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Introduction
Now nearing the end of its 5th year as a revitalized clinical
service, Orthopaedic Surgery at the Beth Israel Deaconess
Hospital has continued to grow into a vibrant and exciting
Department with excellence in education and research. It has
been another busy year! Here are some of the highlights:
- The Spine Center officially opened in March 2008.
- This July we will have 6 Harvard residents (2 PGY 2’s,
2 PGY 4’s and 2 PGY 5’s) rotating at any one time at
the BIDMC.
- BIDMC welcomes 3 New Hires: Fadi Badlissi, M.D.,M.
Sc., Musculoskeletal Medicine Unit, Ayesha Abdeen, M.D.,
Arthroplasty Service, John C. Keel, M.D., The Spine
Center.
OFFICES AND CLINICAL SERVICES.
The new academic offices on Stoneman 10 include offices
for our entire faculty and their administrative assistants as well
as a state of the art conference room and space for resident and
medical student study modules. The hospital received a donation
to make the clinical space on Shapiro 2 possible and we are
now officially the Carl J. Shapiro Department of Orthopaedics.
The construction of our new clinical space on Shapiro 2 is complete.
We expanded the space nearly doubling the number of
functional exam rooms, improved the appearance and comfort
of the waiting areas, and added a new digital radiology unit. The
newly created Spine Center has officially opened for business in
March 2008 offering multidisciplinary care including departments
of neurosurgery, neurology, anesthesia, radiology and
physical therapy.
TEACHING EXPERIENCE
We have continued to develop the teaching program for
the residents. We will expand the PGY 1 orthopaedic interns at
BIDMC to 5 who each will spend 2 months on the orthopaedic
service. We will have 6 Orthopaedic residents starting July of
2008 where the resident will have the chance to work with the
sports, joints, spine and trauma services both in the clinic and
operating room under the direction of Drs. Ramappa, Ayres,
McGuire and Rodriquez, along with Drs. Davis, White and
Appleton. All the residents are very happy with their rotations
and the PGY 2 and PGY 5 residents continue to hone their
arthroscopic skills with the continued excellent contributions
of the Meeks, Zilberfarb, Richardson group as well as Drs.
Ramappa and Davis. Doug Ayres provides an excellent educational
experience in operative arthroplasty. The dedication of
our faculty has been largely responsible for making the return
of the residents to the BIDMC such a positive experience.
The following is a brief synopsis of our faculty accomplishments
and activities for the academic year:
Annual Augustus A. White, III, M.D., Ph.D. devotes his
attention and energies to the students of Harvard Medical
School. We had another very successful Annual Augustus A.
White, III, M.D., Ph.D. Spine Symposium in October, 2007
discussing Low Back Pain: Basic Science to Clinical Care which
included Drs. James Weinstein, Gunnar Andersson, Richard
Woolf and Preston Phillips.
SPINE SERVICE
Dr. Kevin J. McGuire continues as the Program Director of
a new ACGME-approved Spine Fellowship and is the Co-Director
of the Spine Center, a joint venture with the departments of
neurosurgery, neurology, anesthesia, radiology and physical
therapy that opened in March 2008. Andrew P. White, M.D.
who joined the spine service in August 2007 has expanded his
practice to the Orthopedic Care Consultants in Stoughton and
continues to grow his practice at BIDMC. John C. Keel, M.D.,
a graduate of Emory University School of Medicine and fellowship
trained in pain management from Mass General, Boston
will join the Spine Center in August 2008 as a Physiatrist. Paul
Glazer, M.D. continues his practice in the Shapiro Clinical
Center and research in several areas of spine surgery. Jay
Zampini, M.D. is completing his year as the 1st ACGME Spine
Fellow and will start a position at Drexel University College of
Medicine in Philadelphia.
HAND SERVICE
The Hand Service continues to generate large clinical
volumes and excellent academic research. Charles Day, M.D.
has been working on several research projects with Harvard
Medical students and continues to contribute actively in the
medical student education. His excellent work with assessing
the musculoskeletal education of Harvard medical students has
led to a revision of the curriculum to include more education
for first, second and third year students. He recently published
his results on student’s assessment of their musculoskeletal
education and received wide-spread attention. Dr. Day won the
best poster at AAOS convention 2008 for Practice Management/
Non-Clinical Section. Tamara Rozental, M.D. has been very
busy academically along with building a successful hand and
upper extremity practice. Her research efforts are focused in
the area of fragility fractures of the upper extremity. Over the
last year, she has had six publications, has been working on
8 IRB approved studies and has received funding for many of
these efforts. Tamara and Peter are the proud parents of their
first child Anaise. Hillel Skoff, M.D. continues to have an active
practice in Hand Surgery. Rebecca Bennett, M.D. is completing
her year as the 2nd Orthopaedic Hand Fellow at BIDMC (a
combined ACGME fellowship with Plastic Surgery) and will
be starting a position at Lake Shore Bone and Joint Institute,
Chesterton, Indiana.
TUMOR SERVICE
Megan E. Anderson, M.D. continues to grow her practice
in musculoskeletal oncology, at the BIDMC and Children’s
Hospital. She also provides primary orthopaedic care at our
Chelsea Clinic once a month. She has been active with presentations
at the Musculoskeletal Tumor Society and the New
England Orthopaedic Society. She is a member of the faculty
of the Boston Pathology Course and continues to organize
the Tumor Core Curriculum for the residents. She has also
been busy writing chapters in OKU-9 on the topic of pediatric
tumors and in a textbook that will be published by David Fisher.
Despite rumors to the contrary, Mark C. Gebhardt, M.D. is very
busy clinically as well with his tumor practice at BIDMC and
Children’s Hospital. His administrative duties occupy a large
part of his time and he continues to participate in several local,
national and international orthopaedic organizations as well
as continuing collaborative research and publications. The
two “extracurricular” activities for this year included a tour to
London with the Longwood Symphony Orchestra where we
presented a tumor symposium at St. Barts Hospital and visited
the Marie Curie Cancer Institute. We performed 3 concerts
at various venues in London and visited the Harvard Club
of London where we performed some chamber music. The
plan was to combine the missions of music and fund raising
for medical charities, in this case, The Marie Curie Cancer
Institute. It was quite successful. On this side of the pond, I
plan to ride my first Pan Mass Challenge to raise money for the
DFCI and “Pedal for Peds”. All contributions are welcome!
TRAUMA SERVICE
E. Ken Rodriguez, M.D., Ph.D. (a.k.a. “K-Rod”) is our
Chief of Orthopaedic Trauma. Ken continues to organize our
orthopaedic trauma service at the BIDMC and is very glad to
share his duties with Paul Appleton, M.D. Both Ken and Paul
have participated in several regional, national and international
courses over the last year. The trauma service has also had
several publications on the treatment of distal femur fractures,
tibia and ankle fractures. Ken and Paul remain committed to
educating our residents, fellows and medical students and consistently
get rave reviews from those who rotate through their
service. Paul and his wife, Catelyn, are proud parents of their
fourth child born in October 2008. The trauma service continues
to provide not only excellent trauma care, but is active in
research of interest to all. A JBJS article on which orthopaedic
devices are likely to set off the metal detectors in the airport
made the local and national lay press, and a study on when it
is safe to return to driving after an orthopaedic injury is also
receiving a lot of attention.
JOINT ARTHROPLASTY SERVICE
Doug Ayres, M.D. continues his appointment as Vice
Chair of the Department this year and retained his position as
our Quality Assurance Director. Despite these administrative
burdens his practice is booming. He instituted our arthroplasty
clinical pathway and preoperative teaching classes for our
patients. His teaching in the operating room and clinic has
received praise from the PGY-2 residents who have rotated with
him. He continues to work closely with the geriatrics service to
make this a unique educational experience within the Harvard
residency program. Harris Yett, M.D. has also been working
closely with the geriatrics service to provide specialized care
for the elderly patients with fracture and arthroplasty needs.
He and Doug lead the geriatric care program in the Harvard
residency program. Ayesha Abdeen, M.D., a graduate from
McMaster University, Hamilton, ON, Canada, and fellowship
trained in adult reconstruction and orthopaedic oncology from
the University of Southern California and Memorial Sloan
Kettering Cancer Center will be joining the Arthroplasty service
in September 2008. Donald Reilly, M.D. continues his clinical
practice at the New England Baptist Hospital and the BIDMC.
He remains active in the teaching of Harvard residents and
HMS students and continues his research in the areas of knee
replacement implants.
SPORTS SERVICE
Robert Davis, M.D. has continued his clinical work and
expanded his practice in sports medicine and trauma. He
currently serves as member at large of the Medical Executive
Committee of the BIDMC and has an active role in teaching of
the PGY-1 and Emergency Department residents that rotate on
the Orthopaedic Department. Arun Ramappa, M.D. provides
expertise in sports medicine and shoulder surgery. He continues
his efforts as Team Physician of the Lowell Devils, a farm
team for the New Jersey Devils and remains Co-Director of
Medical Research for the Boston Red Sox. He received a grant
from Major League Baseball to study shoulder labral tears. His
research interests include shoulder and elbow injuries in throwers,
articular cartilage injuries and ACL tears, and rotator cuff
repair. He continues to publish scientific articles and is very
active in regional and national meetings.
Drs. Louis Meeks, Lars Richardson and Jeffrey Zilberfarb
continue their busy practice and make a big contribution to the
education of the sports medicine resident on their service, as
well as to the education of HMS students.
FOOT AND ANKLE SERVICE
Naven Duggal, M.D. continues to grow the foot and ankle
service. His practice has expanded to Milton Hospital and he
maintains an active link to the trauma service. He is involved
in research related to outcomes from total ankle arthroplasty.
He has a guest editorial in Orthopaedics on quality assurance
in orthopaedic surgery.
MUSCULOSKELETAL MEDICINE UNIT
The Musculoskeletal Medicine Unit, located in the orthopaedic
suite of the Shapiro Clinical Center is under the direction
of Fadi Badlissi, M.D., M.Sc. Fadi is a rheumatologist
and geriatrician with a joint appointment in the orthopaedic
and rheumatology division who started with us in May 2008.
His clinical interests include rheumatic diseases in the elderly,
regional pain syndromes and inflammatory arthritis. Research
interests include inflammatory arthritis in the elderly, depression
in rheumatoid arthritis, foot disorders and their relation
to pain and function. He, and Sharon Gates, N.P., continue to
provide excellent care for non-operative musculoskeletal disorders
in close collaboration with our Department members. Drs.
Michael O’Brien and Ryan Friedberg, continue to develop their
busy practice as primary care sports medicine physicians.
ORTHOPAEDIC BIOMECHANICS LABORATORY
The Orthopaedic Biomechanics Laboratory at the Beth
Israel Deaconess Medical Center continues to thrive as a worldrenowned
center for biomechanics research. We had a total of
9 abstracts, 1 podium presentation and 6 posters at the ORS in
February. This year Brian Snyder, M.D., Ph.D. was promoted to
Associate Professor of Orthopaedic Surgery. Dr. Mary Bouxsein
currently holds joint appointments as an Assistant Professor
of Orthopedic Surgery at Harvard Medical School, Boston,
MA, adjunct Assistant Professor of Mechanical and Aerospace
Engineering at Boston University, and as a visiting scientist
at the Jackson Laboratory in Bar Harbor, ME. Her research
interests include identification of the genetic determinants
of bone strength; non-invasive imaging for assessment of
bone strength; and the biomechanics of age-related fractures.
She serves on the committee of scientific advisors for the
International Osteoporosis Foundation. Dr. Bouxsein has published
over 70 peer-reviewed articles and 15 book chapters. Ron
Alkalay, Ph.D. has developed novel CT and MRI compatible,
computer controlled loading system which, in conjunction with
the development of parametric high-resolution Finite Element
Models, offers a unique multi-disciplinary approach in studying
the complex behavior of the human spine. He continues
to focus on pathologic fractures of the human spine. He just
received an R0-1 grant. Robert Fajardo, Ph.D. has had a very
productive year. He gave a presentation at the ORS as well as
several presentations at the annual conference for the Society
for Integrative and Comparative Biology. Chris Evans, Ph.D.
will join the lab in July 2008. He is primarily interested in translational
research, developing novel molecular therapies for the
treatment of conditions affecting bones and joints. His unique
emphasis is placed upon the use of gene therapy in arthritis and
the regeneration of orthopaedic tissues. These projects require
the close collaboration of laboratory scientists with clinicians.
He is also active in studying the regeneration of orthopaedic
tissues and developing minimally invasive, clinically expeditious,
cost-effective technologies based upon the in situ genetic
modification of stem cells. This approach is called “facilitated
endogenous repair.” Avoiding traditional approaches to tissue
engineering that require ex vivo cell culture greatly improves
clinical applicability, as well as reducing cost and complexity.
He has shown that this technology can heal experimentally
created segmental defect in rat femora by the direct, in vivo
adenoviral transfer of a gene encoding bone morphogenetic
protein-2. His group is also studying genetic enhancement of
cartilage repair using autologous bone marrow. The proposed
role for Dr. Evans at the OBL will be to create a laboratory that
combines molecular biology and biomechanics of the musculoskeletal
system under one roof and in close collaboration. In
addition to Chris and his lab, Kevin P. McHugh, Ph.D. will move
to the OBL to be an integral part of the research effort. He is a
molecular biologist with a specific interest in bone cell biology.
Initially he honed his molecular biology skills working on conserved
DNA sequences in the Family Anatidae (waterfowl). He
subsequently turned his attention to osteoclasts and the effects
of adhesion of osteoclasts to bone matrix on differentiation
and gene expression in the Avioli-Teitelbaum laboratories in St.
Louis. This evolved into the study of expression and function of
integrin cell adhesion molecules in bone osteoclasts, which are
the cells that primarily resorb bone. He cloned the mouse ß3
integrin cDNA and subsequently characterized the regulation
and functional activities of the ß3 integrin gene.
Bringing together the Center for Molecular Orthopaedics
and the Orthopaedic Biomechanics Laboratory will provide
a rare opportunity to develop novel, cutting edge programs
that encompass both modern biology and modern mechanics.
Initially, there will be approximately 7 Principal Investigators
among total personnel of some 35 scientists and engineers,
sharing approximately 6,000 square feet of contiguous laboratory
space. The opportunities for advanced pre-clinical research
are enhanced by the proximity of a large animal facility, while
collaboration with the clinicians within the Department of
Orthopaedic Surgery will facilitate translation. Guided appropriately,
these synergies will allow us to develop new and better
treatments for some of the most disabling, prevalent and costly
diseases on the planet. I fully believe that within a 5 year period,
we can be one of the top few orthopaedic research centers in
the world.
I hope this gives you some idea about the progress and
excitement that has occurred at the BIDMC Orthopaedic
Department in clinical care, research and education. The
first five years have been very rewarding for me and we have
achieved tremendous growth. The clinical and educational
programs are thriving and we anticipate that they will continue
to grow. We aim to provide a venue for compassionate care
of patients and an educational environment in which medical
students, residents and fellows will learn and thrive. We look
forward to an even more exciting 2008-2009 academic year and
invite you to visit the Department and Laboratories.
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