Massachusetts General Hospital

Harry E. Rubash, MD

Harry E. Rubash, M.D.

Edith M. Ashley Professor of Orthopaedic Surgery
Harvard Medical School

2011-12 Chief's Report

Harris Orthopaedic Laboratory (HOL)

The Harris Orthopaedic Laboratory (HOL) is under the co-direction of Drs. Orhun K. Muratoglu and Henrik Malchau. Members of the HOL have contributed to the field of adult reconstructive surgery for over four decades, studying an array of topics. Major contributions have been made in the areas of implant stability, implant fixation, bearing-surface applications, and first, second, and now third genera-tions of highly cross-linked polyethylenes. The HOL has also contributed many important advances to the field of orthopaedic surgery, including improvements in implant materials, design, surgical technique, surgical instruments, and surgical approaches.


Today, our research areas include advancing material development in joint repair and replacement under the direction of Dr. Muratoglu. The pre-clinical material research team develops novel UHMWPEs for improving longevity of joint implants and expanding the use of joint replacement safely to younger, more active patients. Another cutting-edge research area is the development of non-degradable hydrogel-based materials for integrative and mechanically feasible repair of cartilage defects at an early degenerative state. The materials research team collectively brings experience in material and polymer science, polymer chemistry, biomaterials and biomechanics testing, and bench-to-clinic implant development, as well as follow-up testing of explanted devices to analyze in vivo effects.


Dr. Charles R. Bragdon, who has been a member of the Laboratory for over three decades, is leading several studies to evaluate the clinical performance of first and second generations of highly cross-linked and melted polyethylene, as well as the Vitamin-E doped irradiated polyethylenes for use in hip and knee arthroplasties.


The combination of clinical outcomes studies and specialized RSA studies has determined that the wear behavior of cross-linked polyethylene, in conjunction with traditional as well as large femoral heads, has been dramatically decreased with the use of this new material. These studies have shown marked reduction in wear and femoral head penetration, through ten years of clinical use. Dr. Malchau and co-investigators are quite pleased with these results. They report that, “so far the first generation highly cross-linked polyethylene performs as predicted by the pre-clinical experiments and seems to be the bearing of choice in the active patient.”


Under the direction of Dr. Malchau, the clinical research team develops local and regional implant registries in collaboration with ortho¬paedic surgeons in arthroplasty, spine, hand, sports medicine, trauma, and orthopaedic oncol¬ogy. They also conduct prospective clinical stud¬ies nationally and internationally on alternative bearing materials and new implant designs. This provides fast and valuable information on the performance of newly developed implants and helps compare them to historical standards. These studies also can provide feedback on surgical techniques and skills to improve clinical outcomes.


The remarkable scientists in our Laboratory had another incredible year at the ORS and the AAOS with over 40 abstracts presented. Once again the members of this outstanding Laboratory have added a tremendous amount of new knowledge to our field. I know these important contributions will continue in the future. Here’s to another extraordinary year!

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