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Introduction
As I write my 12th Annual Chief's Report to the Orthopaedic
Journal at the Harvard Medical School, the financial markets
appear to have stabilized, and we remain in a deep recession.
On March 23, 2010 our 44th President signed his comprehensive
health care reform bill, the Patient Protection and Affordable
Care Act, into law. This new law requires most U.S. Citizens
and legal residents to have health care insurance and creates
a state-based American Health Benefit Exchange System
through which individuals can purchase coverage. This is not
dissimilar to the Exchanges available in the Massachusetts
Health Care Program. In addition, this new bill expands
Medicare to many individuals under the age of 65 and provides
a series of premium and cost-sharing subsidies to individuals
of need.
In addition, there are significant tax changes related to
the new health insurance program with an increased tax-rate
on wages and excise tax on insurers and medical devices. The
impact of these tax changes will have enormous repercussions
upon our profession. There are also changes to the private
insurance sector with the establishment of the temporary
national high-risk pool and new insurance market pools. There
are a series of measures designed to improve the quality of our
health care system as well as the health-system's performance.
The field of comparative-effectiveness research will receive
an enormous boost as a result of a series of patient-centered
outcomes research institutes, demonstration projects, and
national Medicare Pilot Programs. We were fortunate to have
heard about one of these programs at Grand Rounds on May
20, 2010 when Richard White, MD, Medical Director, New
Mexico Center for Joint Replacement Surgery, in Albuquerque,
New Mexico, presented a talk entitled, "Potential Advantages
and Dangers for Orthopaedic Surgeons with Participation in
A Bundled-Payment Model." It was a sobering and insightful
presentation. A new national prevention, health care
promotion, and public health council will coordinate federal
prevention, wellness and public health awareness activities.
Long-term care will also be affected with the establishment of
a national voluntary insurance program for community living
assisted services. As we all know, the implementation of the
new taxes will precede the actual benefits of the program and
thus an enormous number of challenges and modifications
will occur.
I have spent many hours reviewing the details of this bill
and find it to be very perplexing. Yet, I remain hopeful that we
will be able to continue to deliver our high-quality patient care
at all of our hospitals and outpatient programs throughout
the country. I eagerly await the analysis of the implications
of this bill as it transitions our care. I am also concerned that
millions of Americans are being steered into a program that has
consistently under-performed for our patients and providers.
Presumably, the best is yet to come and we have an obligation
to be involved in the discussion. The midterm elections should
bring some clarity.
IN MEMORIAM
In April we were saddened by the
passing of Ms. Linda Honeycutt of the
Orthopaedic Trauma Service. Ms.
Honeycutt was a long-time employee
of the MGH and an integral part of the
Department of Orthopaedic Surgery.
She worked most recently as assistant
to Mark Vrahas, MD, Chief of Partners
Orthopaedic Trauma. I first met Ms.
Honeycutt over 20 years ago during
my Arthroplasty Fellowship at the
MGH.
Ms. Honeycutt's outgoing personality, infectious laughter
and unmistakable Southern drawl could make anyone feel
welcome and at home. She would often stop by my office
with fresh tomatoes and blueberries from Wilson's Farm, her
favorite local farm stand.
In May the Department hosted a memorial service in
celebration of Ms. Honeycutt's life. The standing room only
event in the MGH Chapel was filled with words of remembrance
and shared memories.
Ms. Honeycutt will be terribly missed.
FACILITIES
Building of the 3rd Century
We are eagerly anticipating the opening of the Building
of the 3rd Century which is expected to open to patients in the
summer of 2011. For the last two years we have been watching
this massive structure take shape at the site of the former Vincent
and Clinics Buildings. The opening in 2011 coincides with the
200th anniversary of the MGH. This facility will occupy nearly
a half million square feet and will be the home to Radiation
Oncology, Radiology, In-Patient and Out-Patient Surgery,
and twelve new Operating Rooms and will include increased
Intensive Care capacity. We also plan to have an "Orthopaedic
Surgery Operating Room of the Future" with the most-advanced navigation and robotic equipment available. The top five-floors
of this massive complex will provide space for increased bed
capacity for Cancer, Neurology and Neurosurgery. With the
completion of the Building of the 3rd Century, patients, visitors,
and staff will be able to navigate through the main campus with
new and more direct pedestrian routes including connections
which will eliminate the need to go outdoors to travel from the
"front" of the main campus to the "back."
Another exciting aspect of the Building of the 3rd Century
is a new Emergency Department which will be located in the
White Building on the Lobby level. Mr. Sumner Redstone,
Executive Chairman of the Board of Directors of Viacom
pledged over $40 million to develop the new Emergency
Department which will offer advanced state-of-the-art care.
The Building of the 3rd Century will undoubtedly be the
crowning jewel on the MGH main campus. We eagerly await
its completion and our fabulous new operating rooms. Mark
Vrahas, MD, Chief of Partners Trauma, will be the Orthopaedic
"Czar" of the new OR facility and our representative in the
MGH OR Administration. Dr. Vrahas and Thomas Holovacs,
MD, Director of the Outpatient Operating Rooms will work
closely in the new OR facility.
Brigham and Women's / Mass General Heath Care Center at
Foxborough
The Brigham and Women's/Mass General Health Care
Center at Foxborough has been open now for over a year and
continues to provide outstanding care to patients South of
Boston. Located at Patriot Place, it is a 1.3 million square
foot development adjacent to Gillette Stadium. This modern
93,000 square foot, four-story Center houses physician offices,
four operating rooms for outpatient surgery, and advanced
diagnostic imaging. Primary Care Services are available at
the Center as well as Orthopaedic Surgery and other specialty
services including: Cardiology, Dermatology, General and
Gastrointestinal Surgery, Pain Management, Plastic Surgery,
Rehabilitation and Sports Medicine.
The growing list of physicians seeing patients at this
facility includes Thomas Gill, IV, MD; Andreas Gomoll, MD;
Peter Ansis, MD; Eric Berkson, MD; Richard de Asla, MD;
Thomas Holovacs, MD; Chaitanya Mudgal, MD; Joseph Schwab,
MD; Philip Blazer, MD; Christopher Bono, MD; Christopher
Chiodo, MD; Wolfgang Fitz, MD; and Scott Martin, MD. We
are pleased to have recently added Pediatric Orthopaedics to
the medical services offered and we welcome Gleeson Rebello,
MD to the staff.
Congratulations to Dr. Berkson, who was recently named
as the new Medical Director at the Center for the MGH
physicians. Dr. Berkson will follow in the foot steps of Dr. Gill,
our first Medical Director.
The Brigham and Women's / Mass General Health Care
Center is a fine addition to our Department and we look
forward to providing specialized care and convenience to our
patients in the Foxborough area. This Center is an important
element of the Patriot Place complex which includes shopping,
restaurants, and entertainment. Our future offerings there
will include a Performance Analysis Center under the direction
of Dr. Berkson and a Center for the Early Detection and
Treatment of Hip and Knee Arthritis.
Stephan L. Harris Chordoma Center
This year we were extremely pleased to open The Stephan
L. Harris Center for Chordoma Care at the MGH. Under the
direction of Francis Hornicek, MD, PhD, the Center offers
patients access to a multidisciplinary group of physicians and
clinicians who specialize in the diagnosis and the treatment
of chordomas. Our team of clinicians: Francis Hornicek, MD,
PhD; Frank Pedlow, MD; Kevin Raskin, MD; Joseph Schwab,
MD; and Dempsey Springfield, MD, represent one of the largest
chordoma treatment groups in the country. This is the first center in the world with a single focus on chordoma care. The
Center includes Orthopaedic Oncologists and Orthopaedic
Spine Surgeons, as well as dedicated nursing, and is staffed
by radiation and medical oncologists, neurosurgeons, plastic
surgeons, radiologists, pathologists, ENT’s and researchers.
Chordoma is a rare malignant bone tumor; the treatment
is complex and can be difficult. In a recent study, the Harris
Center clinicians achieved a five-year continuous disease-free
survival rate of 62.5% with primary sacral chordoma. The
Stephan L. Harris Center is a center of excellence at the MGH
that provides unsurpassed compassionate care while advancing
the art and science of evaluating, diagnosing, treating, curing,
and supporting the patient with chordoma.
Congratulations to Dr. Hornicek and his team for this
amazing Center!
The Jim & Ellen Kaplan Center for Joint Reconstruction
Surgery at Newton Wellesley Hospital
The Jim & Ellen Kaplan Center for Joint Reconstruction
Surgery at Newton-Wellesley Hospital (NWH) continues to
flourish under the leadership of Director, Joseph McCarthy,
MD. Dr. McCarthy, Vice-Chairman of the MGH Department
of Orthopaedic Surgery, is joined at the NWH by new faculty
members Hany Bedair, MD and John Kwon MD. Dr. Bedair
joined the Department in 2009 and Dr. Kwon will be joining
us later this summer. We continue to expand this important
relationship with the fantastic physicians at the NWH.
FACULTY UPDATES
The Department and the Adult Reconstructive Surgery
Service were pleased to welcome two new members in 2009,
Hany Bedair, MD and Young-Min Kwon, MD, PhD.
Dr. Bedair graduated from Yale University School of
Medicine and did his residency at the University of Pittsburgh
Medical Center. He joined the Department after completing
an Orthopaedic Adult Reconstruction Fellowship at Rush
University Medical Center. Over the last year, Dr. Bedair
has been working closely with Dr. Andrew Freiberg and
Dr. Joseph McCarthy at the Jim & Ellen Kaplan Center for
Joint Reconstruction Surgery. Dr. Bedair’s clinical interests
are in the area of adult reconstructive surgery of the hip
and knee (total hip, total knee arthroplasty, partial knee
arthroplasty), including complex primary and revision surgery
and his research interests focus on periprosthetic infections,
arthrofibrosis, and clinical outcomes.
The Knee Society recently honored Dr. Bedair with the
Mark Coventry Award. This national award was presented to
Dr. Bedair for his research on detecting infections earlier in
joint replacement patient. Congratulations Dr. Bedair on this
wonderful achievement!
Dr. Bedair recently joined the leadership of the Harvard
Medical School Annual Advances in Arthroplasty Course. He
is working closely with myself and Dr. Andrew Freiberg on the
program content. We look forward to Dr. Bedair's impact on
our Department.
It was also a pleasure to welcome back to the Department
and the Adult Reconstructive Surgery Service, Young-Min
Kwon, MD, PhD. Dr. Kwon was a
Fellow in our Adult Reconstructive
Surgery Service from 2005-2006.
Dr. Kwon joined the Department
last fall after finishing his PhD
in the Nuffield Department of
Orthopaedic Surgery at the
University of Oxford. Dr. Kwon
graduated with his medical degree
from the University of Sydney
in Australia. He followed with a
hip and knee fellowship here at
the MGH and then completed a second hip fellowship at the
University Hospital Balgrist, Zurich, Switzerland. Dr. Kwon
has qualified as a specialist in Orthopaedic Surgery in both the
Royal College of Surgeons of England and the Royal Australian
College of Surgeons. Dr. Kwon’s expertise in metal-on-metal
hip replacements is recognized with numerous awards,
including the New Investigator Award from Orthopaedic
Research Society (ORS) for his research. Dr. Kwon is dividing
his time between his clinical activities and research in the
Harris Orthopaedic Laboratories (HOL). Dr. Kwon has recently
joined the leadership of the Harvard Medical School Annual
Advances in Arthroplasty Course and he has also assumed
the role of Director of our outstanding Adult Reconstructive
Surgery Fellowship Program.
Welcome to Dr. Kwon and his wife, Emma and their
two sons, Oh-Jak aged 3 years, and Oh-Joon aged 3 months
to the MGH community. I look forward to Dr. Kwon's many
continued contributions to the Department and the field.
It was a distinct pleasure to have welcomed Luke Oh,
MD, last year to the Department as the newest member of
the Sports Medicine Service and the Shoulder Service. Since
starting his practice here at the MGH in October 2009, Dr.
Oh has had many noteworthy accomplishments. He was the
Recipient of the 2010 Mel Post Award for Excellence in Clinical
Research from the American Shoulder and Elbow Surgeons.
He received a Department AEF Grant to study, "The In-Vivo
Kinematics of the Shoulder After a Latarjet Procedure." Dr.
Oh became the Elbow Consultant for the Boston Red Sox and
the Team Physician for the New England Revolution. He is
an active member of the Department and the Coordinator of
the weekly Sports Medicine Conference, the Sports Medicine
Indications Conference, and the monthly Sports Medicine
Journal Club.
Congratulations Dr. Oh on these fine accomplishments!
I am pleased to introduce Adam Hacking, PhD, to the
Department. Dr. Hacking joined our Department last spring
and is the Director of the newly created Laboratory for
Musculoskeletal Research and Innovation (LMRI). Dr. Hacking
has broad research interests related to improving orthopedic
treatment and patient care and his laboratory is focusing on
providing innovative solutions for unmet clinical needs in
orthopedics.
Dr. Hacking received his PhD in Biomedical Engineering
Dr. Young-Min Kwon
34
from McGill University in 2006. During this time, Dr. Hacking
was the recipient of the Hip Society’s prestigious Otto Aufranc
Award in 2002 for his PhD work implicating the role of
the surface morphology of plasma sprayed HA coatings in
osseointegration. While working on his PhD, Dr. Hacking
co-authored a number of pre-clinical studies validating and
optimizing the properties of Trabecular Metal for hard and
soft tissue fixation. Dr. Hacking completed two post doctoral
fellowships, the first in the Department of Orthopaedics at
McGill University and the second with Dr. Ali Khademhosseini
at the Harvard-MIT Division of Health Sciences and Technology.
He has authored 4 book chapters, 28 journal publications,
generated 4 patents, presented more than 50 conference talks
and has delivered numerous invited lectures.
Welcome Dr. Hacking to the Department. We eagerly
await your contributions to our research mission.
In August we welcomed John Y. Kwon, MD, to the
Department and the Foot and Ankle Service. Dr. Kwon received
his medical degree from New York Medical College in Valhalla,
NY with AOA honors and distinction. He was a surgical
intern at the MGH and an orthopaedic resident in the Harvard
Combined Orthopaedic Residency Program from 2005-2009.
He went on to complete an outstanding Foot & Ankle Surgery
Fellowship at the Institute for Foot and Ankle Reconstruction
at Mercy Medical Center in Baltimore, MD under the guidance
of director, Mark S. Myerson, MD. Dr. Kwon then went on to
complete additional training in Portland, Oregon under the
tutelage of Doug Beaman, MD, on the use of the Taylor Spatial
Frame for foot & ankle and trauma applications.
Dr. Kwon has a keen interest in various foot and ankle
problems including trauma, post-traumatic deformity
correction, flat foot reconstruction, tendon injuries and arthritis.
In addition, he has a strong interest in translational and basic
science research and will be an anchor in our newly developed
Foot and Ankle Laboratory. Dr. Kwon is dividing his time between
the MGH, Newton Wellesley Hospital and the laboratory.
Dr. Kwon, welcome to the Department!
SERVICE UPDATES
Arthroplasty (Adult Reconstructive Surgery) Service
The Arthroplasty Service under the direction of Service
Chief and Department Vice Chair, Andrew Freiberg, MD,
continues to grow and prosper not only on the main campus
but also at the Newton Wellesley Hospital (NWH). Once again
the Arthroplasty Service had an outstanding presence at this
year’s Orthopaedic Research Society, The Knee Society, The
Hip Society, and the American Association of Orthopaedic
Surgeons Annual Meetings in New Orleans, LA with 15 podium
presentations, posters, and exhibits. Henrik Malchau, MD,
PhD, and co-investigators had the distinct honor of receiving
the very prestigious Sir John Charnley Award from the Hip
Society for innovative research on surgical technique and
acetabular component position. Hany Bedair, MD, won the
Knee Society Award for his work on diagnosis of infection in
total knee replacements. We were also well represented by our
clinicians and researchers at the American Academy of Hip and Knee Surgeons Annual Meeting in Dallas, TX this year.
Our clinical practices continue to grow and Young Min
Kwon, MD, PhD has been a fine addition to our Service. Dr.
Kwon’s special interest in hard bearing surfaces and their
failure mechanisms is a fine compliment to the group both
clinically and in the research arena.
The entire Arthroplasty Service has worked hard with
various initiatives to improve peri-operative efficiency, safety,
and opportunity for improved volume. Our clinical volume
has grown to 1600 procedures at MGH and approximately
600 at NWH. Both of the Arthroplasty Programs, MGH and
NWH, were selected by Blue Cross/Blue Shield as Centers of
Distinction for Hip and Knee Arthroplasty Excellence. The
Kaplan Center at the NWH is gaining regional recognition for
outstanding patient satisfaction and outcomes. Well Done!
Close collaboration continues between members of the
Arthroplasty Service and the Bioengineering Laboratory, under
the direction of Guoan Li, PhD. Dr. Li reports, "We continue
to work on a better understanding of gender differences in
kinematics, patello-femoral issues and biology of the knee."
Our Fellows continue to work with Dr. Li and his outstanding
graduate students and report great success in their research
experience. In collaboration with the Harris Orthopaedic
Laboratories, we continue to enroll patients in clinical studies
of Vitamin E highly cross-linked polyethylene.
This year marks our 50th Fellowship class! This year’s
Fellows were another exceptional group: Jennifer Peter, MD;
Anthony Marchie, MD; Matthew Beal, MD; and Philip Glassner,
MD. We wish them much success as they begin their careers.
Dr. Peter has joined one of our previous Fellows, William Allen
McGann (Class of 1984) in practice in San Francisco, CA. Dr.
Marchie joined a practice in Toronto, Canada. Dr Beal joined
Ohio State Univeristy in an academic practice and Dr. Glassner
has joined his family in practice in NJ. Best wishes to our
Fellows on all their future endeavors!
Preparations are currently underway for our Harvard
Annual Advances in Arthroplasty Course: Burning Issues and
The Young Adult With Hip Disease From Early Detection to
Arthroplasty. The Course will take place September 28-October 1, 2010 at the Hyatt Regency Hotel in Cambridge. This year
marks the 40th presentation of the course, making it the longest
Continuing Education Course at Harvard Medical School. In
order to celebrate this significant milestone, the format of this
year’s program will be new and innovative, highlighting today's
important challenges in the field of total joint arthroplasty. Our
Keynote speaker for "The Annual Harris Oration" will be Clive
Duncan, MD, FRCS(S) who will be presenting a talk entitled,
"Just a Thought But See it Through." For more detailed
information, or to obtain a registration form, contact Harvard
Medical School, Department of Continuing Medical Education
at (617) 384- 8600 or e-mail: hms-cme@hms.harvard. edu .
Visit them on the web at http://cme.med.harvard.edu/.
Podiatry Service
The MGH Podiatry Service under the direction of Service
Chief, Robert Scardina, DPM, provides ambulatory foot care,
out-patient surgery, orthotic services, and non-invasive lower
extremity arterial testing in the Yawkey Building. Other
practice sites include: Revere, Chelsea and Charlestown
Health Centers, the South End Community Health Center
and the Lynn Community Health Center. There are nine
professional staff members in the group. The Podiatry Service
staff includes a full-time orthotic technician, Nancy Ferullo
as well as Medical Assistant and Front End support staff. The
Podiatry professional staff provides in-patient consultation
services at the MGH and Spaulding Rehabilitation Hospital.
The Podiatry Service maintains a valuable clinical relationship
with the MGH Orthopaedic Foot and Ankle Service and will
soon develop a more formal collaboration.
The MGH Podiatry Residency Program has one of the most
comprehensive curricula in the country, including over twenty
non-Podiatry medical and surgical month rotations, broad and
diverse longitudinal training experiences in clinical podiatry
and foot and ankle surgery, and extensive didactic activities.
The residents receive training in foot and ankle surgery from
over twenty-five faculty members – podiatric, orthopaedic and
plastic surgeons.
The Seventh Annual MGH Podiatry Service Winter
Lecture, 'Forensic Podiatry' with guest speaker: David Agoada,
DPM, Harvard Vanguard Medical Associates was held in
January. Attendees included podiatrists, podiatric MAs, and
medical professionals from MGH and other metropolitan
Boston hospitals.
Dr. Scardina notes:
"Each member of our Service is dedicated
to excellence in patient care and post-graduate
education. Expanding our clinical practice within
existing locations and to new Partners facilities
is a necessity and a priority for us. Our newly
recruited staff member's background should
facilitate development of a 'research arm' for our
Service - yet another objective we hope to achieve
in the near future."
Hand and Upper Extremity Service
The Hand and Upper Extremity Service continues to
expand both in clinical volume, teaching programs, and clinical
and basic research. The flexibility of our entire faculty has
allowed the Hand Service to maintain its very high standard of
clinical and academic output and excellence.
In March of this year, Jesse Jupiter, MD, stepped down from
his position as Chief of the Hand and Upper Extremity Service.
Chaitanya Mudgal, MD, was asked to assume the position of
Interim Chief of the Service. A national search is currently
underway through Harvard Medical School for a new Chief of
the MGH Hand and Upper Extremity Service.
Jesse Jupiter, MD, Chaitanya Mudgal, MD, David Ring,
MD, PhD, and Sang-Gil Lee, MD, have been very busy utilizing
the excellent outpatient surgery facilities at MassGeneral West.
Drs. Jupiter and Mudgal also regularly see patients at the
MassGeneral West. Outreach efforts have further lead to Dr.
Mudgal seeing patients as well as operating at The Brigham
and Women's/Mass General Health Care Center at Foxborough.
These outreach efforts have lead to very valuable collaborative
efforts at providing comprehensive patient care to patients
located far from the Metro Boston area.
Organizationally, the Hand and Upper Extremity Service
has undergone substantial re-structuring over the last year. This
was largely the result of our efforts to improve office efficiency
and to improve the level of access and expeditiousness of access
for our patients. We invited a consultant to observe and advise
in this plan. Additionally, Dr. Mudgal and Mr. David Gaynor
conducted a site visit to a similar facility in Philadelphia. The
overall result was a better re-structuring of office personnel,
the telephone system as well as an increased emphasis on
our mission statement of having a Hand Surgeon see each
new patient presented to the offices. Expanding our service
perimeter to Waltham and Foxborough has further enhanced
the Service's efficiency.
The Hand Surgery Fellowship is now in its third year as
a combined fellowship with the Plastic Surgery Service. Dr.
Mudgal has completed his first year as the Program Director.
Jonathan Winograd, MD, and Curtis Cetrulo, MD, from Plastic
Surgery have added to the fellow’s education with their expertise
in free tissue transfers as well as management of brachial
plexus injuries. The Service continues to enhance educational
and academic content regularly, with updates to the ‘Hand
CD'. The fellows now have regular access to microsurgical lab
facilities under the supervision of Mr. Mark Randolph from the
Plastic Surgery Service. We are pleased with the continued
collaboration of the Hand Service and Plastic Surgery as it
further enhances the fellow's experience and education during
their time at the MGH. This year also saw the beginning of a
new elective cross rotation with a Hand Fellow from the Beth
Israel Deaconess Medical Center (BIDMC). This promises to be
an exciting new addition to our program. The Service’s Journal
Club has been firmly established as a collective effort across
the BWH as well as the BIDMC. Journal Club meetings rotate
among the three facilities and are extremely well attended by fellows, faculty, researchers, residents as well as by hand
therapists. Reports indicate that the collegial spirit in which
these meetings are conducted and the knowledge exchanged
has made them an invaluable source of education for all.
The Service continues to have PhD candidates doing
research under the guidance of Dr. Ring, and last year
Anneluuk Lindenhovius successfully completed her PhD.
John Sebastiann Souer completed the research work on his
PhD and will be defending his dissertation in the near future.
The Service continues also to regularly host several short-term
research associates, who enhance our research efforts and
productivity. The Service continues to have a steady stream
of international visitors for varying periods of time during
the academic year. We are happy to have the AO fellows visit
regularly for 3 months.
Academic productivity continues to remain high. The
Hand and Upper Extremity Service has nearly two dozen
peer-reviewed publications and has also produced over twenty
clinical communications and review papers and nearly a dozen
book chapters. The faculty continues to be regularly featured in
local, regional, national, and international symposia with roles
varying from speakers to moderators to course chairmen. Two
of our MGH hand therapists Colleen Lowe and Carol Mahony
participated as faculty in Instructional Courses at the Annual
Meeting of the American Society for Surgery of the Hand.
Shoulder Service
The Harvard Shoulder Service, under the direction
of Service Chief, Jon J.P. Warner, MD, has continued in its
mission to lead in clinical service, teaching, and research. The
Clinical volume continues to grow through the busy practices
of Thomas Holovacs, MD, and Jon J.P. Warner, MD, with over
1000 shoulder surgeries performed this past year. Dr. Warner
reports, "The addition of Luke Oh, MD, has been a wonderful
enhancement to the Harvard Shoulder Service as he brings
not only an expertise in the management of shoulder problems
but advanced treatment methods for management of elbow
problems." Dr. Oh joined the Department after a one year
fellowship program in Shoulder and Elbow at the Mayo Clinic.
Prior to this he was a Sports Medicine Fellow at the MGH and
he has a duel appointment on the Harvard Shoulder Service
and the MGH Sports Medicine Service.
Another notable accomplishment this year was the
election of Dr. Warner to the Presidential Line of the A.S.E.S.
(American Shoulder and Elbow Surgeons). This year the
Harvard Shoulder Service also had two of its research papers
nominated for the prestigious Neer Award of the A.S.E.S.
The four Shoulder Fellows are making their final plans for
their first year in practice. Anup Shah, MD, will go into private
practice in Sports Medicine and Shoulder in Atlanta, GA. Danny
Goel, MD, is considering a number of academic opportunities
from Vancouver to Philadelphia. James Romanowski, MD,
will practice either in the Cincinnati area or in the Charlotte,
NC area, and Bryan Butler, MD, is contemplating an academic
position in Shoulder and Sports Medicine either in Baltimore
or Columbus, Ohio.
Orthopaedic Oncology Service
The Orthopaedic Oncology Service under the direction of
Service Chief, Francis Hornicek, MD, PhD, is one of the largest
in the world. Members of the Orthopaedic Oncology Service
have been pioneers in the area of transplantation in limb
sparing procedures and in complex pelvic and spine surgery
for malignant bone and soft tissue tumors.
The Orthopaedic Oncology, Medical Oncology, Radiation
Oncology Services and the members of Pathology and Radiology
from the Center of Sarcoma and Connective Tissue Oncology,
part of the MGH Cancer Center, provide comprehensive care
for patients with bone and soft tissue tumors which are benign
and malignant in children and adults. They are a regional,
national and international referral center for these complex
tumors. Kevin Raskin, MD; Dempsey Springfield, MD; Joseph
Schwab, MD; and Dr. Hornicek continue to divide their
clinical service with additional passions including orthopaedic
research and medical student and resident education. Dr.
Hornicek and Zhenfeng Duan, MD, PhD, run the Molecular
Sarcoma Laboratory and have ongoing multiple collaborative
efforts to study tumor agenesis and stem-cell research on
tumor pathogenesis.
The Musculoskeletal Tumor Fellowship, one of the most
sought after in the country, brings together members of Beth
Israel Deaconess, The Children’s Hospital and the MGH to
develop an undisputed world-class Fellowship program. The
Orthopaedic Oncology group has a truly impressive past, a
highly productive present and a future that includes innovation
in many areas!
Henry J. Mankin Professorship in Orthopaedics
Henry Mankin, MD, was Chief
of the Department of Orthopaedic
Surgery from 1972-1996 and was
also Chief of the Orthopaedic
Oncology Service. He is a worldrenowned
leader in orthopaedic
oncology, cartilage research and
bone transplantation for tumors.
The Henry J. Mankin Professorship
in Orthopaedics is a fitting tribute to
his many contributions to the field of
Orthopaedic Oncology.
In his distinguished career, which spans over 50 years,
Dr. Mankin has cared for patients with tumors and metabolic
bone diseases and conducted innovative research on biologic,
oncologic, and metabolic issues.
Dr. Mankin has been recognized for the leadership roles he
has held throughout his career, including Chief of Orthopaedic
Surgery at the MGH and President of the Orthopaedic Research
Society, the American Orthopaedic Association, and the
American Board of Orthopaedic Surgeons. I and many others
at the MGH believe that his dedication to the health and wellbeing
of others merits a further distinction - a Professorship
named for him at Harvard Medical School.
By establishing the Dr. Henry J. Mankin Professorship in Orthopaedics, we will honor Dr. Mankin's legacy in perpetuity
- ensuring that generations of young surgeons will be taught
by clinician-scientists who exemplify his intellect, energy and
empathy. Therefore, I hope you will join with me, colleagues in
the department, and Dr. Mankin's former students and patients
in making a gift to establish this endowed professorship. You
will be pleased to know that we have already received gifts
and pledges totaling $1.1 million toward our goal of $3.3
million. To make your tax-deductible gift, or if you would like
information on other ways to give, please contact Bob O'Brien
in MGH's Development Office at 617-726-0991 or rhobrien@
partners.org. Thank you!!!
Pediatric Orthopaedic Service
The Pediatric Orthopedic Service under the direction of
Service Chief, Brian Grottkau, MD, continues its work to help
our youngest patients. During Fiscal Year 09 members of the
Service, Dr. Grottkau; Saechin Kim, MD; and Gleeson Rebello,
MD, saw nearly 8500 patients. Dr. Rebello who focuses on
afflictions of the pediatric, adolescent and young adult hip
is now seeing patients weekly at the Brigham and Women's/
Mass General Heath Care Center at Foxborough. Drs. Kim
and Grottkau are each seeing patients on a weekly basis at the
North Shore Center for Outpatient Care in Danvers. Plans are
underway to hire a Nurse Practitioner to aid the Service in the
Foxborough and Danvers sites. Dr. Grottakua reports, "Our
patients’ families have been quite pleased with the relaxed,
efficient atmosphere and the high quality of care received."
Members of the Service are also pleased to continue
the research program within the Laboratory for Tissue
Engineering. Yunfeng Lin, DMD, PhD, joined the Laboratory
as a post-doctoral fellow last year. Research continues to move
along at a brisk pace. Members of the Laboratory are working
on many interesting topics involving adipose derived stem
cells with the ultimate goal of developing novel therapeutic
applications for pediatric orthopedic and spine afflictions.
Sports Medicine Service
The Sports Medicine Service under the direction of Service
Chief, Thomas Gill, IV, MD, continues to see exponential
growth in terms of staff and of programs.
A major development in the Sports Medicine Service has
been the establishment of several programs in the Brigham
and Women's/Mass General Heath Care Center at Foxborough.
Eric Berkson, MD, Luke Oh, MD and Kelly McInnis, DO, have
the major parts of their practices there, and Dr. Berkson has
recently been named the Medical Director of the Foxborough
Center. A major Performance Center for the evaluation
of athletes at all levels of activity has opened in the Sports
Medicine Service. The main focus will be the evaluation,
study, and performance improvement of the baseball throwing
motion and the golf swing. The Foxborough site is also the
trial site for the development of a Sports Medicine database
which began on July 1, 2010. A program to inform the local
communities of the facilities that the Service has to offer in
Foxborough has started.
The medical coverage of the Boston Red Sox, New England
Patriots, Boston Bruins, New England Revolution and a variety
of local high school and colleges has expanded. Plans are in
place to extend the Service’s comprehensive athletic coverage
by developing a Women's Sports Medicine Program and,
with the collaboration of Dr. Ross Zafonte and the Spaulding
Rehabilitation Hospital, a Center for Concussion Treatment
and Research (CCTR). The problem of concussions in contact
sports from the Pop Warner level to the professional level is
a very serious one that has not, as yet, been systematically
addressed.
The Primary Care Sports Medicine Clinic has also opened
in the Sports Medicine Center, and its patient referrals are
growing.
The Sports Medicine Fellowship program continues to
attract outstanding candidates from around the country. The
Service has a number of visiting fellows and visiting residents
from the United States, Europe and Japan. Broader teaching
activities include the Sports Medicine 2010 Course given in
collaboration with the Department of Radiology.
The Sports Medicine research program remains very
productive, and has grown with its affiliation with the
Biomechanical Engineering Laboratory under the direction of
Dr. Guoan Li, the Tissue Engineering Laboratory with Mark
Randolph, Media Laboratory at MIT along with Dr. Joseph
Paradiso, Spaulding Rehabilitation Hospital in association with
Dr. Ross Zafonte and the Department of Human Evolution at
Harvard College in collaboration with Dr. Daniel Lieberman.
Recent grants from the NFL Charities (Drs. Gill and Berkson)
and the NIH (Dr. Gill and Mr. Randolph) have added substantial
support to these programs. A new initiative on the use of
platelet-rich plasma (PRP) has been undertaken by Drs.
McInnis and Berkson. Dr. Thomas J. Gill, III, is involved with
all aspects of the research program as Director of Research
for the Sports Medicine Service. In the academic year 2009-
2010, the faculty of the Sports Medicine Service published 27
papers, 10 chapters and 1 review article, and published 1 book
on Techniques of Knee Arthroscopy.
The Sports Medicine Service physicians have received a
number of recent honors. Dr. Arthur Boland was honored with
the establishment of the Arthur L. Boland Award by Harvard
University for an outstanding graduating senior athlete who
plans to attend medical school. Dr. Luke S. Oh received the
Mel Post Award for Excellence in Clinical Research from the
American Shoulder and Elbow Surgeons. Drs. Bonvaronit
Chuckpaiwong, Eric Berkson and George Theodore were
awarded the Nicola's Foundation Young Researchers Award
of the International Society of Arthroscopy, Knee Surgery and
Orthopaedic Sports Medicine in Osaka, Japan.
The Sports Medicine Service and the Spaulding
Rehabilitation Hospital play a major role in the study of
traumatic brain injury as part of the Home Base Program of
the Red Sox Foundation and the MGH to provide diagnosis,
treatment and rehabilitation to veterans with traumatic brain
injury and post-traumatic stress disorder.
A growing focus of the Sports Medicine Service is to treat athletic injuries, including concussions in young people and to
develop sound criteria for return-to-play (parallel to our work
to develop return-to-combat criteria for the military).
Congratulations to the Sports Medicine Service on all
these wonderful accomplishments.
Patel Arthroscopy Laboratory
We were pleased to open the new Patel Arthroscopy
Laboratory at the Sports Medicine Center in June. The
Laboratory provides simulation training for residents and
fellows, and we hope to expand the Laboratory’s use to trainees
from other institutions. Dr. Patel pioneered the development
of numerous tools and techniques for arthroscopic surgery of
the knee and was one of the first individuals to develop the
current forceps and shavers that are frequently utilized for
this common procedure. He is viewed as one of the founding
fathers of arthroscopic surgery and this learning laboratory
named in his honor is a wonderful tribute to his contributions.
The Sports Medicine Service also hosts groups of young
students who may have an interest in medicine to visit, observe
and have some hands-on experience in the Patel Arthroscopy
Laboratory.
Orthopaedic Spine Service
The Orthopaedic Spine Center at the MGH is under the
direction of Kirkham B. Wood, MD, and now is in its 11th year
of existence. All aspects of spine care, teaching, and research
are under the auspices of this Service. Our Multidisciplinary
Orthopaedic Spine Center includes: Attendings, Kirkham
Wood, MD; Joseph Schwab, MD; and Physiatrists: James Sarni,
MD; Leonid Shinchuk, MD; and David Binder, MD. James
Rathmell, MD, an anesthesiologists with the MGH Pain Center
work closely with this multidisciplinary program to provide a
full breadth of services to our patients.
Dr. Joseph Schwab, is a member of two services, the
Orthopaedic Oncology Service and the Orthopaedic Spine
Center. Dr. Schwab's work and interest is in metastatic disease
of the spine, primary spine tumors, and bone and soft-tissue
tumors. Dr. Schwab is integrating a highly active Orthopaedic
Spine practice along with his clinical practice in Orthopaedic
Oncology. Dr. Schwab recently received a Masters in Clinical
Investigation from the School of Health Sciences and
Technology at Harvard Medical School and MIT.
The Harvard Combined Spine Fellowship (BWH attendings,
Drs. Mitchell Harris and Christopher Bono) has three fellows
(2 at MGH, and 1 at BWH). The fellows are actively involved in
teaching and research programs in addition to their clinical
duties. The Spine Fellowship has authored papers in the
Journal of Biomechanics, Spine, Journal of Spinal Disroders
and Techniques, European Spine Journal, Oncology, and
multiple textbook chapters.
Dr. Kirk Wood and Dr. Guoan Li, Director of the
Bioengineering Laboratory, continue to collaborate actively
in the area of Spine Kinematics. Dr. Wood is using the
Dual-Fluoroscopic Kinematics system to better study the
kinematics of the cervical and lumbar spine. Dr. Li explains,
"The implication of this work is to better provide excellent kinematics data as we move into the field of disc replacement
surgery." In addition, Dr. Wood has developed a spinal database
along with Henrik Malchau, MD, PhD.
The Spine Biomechanics research team under Dr. Li was
the recent recipient of an R-21 Investigator award from the
NIH for two years as well has having received funding grants
from the Scoliosis Research Society and the North American
Spine Society.
RESEARCH UPDATES
Bioengineering Laboratory
The Bioengineering Laboratory under the direction
of Guoan Li, PhD, celebrated another productive year. The
Laboratory continues to play an active role in the field of
musculoskeletal engineering and biomechanics. This year
they reported the first in vivo data on dynamic tibiofemoral
cartilage deformation as well as in vivo lumbar intervertebral
disc deformation. The Laboratory also reported on the
gender morphology of human patellofemoral joints and
the corresponding kinematics. The Laboratory had several
outstanding papers, including a publication in Arthritis and
Rheumatism, a journal with the highest impact in Orthopedics
and Rheumatology combined. It was found that rupture of
the ACL alters the in vivo cartilage contact biomechanics by
shifting the contact location to regions of thinner cartilage
and by increasing the magnitude of the cartilage contact
deformation. Other investigations evaluated the biomechanical
as well as clinical performance of various contemporary ACL
reconstructions including the controversial double-tunnel
double-bundle technique.
The Laboratory has a fabulous contingent of outstanding
graduate students from MIT, including Kartik Varadarajan,
Daniel Massimini, Ali Hosseini, and Shaobai Wang and
postdoctoral fellows, including Drs. Samuel Van de Velde,
Michal Kozanek, Qun Xia, Bing Yue, Jong-Keun Seon, Fang
Liu, Takanebu Sumino, Zongmiao Wan, Weishi Li, and Chihhui
Chen. Mr. Massimini continues to conduct research on in
vivo human shoulder biomechanics in collaboration with Dr.
J.P. Warner and work towards his PhD degree. Mr. Hosseini,
together with Drs. Kozanek and Van de Velde, continue
to investigate in vivo ACL biomechanics using advanced
imaging technology in collaboration with Drs. Thomas Gill,
Peter Asnis and Luke Oh. Mr. Wang and Drs. Wan, Kozanek
and Li are actively studying intrinsic biomechanics of human
lumbar spine in collaboration with Drs. Kirkham Wood and
Brian Grottkau. Drs. Varadarajan, Yue, Sumino and Liu made
enormous progress in the study of human patellofemoral
joint kinematics and the comparison of male and female knee
morphology in collaboration with Dr. Andrew Freiberg and
me. We performed a human knee morphological study by
comparing the Caucasian and Asian populations.
Dr. Varadarajan received the First Award in the 2009
Annual ASME Bioengineering Conference in PhD Thesis
Competition. This is a very prestigious award. Congratulations
to Dr. Varadarajan on this distinct accomplishment! I look
forward to his future contributions to the field.
Drs. Kozanek, Varadarajan, Bedair and Rubash have also put
together a chapter on total knee arthroplasty biomechanics for
the upcoming edition of Orthopaedic Knowledge Update. Drs.
Samuel Van de Velde, Kozanek and Gill are actively publishing
on in vivo ACL and PCL biomechanics. Dr. Van de Velde has
recently been awarded the prestigious Ruth L. Kirschstein
fellowship by the NIH and will soon begin his studies at the
Harvard School of Public Health. Hemanth Reddy Gadikota is
our core bioengineer and has actively participated in a variety of
clinical and robotic projects. Mr. Gadikota, Drs. Seon, Wu and
Sutton have successfully conducted a series of biomechanical
testing of various ACL reconstruction techniques using the
robotic system. There have also been several new additions
to the Laboratory. Dr. Sumino came from Tokyo to work on
improving the biomechanics of total knee arthroplasty. Dr.
Chen joined us from Taiwan to investigate biomechanics of
ACL reconstruction in vivo. Dr. Wan, a senior resident from
Changsha, China, came aboard the spine team to help Drs.
Wood and Mansfield in their investigation of biomechanics of
surgical treatment of spinal stenosis.
The success of the Laboratory is measured not only by the
impact of its research but also by the success of its alumni.
Dr. Seon, upon his return to Korea, has continued to publish
and design new studies at an impressive pace. Dr. Xia, has
become the Chairman of the Department of Orthopedics
in Tianjin, China and has assembled his own testing system
for in vivo motion analysis of the spine. Dr. Wu has rejoined
his department in Taipei, Taiwan and has been awarded the
prestigious Travelling Fellowship by the Orthopaedic Research
Society. Dr. Passias has joined the spine service at the Hospital
for Special Surgery for his clinical fellowship and continues
to publish and conduct studies despite his demanding clinical
commitments. Dr. Varadarajan defended his PhD thesis at MIT
and will stay in the Bioengineering Laboratory at the MGH as
a research scientist. We are very proud of them and wish them
all the best in their careers!
Finally, this year at the ORS/AAOS meeting, the team
had over 30 talks, podium presentations, and posters. They
published over a dozen publications in various peer review
journals in the areas of arthroplasty, sports medicine, spine,
foot and ankle, as well as bioengineering. Wow!!! What a year!
The Shoulder Research Laboratory under the direction of
JP Warner, MD, had a great year with the adoption of a dedicated
research space. Since then, progress within the Laboratory
has occurred at an exponential rate. This year they reported
the first data on in vivo glenohumeral contact kinematics
after total shoulder arthroplasty in the Journal of Bone and
Joint Surgery. It was found that contact kinematics are not
centered on the glenoid as traditionally thought, but in fact are
mostly superior posterior. These data have huge implications
for the next generation design of shoulder arthroplasty. The
Laboratory also developed a technique for nerve tagging for
analysis by dual plane fluoroscopy in a cadaver model. The
suprascapular nerve was tracked under simulated rotator cuff forces. It was found that a tear of the supraspinatus and
infraspinatus caused a retraction of the nerve towards the
spinoglenoid notch and may be responsible for neuropathy
common in many rotator cuff patients.
Luke Oh, MD, a recent addition to the Department won
an AEF grant to investigate the in-vivo kinematics of the
shoulder in patients with anterior instability treated with
the Latarjet technique. Daniel Massimini, a PhD candidate,
in the Department of Mechanical Engineering at MIT
supervises all research activities within the Laboratory. Mr.
Massimini focuses his research efforts on in vivo shoulder
biomechanics. Mr. Massimini just began a new study to
quantify the coupled scapular and humeral contributions to
dynamic shoulder motion in healthy individuals during the
activities of daily living. These data will serve as a benchmark
for all future studies of the kinematics of the shoulder. Dr.
Warner is passionate about our shoulder research and has an
endless supply of questions to answer. The Shoulder Research
Laboratory is looking forward to another productive year.
Plans are in the works to add a full time research engineer and
postdoctoral fellow.
Harris Orthopaedic Laboratories
The Harris Orthopaedic Laboratory (HOL) is under the
co-direction of Orhun Muratoglu, PhD, and Henrik Malchau,
MD, PhD. Members of the HOL have contributed to the field of
Adult Reconstructive Surgery for over four decades. A variety
of different topics have been studied and major contributions
have been made particularly in the area of implant stability,
implant fixation, bearing-surface applications, and 1st, 2nd
and now 3rd generation of highly crosslinked polyethylenes.
Currently, there are a number of outstanding clinical projects
underway at the HOL.
Charles Bragdon, PhD, is leading a study to evaluate the
clinical performance of first generation highly cross-linked
polyethylene and the vitamin-E doped irradiated polyethylenes
for use in hip and knee arthroplasties. Dr. Bragdon has been in
the laboratory for over two decades. Charlie and I did the first
uncemented titanium fiber metal canine hip replacements in
the mid-eighties! An additional clinical outcomes study in its
7th year utilizes RSA techniques to determine the wear behavior
of crosslinked polyethylene in conjunction with the traditional
as well as large femoral heads. This study has shown marked
reduction in wear and femoral head penetration at the 7th
year benchmarks. Dr. Malchau and co-investigators are quite
pleased with these results and state, "So far the first generation
highly crosslinked polyethylene performs as predicted in the
preclinical experiments and seems to be the bearing of choice
in the active patient."
The HOL is also focusing on materials including
crosslinked polyethylene with low-wear and high strength
for applications in hip, knee and other joint arthroplasties.
This section of the HOL is under the direction of the Orhun
Muratoglu, PhD, an innovator in this field for over 15 years.
The newest technology utilizes Vitamin E to stabilize the
residual free radicals and to protect the base polymer against oxidation. FDA cleared the use of this material in total hips
in 2007 and for total knees in 2008. Ebru Oral, PhD, and a
group of scientists along with Dr. Muratoglu are leading this
important area of investigation.
A new exciting innovation is also in the area of load
bearing materials for use in total joint reconstruction. This
new technology limits the crosslinking of the polyethylene to
the articular surface layer, where it is needed to improve wear
resistance. This method minimizes the loss of mechanical
properties. The investigators at the HOL think that this new
technology will be suitable for younger and more active patients.
New exciting areas of collaboration include the area of
knee wear. Drs. Orhun Muratoglu, Henrik Malchau, Harry
Rubash, and Guoan Li, are continuing to tackle the difficult
and perplexing problem of knee wear. This project will provide
some exciting information with the ultimate goal of detecting
in-vivo wear as it relates to implant longevity. Dr. Li states,
"The innovative dual fluoroscopic technique in a combined
effort with the HOL, is being developed to detect in-vivo poly
wear to predict longevity of patients after TKA."
Another new area of collaboration for the HOL is in the
area of spine kinematics and spine reconstruction. The team
is working on technology using hydrogels as materials for
intervetebral disc replacement along with biodegradable
polymer technology. These studies could benefit many of
our patients with degenerative axial-skeleton disease as well
as spinal deformity. Dr. Kirkham Wood reports, "Ongoing
studies in the Biomechanics Lab include projects studying
the three-dimensional analysis of intervertebral disc motion
using a combined MRI-fluoroscopic technique; the effects of
disc degeneration on in-vivo disc deformation and the effect
of spinal deformity surgery on adjacent segment vertebral
kinematics using noninvasive techniques."
The HOL is a source of enormous activity and energy
in the area of translational and basic science research. The
skillful scientists in this laboratory had another incredible year
at the ORS and the AAOS with over 20 abstracts presented.
Once again the members of this outstanding Laboratory have
added a tremendous amount of new knowledge to our field; and
the first generation highly crosslinked UHMWPE developed in
this laboratory has now been implanted in over two million
hip and knee patients worldwide. I know that these important
contributions will continue in the future. Again, another
fabulous year!!!
Laboratory of Musculoskeletal Engineering
The Laboratory for Musculoskeletal Tissue Engineering,
under the direction of Mr. Mark Randolph and Thomas Gill,
IV, MD, focuses on cartilage repair and regeneration in the
knee. The group focuses on developing new hydrogels for
articular cartilage repair and regeneration. Working with
Drs. Robert Redmond and Irene Kochevar from the Wellman
Center of Photomedicine, they have developed a novel means
to photocrosslink collagen gel for use as an encapsulation gel
for chondrocytes and neocartilage formation. Initial work on
cell survival following photopolymerization was published in Tissue Engineering in 2007 (Ibusuki S et al, 13(8):1995-2001).
Follow up studies on the capacity of these photopolymerized
collagen gels to form neocartilage was published in the Journal
of Knee Surgery in January 2009 (Ibusuki S et al 22(1):72-81).
A grant from the AO Foundation is allowing for continued
work with Dr. Redmond where the focus will be on improving
the biomechanics of the gel and improving cell survival. A
grant has recently been received from the Department of
Defense to test the use of cophondrocytes encapsulated in
photopolymerized collagen and PEG gels in swine to restore
the articular joint surface. Parallel work on the cartilage
formation capacity of human articular chondrocytes placed in
hydrogels has been funded by a grant to Dr. Gill from the NFL
Charities. The collaboration will also include Dr. Seemantini
Nadkarni from the Wellman Center for Photomedicine who
will focus on using laser speckle imaging as a noninvasive
means for measuring the modulus of native and engineered
cartilage.
New studies in collaboration with Dr. Orhun Muratoglu
in the Department’s Harris Orthopaedic Laboratories are
exploring a hybrid scaffold composed of nondegradable poly
(vinyl alcohol) scaffold combined with chondrocytes for joint
cartilage replacement. Several types of PVA hydrogels have
been tested for cell compatibility and cartilage formation in
mice with support through the Academic Enrichment Fund
grant from the Department of Orthopedic Surgery. Progress
to date has identified several candidate gels that support new
cartilage formation and one recent publication describes the
use of this PVA gel for craniofacial purposes (Bichara DA et al J
Surg Res. 2010 Apr 24).
Previous work funded by the AO Foundation focused on
tissue engineering strategies to repair lesions in the avascular
regions of the meniscus. The results demonstrated an efficient
means to seed chondrocytes onto polygalactin (PLGA) scaffolds,
and the capacity of this cell-scaffold constructs to heal bucket
handle lesions made in swine menisci. One study published in
the American Journal of Sports Medicine in November 2006
(Weinand C, et al, 2006, 11:34) presented preliminary data on
using allogeneic chondrocytes for meniscal repair. Recent
work funded by the Musculoskeletal Transplant Foundation
has allowed for testing the utility of allogeneic chondrocytes
for healing lesions in the swine meniscus. This work is nearing
completion and will demonstrate the contribution of the
allogeneic cells to the repair as well as document the host's
immune response to the allogeneic cells. Impressive work and
an impressive year!
Sarcoma and Molecular Biology Laboratory
The Sarcoma Molecular Biology Laboratory (SMBL),
is under the direction of Zhenfeng Duan, MD, PhD and
Orthopaedic Oncology Service Chief, Francis J. Hornicek, MD,
PhD. The focus of the Laboratory's work is to examine the
mechanisms of multidrug resistance, to identify small molecules
and targets to reverse drug resistance and to understand the
characterization of molecular mechanisms governing growth,
and the proliferation of human sarcoma cells.
The overall objectives of the Laboratory are to explore
biological mechanisms of tumors arising in bone and
other tissues. One of the major focuses is to elucidate the
mechanisms of the development of drug resistance in cancer.
Previously, Drs. Hornicek and Duan have found multidrug
resistance could be partially reversed by siRNA targeting
of ABCB1 (MDR1) or by combination of nanoparticles with
chemotherapy drug. Recently, they identified two small
molecules that can overcome drug resistance in vitro. Another
significant aim of the research is to define the essential kinases
that are responsible for proliferation and survival of human
sarcoma cells. In addition, translational research into new
treatment options for sarcoma patients has been undertaken.
Continued collaboration with other institutions and
pharmaceutical companies has provided the foundation for
evaluation of new drug development. Many of these drugs
are derived from marine sources and their corresponding
biochemical structures are quite complex. The Sarcoma
Molecular Biology Laboratory has published articles pertaining
to multiple drug resistance in human cancer. Research projects
on sarcoma biology have received funding from a variety of
sources including NIH, foundations, corporate sponsors, and
benefactors.
The Sarcoma Research Group at the MGH includes
investigators from multiple disciplines, as does the clinical
group. I look forward to the results of the Laboratory
continued research expansion and to see the efforts of their
further collaboration within the Harvard community.
Laboratory for Musculoskeletal Research and Innovation
(LMRI )
The focus of the newly created Laboratory for
Musculoskeletal Research and Innovation (LMRI) under the
direction of S. Adam Hacking, PhD is to provide innovative
solutions for unmet clinical needs in orthopedics.
Dr. Hacking reports that he
is actively recruiting students and
research fellows. Dr. Wang MD, PhD
will join the lab this fall and Dr. Ari
Salmi, PhD will join the Laboratory
this spring. Ongoing Laboratory
projects include bone and vascular
tissue engineering, enhancement
of fracture healing and implant
fixation, the development of novel surfaces to reduce implant infection and the use of noninvasive
techniques to quantify implant stability.
Dr. Hacking looks forward to working closely with the
surgical staff to develop and refine new technology. The
Laboratory is adept with large and small animal models,
techniques for undecalcified histology, testing instrumentation,
micro-CT imaging, design and fabrication and mechanical
testing. Collaborations exist with local researchers (Harvard,
MIT and U of Helsinki) that broaden and compliment the
capabilities of the laboratory. To visit the lab, please stop by
GRJ 1120 or email ahacking@partners.org.
Dr. Hacking congratulations on your new laboratory and
welcome to our Department!
DEPARTMENT HOLIDAY PARTY
In December we celebrated the holiday season with our
annual black tie Orthopaedic Department Holiday Party. This
increasingly popular event was again a resounding success.
We returned to the beautiful Seaport Hotel in South Boston
where over 600 guests in attendance were treated to festive
music, holiday-themed decor, and an absolutely wondrous
buffet dinner. Plans are already underway for the 2010 party
at the Seaport Hotel for this "not to be missed holiday event."
PERSONAL NOTE
It is a great pleasure and a distinct honor to work with all
of you in this fabulous Department. I'm pleased to report that
our Department has been recognized again as one of the top
in the nation....# 3 out of nearly 1600 hospitals by U.S. News
and World Report! You can view the rankings at: http://health.
usnews.com/best-hospitals/rankings/orthopedics. The MGH as
a whole was rated #3 out of the 152 hospitals that made it into
the new 2010-11 Best Hospitals rankings (out of nearly 5,000
that were considered). I would like to thank each of you for
your continued outstanding efforts for our patients and our
profession. Well done!!!
My family has had a lot to celebrate over the past year. Kim
and I were extremely proud when our oldest, Brad, graduated
from Rollins College. Steve will be entering his senior year
at Boston University in the fall and we will be having another
graduation next year. Krissy is a rising junior at Rollins
College. She is an economics major with an interest in business
administration. Krissy and her horse, Quizz d'Orange, recently placed 1st at the 2-Day (Dressage, Cross Country and Stadium
Jumping) Huntington Farm Horse Show. Our family gathered
together in July to celebrate my mother-in-law's 90th birthday.
What a milestone! Congratulations Mary Ertman-Kindler. Kim had the opportunity to spend several months in Florida this past
winter and enjoyed the extra time she had with Brad and Krissy.
I wish you all the best of success in the Department and I
stand by to assist you.
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