Faculty

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Tishya A.l. Wren, PhD
Associate Professor of Research Orthopaedic Surgery and Radiology
Pediatric Orthopaedic
CHL 69 Off Campus Los Angeles
+1 323 361 4120

Overview

Dr. Wren is a biomedical engineer working in clinical environment. As Director of Research for the Children's Orthopaedic Center at Children's Hospital Los Angeles, Dr. Wren conducts clinical and basic research in several different areas of orthopaedics. Two of the primary areas are (1) evaluation and treatment of movement abnormalities in children with neurologic deficits and (2) assessment of bone and fractures in children. This research is carried out in collaboration with colleagues in the John C. Wilson, Jr. Motion Analysis Laboratory and the Children's Imaging Research Program.

Awards

Amherst College: Woods-Travis Valedictorian Award, 1992

National Science Foundation Graduate Fellowship

American Academy of Orthopaedic Surgeons: Best Paper Award - Pediatrics, 2015

Gait and Clinical Movement Analysis Society: Best Paper Award, 2014

Pediatric Orthopaedic Society of North America: Marc A. Asher Clinical Scientific Paper Award, 2004

Publications

Ponrartana S, Fisher CL, Aggabao PC, Chavez TA, Broom AM, Wren TA, Skaggs DL, Gilsanz V. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis. Pediatr Radiol. 2016 Sep; 46(10):1424-9. View in: PubMed

Lorenzana DJ, Mueske NM, Ryan DD, Van Speybroeck AL, Wren TA. Quantitative Analysis of Lower Leg Adipose Tissue Distribution in Youth with Myelomeningocele. J Child Neurol. 2016 Jul; 31(8):979-84. View in: PubMed

Edison BR, Lee Pace J, Brophy CH, Mueske NM, Katzel MJ, Zaslow TL, Wren TA. Biomechanical Deficits During Drop Jump In Young Athletes With Recent Anterior Cruciate Ligament Reconstruction: 2635 Board #158 June 3, 11: 00 AM - 12: 30 PM. Med Sci Sports Exerc. 2016 May; 48(5 Suppl 1):735. View in: PubMed

Zaslow TL, Lee Pace J, Hwang AJ, Mueske NM, Katzel MJ, Healy BS, Edison BR, Wren TA. Biomechanical Asymmetries during Single-Leg Loading Tasks in Young Athletes Following Recent Anterior Cruciate Ligament Reconstruction: 3520 Board #3 June 4, 9: 00 AM - 11: 00 AM. Med Sci Sports Exerc. 2016 May; 48(5 Suppl 1):974. View in: PubMed

Lee Pace J, Mueske NM, Padilla RA, Katzel MJ, Healy BS, Zaslow TL, Edison BR, Wren TA. Effect Of Acl Graft Type On Side-step Cutting In Young Athletes: 3126 Board #191 June 3, 2: 00 PM - 3: 30 PM. Med Sci Sports Exerc. 2016 May; 48(5 Suppl 1):888-9. View in: PubMed

Zaslow TL, Pace JL, Mueske NM, Chua MC, Katzel MJ, Dennis SW, Wren TA. Comparison of lateral shuffle and side-step cutting in young recreational athletes. Gait Posture. 2016 Feb; 44:189-93. View in: PubMed

Rethlefsen SA, Nguyen DT, Wren TA, Milewski MD, Kay RM. Knee Pain and Patellofemoral Symptoms in Patients With Cerebral Palsy. J Pediatr Orthop. 2015 Jul-Aug; 35(5):519-22. View in: PubMed

Ryan DD, Lightdale-Miric NR, Joiner ER, Wren TA, Spragg L, Heffernan MJ, Kay RM, Skaggs DL. Variability of the Anterior Humeral Line in Normal Pediatric Elbows. J Pediatr Orthop. 2015 May 16. View in: PubMed

Wren TA. Assessing bone accrual in cerebral palsy: new longitudinal data and future needs. Dev Med Child Neurol. 2015 May 6. View in: PubMed

Horenstein RE, Shefelbine SJ, Mueske NM, Fisher CL, Wren TA. An approach for determining quantitative measures for bone volume and bone mass in the pediatric spina bifida population. Clin Biomech (Bristol, Avon). 2015 Apr 23. View in: PubMed

Lightdale-Miric N, Mueske NM, Lawrence EL, Loiselle J, Berggren J, Dayanidhi S, Stevanovic M, Valero-Cuevas FJ, Wren TA. Long term functional outcomes after early childhood pollicization. J Hand Ther. 2015 Apr-Jun; 28(2):158-66. View in: PubMed

Ponrartana S, Ramos-Platt L, Wren TA, Hu HH, Perkins TG, Chia JM, Gilsanz V. Effectiveness of diffusion tensor imaging in assessing disease severity in Duchenne muscular dystrophy: preliminary study. Pediatr Radiol. 2015 Apr; 45(4):582-9. View in: PubMed

Mueske NM, Ryan DD, Van Speybroeck AL, Chan LS, Wren TA. Fat distribution in children and adolescents with myelomeningocele. Dev Med Child Neurol. 2015 Mar; 57(3):273-8. View in: PubMed

Stebbins J, Trinler UK, Baker R, Brunner R, Wren T, Theologis T. Recommendations for reporting gait studies. Gait Posture. 2015 Feb; 41(2):339-40. View in: PubMed

Lightdale-Miric N, Mueske NM, Dayanidhi S, Loiselle J, Berggren J, Lawrence EL, Stevanovic M, Valero-Cuevas FJ, Wren TA. Quantitative assessment of dynamic control of fingertip forces after pollicization. Gait Posture. 2015 Jan; 41(1):1-6. View in: PubMed

Wren TA, Dryden JW, Mueske NM, Dennis SW, Healy BS, Rethlefsen SA. Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy. Pediatr Phys Ther. 2015; 27(3):218-26. View in: PubMed

Yu S, Rethlefsen SA, Wren TA, Kay RM. Long-term Ambulatory Change After Lower Extremity Orthopaedic Surgery in Children With Cerebral Palsy: A Retrospective Review. J Pediatr Orthop. 2014 Jun 24. View in: PubMed

Ponrartana S, Andrade KE, Wren TA, Ramos-Platt L, Hu HH, Bluml S, Gilsanz V. Repeatability of chemical-shift-encoded water-fat MRI and diffusion-tensor imaging in lower extremity muscles in children. AJR Am J Roentgenol. 2014 Jun; 202(6):W567-73. View in: PubMed

Wren TA, Kalkwarf HJ, Zemel BS, Lappe JM, Oberfield S, Shepherd JA, Winer KK, Gilsanz V. Longitudinal Tracking of Dual-Energy X-ray Absorptiometry Bone Measures Over 6 Years in Children and Adolescents: Persistence of Low Bone Mass to Maturity. J Pediatr. 2014 Jun; 164(6):1280-1285. e2. View in: PubMed

Ramirez RN, Ryan DD, Williams J, Wren TA, Ibrahim D, Weiss JM, Kay RM, Lightdale-Miric N, Skaggs DL. A Line Drawn Along the Radial Shaft Misses the Capitellum in 16% of Radiographs of Normal Elbows. J Pediatr Orthop. 2014 Apr 29. View in: PubMed

Franklin CC, Wren T, Ferkel E, Arkader A. Predictors of conversion from conservative to operative treatment of pediatric forearm fractures. J Pediatr Orthop B. 2014 Mar; 23(2):150-4. View in: PubMed

Milewski MD, Skaggs DL, Bishop GA, Pace JL, Ibrahim DA, Wren TA, Barzdukas A. Chronic Lack of Sleep is Associated With Increased Sports Injuries in Adolescent Athletes. J Pediatr Orthop. 2014 Mar; 34(2):129-33. View in: PubMed

Wren TA, Ponrartana S, Van Speybroeck A, Ryan DD, Chia JM, Hu HH. Heterogeneity of muscle fat infiltration in children with spina bifida. Res Dev Disabil. 2014 Jan; 35(1):215-22. View in: PubMed

Wren TA, Lening C, Rethlefsen SA, Kay RM. Impact of gait analysis on correction of excessive hip internal rotation in ambulatory children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol. 2013 Oct; 55(10):919-25. View in: PubMed

Rethlefsen SA, Yasmeh S, Wren TA, Kay RM. Repeat hamstring lengthening for crouch gait in children with cerebral palsy. J Pediatr Orthop. 2013 Jul-Aug; 33(5):501-4. View in: PubMed

Wren TA, Otsuka NY, Bowen RE, Scaduto AA, Chan LS, Dennis SW, Rethlefsen SA, Healy BS, Hara R, Sheng M, Kay RM. Outcomes of lower extremity orthopedic surgery in ambulatory children with cerebral palsy with and without gait analysis: results of a randomized controlled trial. Gait Posture. 2013 Jun; 38(2):236-41. View in: PubMed

Mueske NM, Chan LS, Wren TA. Reliability of Lateral Distal Femur Dual-Energy X-Ray Absorptiometry Measures. J Clin Densitom. 2013 Mar 26. View in: PubMed

Wren TA, Elihu KJ, Mansour S, Rethlefsen SA, Ryan DD, Smith ML, Kay RM. Differences in implementation of gait analysis recommendations based on affiliation with a gait laboratory. Gait Posture. 2013 Feb; 37(2):206-9. View in: PubMed

Wren TA, Shepherd JA, Kalkwarf HJ, Zemel BS, Lappe JM, Oberfield S, Dorey FJ, Winer KK, Gilsanz V. Racial disparity in fracture risk between white and nonwhite children in the United States. J Pediatr. 2012 Dec; 161(6):1035-40. View in: PubMed

Ponrartana S, Aggabao PC, Hu HH, Aldrovandi GM, Wren TA, Gilsanz V. Brown adipose tissue and its relationship to bone structure in pediatric patients. J Clin Endocrinol Metab. 2012 Aug; 97(8):2693-8. View in: PubMed

Gilsanz V, Smith ML, Goodarzian F, Kim M, Wren TA, Hu HH. Changes in Brown Adipose Tissue in Boys and Girls during Childhood and Puberty. J Pediatr. 2012 Apr; 160(4):604-609. e1. View in: PubMed

Huh K, Rethlefsen SA, Wren TA, Kay RM. Surgical Management of Hip Subluxation and Dislocation in Children With Cerebral Palsy: Isolated VDRO or Combined Surgery? J Pediatr Orthop. 2011 Dec; 31(8):858-63. View in: PubMed

Aisen ML, Kerkovich D, Mast J, Mulroy S, Wren TA, Kay RM, Rethlefsen SA. Cerebral palsy: clinical care and neurological rehabilitation. Lancet Neurol. 2011 Sep; 10(9):844-52. View in: PubMed

Wren TA, Otsuka NY, Bowen RE, Scaduto AA, Chan LS, Sheng M, Hara R, Kay RM. Influence of gait analysis on decision-making for lower extremity orthopaedic surgery: Baseline data from a randomized controlled trial. Gait Posture. 2011 Jul; 34(3):364-9. View in: PubMed

Wren TA, Gorton GE, Ounpuu S, Tucker CA. Efficacy of clinical gait analysis: A systematic review. Gait Posture. 2011 Jun; 34(2):149-53. View in: PubMed

Wren TA, Chung SA, Dorey FJ, Bluml S, Adams GB, Gilsanz V. Bone marrow fat is inversely related to cortical bone in young and old subjects. J Clin Endocrinol Metab. 2011 Mar; 96(3):782-6. View in: PubMed

Al Wren T, Lee DC, Kay RM, Dorey FJ, Gilsanz V. Bone density and size in ambulatory children with cerebral palsy. Dev Med Child Neurol. 2011 Feb; 53(2):137-41. View in: PubMed

Gilsanz V, Chalfant J, Kalkwarf H, Zemel B, Lappe J, Oberfield S, Shepherd J, Wren T, Winer K. Age at onset of puberty predicts bone mass in young adulthood. J Pediatr. 2011 Jan; 158(1):100-5, 105. e1-2. View in: PubMed

Wren TA, Lee DC, Hara R, Rethlefsen SA, Kay RM, Dorey FJ, Gilsanz V. Effect of high-frequency, low-magnitude vibration on bone and muscle in children with cerebral palsy. J Pediatr Orthop. 2010 Oct-Nov; 30(7):732-8. View in: PubMed

Rethlefsen SA, Lening C, Wren TA, Kay RM. Excessive hip flexion during gait in patients with static encephalopathy: an examination of contributing factors. J Pediatr Orthop. 2010 Sep; 30(6):562-7. View in: PubMed

Wren TA, Cheatwood AP, Rethlefsen SA, Hara R, Perez FJ, Kay RM. Achilles tendon length and medial gastrocnemius architecture in children with cerebral palsy and equinus gait. J Pediatr Orthop. 2010 Jul-Aug; 30(5):479-84. View in: PubMed

Di Iorgi N, Mo AO, Grimm K, Wren TA, Dorey F, Gilsanz V. Bone acquisition in healthy young females is reciprocally related to marrow adiposity. J Clin Endocrinol Metab. 2010 Jun; 95(6):2977-82. View in: PubMed

Gilsanz V, Kremer A, Mo AO, Wren TA, Kremer R. Vitamin D status and its relation to muscle mass and muscle fat in young women. J Clin Endocrinol Metab. 2010 Apr; 95(4):1595-601. View in: PubMed

Huh K, Rethlefsen SA, Wren TA, Kay RM. Development of calcaneal gait without prior triceps surae lengthening: an examination of predictive factors. J Pediatr Orthop. 2010 Apr-May; 30(3):240-3. View in: PubMed

Bernthal NM, Gamradt SC, Kay RM, Wren TA, Cuomo AV, Reid J, Bales J, Otsuka NY. Static and dynamic gait parameters before and after multilevel soft tissue surgery in ambulating children with cerebral palsy. J Pediatr Orthop. 2010 Mar; 30(2):174-9. View in: PubMed

Wren TA, Gilsanz V. Evolving role of imaging in the evaluation of bone structure. J Bone Miner Res. 2009 Dec; 24(12):1943-5. View in: PubMed

Wren TA, Kalisvaart MM, Ghatan CE, Rethlefsen SA, Hara R, Sheng M, Chan LS, Kay RM. Effects of preoperative gait analysis on costs and amount of surgery. J Pediatr Orthop. 2009 Sep; 29(6):558-63. View in: PubMed

Lee DC, Campbell PP, Gilsanz V, Wren TA. Contribution of the vertebral posterior elements in anterior-posterior DXA spine scans in young subjects. J Bone Miner Res. 2009 Aug; 24(8):1398-403. View in: PubMed

Wren TA, Engsberg JR. Normalizing lower extremity strength data for children, adolescents, and young adults with cerebral palsy. J Appl Biomech. 2009 Aug; 25(3):195-202. View in: PubMed

Wren TA, Chen AY, Wang VJ, Claudius IA, Skaggs DL. Prior treatment of fracture patients in a tertiary pediatric emergency department: informal referrals from other emergency departments. J Pediatr Orthop. 2009 Mar; 29(2):137-41. View in: PubMed

Rethlefsen SA, Kam G, Wren TA, Kay RM. Predictors of outcome of distal rectus femoris transfer surgery in ambulatory children with cerebral palsy. J Pediatr Orthop B. 2009 Mar; 18(2):58-62. View in: PubMed

Engsberg JR, Tucker C, Ounpuu S, Wren TA, Sisto SA, Kaufman KR. Gait and clinical movement analysis research priorities: 2007 update from the research committee of the Gait and Clinical Movement Analysis Society. Gait Posture. 2009 Feb; 29(2):169-71. View in: PubMed

Yu GY, Yan CH, Yu XG, Zuo Y, Zou XY, Xu J, Wu SH, Shen XM. [Effects of chelation therapy with succimer in young rabbits of moderate lead poisoning]. Zhonghua Yu Fang Yi Xue Za Zhi. 2009 Jan; 43(1):8-13. View in: PubMed

Gilsanz V, Perez FJ, Campbell PP, Dorey FJ, Lee DC, Wren TA. Quantitative CT reference values for vertebral trabecular bone density in children and young adults. Radiology. 2009 Jan; 250(1):222-7. View in: PubMed

Gonzalez J, Wood JC, Dorey FJ, Wren TA, Gilsanz V. Reproducibility of carotid intima-media thickness measurements in young adults. Radiology. 2008 May; 247(2):465-71. View in: PubMed

Wren TA, Do KP, Hara R, Rethlefsen SA. Use of a patella marker to improve tracking of dynamic hip rotation range of motion. Gait Posture. 2008 Apr; 27(3):530-4. View in: PubMed

Wren TA, Sheng M, Bowen RE, Scaduto AA, Kay RM, Otsuka NY, Hara R, Chan LS. Concurrent and discriminant validity of Spanish language instruments for measuring functional health status. J Pediatr Orthop. 2008 Mar; 28(2):199-212. View in: PubMed

Wren TA, Bluml S, Tseng-Ong L, Gilsanz V. Three-point technique of fat quantification of muscle tissue as a marker of disease progression in Duchenne muscular dystrophy: preliminary study. AJR Am J Roentgenol. 2008 Jan; 190(1):W8-12. View in: PubMed

Lee DC, Gilsanz V, Wren TA. Limitations of peripheral quantitative computed tomography metaphyseal bone density measurements. J Clin Endocrinol Metab. 2007 Nov; 92(11):4248-53. View in: PubMed

Wren TA, Engsberg JR. Normalizing lower-extremity strength data for children without disability using allometric scaling. Arch Phys Med Rehabil. 2007 Nov; 88(11):1446-51. View in: PubMed

Wren TA, Do KP, Hara R, Dorey FJ, Kay RM, Otsuka NY. Gillette Gait Index as a gait analysis summary measure: comparison with qualitative visual assessments of overall gait. J Pediatr Orthop. 2007 Oct-Nov; 27(7):765-8. View in: PubMed

Wren TA, Mitiguy PC. A simple method to obtain consistent and clinically meaningful pelvic angles from euler angles during gait analysis. J Appl Biomech. 2007 Aug; 23(3):218-23. View in: PubMed

Gilsanz V, Wren T. Assessment of bone acquisition in childhood and adolescence. Pediatrics. 2007 Mar; 119 Suppl 2:S145-9. View in: PubMed

Wren TA, Sheng M, Hara R, Otsuka NY, Bowen RE, Scaduto AA, Kay RM, Chan LS. Agreement among three instruments for measuring functional health status and quality of life in pediatric orthopaedics. J Pediatr Orthop. 2007 Mar; 27(2):233-40. View in: PubMed

Wren TA, Kim PS, Janicka A, Sanchez M, Gilsanz V. Timing of peak bone mass: discrepancies between CT and DXA. J Clin Endocrinol Metab. 2007 Mar; 92(3):938-41. View in: PubMed

Janicka A, Wren TA, Sanchez MM, Dorey F, Kim PS, Mittelman SD, Gilsanz V. Fat mass is not beneficial to bone in adolescents and young adults. J Clin Endocrinol Metab. 2007 Jan; 92(1):143-7. View in: PubMed

Wren TA, Gilsanz V. Assessing bone mass in children and adolescents. Curr Osteoporos Rep. 2006 Dec; 4(4):153-8. View in: PubMed

Rethlefsen SA, Healy BS, Wren TA, Skaggs DL, Kay RM. Causes of intoeing gait in children with cerebral palsy. J Bone Joint Surg Am. 2006 Oct; 88(10):2175-80. View in: PubMed

Gilsanz V, Wren TA, Sanchez M, Dorey F, Judex S, Rubin C. Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J Bone Miner Res. 2006 Sep; 21(9):1464-74. View in: PubMed

Wren TA, Do KP, Rethlefsen SA, Healy B. Cross-correlation as a method for comparing dynamic electromyography signals during gait. J Biomech. 2006; 39(14):2714-8. View in: PubMed

Wren TA, Rethlefsen SA, Healy BS, Do KP, Dennis SW, Kay RM. Reliability and validity of visual assessments of gait using a modified physician rating scale for crouch and foot contact. J Pediatr Orthop. 2005 Sep-Oct; 25(5):646-50. View in: PubMed

Wren TA, Liu X, Pitukcheewanont P, Gilsanz V. Bone densitometry in pediatric populations: discrepancies in the diagnosis of osteoporosis by DXA and CT. J Pediatr. 2005 Jun; 146(6):776-9. View in: PubMed

Wren TA, Woolf K, Kay RM. How closely do surgeons follow gait analysis recommendations and why? J Pediatr Orthop B. 2005 May; 14(3):202-5. View in: PubMed

Wren TA, Liu X, Pitukcheewanont P, Gilsanz V. Bone acquisition in healthy children and adolescents: comparisons of dual-energy x-ray absorptiometry and computed tomography measures. J Clin Endocrinol Metab. 2005 Apr; 90(4):1925-8. View in: PubMed

Wren TA, Rethlefsen S, Kay RM. Prevalence of specific gait abnormalities in children with cerebral palsy: influence of cerebral palsy subtype, age, and previous surgery. J Pediatr Orthop. 2005 Jan-Feb; 25(1):79-83. View in: PubMed

Kay RM, Rethlefsen SA, Fern-Buneo A, Wren TA, Skaggs DL. Botulinum toxin as an adjunct to serial casting treatment in children with cerebral palsy. J Bone Joint Surg Am. 2004 Nov; 86-A(11):2377-84. View in: PubMed

Wren TA, Do KP, Kay RM. Gastrocnemius and soleus lengths in cerebral palsy equinus gait--differences between children with and without static contracture and effects of gastrocnemius recession. J Biomech. 2004 Sep; 37(9):1321-7. View in: PubMed

Kay RM, Rethlefsen S, Reed M, Do KP, Skaggs DL, Wren TA. Changes in pelvic rotation after soft tissue and bony surgery in ambulatory children with cerebral palsy. J Pediatr Orthop. 2004 May-Jun; 24(3):278-82. View in: PubMed

Kay RM, Rethlefsen SA, Ryan JA, Wren TA. Outcome of gastrocnemius recession and tendo-achilles lengthening in ambulatory children with cerebral palsy. J Pediatr Orthop B. 2004 Mar; 13(2):92-8. View in: PubMed

Kay RM, Rethlefsen SA, Kelly JP, Wren TA. Predictive value of the Duncan-Ely test in distal rectus femoris transfer. J Pediatr Orthop. 2004 Jan-Feb; 24(1):59-62. View in: PubMed

Loboa EG, Wren TA, Beaupré GS, Carter DR. Mechanobiology of soft skeletal tissue differentiation--a computational approach of a fiber-reinforced poroelastic model based on homogeneous and isotropic simplifications. Biomech Model Mechanobiol. 2003 Nov; 2(2):83-96. View in: PubMed

Wren TA. A computational model for the adaptation of muscle and tendon length to average muscle length and minimum tendon strain. J Biomech. 2003 Aug; 36(8):1117-24. View in: PubMed

Wren TA, Lindsey DP, Beaupré GS, Carter DR. Effects of creep and cyclic loading on the mechanical properties and failure of human Achilles tendons. Ann Biomed Eng. 2003 Jun; 31(6):710-7. View in: PubMed

Wren TA, Yerby SA, Beaupré GS, Carter DR. Influence of bone mineral density, age, and strain rate on the failure mode of human Achilles tendons. Clin Biomech (Bristol, Avon). 2001 Jul; 16(6):529-34. View in: PubMed

Wren TA, Yerby SA, Beaupré GS, Carter DR. Mechanical properties of the human achilles tendon. Clin Biomech (Bristol, Avon). 2001 Mar; 16(3):245-51. View in: PubMed

Wren TA, Beaupré GS, Carter DR. Mechanobiology of tendon adaptation to compressive loading through fibrocartilaginous metaplasia. J Rehabil Res Dev. 2000 Mar-Apr; 37(2):135-43. View in: PubMed

Wren TA, Beaupré GS, Carter DR. Tendon and ligament adaptation to exercise, immobilization, and remobilization. J Rehabil Res Dev. 2000 Mar-Apr; 37(2):217-24. View in: PubMed

Wren TA, Beaupré GS, Carter DR. A model for loading-dependent growth, development, and adaptation of tendons and ligaments. J Biomech. 1998 Feb; 31(2):107-14. View in: PubMed

Wren TA, Carter DR. A microstructural model for the tensile constitutive and failure behavior of soft skeletal connective tissues. J Biomech Eng. 1998 Feb; 120(1):55-61. View in: PubMed

Skaggs DL, Sankar WN, Albrektson J, Wren TA, Campbell RM. Weight gain following vertical expandable prosthetic titanium ribs surgery in children with thoracic insufficiency syndrome. Spine (Phila Pa 1976). 2009 Nov 1; 34(23):2530-3. View in: PubMed

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