prospective Randomized Trial. University of Pennsylvania Orthopaedic Journal 2005, 17:1-5.
23. Bal BS, Haltom D, Aleto TJ, Barrett MO. Early Complications in Eighty-nine Primary Total Hip Replacements Performed with a Two-Incision Minimally Invasive Technique. J Bone Joint Surg 87A(11): 2432-2438, 2005.
24. Bal BS, Barrett MO. Acute Sepsis Complicating Degenerative Arthritis of the Hip Joint: A Report of Three Cases. Journal of Surgical Orthopaedic Advances 14(4): 190-192, Winter 2005.
25. Bal BS, Barrett MO, Lowe J. A Modified Two-Incision Technique for Primary Total Hip Replacement. Seminars in Arthroplasty September 2005, 16(3): 198-207.
26. Bal BS, Kazmier P, Burd T, Aleto TJ. Anterior Trochanteric Slide Osteotomy for Primary Total Hip Replacement. Review of Nonunion and Complications. J Arthroplasty 2006 Jan;21(1):59-63.
27. Bal BS, Greenberg D, Buhrmester L, Aleto TJ. Primary Total Knee Replacement with a Zirconia Ceramic Femoral Component. J Knee Surg 2006 Apr;19(2):89-93.
28. Bal BS, Aleto TJ. A Method to Remove the Polyethylene Liner during Hip Revision Surgery. Am J Orthop 2006 May;35(5): 242.
29. Bal BS, Haltom D, Aleto TJ, Barrett MO. Early Complications of Primary Total Hip Replacement Performed with a Two-Incision Minimally Invasive Technique. Surgical Technique Suppl., J Bone Joint Surg Am 2006 88: 221-233.
30. Bal BS, Garino J, Ries M, Rahaman MN. Ceramic Materials in Total Joint Arthroplasty. Seminars in Arthroplasty, September/December 2006, 17(3/4):94-101.
31. Rahaman MN, Brown RF, Bal BS, Day DE. Bioactive Glasses for Nonbearing Applications in Total Joint Arthroplasty. Seminars in Arthroplasty, September/December 2006, 17(3/4): 102-112.
32. Garino J, Rahaman MN, Bal BS. The Reliability of Modern Alumina Bearings in Total Hip Arthroplasty. Seminars in Arthroplasty, September/December 2006, 17(3/4): 113-119.
33. Bal BS, Rahaman MN, Aleto TJ, Miller FS, Traina F, Toni A. The significance of metal staining on alumina femoral heads in total hip arthroplasty. J Arthroplasty. 2007 Jan;22(1):14-9.
34. Bal BS, Greenberg DD, Lowe J, Aleto TJ. Primary Total Knee Arthroplasty Performed with a MIS Subvastus Approach. Techniques in Knee Surgery 6(1):60-67, March 2007.
35. Bal BS, Greenberg D. Failure of a Metal-Reinforced Tibial Post in TKA. A Case Report, J Arthroplasty. 2007 Apr;22(3):464-7.
36. Bal BS, Garino J, Ries M, Rahaman MN. A Review of Ceramic Bearing Materials in Total Joint Arthroplasty. Hip International 2007; 17: 21-30.
37. Barrett MO, Bal BS. Septic Arthritis of the Hip Joint in an Immune Competent Adult: The Significance of the Differential Diagnosis. J Am Board Fam Med. 2007 May-Jun;20(3):307-9.
38. Fu Q, Rahaman MN, Brown RF, Bal BS, Day DE. Fabrication of Macroporous Bioactive 13-93 Glass Scaffolds for Bone Tissue Engineering using a Polymer Foam Replication Technique. J Biomed Mater Res A. 2007 Jul;82(1):222-9.
39. Rahaman MN, Bal BS, Garino J, Ries M, and Yao J. Ceramics for Prosthetic Hip and Knee Joint Replacement. J Am Ceram Soc, 90 [7] 1965–1988 (2007).
40. Yoon RS, Lloyd EW, McGrory B, Bal BS, Macaulay W. Studies Presented in Poster Format at the Annual Meetings of the American Association of Hip & Knee Surgeons: How Do They Fare in the Peer Review Process? J Arthroplasty. 2007 Sept. 6(2) Suppl 2:17-20.
41. Upadhyay A, York S, Macaulay M, McGrory B, Robbennolt J, Bal BS. Medical Malpractice in Hip and Knee Arthroplasty. J Arthroplasty. 2007 Sept. 6(2) Suppl 2:2-7.
42. Bal BS, Garino J, Ries M, Oonishi H. Ceramic Bearings in Total Knee Arthroplasty, J Knee Surg. 2007; 20:261-270.
43. Fu Q, Rahaman MN, Dogan F, Bal BS.Freeze casting of porous hydroxyapatite scaffolds. I. Processing and general microstructure. J Biomed Mater Res B Appl Biomater. 2008 Jul;86(1):125-35.
44. Rahaman MN, Li Y, Bal BS, Huang W. Functionally graded bioactive glass coating on magnesia partially stabilized zirconia (Mg-PSZ) for enhanced biocompatibility.
    J Mater Sci Mater Med. 2008 Jun;19(6):2325-33.
45. Brown RF, Rahaman MN, Dwilewicz AB, Huang W, Day DE, Li Y, Bal BS. Effect of borate glass composition on its conversion to hydroxyapatite and on the proliferation of MC3T3-E1 cells. J Biomed Mater Res A. 2008 Feb 27 [Epub ahead of print].
46. Fu Q, Rahaman MN, Dogan F, Bal BS. Freeze casting of porous hydroxyapatite scaffolds. II. Sintering, microstructure, and mechanical behavior. J Biomed Mater Res B Appl Biomater. 2008 Aug;86B(2): 514-522.
47. Fu Q, Rahaman MN, Brown RF, Bal BS, Day DE. Fabrication of Macroporous Bioactive 13-93 Glass Scaffolds for Bone Tissue Engineering using a Polymer Foam Replication Technique. J Biomed Mater Res A. 2007 Jul;82(1):222-9.
48. Bal BS, Lowe J, Hillard A. Muscle Damage in Minimally Invasive Total Hip Replacement: MRI Evidence that it is Not Significant. Instr Course Lect. 2008 Jan 15;57:223-229.
49. Li, Y, Rahaman MN, Bal BS, Day DE, Fu Q. Early Stages of Calcium Phosphate Formation on Bioactive Borosilicate Glass in Aqueous Phosphate Solution. J Am Ceram Soc. May 2008, 91(5); 1528–1533.
50. Rahaman MN , Li Y, Bal BS, Huang W. Functionally graded bioactive glass coating on magnesia partially stabilized zirconia (Mg-PSZ) for enhanced biocompatibility. J Mater Sci Mater Med. 2008 Jun;19(6):2325-33.
51. Brown A, Matta J, Bal BS. Evolution and Experience with Minimally Invasive Anterior Total Hip Arthroplasty Performed on an Orthopaedic Table. Seminars in Arthroplasty, June 2008, 19(2): 209-214.
52. Bal BS. From Two Incisions to One: The Technique of Minimally Invasive Total Hip Arthroplasty with the Anterior Approach. Seminars in Arthroplasty, June 2008, 19(2): 215-224.
53. Bal BS, Vallurupalli S. A modified two-incision technique for primary total hip arthroplasty. IJO. September 2008;: 42(3):287-294.
54. Fu Q, Rahaman MN, Dogan F, Bal BS. Freeze-cast hydroxyapatite scaffolds for bone tissue engineering applications. Biomed Mater. 2008 Jun;3(2):25005.
55. Bal BS, Greenberg DD, Li S, Mauerhan D, Schultz L, Cherry K. Tibial Post Failures in a Condylar Posterior-Cruciate-Substituting Total Knee Replacement. J Arthroplasty. 2008 Aug;23(5):650-5..
56. Lima EG, Chao GP, Ateshian GA, Bal BS, Cook, JL, Vunjak-Novakovic G, Hung CT. The effect of devitalized trabecular bone on the formation of osteochondral tissue-engineered constructs. Biomaterials 29 (2008) 4292–4299.
57. Huo MH,  Parvizi J,  Bal BS,  Mont MA; Council of Musculoskeletal Specialty Societies (COMSS) of the American Academy of Orthopaedic Surgeons. What's new in total hip arthroplasty. J Bone Joint Surg Am. 2008 Sep;90(9):2043-55.
58. Bal BS. A Technique to Direct and Retrieve a Free-hand Interlocking Screw. J. Surg Ortho Adv. In press, 2008.
    

Book chapters:

Jasty M, Bragdon C, Bal BS and Harris WH: Acetabular Modularity In: Galante JO, Rosenberg AG, Callaghan JJ, Eds. Total Hip Revision Surgery, Bristol-Myers-Squibb/Zimmer Orthopaedic Symposium Series, Raven Press, New York, NY, Ch. 6:73-80, 1995.

Online journals: 

Du Y, Simmons D, Bal BS, Yin L, Calhoun J. Pathogenesis of osteomyelitis. UpToDate; 2004.

Shirtliff M, Cripps M, Bal BS, Yin L, Calhoun J. Cierny-Mader staging and the treatment of long bone osteomyelitis. UpToDate; 2004.

Shirtliff M, Cripps M, Bal BS, Yin L, Calhoun J. Staging systems for long bone osteomyelitis. UpToDate; 2004.

Audio publications:

Bal, BS. My 50 First Cases – Minimally Invasive Surgery: A Beginner’s Guid to MIS for Total Hips. Audio-Digest Orthopaedics, Volume 28, Issue 03, March 28, 2005, ISSN 0271-132X.

Other publications:

Mahowald ML, Bal BS, Burkman RT, Jones KW, Killilea T, Guay DRP, and Scherger JE (eds).The Role of Nonprescription Analgesics in Treating Mild to Moderate Pain: Clinical and Economic Considerations. A CME/CPE activity sponsored by the University of Minnesota, 2000.

Bal BS. Orthopaedic Resident Education in Academic Practice. AAOS Academy Bulletin 2004.

Bal BS and Adams M. Ancillary services can attract physician educators. AAOS Academy Bulletin, 53(1):12-13, February 2005.

Bal BS. Risk Management Spotlight: Dealing with an Adverse Outcome – The Role of Documentation. AAOS Orthopaedic Medical Legal Advisor, Winter 2005.

Bal BS. Orthopaedic educators vital to specialty’s future. AAOS Academy Bulletin, June 2004.

Editor:

Guest Editor, Minimally Invasive Total Joint Replacement. Seminars in Arthroplasty September 2005 ; 16(3).

Guest Editor, Ceramics Bearings in Total Joint Arthroplasty. Seminars in Arthroplasty September/December 2006; 17(3/4).

Guest Editor, MIS Two-incision Total Hip Arthroplasty: Methods and Outcomes: Part I. Seminars in Arthroplasty December 2007;18(4).

Guest Editor, MIS Two-incision Total Hip Arthroplasty: Methods and Outcomes: Part II. Seminars in Arthroplasty June 2008;19(2).

Managing Editor, eMedicine Clinical Knowledge Base (http://www.edmedicine.com).

Editor-in-Chief , Orthopaedic Medical Legal Advisor, November 2005.

Contact Information:

Department of Orthopaedic Surgery
University of Missouri - Columbia
One Hospital Drive, MC213
Columbia, MO 65212
(573) 882-6762
Email: balb@health.missouri.edu

Contact person: Rachel Stockman
stockmanr@health.missouri.edu