| 
         
         
          | 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 |  |