Thomas S. Thornhill, MD


A wise man once said “Do not tell people your problems because half of them do not care and the other half are actually glad you got them.” As a country we are trying to crawl our way out of a recession but it appears that the global economy may prolong this recovery effort. The Healthcare Affordability Act has been signed into law. I am certain that each of you struggles, as do I, with the mere size of the bill and the staggered starts. It will clearly bring change and I think that the leadership at AAOS has done a credible job in informing the membership in support of part of the legislation and expressing concern over other parts. Changes in healthcare in Massachusetts may in fact pose a greater threat to us, particularly at academic medical centers. This seems to happen on a cyclical basis and, to-date, things have always seem to work out.

We have just emerged from the long winter and our spring has been beautiful except for the Red Sox who seemed to have decided to fold earlier than usual.

The Brigham and Women’s Hospital remains strong as does the Orthopedic Department. Our president and CEO, Dr. Gary Gottlieb left to become our president of Partners Healthcare, now overseeing our entire Health System. Dr. Elizabeth Nabel was successfully recruited from the NHLBI to be our new president and CEO. Betsy is a cardiologist trained at the Brigham and is a proven leader in healthcare. The Department of Orthopedics has undergone further administrative change. Mr. Jonathan Beauchesne was recruited this past year to be our new department administrator. He has added some new faces in the administrative team and I am very pleased with our current organizational structure. We still are at multiple campuses including the Brigham, 850 Boylston Street, Faulkner Hospital, Braintree Hospital and Foxborough.

The educational program in the Harvard combined residency will graduate another outstanding group of residents in a few months. They have all been accepted to outstanding fellowships throughout the country. Our fellowship program continues to grow with graduating fellows in joint arthroplasty, hand and upper extremity, shoulder, sports, spine, foot and ankle and trauma. We also had an outstanding recruiting year, both for the new residents in the combined program and the fellows.


The Combined Trauma Program reports as a single group and will be found in this document.

DFBWH Musculoskeletal Oncology Service:

The musculoskeletal oncology service has undergone a significant change. Dr. John Abraham has accepted the position as chief of musculoskeletal oncology at Jefferson Medical College and the Rothman Institute. He will relocate there this summer. We have been fortunate to recruit Dr. Marco Ferrone to replace Dr. Abraham. Dr. Ferrone is a graduate of the McGill Orthopedic Program. He then completed a spine fellowship at the Hospital for Special Surgery and is now completing a musculoskeletal oncology fellowship at the Massachusetts General Hospital. Marco has both clinical and academic interests in skeletal metastasis and will join John Ready, the chief of orthopedic musculoskeletal oncology at the Dana-Farber/Brigham and Women’s Hospital, adding to the continued growth in the sarcoma program and integration with the Spine Service for treatment of spinal metastasis.

Hip and Knee Arthroplasty Service

The Arthroplasty Service at the Brigham continues its traditional role as one of the most active divisions of the department. The fellowship awaits three new fellows, who are the first to navigate the arthroplasty match.

Dr. Richard Scott and Dr. Thomas Thornhill are still active and operating three days a week. Dr John Wright has led most of the initiatives focusing on efficiency, outcomes and bundled payments that will be essential in dealing with the new healthcare economy. Dr. Wolfgang Fitz has focused his interest on unicompartmental and bicompartmental knee arthroplasty. Dr. Tom Minas bridges the transition from sports medicine to arthroplasty as director of the Cartilage repair Center. This center is nationally and internationally recognized for its clinical and research efforts. In addition, the ConforMIS custom knee is becoming a widely used and the I-duo knee is in its final stages of design for use in total knee arthroplasty. Dr. Andreas Gomoll has joined that service and has been very productive academically and clinically.

Dr. Daniel Estok, who is the Chief of Arthroplasty division, has the most active revision practice in the area. Dr. John Ready, who is dually trained both in arthroplasty and musculoskeletal oncology, is a leading authority in the area of joint resurfacing

BWH Hand/Upper Extremity Service

The Hand and Upper Extremity Service, directed by Barry P. Simmons, MD and including Philip E. Blazer, MD, Brandon E. Earp, MD, and George S.M. Dyer, MD., has had a robust year continuing efforts in education, research and patient care. Our close affiliation with Children’s Hospital continues with Peter M. Waters, MD, director of the Hand and Upper Extremity service and now Clinical Chief of Orthopaedics, and Donald S. Bae, MD. The combination of BWH and Children’s continues to offer a spectrum of fellowship training that is unrivaled. We also are continuing the valuable cross rotation of the fellows with the Hand Service at MGH.

We celebrated the 28th year of our fellowship in the spring of 2009 and over 50 former fellows and their guests attended the festivities. This year we hosted the Richard J. Smith, MD, lecture and Peter M. Waters was the celebrated guest lecturer. In addition, we appreciated the visit of Mark J. Koris, MD, who spoke at the meeting. We continue to attract a large number of fellowship applicants and will maintain educating 5 fellows (3 at BWH and 2 at MGH) for the coming academic year.

Following Haiti’s large earthquake on January 12th 2010, Dr. Dyer was deployed twice to that country to assist with relief efforts. Dr. Dyer worked in a Haitian hospital undamaged by the earthquake but overwhelmed with critically injured patients. His team performed more than 200 life and limbsaving operations in 2 weeks. He returned to Haiti 8 weeks later on March 20th, to follow up on some of those same patients and also to help establish a long-term project to assist the Haitian government to train Orthopaedic surgeons in the future. Back home, since joining the VA as Chief of Upper Extremity surgery, Dr. Dyer has dramatically expanded the scope and scale of shoulder, elbow, wrist and hand surgery to meet the needs of needs of veteran of all conflicts, but particularly those injured recently in Iraq and Afghanistan

The Harvard Combined Orthopaedic Fellowship, which includes the Hand and Upper Extremity service at Children’s Hospital, continues to attract a large number of talented applicants. Now in its 27th year, and planning for our second alumni/ ae reunion in 2009, we continue to train 3 fellows a year. The cross-rotation with the fellowship at the MGH, started in 2000, remains enormously beneficial and has allowed us to participate in educating over 70 fellows. Our current fellows, Michael Garcia, Ross Richer and Farnaz Yassaee joined us after completing residencies in Chicago and New York respectively.

BWH Spine Service

The spine service continues to progress in many different arenas. Educationally, the combined MGH-BWH spine surgery fellowship has gained a tremendous amount of momentum. Our young spine fellowship appears to be in competition with many long-standing top fellowships in the country. In addition, our previous fellows continue to be active in research, publications, and resident education at their respective institutions.

Spine research has exploded at Brigham and Women’s Hospital. Currently, we have at least six IRB-approved clinical research projects underway. These include an analysis of operative and nonoperative treatment of epidural abscesses, vertebral artery injuries and their treatment after cervical trauma, a retrospective study of drain use after anterior cervical disectomy, and a prospective randomized controlled trial of short versus long postoperative restrictions following discectomy. These Brigham originated studies often involve other spine centers in the Harvard community, such as MGH and BIDMC.

The spine research that has been completed has achieved both national and international attention during presentations at scientific meetings. We have had a very strong showing at the recent annual meetings of the American Academy of Orthopaedic Surgeons, International Society for the Study of the Lumbar Spine, and the North American Spine Society (NASS). In particular, two of the studies that we performed were presented at the “best paper” session at the NASS annual meeting in San Francisco. Another study, led by Dr. Mitchel Harris, has been featured in Orthopaedics Today in a discussion of cervical spine clearance after trauma.

The Spine service attendings at BWH have enjoyed many personal achievements. Since January, 2009, Dr. Mitchel Harris has published 15 peer-reviewed articles, some of which will likely be classic studies, such as “Mortality in elderly patients after cervical fractures” which appeared in the March issue of JBJS-American. During the same period, Dr. Christopher Bono has published 24 peer-reviewed articles across a variety of topics such as cervical trauma, evidence-based guidelines, and the outcome of lumbar fusion in the elderly. Dr. Bono and Dr. Harris have co-authored numerous book chapters, which usually involve of the fellows or residents from out program. On the editorial side, Dr. Bono as the editor for the recently released ICL Spine 2 from AAOS. He is also in the final stages of completing a new book on the practical application of evidence- based medicine to spinal surgery entitled Prove It, to be published by Wolters Kluwer.

Both Dr. Bono and Dr. Harris have given numerous grand rounds lectures at various institutions across the country. In addition, they have both been extremely active in moderating at national meetings as well as organizing and chairing courses. Dr. Bono is the program chair for the upcoming Spine Study Group in West Palm Beach.

The Spine service attendings are highly active in many professional organizations. Dr. Harris is a member of several committees in the North American Spine Society and the Leadership Committee of the AAOS. He has recently been asked to chair a Spine Tumor symposium for AO Spine North America and has been promoted to the associate editorial position of The Spine Journal. Dr. Bono is active on many NASS committees and currently serves on the Board of Directors. Dr. Bono is not only the chair of the Adult Spine Evaluation Subcommittee for the AAOS. He is also the Deputy Editor for Orthopedics for The Spine Journal and has recently been asked to be the Deputy Editor of CME for the JAAOS.

Dr Greg Brick continues to have an active practice split between Total Joint Arthroplasty and Spine.

BWH Foot and Ankle Division

The Foot and Ankle Division has enjoyed another industrious year. The staff sees patients at all four campuses, now including Foxboro. With continued growth in volume, the division is pleased to announce that Eric Bluman, MD, PhD has been hired as full-time faculty. Dr. Bluman comes from the Madigan Army Medical Center where he served as Chief of the Foot and Ankle Division. He has advanced training in foot and ankle as well as trauma surgery, and served in Iraq. He is already very busy both clinically and academically. Also joining the division is Stuart Kigner, DPM. Dr. Kigner is an experienced podiatrist and sees patients for us at the main campus. He also practices at the Mass General and in Framingham.

On the academic front, the Division continues to be very productive. Its research on tendon injury and patient satisfaction has been presented at the Annual Meetings of the AAOS and at the American Orthopedic Foot and Ankle Society. At AAOS, Drs. Chiodo and Bluman also chaired an Instructional Course Lecture on tendon transfers about the foot and ankle. Numerous review articles and chapters have also been published.

Michael Wilson, MD continues to run the Orthopaedic Service at the Faulkner. He has also been nominated to the American Orthopaedic Association. Dr. Chiodo chaired the AAOS Clinical Guideline Committee on Achilles Tendon Rupture. He has also been appointed to be Chair of the AOFAS Evidenced-based Medicine Committee. Dr. Bluman has been appointed content editor for the foot and ankle section of He also is a member for the AAOS taskforce on non-physician education of orthopaedic residents. Finally, Jim Ioli, DPM, our Brigham Podiatry Chief, leads our Faulkner Podiatry Division.

BWH Orthopedic Surgery Sports Medicine/Shoulder Service

The Sports Medicine/Shoulder Service is currently composed of four Attending Physicians: Dr. Laurence Higgins (Chief of the Service), Dr. Andreas Gomoll, Dr. Scott Martin and Dr. Thomas Minas. The care for patients has spread out with services provided at the BWH Main Campus, 850 Boylston Street Clinic, Faulkner Hospital, BWH at Foxboro and the outpatient surgical center in Foxboro. Each of our physicians are active in the Harvard Combined Orthopedic Residency Program training residents, medical students and fellows. The two Fellowship programs continue to be run within the Service: The ACGME accredited Harvard Sports Medicine Fellowship program and the Harvard Shoulder Service Fellowship Program. The Shoulder Fellowship rotates 3-4 full time Fellows through the program each year and collaborates with Dr. Jon JP Warner from MGH and includes an international experience working with leading shoulder surgeons throughout Europe.

Dr. Laurence Higgins, Chief of the Sports Medicine/ Shoulder Service, has been elected into the Herodicus Society for notable achievement in the field of Orthopedic Surgery this past year. Dr. Higgins’ practice has been chosen as the training site for K23 Grant Recipient Dr. Nitin Jain for the upcoming 2010 Fellowship term. A robust research program continues to be productive with multiple randomized prospective studies underway. Currently they are focused on the role of Vitamin D in Sports Medicine. In addition we have also received additional funding from the OREF Resident Research Grant awarded to Dr. Jae Kim to study the effects of NSAID’s on rotator cuff healing. Dr. Higgins is involved in both prospective and retrospective research studies including the study of PRP injections into high grade tendinopathy of the rotator cuff. Dr. Higgins was asked to serve as Chairman for the AAOS/ASES Open Arthroscopic Techniques in Shoulder Surgery Meeting in Chicago in May 2009. In addition, he participated as an invited lecturer at over fifteen educational courses and Orthopedic Society meetings across the country this past year. Dr. Higgins also serves as the Team Physician for Brookline High School.

Over the past year Dr. Tom Minas has notably performed the 500th Autologous Chondrocyte Implantation (ACI) on January, 27 2009 at the Brigham and Women’s Hospital in Boston. He was also nationally profiled on an interview with The Early Show on CBS News in December 2009 with the featured story of Dara Torres after her reconstructive knee surgery. He has been an invited speaker at ten Orthopedic Conferences nationally and internationally over the past year, including the Australia Orthopedic Society Meeting in October 2009 and the ConforMIS Europe GmbH in Germany in November 2009. Dr. Minas continues to publish journal articles and books, in addition to performing live webcast surgery of ConforMIS iUni for Harvard Annual Arthroplasty Course on October 30, 2009.

Dr. Andreas Gomoll received grant funding from the AANA (2009) and NIH (2009-2011) for the research project which he serves as Principle Investigator on: Does simulator training improve surgical skills in orthopaedic surgery residents? In April 2009 Dr. Gomoll received the APOSSM Traveling Fellowship award to serve as a host of a North American Pacific Rim Fellow from the American Orthopaedic Society for Sports Medicine’s international program. He has presented as an invited guest lecturer at ten venues over the past year including Grand Rounds presentations and lectures at international meetings for Orthopedic Surgery. Dr. Gomoll has recently published his book on Biologic Joint Reconstruction: Alternatives to Arthroplasty along with several journal publications and chapters.

Dr. Scott Martin continues to be the team physician for Bridgewater State College and the New England Revs along with Tom Gill and Bert Zarins. His work with Mark Brezinski has made great strides with a recent publication in March 2010 comparing OCT to MRI in evaluating early changes of articular changes with degeneration.

The Sports Medicine fellowship program was officially recognized and approved by Partners Educational Committee in January 2009 and received national accreditation by the ACGME in July 2009. Last year, the BWH Sports Fellowship was entered into the National SF Matching program which will further enhance our ability to compete with other programs on a national arena.

The department as a whole will continue to work with the commitment of performing quality research studies, providing the best orthopedic care to our patient and the best possible teaching of our residents and fellows while meeting the challenges the future may present.

Skeletal Biology Research Laboratory

Professor Julie Glowacki is Director of the Skeletal Biology Research Laboratory, which studies basic, clinical, and translational aspects of skeletal pathophysiology, skeletal cell differentiation, effects of age and vitamin D status on bone physiology, mechanisms of chondro/osteoinduction, and tissue engineering approaches for skeletal regeneration. In the past year, the group published several reports on the effects of age on human marrow cells, obtained from hip and shoulder tissues discarded during arthroplasty. Following the surprising discovery by Dr. Shuanhu (Joe) Zhou that vitamin D substrate is activated in bone marrow and may be part of paracrine regulation of bone metabolism, we discovered that there is a age-related decline in the expression of the activating enzymes that may explain the observed age-related decline in osteoblast differentiation from marrow cells. We also reported age and gender differences in constitutive expression of members of the important WNT pathways that may also underlie skeletal aging. The group has NIH funding to gain further understanding of dysregulation of human osteoblast differentiation and function in order to test ways to rejuvenate bone formation.

Two NIH grants have built upon the development of novel mitochondrial-targeted anti-oxidants to mitigate the irradiation-induced impairment of bone healing. Work to date in mice models shows that the anti-oxidants stimulate bone healing in normal mice as well as irradiated mice. Ongoing work tests their effects on aged animals and aged cells. Tissue engineering research involves the regulation of chondrocyte and osteoblast differentiation, optimization of Dr. Shuichi Mizuno’s tissue bioreactor, and mechanisms of actions with differentiation agents to enhance histogenesis. Drs. Bueno and Glowacki published a review of cell-based and cell-free tissue engineering for skeletal applications and have written a monograph on the biological principles underlying orthopedic tissue engineering. An OREF grant to Dr. Laurence Higgins concerns the pathophysiology of rotator cuff arthropathy in collaboration with Professor Meryl LeBoff. Translational and clinical research continues our multidisciplinary program to improve follow-up management of osteoporosis in fragility fracture patients, expand fracture pathways with other in-hospital caregivers, the natural history of osteoporosis in patients with osteoarthritis, importance of vitamin D status for skeletal health.

Dr. Glowacki continues to serve the department as Co-Chair of the BWH Musculoskeletal Research Center of Excellence, representative to the BWH Biomedical Research Institute’s Research Oversight Committee and the Partners Steering Committee for the Biospecimens Enterprise for Translational Research (BETR), and as Professional Standards Officer for BWH Research Staff. She is a member of the Harvard Medical School Committee on Promotions, Reappointments, and Appointments, which concerns promotions to Assistant and Associate Professor.


Anuj Bellare, PhD:

The research of the Orthopedic Nanotechnology Laboratory has focused on using a structure-property approach to improve the mechanical and tribological properties of ultra-high molecular weight polyethylene (UHMWPE) used in total joint replacement prostheses. The Orthopedic and Arthritis Center for Outcomes Research (OrAC ORe):

OrACORE is a clinical and policy research unit established in the Department in 2006 under the leadership of Drs. Jeffrey Katz and Elena Losina. OrACORe investigators have several exciting projects ongoing and others starting up. The MeTeOR Trial (Meniscal Tear in Osteoarthritis Research; J Katz, PI) is a seven center randomized controlled trial of arthroscopic partial meniscectomy vs. a physical therapy based nonoperative regimen in patients with symptomatic meniscal tear and concomitant osteoarthritis of the knee. As of July 2010, 75% of the target sample of 340 patients have been enrolled. BWH is the leading enrolling site, led by Dr. Scott Martin, the leading MeTeOR enroller nationwide and Dr. John Wright. Other sites include Hospital for Special Surgery, Cleveland Clinic, Vanderbilt Unviersity, Mayo Clinic, Rush University and Washington University.

Dr. Losina leads the Osteoarthritis Policy Model project, an NIH funded computer simulation study of the costs and outcomes of osteoarthritis over the lifetime. Dr. Losina and team have used the model to publish the most comprehensive cost effectiveness analysis of total knee replacement to date (Archives of Internal Medicine, 2009). Numerous other analyses are ongoing including the lifetime costs of osteoarthritis in the US and the cost effectiveness of disease modifying therapy in OA and of technical innovations in total knee replacement, among others.

Finally, several clinical faculty members are collaborating with OrACORe investigators on clinical projects in the PRIDE program (Program for Research Incubation and Development). Two PRIDE projects were published in the last year including an epidemiologic study of mortality following cervical spine fracture led by Dr. Mitchel Harris and a comparison of 1-day vs. 2-day epidural anesthesia strategies in patients undergoing total knee replacement, led by Dr. John Wright. Other projects led by Drs. Bono, Martin, Thornhill, Earp and others are ongoing.

Center for Molecular Orthopaedic in the Department of Orthopedic Surgery

Keith D. Crawford, M.D., Ph.D. is the Director of the Center for Molecular Orthopaedic in the Department of Orthopedic Surgery. Dr. Crawford’s primary research efforts are in the areas adult stem cell biology and regenerative medicine, with a primary research emphasis on the role of adult stem cells in osteoarthritis. Recently, he discovered a novel adult stem cell name the ELA stem cell (early lineage adult stem cell), which is phenotypically and functionally distinct from mesenchymal stem cells (MSCs), MAPCs, MIAMI, and VSEL adult stem cells. A publication of his finding is forthcoming. In addition, Dr. Crawford has identified cellular mediators in the synovial fluid, which interfere with the ability of the ELA cell to propagate and differentiate into cartilage. Furthermore, these cellular mediators have been found to suppress the growth of a subset of soft tissue cancers.

In addition to Dr. Crawford’s research efforts, he sits on the Culturally Competent Care Education Committee for the Combine Orthopaedic Residency Program. The responsibility of this committee is to foster the development of faculty and curricula to prepare students and residents with the knowledge, skill, and attitude to practice culturally competent medicine; thereby diminishing healthcare disparities. Dr. Crawford has also been appointed the Director of the BWH sponsored Summer Training Academic Research and Scholarship (STARS) and serves as the scientific advisor to the Harvard Catalyst SCTRP and VRIP Programs. All of these programs are designed to increase the number of under represented minority students persuading careers in the healthcare professions, as well as, diversifying the BWH residency staff.


Four years ago, I joined Operation Walk Denver to a mission in Panama. Operation Walk, patterned after Operation Smile was started by Dr. Larry Dorr in Iowa and has grown into many chapters around the country. On the first trip to Panama, I took 2 colleagues. The next year, we combined Op Walk Boston and Op Walk Denver for a trip to the Dominican Republic. For the past 2 years Operation Walk Boston has returned to the Dominican Republic and is now firmly established as Operation Walk Boston.

The events in Haiti earlier this year posed both challenges and opportunities. Several members of our team volunteered and went to Haiti early after the earthquake. Fortunately, our group is integrated with Partners in Health, which has been firmly established in Haiti for years with their work on HIV and multiply drug resistant tuberculosis. This gave our teams the infrastructure to succeed in the otherwise chaotic environment. The Haitian relief has been truly a combined effort and I am pleased with the global response. Several surgeons from the BWH and MGH Trauma teams were there the first week and have been back more than once. Many of you have also contributed to this effort and I think that we can all be proud of the response from the orthopedic community. The problem now is to sustain that effort.

The Operation Walk team was concerned about performing elective total hip and total knees in the Dominican Republic sitting in the shadows of the Haitian disaster. We released a large part of our cargo, which helped in the early relief effort. We have subsequently released much of our rehabilitation equipment that had been stored in the Dominican (crutches, walkers, etc.). We recently finished our Op Walk mission where we performed 60 total hip and total knee replacements in 5 days with a team of 5 surgeons, 5 anesthesiologists, nurses, physical therapists, physician’s assistants and 3 Harvard residents. I am pleased that the Operation Walk Program has been officially adopted by the residents and it is an opportunity for training residents to become involved in an international effort during their residency. The Medical leader this year was Jeremy Smith PGY 4 and the other residents were Kanu Okike PGY3 and Courtney Dawson PGY5.


Many former residents of my vintage remembered little about official resident social outings. The golf outing is now firmly established across the residency. Dr. Gregory Brick and Dr. John Ready have now been established a ski event at Waterville Valley. This year was again a success featuring resident teaching, the downhill race and a chance for the faculty and residents to gather informally. Finally, Gregory Brick has become an avid fisherman in Boston Harbor and Stelwagen Bank.


There is not much to report on the alumni front. Clem Sledge spends much of his time in Maine and comes down this way only when necessary. I speak to Bob Poss who has now left his position with the JBJS and is doing well. You may remember Nicki Champagne who for 40 years worked at the Robert Brigham and then the Brigham and Women’s Hospital keeping all of the orthopedic instruments straight. Nichole has been an inspiration to all of us and she will be retiring in a few months. Hopefully, some of the old guard will come to her event. I saw Bill and Dicky Thomas at a Robert Brigham event as well as Sarah and Fred Ewald. I am pleased that everyone is thriving.

I wish you all a happy year and look forward to seeing you soon.

Sincerely yours,

Thomas S. Thornhill M.D.

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