Harry E. Rubash, MD


My eighth annual Chief’s Report for the Orthopaedic Journal at Harvard Medical School will highlight a tremendous year of growth and productivity in the Department. I will spotlight the many significant contributions by the orthopaedic staff at the Massachusetts General Hospital (MGH). I will showcase our Department’s continued commitment to education, research and clinical care and our Mission Statement, “to provide the highest quality musculoskeletal patient care, teaching and research, with a dedication to service and a commitment to leadership.”


We have been in our new space at the Yawkey Center for Outpatient Care (YCOC) for well over a year now. All agree that our new state-of-the-art facility, adjacent to the main campus is an unprecedented success! The YCOC has given us the opportunity to double our clinical space and to practice as a cohesive group in a centralized geographical location. In 2006, we will see over 70,000 patients at the YCOC. Our patients are enjoying the ease involved in using the facility which houses many clinical programs at the MGH and has convenient underground parking. Having centralized Radiology embedded in our second and third floor suites has offered unparalleled efficiency and greatly enhances the patient experience. I would invite everyone to stop by our fabulous new clinical center.

From our offices in the YCOC we are watching construction of a new hotel at the former Charles Street Jail site. The hotel will have 308 rooms, and will feature a number of restaurants, a health club and conference room space. This new facility, which is tentatively scheduled to open in early 2007, will add immensely to our patient and their family’s experience when visiting the MGH.


Three important new naming events occurred on the Orthopaedic Service this year during the 35th Annual Arthroplasty Course. We honored Dr. William H. Harris by: 1) renaming the Orthopaedic Biomechanics and Biomaterials Laboratory (OBBL), the “Harris Orthopaedic Biomechanics and Biomaterials Laboratory” (HOBBL), 2) naming the newly created outcomes registry “The Harris Joint Registry”, 3) the rededication of the recently renovated “Harris Conference Room” on White 10. Over fifty participants including faculty members from the Annual Advances in Arthroplasty Course attended these events and were escorted through the MGH to visit these 3 important facilities… a facilities are a fitting tribute to a surgeon who has dedicated so to the field of hip arthroplasty, the MGH, and the Department of Orthopaedic Surgery! Dr. Harris hosted all of the guests in the new “Harris Conference Room” and was able to highlight the state-of-the-art audio and video equipment that has been added. On display in the conference room is a painting of Dr. Harris created by one of his former patients as well as a large glass enclosure displaying a record of his numerous contributions to the field of orthopaedic surgery. This display includes Dr. Harris’ Kappa Delta Awards in 1970 and 1976, his 6 Hip Society Awards, diplomas, several important patents and the letter establishing the Harris Professorship at Harvard Medical School. The most prized items however, are the reflections of the teaching (the room itself and photos of the Fellows as examples), the clinical care (the portrait in scrubs as an example), the innovations in surgical care (the crosslinked polyethylene, the CDH implants, the modular metal backed socket as examples) and contributions to the conquest of three worldwide diseases, namely periprosthetic osteolysis, venous thromboembolic disease, and the etiology of osteoarthritis.

We were all deeply moved by the ceremony and Dr. Harris was greatly appreciative of this lasting tribute to him at the MGH. Dr. Harris states, “The naming of the laboratories in my honor is the climax of my 49 year career at the MGH, encompassing both the clinical and research aspects of my endeavors to advance orthopaedic science and patient care. Central to the greatness of the MGH is the permeating and integral dedication of both its people and the institution itself to that singular issue – caring.”


An exciting new addition to the Department opened in 2006. The “Orthopaedic Ambulatory Surgical Center” (ASC) in the MG West Building in Waltham houses four outpatient operating rooms, patient friendly pre- and post-operative care areas as well as large waiting rooms and other modern patient amenities. The Medical Executive Committee of the ASC including: Drs. Bertram Zarins, Jesse B. Jupiter, Jon “JP” Warner (Chairman), Thomas J. Gill and Mr. David Gaynor is involved in all aspects of developing and managing this new facility. Mr. Gaynor reports, “The state-of-the-art ASC will provide a friendly, safe and convenient environment for our patients and families with amenities such as free covered parking, internet access for waiting family members and a convenient location right off the highway. On-time starts, short turnover time and most importantly a consistent, talented teams in the operating rooms will make the ASC a desired location for their surgical cases.” These are lofty goals and we are committed to the success of our new ASC. This new center represents a major step forward for the MGH and creates a new paradigm for the delivery of orthopaedic care.

Several new additions have been added to the faculty as a result of our new center. The Ortho ASC is under the apt direction of Medical Director, Jeffrey Wilson, MD. Dr. Wilson is an Instructor in Anesthesia at the Harvard Medical School and will be an active member of the Department and the ASC Medical Executive Committee. Dr. Wilson received his B.A. from Harvard College and his M.D. from Boston University in 1982. He did his Internship in Internal Medicine at the Boston V.A. Medical Center and was a Resident in Anesthesia here at the MGH. He completed in a Fellowship in Anesthesia at the Brigham and Women’s Hospital. Dr. Wilson comes to us from the Caritas Good Samaritan Surgicenter in Stoughton, where he was the Medical Director and Chief of Ambulatory Anesthesia. Dr. Wilson has extensive experience in outpatient and regional anesthesia, specifically targeted toward orthopaedics. I wish him much success as the ASC continues to provide optimum care for our ambulatory surgical patients.

Dr. Wilson says, “For the past 10 years I have dedicated myself professionally to my clinical passion, regional anesthesia, and to the development and maturation of an efficient, respected surgery center which surgeons, patients and staff love. I return to Mass General to pursue my dream job as medical director of the new ASC with a fantastic staff. We will share our enthusiasm and expertise in making our new surgicenter meet and exceed your hopes and expectations.”

Please join me in welcoming Dr. Wilson and his family to the MGH community: wife, Beth; and their children: Melissa (21), who is going to be a Senior at the University of New Hampshire; Rachel (18), who will be starting at George Washington University and son, Jason (16), who is in high school.

Also joining the Anesthesia staff at the ASC will be Dr. Charles Kelly, an instructor in Anesthesia at the Harvard Medical School. Dr. Kelly received his B.S. and M.D. from the University of Massachusetts. He completed his internship and residency training at Tufts New England Medical Center. He has spent the last ten years working primarily at the Caritas Good Samaritan Medical Center Surgicenter with Dr. Wilson. “During that time Dr. Wilson and I worked closely and diligently together making the Surgicenter a profitable endeavor for the Caritas medical system; an efficient and desirable workplace for the surgeons; and an enjoyable experience for the patient while maintaining the highest levels of quality, care and patient safety. Over the past fifteen years my clinical interests have evolved and working at the ASC will allow me a unique opportunity to concentrate on my true passions regional anesthesia and ambulatory orthopaedic surgery. I welcome this new challenge and look forward to working with the excellent staff and clinicians at the ASC.” Please join me in welcoming Dr. Kelly and his family: wife, Mary, and children, Charles, (20) who is a Junior at Roger Williams University; Patrick, (19) a Sophomore at Saint Michael’s College, and Kathleen (13), a 7th grader in the Cohasset Middle School, to the MGH.

Claire O’Brien, RN, CNOR, will be the nurse manager of the center. Claire has over 7 years of nursing management experience in the surgical setting and 24 years in the surgical environment as a registered nurse. Claire holds a Bachelor of Science in Nursing (BSN) from Salem State

College and a Masters in Business Administration (MBA) from the University of Massachusetts. Claire will be responsible for the management of the day-to-day operations of the ASC including supervision of both clinical and administrative staff. Claire reports, “We couldn’t be more excited about this project. Dr. Wilson and I have been fortunate to recruit an extraordinary staff with years of surgical experience between them. We are all looking forward to the challenges and opportunities that will be part of an ASC start up project. We all share the Department of Orthopaedics passion for service excellence, commitment to patient safety and desire for quality outcomes. Opening a single specialty orthopaedic ASC provides us with an opportunity to refine existing services and streamline clinical practice and operations.” It is a pleasure to welcome Claire, her husband, Kevin, and sons, Brendan (21), a senior at Hamilton College in Clinton, NY and Collin (17), a senior at Stoneham High School.


I was most pleased to deliver a five-year, “Lustrum” Report to the faculty at the May 10th Orthopaedic Staff Meeting. The report to highlighted the group’s clinical and academic productivity and set the stage for the Departmental/MGOA Retreat, which was held in May over two days at the gorgeous Chatham Bars Inn on the Cape. The Lustrum Report included an “MGH Orthopaedic Timeline” where I remembered enduring contributions that members of the department have made to the field of orthopaedic surgery. In 2006, our Orthopaedic Department celebrates its 108th year of existence! We are working to create a display on the “Century of Orthopaedics at the MGH” for the Yawkey Center and the hospital.

I was also very pleased to announce the appointment of two new Vice Chairs in the Department: Dr. Andrew Freiberg as the new Vice Chair of In-Patient Services and Dr. Jon J.P. Warner as the new Vice Chair of Out-Patient Services. Both of these individuals have been tremendous assets to the Department and have brought their maturity, leadership and innovation to our departmental activities. I welcome both of them in their new roles and look forward to their future contributions to our department. Dr. Freiberg reports, “It’s a great honor to be appointed the first Vice Chair for Inpatient Services, and I very much look forward to working with Dr. Rubash as we strive to improve our quality and volume of care. There is much optimism as we plan for our next five years, and we will need to work hard to find ways to accommodate our incredible growth.”

In addition, I highlighted the past five-years of growth in the Department. We have increased our patient admissions during this time, nearly 9%; our inpatient surgery nearly 10% and our outpatient surgeries a staggering 19%. Each service Chief and members of the service have contributed greatly to our continued success in the Department. In addition, in 2005 we contributed over 197 publications and nearly 100 citations at the ORS and AAOS Annual Meeting. The Department continues its excellence in clinical activity as well as research and scientific contributions

Orthopaedic demand over the next decade will grow approximately 18% in all inpatient and outpatient services, this is driven by our “baby boomer” wave, our technological advances, and our patient expectations and their increasingly active lifestyle. As a department we have to be prepared to identify the future models for the delivery of orthopaedic care. We must continue to be our patient’s best advocates and deal with the many complex issues facing orthopaedic surgeons which include: direct to consumer marketing, gain sharing, specialty care centers including ambulatory surgicenters, as well as opportunities to enhance our inpatient activities. These and other important contemporary issues in orthopaedic surgery formed a backdrop for the retreat at the Chatman Bars Inn. The purpose of the Retreat was to begin a “strategic discussion on the future of the Department.” The Retreat included four major sections with an appropriate question to be answered in each section. Section 1: Personalysis - How do we become better communicators within the group, the department and the Hospital? Section 2: Departmental Finances - How do we leverage our resources to ensure continued financial success? Section 3: Education - How do we better prepare our students, residents and fellows for a future in medicine? Section 4: Research - How do our research laboratories successfully participate in thematic research? Over 30 physicians and scientists attended The Retreat and the response was overwhelmingly positive.


The “Primary Care Orthopaedics” is a Harvard University CME course run by the MGH Department of Orthopaedic Surgery for the past 20 years. Current course director, David Ring, and co-directors Richard De Asla, George Theodore, Tom Gill, Malcolm Smith, and Kirk Wood have polished the course content to deliver the fundamentals of musculoskeltal medicine to over 130 primary care providers in two and a half days. The course includes lectures, discussion groups, physical examinations sessions and casting and splinting opportunities. As one of the few courses of its kind, it continues to attract national, and international participants in addition to its regional base.


The National Association of Orthopaedic Nurses held its 26th Annual Congress in Boston in May. The mission of the society is to advancing the art and science of orthopaedic care. Many member of our Department prepared posters and gave presentations at the Congress. Kathy Meyers, Nurse Manager on White 6 had a poster entitled, “ Confronting Healthcare Disparities Through Culturally Competent Care. Sharon Brothers, RN, Operating Room Nurse for Orthopaedics, had a poster titled, “ The Role of Orthopaedic Instrument and Equipment Technician in the Operating Room. There were also a number of interesting presentations. Janet Dorrwachter, RN, and Dr. Andrew Freiberg presented, “A Spectrum of Care for the Total Hip Arthroplasty- Three Different Surgical Approaches.” Dr. John Siliski presented, Computer -Assisted Surgery in Orthopaedics. Dr. Brian Grottkau presented, “Current Trends in the Diagnosis and Management of Scoliosis. Joanne Hughes Empoliti, Clinical Nurse Specialist and Ruth Bryan, Perioperative Clinical Nurse Specialist presented, “Make no Bones about it! Patient Safety is Important. Following in the same vein, Dr. James Herndon presented, “Patient Safety: What’s All the Fuss About?” Deirdrew Fleming, FNP, Nurse Practitioner in the Sports Medicine Service presented, “Making Sense of Shoulder Pain: Diagnosis and Management of Common Shoulder Problems,” and Erin Hart, CPNP, Nurse Practitioner with the Pediatric Orthopaedic Service presented, “Another Day in the Pediatric Orthopaedic Clinic: Common Diagnoses & Clinical Management.” Congratulations to NAON and our many nurse presenters from the MGH.


I am pleased to welcome Dempsey Springfield, MD, back to the Department. Dr. Springfield obtained his undergraduate degree from Emory University and his medical school education at the University of Florida’s College of Medicine. He did a residency in Orthopaedic Surgery at the University of Florida and, after two years of military service, a fellowship in musculoskeletal oncology at the University of Florida. He remained on the faculty there until 1987 when he joined the Orthopaedic Department at the MGH. He spent 9 years here before accepting the Chair and the Leni & Peter W. May Professorship in the Department of Orthopaedic Surgery at the Mount Sinai Medical Center in New York City. Dr. Springfield is international known for his work in musculoskeletal tumors. He is the co-editor of the text, Surgery for Bone and Soft-Tissue Tumors published in 1998, which is used by orthopaedic surgeons, residents, and students around to world. “Dr. Springfield says he is delighted to return to the Department of Orthopaedic Surgery and the MGH after a ten year visit to New York City. He is excited to be able to work with Drs. Hornicek and Raskin in the Orthopaedic Oncology Division. The Connective Tissue Oncology Group at MGH is a world renown group of sarcoma specialists and Dr. Springfield feels honored to be included.” Dr. Springfield will add immense depth and expertise to our department. Please join me in welcoming, Dr. Springfield and his wife, Deanna, back to Boston.

I would also like to welcome Peter Asnis, MD to the department and the Sports Medicine Service. Dr. Asnis graduated from Cornell University Medical College and completed his Orthopaedic Residency at The Hospital for Special Surgery in New York. Dr. Asnis recently completed a Fellowship with the MGH Sports Medicine Service and performed in an exemplary fashion. Dr. Zarins, reports, “Dr. Asnis will expand our capabilities to treat hip and elbow problems using minimally invasive techniques as well as the more traditional approaches to Sports Medicine.” Now that he has completed his Sports Medicine Fellowship he will be doing a mini-fellowship in hip arthroscopy at the Hospital for Special Surgery in New York and the Steadman Hawkins Clinic in Vail, Colorado. Dr. Asnis is interested in the biomechanics of sports related injuries. Please join me in welcoming Dr. Asnis, his wife, Brooke, and 3 children: son, Owen, age 5, and 3-year-old twin girls, Caitlyn and Sydney to the department and the MGH community.

The Foot and Ankle Service continues to grow at a rapid pace and provides comprehensive care to patients from the greater Boston area and beyond. Dr. Richard de Asla, Co-Director of the Foot and Ankle Service, and his team on research team on Jackson 12 had an outstanding year at the Orthopaedic Research Society (ORS) and the American Academy of Orthopaedic Surgeons (AAOS). It’s a pleasure to congratulate Dr. de Asla for having received the OREF Career Development Award this year at the AAOS. Dr. de Asla explained, “The ultimate goal is to design a new and durable total ankle replacement. The grant will fund research in how ankle joint complex kinematics change with arthritis. This information will be useful in prosthesis design.”

Guoan Li, PhD, reports, “Ankle biomechanics research has been historically difficult due to the complicated anatomy of the foot and ankle. Our newly developed imaging approach provided us with the opportunity to directly observe the in-vivo articulation of each joint of the ankle complex under normal and pathological conditions”

These studies combine the use of robotic technology as well as our dual fluoroscopic and MRI Imaging techniques to develop an entirely look at ankle joint kinematics. Dr. de Ala, Guoan Li, PhD, and their team are doing some outstanding work and we welcome their continued input into the clinical analysis of foot and ankle abnormalities. Congratulations Rich!

Chaittanya “Chai” Mudgal, MD, is in his second year of practice with the Hand and Upper Extremity Service and has been an extremely active clinician. His microvascular surgery training has added greatly to our expertise at the MGH and he is rapidly incorporating himself into outstanding clinical as well as research projects within the Hand and Upper Extremity Service. Dr. Jupiter states, “Dr Mudgal has added to our Service expertise in management of neuromuscular disorders as well as becoming an important person in our ever expanding educational programs.”

Timothy Bhattacharyya, MD, has been a welcome edition to the Partners Trauma Service and has been splitting his time between the MGH and the BWH. He has added to the clinical as well as educational programs on the Trauma Service and we are pleased that his practice continues to grow. In addition, he continues to work as a site minder for CIMIT. Dr. Bhattacharyya reports, “I continue to enjoy the rewards of working in this challenging and collaborative environment. We continue to grow our and increase our productivity. At home, our son, Rohan, has begun walking and is getting very difficult to keep up with!”

Kirk Wood, MD, Chief of the Orthopaedic Spine Service at the MGH, continues to grow his clinical as well as academic service. In addition to incorporating himself into the teaching program at the MGH he has developed the new Boston Spine Society. The inaugural event was held at the Copley Plaza Hotel and featured John Hall, MD from Boston Children’s Hospital as the guest speaker. In all, some thirty-five prominent spine surgeons from around the greater Boston area attended. Dr. Wood reports, “The Society brings together both Orthopaedic as well as Neurosurgical spine surgeons to compare notes, discuss cases and present new ideas in a relaxed and congenial atmosphere. The society meets twice a year, and continues to grow, even at this early stage.”

Henrik Malchau, MD, PhD, Co-Director of the Harris Orthopaedic Biomaterials and Biomechanics Laboratory and world-renowned researcher in the field of outcomes after total hip and total knee arthroplasty continues to grow and expand our outcomes expertise in the department. Recently, we have added two new modules to the Yawkey Center for establishing and validating the patient directed outcomes scores with those obtained by physicians. This very important work will lay the groundwork for development of a patient driven registry program. Dr. Malchau states, “H-OBBL a web based software for online capture of outcome measures has been further developed. Through an IRB approved application clinical and radiographic data is captured semi automatically; patient outcome data is captured direct from a specific web application. The Registry is currently implemented for the Reconstructive (hip and knee replacements) and Shoulder services at MGH. Similar outcome programs are planned for the Tumor, Hand, Spine and Sport services at MGH. Statewide registries are developed and will be functional during 2006 for Maine and Virginia.”


The Arthroplasty Service, under the direction of Andrew A. Freiberg, MD, has again had another outstanding year with respect to both clinical activities and research. Our Morning Arthroplasty Conference is recognized as one of the best conferences in the MGH training program. In addition, multidisclipinary CAOS (Combined Arthroplasty Oncology Service Rounds) Conference has added greatly to our understanding and capabilities in treating patients with Orthopaedic oncologic problems.

The interest of both our clinicians as well as patients in minimally invasive hip and knee arthroplasty continues to grow. We perform a variety of types of minimally invasvie procedures including total hip and knee arthroplasty, unicondylar arthroplasty, and are developing a program for surface replacement. In addition, we have futher refined our anesthetic and peri-operative protocols and greatly enhanced our patients’ peri-operative pain and function.

The Arthroplasty Service had an outstanding presence at this year’s AAOS and ORS Meetings with 39 podium presentations, posters, and exhibits by our surgeons. We were recognized for two outstanding awards: The Orthopaedic Research and Education Foundation 2006 Clinical Research Award for outstanding clinical research, presented to Dr. Harry E. Rubash, Dr. Kevin Bozic (former Resident and HBS graduate), Dr. Daniel Berry (former Harvard Orthopaedic Resident and Chairman, Mayo), Dr. Michael Reis (UCSF), Dr. Patricia Katz, Dr. Jonathan Showstack, and James Naessens, MPH. This study entitled, “Using Clinical and Economic Outcome Data to Influence Health Policy in the United States: The Case of Total Joint Replacement,” was recognized for its multi-center perspective on reimbursement for revision total hip arthroplasty. The hypothesis and pilot work for this study was done at the MGH and as a result CMS has modified their payment for revision total hip as a result of this multi-center study. This is the ORS/AAOS highest clinical research award. Congratulations to Kevin and our team!

We also were honored with Best Poster Award: this award is given to the presentation with the most impact in the field of orthopedic surgery. The study entitled, “A Minimum 5-Year Follow-Up of Highly Cross linked Polyethylene (HXLPE) Liners in Total Hip Replacement,” Jeffery Geller, MD; Murali Jasty, MD; Dennis Burke, MD; Harry E. Rubash, MD; Andrew A. Freiberg, MD; William H. Harris, MD: Henirk Malchau, MD; Charles R. Bragdon, BS; and Meredith E. Greene, BS, reviewed our 2-5 year follow up of the MGH polyethylene in total hip arthroplasty thus us the first mid-term report of the new crosslinked polyethylene that is functioning in-vivo as expected with minimal wear.

Our Adult Reconstructive Fellowship Training Program continues to be an outstanding one. This fellowship is one of the oldest and most renowned in the field of Arthroplasty and our fellows are drawn to our rich heritage of clinical and research excellence. This year’s Fellows: Young Min Kwon, MD, John Barrington, MD, Allen McDonald, III, MD and Carl Talmo, MD have been an outstanding group of trainees. We will miss them as they matriculate to a variety of programs across the country. Dr. Kwon will join the academic faculty at Concord Repatriation General Hospital, at the University of Sydney in Australia; Dr. Barrington will join an outstanding practice in Plano, Texas, the Texas Center for Joint Replacement, Dr. McDonald will join a large private practice in Atlanta, Peachtree Orthopaedic Clinic along with his Father; and Dr. Talmo will work with an outstanding private practice group at the New England Baptist Hospital.

Our research program in crosslinked polyethylene is thriving in new applications in total knee arthroplasty, shoulder and spine. This year we reported results of our initial clinical trials evaluating wear utilizing these materials using radiosterometric analysis (RSA). These new materials have outstanding wear resistance and, as a result, have few of the liabilities of first generation crosslinked polyethylenes. In addition, we recently developed a constrained acetabular component that, for the first time, allows an increased range of motion, the use of crosslinked polyethylene and provides a powerful constraint to prevent dislocation and now has early 1 -2 years follow-up results with no failures.

We congratulate Dr. Guoan Li and his team for their outstanding contributions at the Orthopaedic Research Society (ORS) this year with reports on the Kinematics of Knee Arthroplasty and Posterior Stabilized Knee Arthroplasty Post Impingement Using Robotic Technologies, as well as his outstanding ORS symposium on Kinematics of the Knee. Here, he reported some of his newest knee kinematics research as well as unicondylar knee arthroplasty and high flexion knee data. In addition, Dr. Li has developed an extensive and innovative dual fluoroscopy program to evaluate the clinical performance of a variety of different knee arthroplasty designs with a highly reproducible and accurate kinematic evaluation. Early results are now available comparing different implant designs and kinematics using these innovative methods.

Dr. Freiberg reports, “Our future plans include expanding our clinical practices with an emphasis on state-of-the-art methodologies for primary and revision arthroplasty. In addition, we will have continuing emphasis on studying advances in bearing surfaces and crosslinked polyethylenes. We will continue with sustained efforts at long-term follow-up studies using our Patient View Registry, which promises to guide our clinical activities for many years to come. It is a pleasure to be the Chief of such a fine Service with rich heritage and an incredibly bright future.” In celebration of the generosity of Richard and Ingrid Anderson, this year we initiated the Anderson Arthroplasty Fund. This Fund will be used to support a variety of functions for the Arthroplasty Service including Fellowship training, additional research support, and educational experiences for our faculty.

Dr. Freiberg and Dr. William H. Harris and the Arthroplasty Service celebrated the “46th Year End Party,” in June 2006, at Dennis and Martha Burke’s home. The program was a spirited event with cocktails, dinner, and speakers including our graduating fellows. We started the event with a group-racing event at the F1 Boston racing track. It was an outstanding year-end event and we look forward to many more in the future.

Preparations are currently underway for the 36th Annual Harvard Arthroplasty Course. This year’s offering is entitled: Advances in Arthroplasty: An emphasis on treatment option for the young and will be held October 4 - October 7, 2005, at the Hyatt Regency Hotel, in Cambridge. For more 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


Under the direction of Dr. Robert J. Scardina, the M.G.H. Podiatry Service remains committed to its mission to provide excellence in both patient care and residency education & training. The main campus practice has settled into our new location along with other Orthopaedic specialties. We continue to develop a stronger clinical and educational relationship with the Foot & Ankle Service. A new laser scan cad/cam system for fabrication of custom foot orthoses has been added to our clinical practice. Associate staff members provide ambulatory care at the three MGH Affiliated Health Centers (Revere, Chelsea and Charlestown) and at non-affiliate health centers (South End Community and Lynn Community), as well as in-patient consultation services at Spaulding Rehabilitation Hospital. In 2005, our group proudly celebrated 15 years of providing volunteer foot care to patients at the Pine Street Inn.

The Council on Podiatric Medical Education conducted a residency program site-visit at the MGH in December. The program received provisional approval as a 36 month Podiatric Medicine and Surgery Residency (PM&S-36), leading to Board Qualification in Podiatric Surgery, Podiatric Orthopedics and Podiatric Medicine for our current and future graduates. We look forward to official approval in the spring of 2006. The program now includes more than 20 non-podiatric medical & surgical rotations integrated with longitudinal training in podiatry. Of note, the MGH is one of only three hospitals listed in the 2005 U.S. News and World Report ‘Best Hospitals Honor Roll’ to sponsor a podiatric residency program, and the only one with no podiatric medical school in its state.

As Service Chief and Program Director, Dr. Scardina maintains a clinical and surgical patient care practice along with seven other M.G.H. Podiatry staff members, and provides resident surgical training with additional podiatric and orthopaedic faculty members at M.G.H. and other Partners institutions.

“Together, our group members take pride in a twenty-plus year history of service to the M.G.H. community and contributions to podiatric post-graduate education. We eagerly look forward to additional opportunities for growth and expansion in all aspects of our Service under the auspices of the MGH Orthopaedic Department”, notes Dr. Scardina.


The Foot and Ankle service at MGH is under the leadership of Co-directors, Drs. Richard de Asla and George Theodore. This growing service continues to provide comprehensive clinical care to patients in the MGH community and the greater Boston area. During the past year the service has seen the addition of a full time resident in the PGY 4 year. Dr. de Asla remarks, “ I believe we provide a well balanced rotation with excellent operative and clinic exposure. Dr. Heckman’s participation in the office setting strengthens the rotation even further. The rotation has been very well received.” The Foot and Ankle service looks forward to new opportunities in the off-site ambulatory surgery center as well as the vascular center.

In conjunction with the MGH biomechanics laboratory on Jackson 12, Foot and Ankle enjoyed exceptional representation at both the Orthopaedic Research Society and the American Academy of Orthopaedic Surgeons meeting in March of 2006. Two podium and two poster sessions were presented. The week culminated in receipt by Dr. de Alsa of an “OREF Career Development Award” dedicated to studying kinematics in the arthritic ankle. The unique technique used for studying in vivo kinematics as it applies to the ankle joint complex was also presented at the CIMIT forum in Boston.

The service will soon focus on establishing a Foot and Ankle Fellowship. Watch for more to come from this productive academic service.


The Hand and Upper Extremity Service, led by Service Chief, Jesse B. Jupiter, MD, the Hansjörg Wyss Professor of Orthopaedic Surgery continues to be one of the busiest services in the Department of Orthopaedic Surgery. Dr. Jupiter reports, “The past 5 years have witnessed the Service become a comprehensive hand and upper limb unit providing a wide breadth of expertise in virtually every problem in the specialty. We now have 4 full time faculty with each have unique and varied expertise, our unit is a center of excellence for brachial plexus problems, stroke, microvascular reconstruction and trauma management, fractures and posttraumatic reconstructions of the entire limb, pediatric trauma and reconstruction, and all aspects of elective hand and upper limb surgery.”

Collaborations have continued with the Orthopaedic Trauma Service and the Hand and Upper Extremity Service has become an integral part of providing expertise in all upper limb trauma as well as education and research activities. In addition, the Service has become an internationally recognized center for the management of traumatic and reconstructive problems about the elbow and wrist. The Hand Service has integrated Fellowship rotations with the Brigham and Woman’s Fellowship making our Fellowship one of the most sought out Fellowships in the country.

Due in part from a large ongoing research grant from the AO Foundation as well as an association with the Amsterdam Medical Center, we have developed an active clinical research unit with 2 full-time research associates as well as PhD candidates from Amsterdam. The qualities of research publications and presentations reflect well on the unit itself and the Orthopaedic Department.

The Annual Richard Smith Lectureship, now in its 17th year, was another tremendous success. Dr. Barry Simmons presented as the as the Smith Orator. Each year this wonderful program offers an opportunity for individuals in the Boston Hand and Upper Extremity community a forum to meet and present interesting ideas and the newest innovative research.


The Harvard Shoulder Service, led by Jon “J.P.” Warner, MD, continues to grow and achieve excellence on three levels; academic contributions, clinical service, and teaching initiatives.

The clinical volume has continued to grow with more than 800 surgeries performed at the MGH by members of the Shoulder Service. One area of recent development has been the use of the newly developed Reverse Prosthesis to salvage failed shoulder replacements and otherwise irreparable tendon tears. Over 100 cases have been performed at the MGH with dramatic improvement in pain and function for individuals who otherwise had no alternative. The Shoulder Service has pioneered the work in this area.

Educational initiatives also continue to grow. This year’s fellows, selected from a national pool of 30, included our top two choices. Our current fellows will be entering private practice at the completion of their fellowship. Dr. Todd O’Brien has gone into private practice on the North Shore and Dr. John Costouros be returned to the Bay Area of San Francisco where he has accepted a post as Chief of Shoulder and Elbow Surgery at Kaiser Permanente of Northern California.

Our current fellows have also taken jobs. Dr. Ryan Simovitch will go into private practice in Palm Beach Florida. Dr. Scott Pennington will be joining a large orthopaedic private group in Atlanta, GA. And Dr. Brett Sanders will be going on to a fellowship in Hand Surgery in Edinburgh, England.

Dr. Peter Millett left our Service last summer to become a member of the Steadman-Hawkins Clinic. He will be missed as a surgeon, colleague and friend. We are proud to say that Dr. Laurence D. Higgins has accepted a position on the Shoulder Service and will have his primary responsibility as Chief of the Sports Medicine and Shoulder Service at the BWH. He will also be involved in patient care and research at the MGH. Dr. Higgins was, for the past 10 years, Director of the Sports Medicine and Shoulder Fellowship at Duke University.

The future of the Harvard Shoulder Service is an exciting and bright one. Basic science projects, which promise to yield important insights in to shoulder arthroplasty, include an RSA analysis and 3-Dimensional Fluoroscopic Analysis. We believe the information gained from this work may change the understanding of shoulder reconstruction and ultimately lead to greater durability of this surgery.

The Shoulder Service welcomes Kelly Richards, NP, new nurse practitioner in the service. She is heavily involved in the clinical as well as the research activities on the service. Dr. Warner states, “Kelly Richards joined the Shoulder Service as a welcome and very needed addition. She will assist with care of complex patients and act as a coordinator for preoperative and postoperative management of all shoulder patients.”

Clinical research underway includes over 10 prospective outcome studies of the effectiveness of surgical procedures on the shoulder, and a patient-relational database which will allow for internet-based acquisition of outcome information from patients and their treating physicians.

Additionally, an initiative to develop a patient electronic informed consent for different shoulder surgical procedures has been started. This promises to improve patient education while at the same time standardize the information given to patients regarding the risks and benefits of surgery.


The Orthopaedic Oncology Service led by the Service Chief, Francis Hornicek, MD, PhD, continues to flourish. Dr. Hornicek, attending, Kevin Raskin, MD, and Senior Consultant, Henry Mankin, MD, were joined earlier this year by Demspey Springfield. Dr. Hornicek states, “The Orthopaedic Oncology Service, and the Center for Sarcoma and Connective Tissue Oncology are extremely fortunate to have Dr. Springfield return to Boston. Dr. Springfield has an excellent national and international reputation in the field of orthopaedic oncology and as a leader in orthopaedic surgery. His addition to our department continues to strengthen this service, which was established about 30 years ago.” Dr. Raskin continues to grow his practice and Dr. Mankin is involved in clinical research projects. Dr. Lawrence Weissbach will be leaving the Sarcoma Laboratory in the fall and we wish him well. Dr. Christine Towle continues to pursue cartilage research. Dr. Hornicek also reports, “the laboratories are considering a new focus on stem cell research and continue to expolore mechanisms of drug resistance in tumor models. Together with Dr. Gebhardt and Dr. Anderson, we have one of the largest musculoskeletal tumor fellowships. We are pleased to continue are relationship with Boston Children’s Hospital and BIDMC to build further on this strong foundation.” The Oncology Group is truly impre4ssive and continues to grow and prosper.


The Pediatric Orthopaedic Service is in the midst of expanding. The service has achieved capacity in terms of outpatient volume. They are attempting to develop new care models to meet the demands of their ever-expanding patient base. The service continues to focus on establishing a solid research program in regenerative medicine to complement the ongoing clinical and basic science projects. They have enjoyed increasing success in developing a national presence with 7 presentations at national meetings. Additionally, they collectively produced 5 orginal peer-reviewed publications, 4 review articles and 1 book chapter. Drs. Albright, Grottkau and Kim continue to labor tirelessly to provide outstanding pediatric orthopaedic care to the patients of the MassGeneral Hospital for Children. Dr. Grottkau states, “Our recent move to the Yawkey Center for Outpatient Care has more than doubled our office space. We now have a comfortable, adequate and engaging waiting area for our patients and families. Our examination rooms, access to radiology services, cast rooms and personal office space have improved our abilities to provide timely, efficient, cost-effective care to our young patients.”

Erin Hart, RN, MS, CPNP, continues to impress us with her academic talents and this year was awarded the coveted “Nan Hilt Journalism Award” for the outstanding paper of the year in Orthopaedic Nursing for 2005. Her publication was on neonatal foot disorders. She will be presenting and playing a large role at the upcoming National Association of Orthopaedic Nurses (NAON) conference in Boston.


The MGH Sports Medicine Service has seen another year of exponential growth, thanks to the leadership of Dr. Bertram Zarins, Service Chief and Associate Director, Dr. Thomas Gill. Most of the surgical procedures they perform are done arthoscopically on an outpatient basis. When the MGH West Surgicenter opens in July 2006 they will do most of their surgery in the new center.

In September 2006 the Service will move from its current location on Yawkey 3200 to a new MGH Sports Medicine Center. This 16,000 square foot facitily will be located at 175 Cambridge Street, next to the Holiday Inn and close to the hospital. This new space will allow the physicians in the service to expand their ability to provide first class care to our patients. The orthopaedic surgeons, primary care physician, and physiotherapists in the Center will have a close working relation. There will be space for clinical research and education. The new center will also have an in-house Sports Medicine Physical Therapy Unit. This new facility will add immensely to the luster of this world-class service.

Dr. Tom Gill was recently named Medical Director for the Boston Red Sox. In addition, MGH Sports Medicine Service continues to provide care for the New England Patriots. The quarter century mark on this alliance is quickly approaching. Dr. Gill has stepped up to the role of Head Physician of the Patriots and Dr. Zarins will be Medical Director for the team. Members of the Service also have been team physicians for the Boston Bruins for 30 years and for the New England Revolution since the league was formed ten years ago.

Biomechanics research work continues with a focus on: knee ligament reconstruction (anterior and posterior cruciate ligaments), in-vivo shoulder kinematics and tissue engineering. The tissue engineering research is involved in finding how to repair meniscal and articular cartilage lesions.

The MGH Sports Medicine team is also pleased that Dr. Peter Asnis will join the Service and the Department. Dr. Asnis will specialize in minimally invasive (arthroscopic) hip and elbow surgery.


The Orthopedic Spine Center, at the MGH, under the skillful Direction of Orthopedic Spine Service Chief, Kirkham B. Wood, MD, is now in its seventh year. The Service continues to be responsible for the clinical, teaching and research activities related to cervical, thoracic and lumbar spine. The members of this multidisciplinary Center include, Physiatrists, Sayed Ali Mostoufi, MD, and James Sarni, MD, and collaborations are expanding with Physiatry and the MGH Pain Center. Physician Assistant, Lisa Byer (Orthopedic Spine), and John James, RN, in the Access Program have contributed greatly to the Service’s expansion. Nearly 8,000 outpatients are accommodated annually. Dr. Wood notes, “Clinical and basic research are an important part of Orthopedic Spine Center’s mission. We have numerous clinical research investigations underway. In addition, basic science research into the care, treatment and understanding, of the spinal pathology has begun in conjunction with the Orthopedic Research Laboratories, here, at the Massachusetts General Hospital.”

It was a busy year for the Service whose members had numerous articles published in Spine, Journal of Spinal Disorders, and the Journal of Bone and Joint Surgery. Dr. Wood is pleased to be Chairing the Scoliosis Research Society’s Committee on Data Base and Co-Chairing the Scoliosis Research Society’s Committee on Adult Spinal Deformity. This summer, we will begin the second year of our Orthopedic Spine Surgery Fellowship in conjunction with Drs. Fredrick Mansfield, Frank Pedlow and Mitchell Harris (at the BWH). Along with Dr. Wood, this team is the core of our academic Spine Service.


The Harris Orthopaedic Biomechanics and Biomaterials Laboratory (HOBBL), led by Co-Directors Orhun Muratoglu, PhD, and Henrik Malchau, MD, PhD, continues to play a significant role in total joint arthroplasty research with many innovative contributions. Members of the H-OBBL have contributed in fields of cementing techniques, hip and knee implant design, revision total hip arthroplasty techniques, biology of bone in growth, load bearing surface applications in total joints (such as the first and second generation highly crosslinked polyethylenes) and also in the area of hydrogels for joint applications.

Currently, there are a number of clinical studies underway at the HOBBL. One of these, in its fourth year, utilizes the radiostereometric analysis (RSA) technique to determine the wear behavior of a first generation highly crosslinked polyethylene in conjunction with large head femoral components. The data is already showing a marked reduction in the femoral head penetration. In addition, another clinical follow-up study, with a larger patient population in its sixth year, is showing no detectible periprosthetic osteolysis. The H-OBBL is also focusing on novel crosslinked polyethylenes with low wear and high fatigue strength for applications in high-stress total knee replacements. Under the direction of Dr. Muratoglu, the team has added new inventions to their strong intellectual property portfolio: two novel methods of improving the fatigue resistance of highly crosslinked polyethylenes, the first uses mechanical annealing and the second uses vitamin-E to stabilize the residual free radicals and plasticize the base polymer. Both of these technologies were licensed to implant manufacturers and will be in clinical use within the next few years.

In addition, the laboratory is collaborating with Dr. Kirk Wood to identify research focus areas in the spine. The team has already identified a hydrogel technology for nucleoplasty of the intervertabral disc; human cadaver studies are underway.

On an annual basis, the Laboratory brings in over $3 million in funding from a variety of sources: government, foundations, and industrial. The H-OBBL is over flowing with new activity and energy. The skillful scientists in the lab had a phenomenal year at the ORS/AAOS. Congratulations to the members of the H-OBBL on these outstanding accomplishments!


This has been a busy year for the Biomaterials Lab guided by Arun Shanbhag PhD, MBA. We published our first book “Joint Replacements and Bone Resorption: Pathology, Biomaterials and Clinical Practice,” edited by Arun Shanbhag, Harry Rubash and Joshua Jacobs (Taylor and Francis, NY). It was satisfying to see the 30 chapters authored by leading esearchers and clinicians from around the world, collected in this form.

In the lab, we have continued to leverage the newest technologies to gain insight into osteolysis around total joint replacements. A combination of advanced gene chips representing the entire repertoire of human genes, and targeted multiplexed protein assays is driving our research to identify markers for the onset of osteolysis. We have deepened our use of core facilities and collaborators locally, and internationally. In an era of rapidly shifting and maturing technologies, this stance permits us to take advantage of each incremental development without the accompanying capital investments. The skill sets now represented in the lab are also evolving. We work with individuals who can formulate research questions, plan experiments, analyze data and communicate effectively.

Our previous research fellows: Dr. Koichiro Hayata, from Tokyo Women’s Medical University Hospital, and Dr. Masayuki Kawashima from Oita University (Japan) returned briefly to the laboratory to complete the manuscripts detailing their studies. Dr Mahito Kuwahara from Takagi

Hospital, Japan is continuing these investigations on the biological mechanisms of osteolysis. Dr James (Hutch) Huddleston, who did commendable work studying the kinetics of macrophage interactions with cross-linked UHMWPE, is currently on the faculty at Stanford University.

Dr Rajiv Sethi who started working in the laboratory as a medical student, and continued as our Resident, will be graduating from the program. We wish him too all the very best in his future endeavors. We thank Dr. Lawrence Weissbach, of the Molecular Sarcoma Laboratory who provided the much needed molecular biology expertise and valuable friendship. And to so many others who make life a little less difficult, everyday, a big thank you.


Guoan Li, PhD, Laboratory Director, and members of the Bioengineering Laboratory, have continued using their dualorthogonal fluoroscopic imaging technique for accurate measurement of in-vivo musculoskeletal joint kinematics. The cutting edge imaging technique and robotic testing, are being utilized to provide baselines for the development of new concepts in total knee arthroplasty, unicompartmental knee arthroplasty, anterior and posterior cruciate ligament research, studies of the in-vivo function of the lower and upper extremities, and human spines. This research is aimed at developing new concepts in the understanding of musculoskeletal joint functions, injury mechanisms, and efficiency of surgical modalities.

Congratulations to Guoan Li, PhD and Thomas Gill, MD for a newly awarded R21 research project from NIH which has teamed up bioengineers and clinicians to explore the in-vivo tension of anterior cruciate ligament. This research will fully utilize the advanced dual-orthogonal fluoroscopic and MR imaging techniques and the robotic testing system to quantify the forces in human ACL during functional activiries, the first of its kind to estimate in-vivo forces in human ligaments.

The laboratory recently celebrated the departure of Dr.Louis DeFrate, who takes a faculty position at Duke Medical School and will establish his own orthopaedic research laboratory. Dr. DeFrate has been an integral member of the laboratory since 1999, and concentrated on the experimental and theoretical modeling of the knee and soft tissue biomechanics. The laboratory also celebrated Mr. Jeffrey Bingham’s Master’s Degree in Department of Mechanical Engineering of MIT. Mr. Bingham joined the laboratory in 2004, and has been developing a automated global converging optimization method to accurately matching the 3D models of the knee to the dual fluoroscopic images, so that the in-vivo knee kinematics can be obtained. He will continue his research in the laboratory working towards his Ph.D degree of MIT. Jeremy Suggs, an MIT graduate student, joined the laboratory in 2000 and is studying the mechanisms that affect knee flexion after total knee arthroplasty. Mr. Lu Wu, a graduate student of MIT, has been studying the in-vivo ankle joint kinematics and in-vivo articular cartilage contact mechanics. Mr. Daniel Massimini, an MIT graduate, has recently joined the lab to conduct research on in-vivo human shoulder biomechanics in collaboration with Dr. JP Warner. Ms. Meng Li, a grauate of EE of Boston University joined our laboratory to investigate the MR imaging process of human musculoskeletal joints. Mr. Ali Hosseini, a graduate student of MIT, joined our lab this year to investigate in-vivo ACL tension. Drs. Samuel van de Velde and Kyung Wook Nha have joined us as postdoctoral fellows in 2005 and both are actively working in-vivo human knee joint biomechanics. Ramprasad Papannagari and George Hanson, two young and core bioengineers, have actively participated in a variety of clinical and robotic projects, including in-vivo ACL, in-vivo TKA as well as in-vivo shoulder investigations. The laboratory has recruited two more graduate students to carry out research in upper extremity and spine. The team had over 20 podium, posters and symposiums at this year’s ORS and AAOS meetings and published extensively in various orthopaedic and biomedical journals.


The Cartilage Biology and Orthopaedic Oncology Laboratory is under the direction of Christine A. Towle, PhD, and Dr. Henry J. Mankin. Dr. Towle’s research team is exploring the mechanisms that regulate metabolism in normal articular cartilage; aberrations in these mechanisms may lead to cartilage damage in pathological conditions such as osteoarthritis. In particular, the group is interested in understanding the soluble and mechanical factors that regulate the integrity of the articular cartilage in both health and disease. They are beginning to dissect the roles that the various components of static or invariant mechanical compression play in decreasing extracellular matrix synthesis in articular cartilage. The laboratory recently published a paper demonstrating that osmotic stress, a component of static mechanical compression, acts synergistically with interleukin-1 to stimulate the production of COX-2 and prostaglandin E2. A grant from the National Institute of Aging supports this investigation of the role of IL-1 in mechanical signal transduction. In collaboration with Tayyaba Hasan in the Wellman Center for Photomedicine, Dr. Towle’s group is conducting preclinical studies in mice aimed at developing a novel light-based technology as a minimally invasive approach for protecting articular cartilage in conditions such as osteoarthritis. The animal studies are supported by a grant from CIMIT.

The Oncology group continues to focus on clinical, molecular, and biochemical markers that may serve as predictors of metastasis in bone and soft tissue tumors. Recent research demonstrated that while COX-2 is not expressed in benign cartilage tumors, it is expressed in about half of malignant chondrosarcomas. The laboratories have access to a computerized database with information on almost 17,000 patients treated by the Orthopaedic Oncology Service including 1200 treated with allograft transplantation. The data have been used in numerous clinical studies.

Henry Jaffe MD and Crawford Campbell MD, bequeathed to Dr. Mankin their pathology collections consisting of thousands of cases, including histological slides, x-ray films, and patient records. Dr. Mankin obtained a grant from the Orthopaedic Research and Education Foundation (OREF) to convert this incredible resource into a digital format for educational purposes. The Musculoskeletal Tumor Society, corporate funding, and donations from patients and their families further support Dr. Mankin’s clinical research projects.


The Sarcoma Molecular Biology Laboratory (SMBL), under the direction of Francis J. Hornicek, MD, PhD, Chief of Orthopaedic Oncology. This laboratory investigates novel approaches to further advance the treatment of bone sarcomas. The overall objectives of this laboratory are to explore biological mechanisms of tumors arising in bone and perform translational research into new treatment options for sarcoma patients. Continued collaboration with 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 quite complex. The Sarcoma Molecular Biology Laboratory has published articles pertaining to sarcoma biology, and has received funding from a variety of sources including foundations, corporate sponsors, and benefactors.

New areas of interest include stem cell research. Unlike carcinomas, sarcomas do not have premalignant states, in general. The mesencymal stem cells may give rise sarcomas and may play an important role in the development of drug resistance.

The Laboratory is sorry to announce the departure of Dr. Lawrence Weissbach. Dr. Weissbach was a member of the of the orthopaedic laboratories for over years and contributed immensely to the laboratory and its success. We wish him well into the future!


Teresa Morales, PhD, directs the Laboratory of Orthopaedic Biochemistry and Osteoarthritis Therapy. Dr. Morales has been a member of many NIH panels, and continues to serve in special emphasis panels. She explains, “The global mission of the Laboratory is to understand the regulation of chondrocyte biology in health and disease and to apply this knowledge towards investigations of cartilage repair.” Dr. Morales and her team continue to examine how normal regulatory pathways are altered during osteoarthritis (OA) to cause progressive matrix degradation, with major emphasis on the dysregulated actions of the Insulin-like growth factor binding proteins (particularly IGFBP-3). Work in this area was the subject of a podium presentation at the International Congress of Osteoarthritis in Boston, MA in December 2005 in collaboration with Dr. Ernst Hunziker’s laboratory (Muller Institute, Bern Switzerland). Dr. Adetola Adesida, formerly from the Tissue Engineering Centre in Manchester, U.K., has recently joined the laboratory. Dr. Adesida’s goals include the inhibition of synthesis of the IGFBP- 3 protein in human cartilage explants in order to study its impact on cartilage pathophysiology. The group also continues to make progress in understanding how to enhance chondrocyte migration, a novel and potentially key area of investigation in the cartilage repair field. Cell biology and proteomic approaches are being used to advance knowledge in this area. Dr. Morales and Dr. Hideaki Nagase from the Kennedy Institute of Rheumatology (Imperial College London) are making headways in discovering new protein regulators of motility.

The Laboratory’s funding includes an R01 grant from the NIH. Congratulations to Dr. Morales for her noteworthy accomplishments!


The Laboratory for Musculoskeletal Tissue Engineering, under the direction of Mark Randolph and Dr. Thomas Gill, focuses on cartilage repair and regeneration in the knee. Work over the past two years, funded by the AO Foundation, continued on tissue engineering strategies to repair lesions in the avascular regions of the meniscus. Results presented at the Orthopedic Research Society (ORS), in San Francisco, and the International Cartilage Repair Society, in Ghent, Belgium, demonstrated an efficient means to seed chondrocytes onto polygalactin (PLGA) scaffolds, and the capacity of these cell-scaffold constructs to heal bucket-handle lesions in swine meniscus. A new collaborative agreement with the Genzyme Corporation is exploring new scaffold materials and cell types for meniscal repair and regeneration. Dr. Giuseppe Peretti, from San Raffaele Hospital, in Milan, Italy, has been a long-time contributor to this work and continues to collaborate on these studies. One of their recent articles, “Cell-Based Therapy for Meniscal Repair: A Large Animal Study,” was the winner of the 2005 Hughston Award for the most outstanding paper in the American Journal of Sports Medicine in 2004. This work was presented at the American Orthopaedic Society for Sports Medicine’s meeting in Keystone, Colorado in July.

Mark Randolph’s group continues to explore alternative cell sources and new hydrogels for articular cartilage repair and regeneration. Work published over the past year reports on the cartilage-forming capability of chondrocytes from the ear and the ribs. An additional study collaborating with Dr. Lawrence Bonassar, from Cornell University, examined the ability of these types of chondrocytes to integrate and heal cartilage disks together, with increasing strength over time. Collaboration with Dr. Kristi Anseth, at the University of Colorado, is exploring photoactive substances that can form hydrogel scaffolds for cartilage formation.


The Biomotion Laboratory, in Ruth Sleeper Hall, is directed by David E. Krebs, DPT, PhD. Dr. Krebs explains, “The mission of the MGH Biomotion Laboratory is to better understand the biomechanical and neural constraints of human movement. The major goals are to investigate the means by which, body segment kinematics and kinetics are governed by neuropathic and arthropathic conditions. Our objectives include determining the means by which humans compensate for, and adapt to, specific orthopaedic and neurophysiological motor deficits. We employ state-of-the-art modeling, theory and data acquisition to generate appropriately detailed analyses of impairments (organ level function or dysfunction), functional limitations (whole person function or dysfunction), as well as medical imaging techniques such as MRI to quantify the internal derangement of the joints and body segments. We recently acquired, and validated, a wearable motion detection system that patients wear continuously for up to a week. The device classifies over 50 different activities (e.g., walking, climbing stairs) and records joint motions, 32 times a second - even while sleeping!”


This year’s gala black-tie Department Holiday Party was held at the Museum of Fine Arts (MFA), Boston. We had a tremendous turnout and all had a wonderful time. The MFA has one of the most comprehensive art museums in the world; with a collection that encompasses nearly 450,000 works of art. On was a special Exhibit, by great American landscape photographer, Ansel Adams, which was touring the museum at this time.


We held our sixth Annual Children’s Holiday Party at the Boston Children’s Museum this past December and it was a great day filled with laughter, fun and many little ones with big smiles. After enjoying the sites in the museum, everyone’s favorite, McDonalds, was served for lunch in a private function room. After dessert, the kids were entertained by a clown and visited by Santa and Mrs. Claus who passed out goody bags and toys. Michelle Rose, from MGH Photography, was onsite and captured wonderful family pictures which were distributed after the event as a keepsake.


2005 was another year of incredible growth and prosperity in the Department of Orthopaedic Surgery at the MGH. On May 12-13, we had our first Strategic Retreat for the Mass General Orthopaedic Associates (MGOA) and the Department of Orthopaedic Surgery. We established strategic goals and we will now work to refine these goals over the ensuing year. A new spirit of collaboration, cooperation, and department pervades the Orthopaedic Service.

On June 3rd Kimberly and I celebrated the high school graduation of our second child, Steven. Steven finished a wonderful season in the 215lb weight class in wrestling and won the sectionals and placed 3rd overall in the state. He is a gifted athlete and we are hoping he utilizes these talents in his collegiate career. He has not decided upon a college at this point but plans to enter a business management program somewhere in the East Coast. We hope that he will be able to leverage his immense abilities in the future and we will miss him greatly as he departs for college.

Kristen has just finished 10th grade and will embark upon a summer of activities. She will be attending an outdoor program where she can further develop her athletic and equestrian activities. She has had a successful academic year, despite her illness and is back to regularly attending class. Kim and I marvel at her perseverance and resilience and hope and pray that her health continues to improve.

Brad has just finished a successful freshman year at Rollins College in Florida. He missed the NCAA cut in Swimming by only a few 10th of a second and will continue to train through the summer. He continues along his path towards a business degree and later this year will get his scuba Dive Master Certificate as he works on a ship in the British West Indies. Brad and I are in the final phases of restoring a 1970 Chevelle Super Sport. It is a beauty and we look forward to seeing its completion.

Three teenagers make for an incredibly busy and complicated household. Despite this, we have had an opportunity to spend a little more time together as a family and to enjoy the wonderful sites and activities of New England. After a hiatus of approximately of fifteen years, Kimberly and I will travel together to the International Hip Society later in the fall in Paris. We look forward very much to this event and to our thirtieth wedding anniversary.

Finally, I am so very proud of the many contributions of our world-class orthopaedic department at the MGH. Our clinical services and laboratories continue to grow and flourish and we facing the challenges of our complex academic environment with rigor and creativity. The opening of our new Ambulatory Surgicenter in Waltham, the new Sports Medicine Center, on Cambridge Street, and the continued recruitment of fabulous junior faculty will form the foundation for Department of Orthopaedic Surgery at the MGH in the future.

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