Faculty

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Tishya A.l. Wren, PhD
Associate Professor of Research Orthopaedic Surgery and Radiology
Pediatric Orthopaedic
CHL 4650 Sunset Blvd 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

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

Amherst College: Woods-Travis Valedictorian Award, 1992

National Science Foundation Graduate Fellowship

Publications

A randomized controlled trial testing an adherence-optimized Vitamin D regimen to mitigate bone change in adolescents being treated for acute lymphoblastic leukemia. Leuk Lymphoma. 2017 Oct; 58(10):2370-2378. View in: PubMed

Reliability of patellar height indices in children with cerebral palsy and spina bifida. J Child Orthop. 2017 Aug 01; 11(4):249-255. View in: PubMed

Biomechanical Modeling of Spine Flexibility and Its Relationship to Spinal Range of Motion and Idiopathic Scoliosis. Spine Deform. 2017 Jul; 5(4):225-230. View in: PubMed

Walking activity during daily living in children with myelomeningocele. Disabil Rehabil. 2017 Jul; 39(14):1422-1427. View in: PubMed

Gastrocnemius operating length with ankle foot orthoses in cerebral palsy. Prosthet Orthot Int. 2017 Jun; 41(3):274-285. View in: PubMed

A comparison of three methods of measuring tibial torsion in children with myelomeningocele and normally developing children. Clin Anat. 2017 May 03. View in: PubMed

Rectus Femoris Transfer Surgery Worsens Crouch Gait in Children With Cerebral Palsy at GMFCS Levels III and IV. J Pediatr Orthop. 2017 Apr 03. View in: PubMed

Vertebral cross-sectional area: an orphan phenotype with potential implications for female spinal health. Osteoporos Int. 2017 Apr; 28(4):1179-1189. View in: PubMed

Fasting serum blood measures of bone and lipid metabolism in children with myelomeningocele for early detection of cardiovascular and bone fragility risk factors. J Spinal Cord Med. 2017 Mar; 40(2):193-200. View in: PubMed

The Determinants of Peak Bone Mass. J Pediatr. 2017 Jan; 180:261-269. View in: PubMed

Prevalence of specific gait abnormalities in children with cerebral palsy revisited: influence of age, prior surgery, and Gross Motor Function Classification System level. Dev Med Child Neurol. 2017 Jan; 59(1):79-88. View in: PubMed

Association between vertebral cross-sectional area and lumbar lordosis angle in adolescents. PLoS One. 2017; 12(2):e0172844. View in: PubMed

Percutaneous Hamstring Lengthening Surgery is as Effective as Open Lengthening in Children With Cerebral Palsy. J Pediatr Orthop. 2016 Dec 22. View in: PubMed

Effect of Tibia Marker Placement on Kinematics in Pathological Gait. J Appl Biomech. 2016 Dec; 32(6):603-607. View in: PubMed

Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis. Pediatr Radiol. 2016 Sep; 46(10):1424-9. View in: PubMed

Quantitative Analysis of Lower Leg Adipose Tissue Distribution in Youth with Myelomeningocele. J Child Neurol. 2016 Jul; 31(8):979-84. View in: PubMed

Early injury to cortical and cancellous bone from induction chemotherapy for adolescents and young adults treated for acute lymphoblastic leukemia. Bone. 2016 Apr; 85:131-7. View in: PubMed

Variability of the Anterior Humeral Line in Normal Pediatric Elbows. J Pediatr Orthop. 2016 Mar; 36(2):e14-6. View in: PubMed

Comparison of lateral shuffle and side-step cutting in young recreational athletes. Gait Posture. 2016 Feb; 44:189-93. View in: PubMed

Assessing bone accrual in cerebral palsy: new longitudinal data and future needs. Dev Med Child Neurol. 2015 Nov; 57(11):990-1. View in: PubMed

An approach for determining quantitative measures for bone volume and bone mass in the pediatric spina bifida population. Clin Biomech (Bristol, Avon). 2015 Aug; 30(7):748-54. View in: PubMed

Knee Pain and Patellofemoral Symptoms in Patients With Cerebral Palsy. J Pediatr Orthop. 2015 Jul-Aug; 35(5):519-22. View in: PubMed

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

Long-term ambulatory change after lower extremity orthopaedic surgery in children with cerebral palsy: a retrospective review. J Pediatr Orthop. 2015 Apr-May; 35(3):285-9. View in: PubMed

Long term functional outcomes after early childhood pollicization. J Hand Ther. 2015 Apr-Jun; 28(2):158-65; quiz 166. View in: PubMed

Fat distribution in children and adolescents with myelomeningocele. Dev Med Child Neurol. 2015 Mar; 57(3):273-8. View in: PubMed

Recommendations for reporting gait studies. Gait Posture. 2015 Feb; 41(2):339-40. View in: PubMed

Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy. Pediatr Phys Ther. 2015; 27(3):218-26. View in: PubMed

Quantitative assessment of dynamic control of fingertip forces after pollicization. Gait Posture. 2015 Jan; 41(1):1-6. View in: PubMed

A line drawn along the radial shaft misses the capitellum in 16% of radiographs of normal elbows. J Pediatr Orthop. 2014 Dec; 34(8):763-7. View in: PubMed

Reliability of lateral distal femur dual-energy X-ray absorptiometry measures. J Clin Densitom. 2014 Oct-Dec; 17(4):522-7. View in: PubMed

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):1280-5. e2. View in: PubMed

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

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

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

Heterogeneity of muscle fat infiltration in children with spina bifida. Res Dev Disabil. 2014 Jan; 35(1):215-22. View in: PubMed

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

Repeat hamstring lengthening for crouch gait in children with cerebral palsy. J Pediatr Orthop. 2013 Jul-Aug; 33(5):501-4. View in: PubMed

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

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

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

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

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

Surgical management of hip subluxation and dislocation in children with cerebral palsy: isolated VDRO or combined surgery? J Pediatr Orthop. 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

Cerebral palsy: clinical care and neurological rehabilitation. Lancet Neurol. 2011 Sep; 10(9):844-52. View in: PubMed

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

Efficacy of clinical gait analysis: A systematic review. Gait Posture. 2011 Jun; 34(2):149-53. View in: PubMed

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

Bone density and size in ambulatory children with cerebral palsy. Dev Med Child Neurol. 2011 Feb; 53(2):137-41. View in: PubMed

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

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

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

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

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

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

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

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

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

Effects of preoperative gait analysis on costs and amount of surgery. J Pediatr Orthop. 2009 Sep; 29(6):558-63. View in: PubMed

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

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

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

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

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

Quantitative CT reference values for vertebral trabecular bone density in children and young adults. Radiology. 2009 Jan; 250(1):222-7. View in: PubMed

[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

Reproducibility of carotid intima-media thickness measurements in young adults. Radiology. 2008 May; 247(2):465-71. View in: PubMed

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

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

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

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

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

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

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

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

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

Timing of peak bone mass: discrepancies between CT and DXA. J Clin Endocrinol Metab. 2007 Mar; 92(3):938-41. View in: PubMed

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

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

Causes of intoeing gait in children with cerebral palsy. J Bone Joint Surg Am. 2006 Oct; 88(10):2175-80. View in: PubMed

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

Cross-correlation as a method for comparing dynamic electromyography signals during gait. J Biomech. 2006; 39(14):2714-8. View in: PubMed

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mechanical properties of the human achilles tendon. Clin Biomech (Bristol, Avon). 2001 Mar; 16(3):245-51. View in: PubMed

Interpretation of calcaneus dual-energy X-ray absorptiometry measurements in the assessment of osteopenia and fracture risk. J Bone Miner Res. 2000 Aug; 15(8):1573-8. View in: PubMed

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

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

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

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

Weight gain following vertical expandable prosthetic titanium ribs surgery in children with thoracic insufficiency syndrome. Spine (Phila Pa 1976). 2009 Nov 01; 34(23):2530-3. View in: PubMed

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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