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Harvard Combined
Orthopaedic Residency

James H. Herndon, MD, MBA

Chairman, Partners Department of Orthopaedic Surgery
Program Director, Harvard Combined Orthopaedic Residency



I am pleased to welcome you to the second issue of the Harvard Orthopaedic Journal. Our first issue was a huge success due to the outstanding efforts of the resident editorial board and especially the editor, David Ring, M.D. I have had nothing but positive feedback from our faculty and alumni about the value of this publication. This second volume continues this early tradition of excellence. I hope you enjoy it. I would like to thank all of you who have contributed articles to this issue and encourage everyone in the Harvard Orthopaedic family to contribute to future issues. Because our Program is dispersed across four large institutions, The Journal provides an important opportunity for sharing our research and new developments.

In my role as Head of the Residency Program, I am pleased to report that we had a very successful site visit last summer which has resulted in full accreditation for our program for the next five years. We were acknowledged for the many new ele-ments that have been added to our residency program, as well as the addition of greater clarity around the responsibilities of junior and senior residents and goals for each of our rotations. The ACGME's letter stated, "The Committee commended you and your teaching staff for the steps that have been taken to establish one, integrated Harvard program and improve the structure and organization of resident education." The Core Curriculum and Anatomy Course continue to be well received by our residents. I applaud the efforts of Mark Gebhardt and the Core Curriculum faculty, as well as the efforts of Richard Ozuna and faculty that contribute to the Anatomy Course. In addition, the combined Grand Rounds continues to provide an excellent learning opportunity for residents and faculty alike as reflected in the list of distinguished speakers and their topics. I am hopeful that more of our own faculty will share their par-ticular expertise as Grand Round speakers in the coming year. We are working to make our Grand Rounds series regularly available via teleconference to orthopaedic surgeons throughout the Partners HealthCare System.

The group of residents who will graduate in June have contributed greatly to the success of our program through their participation and planning of the Core Curriculum and subspecialty conferences during their rotations. Individually, they have distinguished themselves as authors, physician-scientists and recipients of a number of impressive awards. On behalf of the Harvard Orthopaedic faculty, I want congratulate them on their acceptance to many of the best fellowship programs in the country. As a faculty we take great pride in having launched such an accomplished group of young surgeons.

2000 Graduating Residents with Executive Committee
In my role as Chairman of the Partners Department of Orthopaedic Surgery, I am pleased to report that the new faculty members we have recruited over the past two years are well on their way to establishing successful practices at the Brigham and Women's and Massachusetts General Hospitals. The Shoulder Service, under J. P. Warner's leadership, has experienced tremendous growth and will be adding a new physician at the Brigham and Women's Hospital later this year. The Service's Harvard-Zurich International Shoulder Fellowship is now underway with the second fellow due to arrive in July. The Partners Orthopaedic Trauma Service under the leadership of Mark Vrahas has made significant gains in improving resident education in trauma at both institutions. Dr. Vrahas is working closely with chief residents in both locations to provide the type of teaching and mentoring that had previously not been possible in our program. Dr. Vrahas also has initiated a program-wide trauma conference for faculty and residents. We are planning to add an additional trauma surgeon in the coming year to further shore up our accomplishments in orthopaedic trauma.
In addition to recruitments in trauma and shoulder, we are planning to add new physicians in adult reconstruction, spine, hand and foot /ankle as we move into the next academic year. Our goal is to continue to strengthen our capabilities in each of the subspecialties areas with the long-term goal of establishing Partners Centers of Excellence in each of these areas of orthopaedic surgery allowing further improvement of the combined residency program and facilitation of the integration of our fellowship programs. Beginning in July, the Partners Department will have integrated fellowship opportunities in trauma, foot and ankle, adult reconstruction and hand and upper extremity.
 
1999-2000 Core Curriculum
Topic Faculty Resident
Trauma William Tomford Wael Kaawach
Tumor John Ready Rahul Deshmukh
Pediatrics John Emans David Kim
Sports Medicine Tamara Martin Sonu Ahluwalia
Adult Reconstruction Richard Scott and Arun Shanbhag Ajeya Joshi
Report of ORS/AAOS mtgsSpine (including trauma) Frank Pedlow Patrick Tyrance
Hand and Elbow Jesse Jupiter Greg Erens
Rehabilitation and Prost Don Pierce Rahul Deshmukh
Foot and Ankle Tamara Martin Shahram Solhpour
Business and Biostatistics Dan Estok  
Medicolegal/Ethics Tamara Martin  
 
On the performance side, I am pleased to report that the Partners Department of Orthopaedic Surgery, the Brigham and Women's and Massachusetts General Hospitals combined, showed an 8% overall increase in surgical volume from FY97 to FY99, improving to 13% with the addition of cases by BWH physicians at the Faulkner Hospital. As expected, the greatest gains were in ambulatory surgery. I am working closely with Harry Rubash and Tom Thornhill to grow our surgical volume by 10% for FY00. To do so will require maintaining and/or growing our inpatient volume while we continue to expand our outpatient volume. We will be looking to our new faculty in adult reconstruction and future recruits in spine to ensure our inpatient volume. These additions to our faculty are intended to maximize our presence in the subspecialty orthopaedic marketplace.
 
1999-2000 Grand Rounds Speakers
Date Name Institution Topic
9/8/99
Harry Rubash Massachusetts General Hospital Pathophysiology and Treatment of Osteolysis
9/15/99 Susan Sheehy
 
Spinal Cord Injury: A Personal Perspective
9/22/99 Bruce Browner Univ of Conn Health Center The Management of Subtrochanteric Fractures
9/29/99 JP Warner and Bertram Zarins Massachusetts General Hospital Rotator Cuff and Impingement
10/6/99 Mark Vrahas MGH & BWH Indications for Open Reduction and Internal Fixation of Acetabular Fractures
10/13/99 Mark Bernhardt MGH & BWH An Approach to Sagittal Plane Deformities of the Spine
10/20/99 Claudi Thomas Johns Hopkins Diversity in Orthopaedics
10/27/99 Alan Grodzinsky MIT Physical Regulation of Cartilage Metabolism: Relevance to Degradation and Repair
11/3/99 Hamlet A. Peterson Mayo Clinic Grice Lecturer: Growth Plate Fractures: Risks and Treatment of Growth Arrest
11/10/99 Alan Levine Sinai Hospital Have advances in technology really changed the way we treat cervical spine fractures?
11/17/99 Peter Waters The Children's Hospital Complex Pediatric Fractures
11/24/99 Jesse Jupiter Massachusetts General Hospital Operative Tactics of Long Bone Malunions
12/1/99 Howard An   Current Trends in Lumbar Disc Disease
12/8/99 Thomas Einhorn Boston Medical Center Bone Regeneration
12/15/99 Kenneth Koval New York University Hospital for Joint Diseases Hip Fractures: The Hospital for Joint Diseases Experience
1/5/00 Thomas Thornhill Brigham & Women's Hospital Evaluation of the Painful TKR
1/12/00 Joseph Bernstein University of Pennsylvania Evidence Based Medicine: Arthroscopy for Degenerative Joint Disease of the Knee
1/19/00 Richard Ozuna Brigham & Women's Hospital Cervical Spondylitic Myelopathy and Radiculopathy: Review and Current Concepts
1/26/00 Stephen Murphy Beth Israel DeaconessMedical Center Hip Dysplasia
2/2/00 Tony Herring Texas Scottish Rite Hospital Stories of Polio
2/9/00 Michael Millis The Children's Hospital Surgical Treatment of Developmental Hip Diseases in the Adolescent and the Young Adult
2/16/00 Francis Hornicek Massachusetts General Hospital Prediction of Outcome in Osteosarcoma
2/23/00 Mark Hoffer Orthopaedic Hospital Management of Brachial Plexus Palsies in Children
3/1/00 Jeffrey Katz Brigham & Women's Hospital Association between hospital and surgeon volume and the outcomes of THR
3/8/00 Hubert Labelle Hospital Sainte-Justine Non-operative Treatment for Scoliosis: A New Bracing Technique
3/22/00 Yoshihori Kadoya Osaka City UniversityMedical School "Three traveling fellows with various topics related to congenital deformities, spine and total joint replacements"
3/29/00 Michael Wilson Brigham & Women's Hospital Ankle Update
4/26/00 Robert Bourne Osgood Lecturer  
5/3/00 Joel Matta    
5/10/00 Kurt Spindler Vanderbilt Sports Medicine Center  
5/17/00 ABC Traveling fellows    
5/24/00 John Hall Children's Hospital  
5/31/00 Jo Hannafin Hospital for Special Surgery  
6/7/00 William Sterett    
6/14/00 Lawrence Karlan The Children's Hospital  
 
Our performance in FY99 can be attributed in part to the superb job Meg Walsh, RNP has done as the Department's Access Facilitator. In her first year, Ms.Walsh assisted with close to 1,000 referrals to physicians in the Partners Department of Orthopaedic Surgery. It is expected that the improved communication made possible with Meg's help has and will continue to result in the establishment of new referral relationships. Ms. Walsh will also be working over the next year to better understand the needs of referring physicians in order to improve and strengthen our communication with these colleagues.
On the operations side, I am pleased to report that we have launched the first pilot template the knee, for our electronic medical record system geared towards improved record-keeping and compliance. An article authored by Drs. Samuel Wang and Jonathan Schaffer as part of this issue fully describes the rationale and vision for this project. We are indebted to Dr. Wang, working closely with Dr. Jonathan Schaffer, for his contribution to this project. Clearly a transition of this nature will take much time and good will on the part of the physicians in each of the subspecialties who are designing and testing thetemplates. I am hopeful that we will have five templates in use by this time next year.
 
Plans of Graduating Residents
Kevin J. Bozic, MD
• MBA Program, Harvard Business School
• Musculoskeletal Trauma Fellowship
David Gazzaniga, MD
• Sports Medicine Fellowship,
  Steadman-Hawkins Clinic, Vail, 
  Colorado
Andrew Hecht, MD
• Spine Surgery Fellowship,
  Emory University, Atlanta, Georgia
Saechin Kim, MD
• North American Mueller Fellowship,
  Berne, Switzerland (6 mo), Children's
  Hospital/BIDMC (6 mo)
Bruce Miller, MD
• Shoulder and Elbow Fellowship, Professor
  David Sonnabend, Prince of Wales Hospital,
  Sydney, Australia
• Sports Medicine Fellowship
Martha Murray, MD
• Research Fellowship, Brigham Orthopaedic
  Research Laboratory
• Sports Medicine Fellowship
Lars Richardson, MD
• Foot & Ankle Fellowship, BWH
• Sports Medicine Fellowship, MGH
Lisa Taitsman, MD
• Musculoskeletal Trauma Fellowship,
Harborview Medical Center, Seattle
Paul Weitzel, MD
• Sports Medicine Fellowship
Andrew Yun, MD
• Adult Reconstruction Fellowship, Hospital
  for Special Surgery
 
Resident Awards, Grants, and Other Accomplishments

Awards

Kevin J. Bozic, MD

The Leonard Marmor Surgical Arthritis Foundation Resident Award of Excellence

Christopher D. Chiodo, MD

William H. Thomas Award

Ashwin Deshmukh, MD

2000 Neer Award from the Shoulder & Elbow Society for his paper entitled, "Minimum ten-year follow-up, functional outcome, and quality of life after neer-type total shoulder arthroplasty."

Martha M. Murray, MD

1999 AOA/Zimmer Resident Research Award for paper entitled, "The migration of cells from human anterior cruciate ligament explants into collagen-glycosaminoglycan scaffolds"

NIH Individual National Research Service Award for ACL research

OREF Resident Research Award for growth factor optimization of collagen production by human ACL cells

Center for Minimally Invasive Therapy (CIMIT) Post Doctoral Research Fellowship Award

 

Grants

Saechin Kim, MD

OREF Resident Research Grant for his study entitled, "Studies of the Role of Nitric Oxide Synthase Isolforms in Bone Using Gene Knockout Models in the Mouse"

Martha Murray, MD

NIH RO3 grant (3 year grant) for research entitled, "Scaffold optimization for healing of the ruptured ACL"

Other Achievements

Eric Giza, MD, is the sole author of a book entitled, Hints for Success in Medical School and the Match, available from J&S Publishing Company. coinventor on a pending patent for a novel anti-angiogenesis factor.

On the research side, I am delighted to report the arrival of Chris Evans and his colleague Steve Ghivizzani and their efforts to establish the Partners Center for Molecular Orthopaedics. The Center and its laboratories are based in the Boston Lying-In Building on Longwood Avenue. Since arriving, Chris as submitted a Clinical Trials Planning Grant to begin work on a Phase II gene therapy trial and completed a corporate research agreement for stem cell research. Drs. Evans and Ghivizzani are working toward submission of a core center grant in musculoskeletal diseases later this year. This grant will enable the type of collaborative work made possible in the Longwood Medical Area. I know Chris and Steve look forward to building an impressive research program in molec-ular biology and working with the Harvard Orthopaedic faculty to pursue innovative advances in the treatment of musculoskeletal disease.

In closing, I want to introduce and welcome Dr. James Heckman, the new editor of the Journal of Bone and Joint Surgery. Dr. Heckman, who is past chairman of the Department of Orthopaedic Surgery at the University of Texas at San Antonio, has joined the Partners Foot and Ankle Service and will be seeing patients at MGH, BWH and Faulkner Hospital sites. We are pleased to have Dr. Heckman's wisdom and experience in growing an outstanding program in foot and ankle medicine.
Dr. James D. Heckman



Incoming Residents

Renn J. Crichlow, MD, Harvard Medical School Joseph J. Czarnecki, MD,
Jefferson Medical College
Brandon E. Earp, MD,
Stanford University
Neil G. Harness, MD,
Loyola University
James I. Huddleston, MD,
University of Vermont
Pearce McCarty, MD, University Mississippi Med Ctr Robert V. O'Toole, MD, Harvard Medical School Robert C. Parisien, MD, Dartmouth Medical School
Sean O. Rassman, MD, Virginia Comm U/MCV Jason D. Tavakolian, MD, Dartmouth Medical School

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