Dr. James Neff, outstanding orthopaedic surgeon, dies

by Tom O’Connor, UNMC public affairs | July 15, 2005

picture disc.James Russell Neff, M.D., an internationally recognized faculty member and orthopaedic surgeon for UNMC and its hospital partner, The Nebraska Medical Center, died Tuesday at Methodist Hospital in Omaha after an extended battle with cancer. He was 65.

A memorial service will be held at 2 p.m., Aug. 6, at Dundee Presbyterian Church, 5312 Underwood Ave.

A native of Kansas, Dr. Neff attended public schools in Topeka and graduated from the University of Kansas School of Medicine in 1966. His training in orthopaedic surgery at the University of Michigan was interrupted by service in the US Navy aboard the USS George Marshall as a Lieutenant Commander. His duty honored, he resumed his training in Michigan followed by a fellowship at the University of Florida in musculoskeletal oncology. Here, he was exposed to novel limb sparing procedures for patients afflicted with osseous and soft tissue malignancies. In due course, he would make his mark as an innovative surgeon for such patients on the regional, national and international scene.

In 1975, Dr. Neff returned to the University of Kansas. By 1983, he was appointed professor of surgery.

Dr. Neff arrived at UNMC in 1991 as professor and chairman of the Department of Orthopaedic Surgery and Rehabilitation. A specialist in treating cancer of the bone and soft tissues, Dr. Neff was known for performing innovative procedures to help people lead a more normal life following cancer.

Over the years in Kansas and Nebraska, Dr. Neff's group characterized more than 5,000 bone and soft tissue tumors genetically. Dr. Neff elevated the standard of care for these life-destroying diseases and his group literally re-wrote the textbooks, especially in regard to the pathogenetic mechanisms central to these conditions. These works have had a major impact on patient care.

"Dr. Neff was a world-class pioneering surgeon and one of the most creative people I have ever met," said UNMC Chancellor Harold M. Maurer, M.D. "He cared greatly about the welfare of his patients. I worked closely with him in treating children with bone and soft tissue sarcoma. He attracted me to UNMC. He was a giant in the field in every way. I will miss him."

Considered one of the most innovative people in the orthopaedic surgery field, Dr. Neff was known for combining ingenuity and technology to come up with answers to complex surgical cases.

"His name is known around the world for limb-sparing orthopaedic implant devices," said David Anuta, retired vice president for manufacturing and custom products for Zimmer Holdings, Inc., the world's largest joint implant company. "Surgically, he was amazing. He enriched the lives of so many people the way that very few people have the possibility of doing."

Two procedures that Dr. Neff was known for were the rotationplasty and the hemipelvectomy. The rotationplasty was used for patients with osteosarcoma, a bone cancer that usually occurs in adolescents and young adults. Instead of amputating the patient's entire leg, Dr. Neff was able to spare the sciatic nerve along with the ankle and foot, then connect the ankle and foot to the upper leg. The heel of the foot wound up serving as the knee when the prosthesis was placed over it. It provided the patient with much mobility and flexibility. Dr. Neff received training for this procedure in Vienna and was one of only a handful of surgeons capable of performing this complex surgery in the United States.

The hemipelvectomy was performed for patients with cancer in the hip region. The unique operation involved replacing the entire hip socket, a portion of the pelvis and part of the proximal femur. Dr. Neff developed a custom hemipelvis and modular implant system that could be adjusted in the operating room to fit the patient's precise needs.

Dr. Neff, who maintained a mill in his basement to test out some of his ideas, created an orthopaedic device nearly 25 years ago. The device, called the Neff Nail, continues to be frequently used by orthopaedic surgeons. It is used as a knee fusion device for patients with failed knee surgeries.

"He was really brilliant - probably the best surgeon to come through Nebraska in any field," said Walter Huurman, M.D., professor of orthopaedic surgery at UNMC and a colleague of Dr. Neff for the past 14 years. "His hands were very good. He was very accomplished."

Dr. Huurman was always impressed with how Dr. Neff looked after and nurtured the resident orthopaedic surgeons under his charge. "When Jim was chairman, he was responsible for the education of 40 residents - that's a sizeable group of individuals," Dr. Huurman said.

"Jim always took the time to learn as much about the residents as he could," he said. "When the residents left, they took with them Jim's concern for his patients as well as great admiration for his abilities. He was superior as a surgeon to probably anybody they'll ever come in contact with."

Dr. Neff served in the esteemed role of examiner for the American Board of Orthopaedic Surgery for nearly 20 years.

In orthopaedic surgery, being strong enough to manipulate bones into place is a key commodity, and Dr. Neff was exceptionally strong, Dr. Huurman said. "When I think of Jim Neff, I think of Mickey Mantle," he said. "His upper torso and body were huge. He was really ripped. He kept in excellent condition and it really came in handy in the OR."

Kevin Garvin, M.D., who succeeded Dr. Neff as chairman of orthopaedic surgery, admired Dr. Neff for his leadership. "He was a true leader in every sense of the word. He was someone we all looked to for advice in times of need. He embodied what academic medical centers are all about - patient care, education and research."

Dr. Neff served on the osteosarcoma committee of the National Childrens Oncology Group, as president of the Musculoskeletal Tumor Society, the executive committee of the American Orthopaedic Association, the musculoskeletal tumors and diseases committee of the American Academy of Orthopaedic Surgeons, and the chair-elect of the Musculoskeletal Transplant Foundation, among other national and international leadership roles.

Rod Markin, M.D., Ph.D., president and CEO of University Medical Associates and associate dean of UNMC's College of Medicine said: "He's one of those people who didn't make a lot of noise but did a marvelous job for his patients. He was very innovative with limb-sparing surgical procedures, but more than that, I will always remember him for being a very caring, compassionate physician."

Irene Klintberg, Ph.D., executive associate dean in the College of Medicine, said: "Throughout his years at UNMC, Dr. Neff exemplified the highest level of commitment to the standards of excellence in patient care and medical education. Dedicated to scholarship and the advancement of patient care, Dr. Neff provided strong leadership for the Department of Orthopaedic Surgery and the College of Medicine. He was a loyal friend, a congenial colleague and a true gentleman."

A prodigious researcher, Dr. Neff was involved in more than a dozen grants during his career. Said J. Graham Sharp, Ph.D., professor, UNMC Genetics, Cell Biology & Anatomy: "Dr. Neff's passing is very sad for us. Dr. Neff always had the best interests of his patients on his mind and when there were problems such as difficulties in the healing of large bone defects created as a necessity of cancer surgeries, he approached us with ideas for research that might help with this problem. Consequently, we began a project to try and improve the repair and healing of bone by adding cells to artificial matrix products. Dr. Neff was instrumental in obtaining funding from various manufacturers and encouraging this research. I am pleased we were able to publish our progress with him earlier this year in Clinical Orthopedics and Related Research. He will be sorely missed."

Dr. Neff made 149 presentations at scientific meetings, published more than 150 articles in scientific journals and authored 14 books or book chapters. For the past five years, he has been named to "America's Top Doctors," a national guide published annually by Castle Connolly Medical Ltd. of New York City. Of more than 650,000 physicians in the U.S., only about 4,200 physicians ultimately are chosen for inclusion in the guide.

Dr. Neff was one of a select group of surgeons in an organization called the International Society for Limb Salvage. "This was a group of premier thinkers, visionaries, miracle workers and simply great surgeons," said Anuta of Zimmer Holdings, Inc.

Most recently, Dr. Neff was notified that he would be receiving the University of Kansas Distinguished Medical Alumni Award. This prestigious award recognizes a recipient's outstanding contributions to society and their respective professions. It is granted to only one or two alumni a year.

Diagnosed with osteosarcoma at age 9, Omaha dental hygienist Jill Stephenson was the third patient at UNMC to get rotationplasty surgery under Dr. Neff. At age 10, Stephenson, who is now 23, wrote a book "A Change of Plans," which she dedicated to Dr. Neff.

In the book, she wrote, "He made a huge impact on my life..Dr. Neff means everything to me. He saved my life the best way he could by doing the rotationplasty surgery, which lets me do more of the things I enjoy. He is gentle, kind, nice -- dedicated to kids. I can tell he cares. He talks slowly and explains well so I can understand the best way. He always tells me the truth, whether it is good or bad. He makes cancer seem not so bad after all."

Dr. Neff is survived by his wife, Julia Bridge, M.D., professor, UNMC Pathology and Microbiology Department and the Department of Pediatrics; daughters, Rachael and Kirsten; son, Gregory; and step-son, Stuart.

Memorials should be made to the James R. Neff, M.D., Memorial Cancer Fund in care of the University of Nebraska Foundation, 8712 W. Dodge Rd, Suite 100, Omaha, NE 68114, or Dundee Presbyterian Church Music Ministry, 5312 Underwood Ave., Omaha, NE 68132.