Adult Reconstructive Surgery Service

The Adult Reconstructive Surgery Service at the MGH is under the direction of Dr. Andrew Freiberg, Service Chief and Department Vice-Chair had a successful year of multilateral with gains in clinical activity, research productivity, and further growth of new faculty. The Service continues to be a leader in the orthopaedic community, delivering the most up-to-date surgical techniques for hip and knee arthroplasty, evaluation of problem joint replacements, and advanced treatments for infection and peri-prosthetic fractures. We also continue our interest in minimally invasive techniques and partial arthroplasty.

Our Service has been a major focus of care redesign efforts at MGH. Our surgical volumes continue to grow, length of stay has decreased due to our EXCELerated recovery program, and patient satisfaction scores have improved significantly. All of these achievements will allow us to provide better patient access and enable us to meet increasing demand for lower extremity arthroplasty. We are indebted to the work of Lauren Lebrun and Greg Pauly, as well as to Emily Mulla, N.P., and Lauren Swisher, P.A., for the tremendous success of our inpatient NP Program.

We had a wonderful year in terms of increased productivity and efficiency, with over 1,800 hip and knee arthroplasties performed. In addition, our practice at Newton-Wellesley Hospital, in collaboration with the Kaplan Center for Joint Replacement, continues to thrive. Dr. William Healy, our new faculty member, adds the capability of anterior hip replacement techniques, which is a welcome addition to our practice and training program. The Center for Metal-on-Metal Total Hip Replacements continues to thrive and is a national resource for patients seeking consultation and surgery. Dr. Hany Bedair has become recognized as a leader in the diagnosis and treatment of peri-prosthetic infection, and we greatly benefit from our clinical association with the Infectious Disease Service, especially Dr. Sandra Nelson. Dr. Rubash, Dr. Healy and Dr. Bedair have been selected as delegates to the first International Consensus Meeting on peri-prosthetic infection.

The Adult Reconstructive Surgery Service had another outstanding year at the annual meetings of the Orthopaedic Research Society, The Knee Society, The Hip Society, the American Acade¬my of Orthopaedic Surgeons, the American Orthopaedic Association, and the American Academy of Hip and Knee Surgeons. Our group had numerous podium and poster presentations at these meetings, and it was rewarding to see the academic successes and the presence of so many former fellows. Dr. Freiberg served on the Program Committee for the annual AAHKS meeting in Dallas, where a record number of papers and posters were presented. Many of our faculty and fellows presented important clinical and scientific information. A highlight was a symposium that included Dr. Young-Min Kwon on Metal/Metal total hip replacement failure mechanisms. In addition, Dr. Kwon served on the FDA national advisory panel on metal/metal implants, which has produced a significant advisory statement.

Dr. Rubash is the Secretary/Treasurer of The Hip Society and will continue in a national leadership role for this group over the next few years. He is also leading efforts to develop a new “Hip Score” for The Hip Society and for our profession.

Collaboration with the Bioengineering Laboratory, under the direction of Dr. Guoan Li, is ongoing as we do the groundwork to study new robotic techniques and implants that can be applied to hip and knee surgery. We are confident that these exciting discoveries will translate into a major clinical pro-gram. In addition, extensive work with the Harris Orthopaedic Laboratory continues as we finish recruitment into our large “Vitamin-E Highly Cross-linked Polyethylene RSA” study and the “MGH Administered International Multi-Center” study. We continue to focus on the extensive evaluation of retrieved cross-linked liners from hip and knee patients. We have contributed a significant number of cases to the National Total Joint Registry and continue to work with our colleagues at the Mayo Clinic to make this Registry successful. In addition, we have finally incorporated the NWH Registry into our larger Harris Registry.

This year marks our 52nd Fellowship Class and the second with Dr. Young-Min Kwon as Fellowship Director and Dr. Hany Bedair as Director, Arthroplasty Fellowship Education. Dr. Freiberg continues to work closely on all administrative matters, including education and fellow supervision. These younger faculty members have provided new energy and abilities. Our Fellows this year were Drs. Kumar Agrawal, Wesley Clark, Matthew Dietz, and John Tiberi. Dr. Agrawal is practicing locally at St. Elizabeth’s Hospital in Brighton. Dr. Clark and his family have returned to New Orleans, where he has joined the Jefferson Orthopedic Clinic. Dr. Dietz is an Assistant Professor at West Virginia University, where he will be helping to establish a new total joint center. Dr. Tiberi has returned to the Los Angeles area and joined South Bay Orthopaedic Specialists; he will also serve as a voluntary faculty member at the Harbor-UCLA Medical Center. We wish them all great success as they enter practice.