This has been a challenging year for the Orthopedic Department at the Beth Israel Deaconess Medical Center as well as for the medical center itself. Greg Altman, MD left early in the academic year, relocating to Pittsburgh, leaving us without a trauma chief. A second challenge came with the impact of some of the Harvard residents being diverted from the BIDMC rotation. In addition, we were dealing with a financial crisis at the hospital and the impact of the Hunter Group which was hired to guide the hospital through its financial crisis. We participated with their fact finding and are now living with the repercussions of their recommendations. The hospital turnaround plan was underway before the Hunter Group began and continues to proceed, incorporating many of the recommendations from the Hunter Group. During all this process, I helped interpret these issues and made recommendations and decisions, often under strange circumstances as a member of the CareGroup Board of Trustees. This is an ongoing challenge to which there has been some resolution and I feel we are in a better position for a positive outcome. Recruitment efforts continue, as we seek to build the department in the specialties of trauma, hand, adult reconstruction and foot and ankle surgery.

The current professional staff continues to be involved and engaged in many academic ventures. Dr. Augustus A. White III was named Master of the Oliver Wendell Holmes Society at Harvard Medical School and was also named the Ellen and Melvin Gordon Professor of Medical Education at Harvard Medical School. Gus was selected for membership in The Academy at Harvard Medical School. He presented the 29th Alfred R. Shands Lectureship at the annual meeting of the American Orthopaedic Association and was the President’s Guest Lecturer at the Scoliosis Research Society. Gus was elected President of the J. Robert Gladden Orthopaedic Society and continues his work with the American Academy of Orthopaedic Surgeons, serving as Chair of the Diversity Committee and as a member of the Council on Academic Affairs, the Council of Musculoskeletal Specialty Societies, and the Council on Health Policy and Practice. He was also appointed to the Board of Directors of Zimmer, Inc. In his spare time, he has coauthored Biomechanics in the Musculoskeletal System with Dr. M M. Panjabi, and updated the section on Biomechanics of the Spine in the Orthopaedic Knowledge Update: Spine 2 of the American Academy of Orthopaedic Surgeons, with Drs. Panjabi and Yaszemski. Gus also continues as mentor to the current Daniel E. Hogan Spine Fellow for 2002, Dr. Ardavan Mortezazadeh.

Dr. Paul A. Glazer was named a Senior Fellow in the Oliver Wendell Holmes Society at Harvard Medical School. He was elected as an editorial board member of The Spine Journal, the official journal of the North American Spine Society, as well as being elected a founding member of the Micromechanical Tissue Repair Society. He was selected by the North American Spine Society to sit on an FDA panel to evaluate vertebroplasty procedures. A poster presentation was given at the meeting of the International Society for the Study of the Lumbar Spine in Edinburgh, Scotland. Paul continues to publish on subjects related to the spine. These include articles on anterior and posterior allografts in symptomatic thoracolumbar deformity, with Butterman, Hu and Bradford in the Journal of Spinal Disorders; Prevention of postlaminectomy epidural fibrosis using bioelastic materials, with Alkalay, Kim and Urry in Spine; the use of calcium sulfate as a bone graft substitute in a spinal fusion model, with Spencer, Alkalay and Schwardt in The Spine Journal; and two articles currently in press in Orthopedics on delayed esophageal and abscess formation after cervical vertebrectomy and fusion for fracture, with Kim; and intradural herniation of lumbar vertebral disc with Mithoefer. Paul is currently participating in the Harvard Resident Mentoring Program and is sponsoring a clinical spine surgery fellowship, recently completed by Saechin Kim, MD and currently enjoyed by Shawn Hayden, MD.

Louis W. Meeks, MD was promoted this year to Assistant Clinical Professor of Orthopedic Surgery at Harvard Medical School and was named a Senior Fellow in the Oliver Wendell Holmes Society at the medical school.He was the recipient of the “Golden Apple” (Teacher of the Year) award presented by the residents in the Harvard Combined Orthopedic Residency Program. In addition to resident education, Dr. Meeks has continued his many teaching activities with HMS students, BIDMC medical residents and the clerkship under his direction at the medical school.

Jeffrey Zilberfarb, MD continues his busy ambulatory practice with Dr. Meeks, in addition to which he is actively involved with the teaching of Harvard residents, HMS students and residents from the Department of Medicine. He was accepted into the American Arthroscopy Society of North America this year and has written several articles on shoulder surgery: Effect Of Subacromial Decompression on the AC Joint: Biomedical Testing in a Cadaveric Model, submitted to the Journal of Shoulder Surgery; Stability of AC Joint Reconstruction, submitted to the Journal of Orthopedic Research; and Stability Of AC Joint Reconstruction: Biomechanical Testing of Various Surgical Techniques in a Cadaveric Model, to the Journal of Sports Medicine. Drs. Meeks and Zilberfarb will welcome Lars Richardson, MD to their practice later this year.

Stephen Murphy, MD has continued his work as the principal investigator of the FDA IDE study of ceramic-ceramic bearings, study including more than 1300 patients. He has developed instruments and software algorithms to advance the applications of computerized surgical navigation to reconstructive surgery of the hip and knee. He has done a clinical study of twenty-one acetabular cups placed with the aid of surgical navigation which demonstrated that the use of navigation helps eliminate poorly positioned cups.

Dr. Murphy became a member of The Hip Society and presented a paper at their recent annual meeting on a prospective study of periacetabular osteotomy. At the annual meeting of the American Academy of Orthopaedic Surgeons, he presented papers on surgical navigation in total hip and total knee arthroplasty and had a poster presentation on ceramic-ceramic bearings in total hip arthroplasty. In addition, Steve has continued his teaching efforts with lectures on surgical anatomy of the hip at the summer dissection course for the orthopedic residents.

The Boston Orthopedic Group (Dr. Harris Yett, Dr. Hyman Glick, Dr. Tobin Gerhart, Dr. Stephen Murphy, Dr. Paul Glazer, and Dr. Saechin Kim) continue their work of patient care, dedicated teaching of HMS students and education of medical residents rotating year-round through their practice. Dr. Hyman Glick was recently named the Chief of Orthopedics at Harvard Vanguard Medical Associates.

At the request of the Caregroup Board of Directors, Donald T. Reilly, MD PhD moved his adult reconstructive practice to the New England Baptist Hospital. However, he remains active in the teaching of Harvard orthopedic residents and HMS students and continues his research interests in the area of knee replacement implants.

We acutely felt the loss of Gregory T. Altman, MD who returned to his hometown to practice trauma surgery at Allegheny General and Mercy Hospitals in Pittsburgh. Robert Davis, MD, Saechin Kim, MD and Tobin Gerhart, MD have stepped in to help with trauma coverage. Stephen J. Lipson, MD and Katherine Taft, MSN RNC moved to Harvard Vanguard Medical Associates to continue their work with patients with neck and back pain. We thank them all for their years of dedication to Harvard Orthopedics.

During this past year, we have enjoyed the chief residencies of Ashwin Deshmukh, MD who took a private practice position in Los Angeles and Domingo Cheleuitte, MD who stayed on with us until May, 2002 and will pursue the Baylor Medical Center and University of Texas-Southwestern Combined Foot and Ankle Fellowship under the direction of Drs. James Brodsky and John Early in Dallas in August. Our current chief resident, Dr. Thomas Myers will undertake a sports medicine fellowship under the direction of Dr. James Andrews at the American Sports Medicine Institute in Birmingham, Alabama beginning in August 2002.

In February, we were pleased to welcome Isil Yasar as the new Administrative Director of the department. While we have to share her with the Transplant Service, she has established good working relationships with hospital administration, staff physicians and support staff in the department and has set a positive tone for leadership.

On a personal level, I was honored with the Marion Ropes Award at the annual Arthritis Foundation dinner in June. This year also included my presidency of the Hip Society, although our scientific meeting in Boston was cancelled because of the events of September 11. My AAOS responsibilities include being a representative on the Council of Medical Specialty Societies and the Research Committee. I was named a Senior Fellow of the Oliver Wendell Holmes Society and concluded six years of service as a trustee of the Orthopaedic Research and Education Foundation.

The most exciting part of my leadership has been the many interactions with our research affiliates and clinical staff. These include the clinical research programs with Drs. Goldring, Jeffrey Katz and Dan Rooks, the association with Dr. Michael Rosenblatt’s research on metastatic tumor growth, and the research of Dr. Brian Snyder and his team in the Orthopedic Biomechanics Laboratory. We are forging ahead with Dr. Buck Struller in his osteoporosis research and collaborating with the geriatric program at the hospital and the many geriatric facilities associated with BIDMC. Our association with the Joslin Diabetic Group and its combined foot service and vascular team is a threshold for much more work to be done in this area.

Daniel Rooks, Ph.D. has continued his work with nonpharmacological approaches to disease management. The focus of his work remains on disease and limitation specific exercise programs to improve functional status. Dr. Rooks is the principal investigator on a grant where we are collaborating to evaluate the effects of a preoperative exercise program on the recovery of functional status after primary total hip or knee arthroplasty. The pilot study was completed early and a large randomized controlled trial is underway. He is continuing his work in the area of rheumatic disease self-management with two studies looking at exercise and behavioral interventions for the short and long-term management of fibromyalgia. Dan also received a grant this year to apply his model of nonpharmacological management to the HIV+ population. This past year, Dan received an Arthritis Investigator Award from the Arthritis Foundation and a K23 Career Development award from NIAMS. In his role as Director of the Be Well! Tanger Center for Health Management at BIDMC, he has collaborated with Drs. Steven Goldring, Lisa Fitzgerald and John Donahue in Rheumatology and me to develop and pilot a new pathway of care that incorporates disease self-management into the care of chronic musculoskeletal conditions.

The Orthopedic Biomechanics Laboratory of the Beth Israel Deaconess Medical Center is a world renowned center for biomechanics research in orthopaedics. In addition, the lab trains numerous Harvard residents, Harvard medical students, and engineering students from the Massachusetts Institute of Technology and Boston University. The Orthopedic Biomechanics Laboratory has been in transition since Dr. Wilson C. (Toby) Hayes, Ph.D. left for Oregon in 1998.

Dr. Brian Snyder, M.D., Ph.D., of Children’s Hospital has been acting director since May, 1998. Now more than ever, the Orthopedic Biomechanics Lab is a resource for orthopedic researchers at all the hospitals in the Harvard Combined Orthopedic Residency Program. Brian Snyder, M.D., Ph.D., is investigating the biomechanics of metastatic defects in bone, the biomechanics of fracture healing, as well as a breadth of clinical investigations centered in pediatric orthopaedics at The Children’s Hospital. Mary L. Bouxsein, Ph.D. is involved in research on the etiology of osteoporosis, non-invasive methods to predict osteoporotic fracture risk, and growth factors for the acceleration of fracture healing. Dr. Guoan Li focuses on utilizing the most recent technological advances to delineate musculoskeletal joint function and investigate the etiology of joint disease. He and his students are specifically interested in the biomechanical factors that lead to joint injuries and long-term joint degeneration. Their research also includes examination of the biomechanical effects of current surgical options (e.g., ligament reconstruction, total joint replacement) used to treat these injuries and devise new techniques (e.g., minimally invasive surgical technique). Ron Alkalay, Ph.D. focuses on spinal biomechanics in the areas of instrumentation and the use of biomaterials to enhance surgical procedures. Of particular interest is the relationship between mechanical forces and biological processes affecting spinal fusion and degeneration of the intervertebral disc. Diana Hauser, Ph.D. is investigating the biomechanics of benign and metastatic defects in the appendicular skeleton, as well as radiological predictors of pathological fracture risk derived from DEXA, QCT and QMRI techniques. Dietrich von Stechow, M.D. focuses on tissue engineering of bone and cartilage. Current projects include the angiogenesis of tissue engineered bone as well as the biomechanical behavior of a newly developed bone cement.

Perhaps most exciting is our new collaboration with the New England Baptist Bone and Joint Institute Basic Science Laboratory. This laboratory is located at the Harvard Institutes of Medicine, Harvard Medical School and includes eight principal investigators who are working with a team of thirty-three post-doctoral fellows, graduate students, and laboratory technicians investigating more than two dozen studies. These projects are funded by over five million dollars of NIH, Arthritis Foundation and private industry support. A detailed description and summary of their research projects is presented by Dr. Steven Goldring later in this journal.

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