Hospital for Special Surgery535 East 70th StreetNew York, NY 10021www.hss.edu

Demand for Care Spurs ExpansionNew Ambulatory Surgery Center Opens First Phase of Clinical Improvements

With an ever increas-ing demand for specialized care in orthopedics and

rheumatology, Hospital for SpecialSurgery (HSS) has embarked on anambitious multi-year expansion proj-ect that will add more than 200,000square feet of new space and renovateover 100,000 square feet of existingspace in and around its campus. Thisexpansion is a direct response to theincreased attention being paid tomusculoskeletal health by the publicand professional health care commu-nity. Major demographic and socio-logical trends have brought this issueto the forefront. A dramatic increasein the over-sixty population and theirneed for orthopedic and rheumatictreatment, and a more active, youngerpopulation desiring to remain activeand involved in sports as they growolder are among these trends.

Indeed, The World HealthOrganization declared 2000 to 2010to be the “Bone and Joint Decade,” inrecognition of the impact of muscu-loskeletal health on quality of life.Providing the best and most innova-tive treatments to patients is chiefamong the Hospital’s priorities as itexpands beyond its current perime-ter. “Here at Special Surgery, ourpatients are treated by the most tal-ented physicians and surgeons andwe must continue to improve the careenvironment for our patients,” saysThomas P. Sculco, MD, Surgeon-in-Chief and Korein-Wilson Professor inOrthopedic Surgery. “Our goal is torevolve our care around the patient

and focus on their recovery and rehabilitation, in the best tradition ofpatient-focused care.”

Increasing Surgical SpaceSince Special Surgery’s last expan-sion in 1996, surgical volume andoutpatient visits have increased byapproximately 60 percent. “HSS is inneed of additional operating space tobetter accommodate the extraordi-nary growth in patient volume thatwe have seen over the last severalyears,” says Lisa Goldstein,Executive Vice President and ChiefOperating Officer. “Wait time forpatients requiring surgery willdecrease significantly because therewill be more physical space in whichto perform surgeries.” In 2005, morethan 17,500 inpatient and ambulatorysurgeries were performed at SpecialSurgery. In response to the growingdemand for inpatient surgical care,plans are underway to increase thenumber of inpatient operating roomsfrom 15 to 21 on the Hospital’s 4thfloor by late 2008.

This fall, HSS will open a newambulatory surgery area on the 9thfloor, increasing the number of ambu-latory surgical suites from five toeight. In 2007, two additional operat-ing rooms for ambulatory surgery willopen on the first floor. By teaming up with nursing and medical staff,architects have designed the mostadvanced surgical facilities with cut-ting edge technology. A brighter, moreexpansive ambulatory surgery spacewill accommodate larger equipmentused for outpatient procedures such as

hip arthroscopy, while also creating anenvironment that is more efficient formore routine knee and shoulder liga-ment repairs.

Promising to enhance patient flow,the new ambulatory surgical suiteswill offer private and semi-privateholding areas for patients and theirfamilies. Modern features in the sur-gical suites include the capability foraudio/visual integration with otheroperating rooms and conferencespaces, providing an educational toolfor staff physicians and visiting

surgeons to monitor surgeries inprogress. Carts that are currentlyused to hold surgical tools and equip-ment will be replaced with “booms”that will hang down from the ceiling,enabling physicians and staff todeploy equipment on either side ofthe patient for maximum coordina-tion. Moreover, dedicated elevatorservice between the operating roomsand Central Sterile Supply willenhance the Hospital’s already out-standing infection control efforts,with one elevator exclusively used forsterile linens and equipment.

CLINICAL AND RESEARCH HIGHLIGHTS AT HSS | FALL 2006

Continued on page 8

Discoveryto

Nonprofit Org.U.S. Postage

PAIDPermit #186

Lakewood, NJ 08701

Recovery

Steven R. Goldring, MD, recognized worldwide asan expert in orthopedic and rheumatology researchand care, has been named Hospital for SpecialSurgery’s Chief Scientific Officer (CSO). In his newposition, Dr. Goldring will oversee all aspects ofclinical and basic science at HSS, a leader in thefield of musculoskeletal research. See page 3

The expansion will increase inpatient and

ambulatory operating rooms from 20 to 29.

Renowned Rheumatologist Steven R. Goldring, MD,Appointed Chief Scientific Officer at HSS

Research Breakthroughs

A Bridge to the Future

With the conclusion of our landmarkCampaign forResearch and the

recent inauguration of a major mod-ernization and expansion program,Hospital for Special Surgery hasentered a dynamic and exciting peri-od of growth on a number of fronts.

Research Enterprise ExpandedWith $115.7 million raised forresearch, we surpassed our goal bymore than $5.7 million. The phenome-nal success of this campaign has pro-vided the resources to transform ourscientific agenda and to set the stagefor major advances in patient care. We have already seen the constructionand renovation of Special Surgery’sresearch facilities. Moreover, we haveestablished 21 named chairs and fellowships and recruited a cohort ofrenowned scientists.

Over the past few years, HSS hasundertaken a major organizationalrestructuring of its research programwith a goal toward accelerating thetranslation of discoveries into newmethods of diagnosis, treatment andprevention. Now in place are paceset-ting research initiatives aimed at find-ing the causes and developing new

2

therapies for musculoskeletal condi-tions. To lead and shape the future ofresearch, we are pleased to welcomeSteven R. Goldring, MD, as ChiefScientific Officer. Internationallyrenowned for his research in bone biol-

ogy andinflammatorydisorders, Dr. Goldringjoins us fromHarvardMedicalSchool, wherehe served asProfessor ofMedicine; New EnglandBaptistHospital, wherehe was Chief ofRheumatology;and the New

England Baptist Bone and JointInstitute at the Harvard Institutes of Medicine, where he was Director of Research.

As we embark on major construc-tion of new clinical facilities, SpecialSurgery continues to achieve nationaland international recognition as apremier institution for musculoskele-tal care, research, and education. Inthe 2006 U.S. News & World Report“America’s Best Hospitals” survey,the Hospital has again ranked sec-ond in the nation in orthopedics andthird in rheumatology. For the 16th

consecutive year, HSS has rankedabove all other hospitals in theNortheast in orthopedics andrheumatology, and it is the only NewYork metropolitan area hospital inthe top 10 nationwide in orthopedics.

Growing Demand for CarePatients from around the world seekour care in increasing numbers. Withmore than 17,000 surgeries per year,the Hospital’s 20 operating rooms arenow functioning at virtually fullcapacity. A growing demand for ourservices has necessitated a buildingprogram that will add nine operatingrooms, a new ambulatory surgery cen-ter opening this fall, as well as addi-tional inpatient units. Plans also callfor a new physician office building,expanded rehabilitation centers, a newsports rehabilitation and performancecenter, as well as a new children’spavilion. We are delighted that ourclosest friends and supporters havestepped forward during this earlyphase of expansion to provide signifi-cant resources as part of the “nucleus”fund of a new capital campaign.

For the past five years, theDiscovery to Recovery newsletter has reported on the progress of ourresearch campaign as well as theinnovative work and achievements –from the laboratory to the bedside –of our dedicated researchers. As wemove forward, this publication will

Stephen A. Paget, MD

Thomas P. Sculco, MD

Our Mission

now reflect our renewed and expand-ed focus not only on research, but onclinical programs as well. In thisissue, we formally introduce Dr.Steven Goldring; preview our newambulatory surgery center andpatient rooms; profile new clinicalprograms, including the new Centerfor Musculoskeletal Ultrasound andNuclear Medicine; and highlight theRudolph Rupert Foundation’s sup-port for scleroderma research andnew NIH grants recently awarded toHSS scientists.

Our many friends and donorshave made possible extraordinarydevelopments at Special Surgery andprovided the resources that enable usto continue at the forefront of muscu-loskeletal care. With groundbreakingbasic and clinical research underway,new clinical programs that areenhancing the care we can provide topatients, and the continued confi-dence of our supporters, HSS is wellpoised for the future.

Sincerely,

Thomas P. Sculco, MDSurgeon-in-Chief and Medical Director

Stephen A. Paget, MDPhysician-in-Chief

Three of HSS’s exceptional young scientists –Theresa Lu, MD, PhD, William T. Morris Fellowin Pediatric Rheumatology, Eric Meffre, PhD,Immunology and Inflammation Fellow, and Inez

Rogatsky, PhD –were recentlyawarded their first individualResearch ProjectGrants (RO1) from the NationalInstitutes ofHealth (NIH).These largeawards are a hugestep forward inestablishing the

laboratories of these up-and-coming investiga-tors, who were recruited to Special Surgery dur-ing the Hospital’s Campaign for Research.

As members of the Hospital’s Autoimmunityand Inflammation Program, Drs. Lu and Meffreare dedicated to understanding the underlyingmechanisms that account for autoimmune andinflammatory diseases and identifying new therapeutic targets for illnesses like lupus andrheumatoid arthritis. Dr. Lu’s innovativeresearch is focused on elucidating how the bloodvessels of the lymphoid tissue can shape immune

functioning. Dr.Meffre’s work isconcentrated onunderstanding whypatients withautoimmune diseasedevelop autoreactiveB cells and damag-ing autoantibodiesthat attack thebody’s own tissuesand organs. By pro-viding importantinsights about how abnormal immune responsesare initiated and what factors are responsible forcontrolling them, the groundbreaking investiga-tions of Drs. Lu and Meffre promise to help speedthe development of more effective treatments.

Understanding Tissue DestructionDr. Rogatsky is an investigator in SpecialSurgery’s Arthritis and Tissue DegenerationProgram, which is devoted to understandingpathogenesis and tissue destruction in diseasessuch as arthritis. She is working to elucidate themolecular mechanisms by which glucocorticoidhormones, which have been used for decades tocombat inflammatory and autoimmune illnesses,act on the immune system. Understanding this

Three Young Investigators Receive NIH Awards

Eric Meffre, PhD

Inez Rogatsky, PhD

Theresa Lu, MD, PhD

interaction may enable scientists to selectivelychannel glucocorticoids exclusively to the cells ofthe immune system so that excessive exposureto these drugs no longer causes harmful side-effects, which can include osteoporosis, muscu-lar dystrophy, and vascular hypertension.

“The Research Division is delighted that theNIH has recognized the great promise of thework being conducted by Drs. Lu, Meffre, andRogatsky,” commented Lionel Ivashkiv, MD,Director of Basic Research and David H. KochChair for Arthritis and Tissue Degeneration.“The ability of these young scientists to achievethe gold-standard of peer-reviewed researchgrants is evidence of their extraordinary hardwork,” added Dr. Ivashkiv, “as well as a clearsign of the strength of HSS.” l

New Research Leadership

3

awards and honors, Dr. Goldring istwo-time winner of the Paget’sDisease Foundation Research Award.

Research Recognized WorldwideA native of St. Louis, Dr. Goldringreceived a BA from Williams Collegein 1965. He returned to his hometownto earn his MD at WashingtonUniversity School of Medicine in 1969.He served his residency in medicine atPeter Bent Brigham Hospital, Boston,and completed a clinical and researchfellowship in the Arthritis Division atMassachusetts General Hospital,Boston, in 1976.

In September, Dr. Goldringassumed the role of president of theAmerican Society of Bone andMineral Research. He is past chair-man of the Massachusetts Chapter ofthe Arthritis Foundation and contin-ues as a trustee. Dr. Goldring is alsoa member of the Subspecialty Boardon Rheumatology for the AmericanBoard of Internal Medicine.

“I am honored to join colleagueswho are committed to building onHSS’s tradition of interdisciplinarytranslational research,” said Dr.Goldring. “Together, we will advanceSpecial Surgery’s research mission totranslate basic science findings intonew ways of treating and preventingmusculoskeletal conditions.” l

Renowned Rheumatologist Steven R. Goldring, MD,Appointed Chief Scientific Officer

HSS has named Steven R.Goldring, MD, an interna-tionally recognized expertin orthopedic and rheuma-

tology research and care, as ChiefScientific Officer (CSO).

“In this position, Dr. Goldring willhead the Hospital’s basic and clinicalresearch faculty, shape the overalldirection of clinical and basic researchat HSS, and oversee all aspects ofresearch administration,” said John R.Reynolds, President and CEO.

Dr. Goldring comes to HSS fromHarvard Medical School where hewas chief of rheumatology at BethIsrael Deaconess Medical Center andNew England Baptist Hospital,Boston. In addition, he served as professor of medicine at HarvardMedical School. He was also directorof research at the New EnglandBaptist Bone and Joint Institute atHarvard Institutes of Medicine.

A Leading Physician-ScientistIn welcoming Dr. Goldring, StephenA. Paget, MD, Physician-in-Chief andJoseph P. Routh Professor ofRheumatic Diseases in Medicine, said,“The decision by Dr. Steven Goldring,a world-class physician-scientist, tobecome Chief Scientific Officer reflectstwo key realities in our history: the

first relates to the reputation andlevel of science that HSS has attainedin the past, sufficient to attract someone of Dr. Goldring’s caliber;the second speaks to our brightfuture in his hands.”

Thomas P. Sculco, MD, Surgeon-in-Chief, noted, “Dr. Goldring’sexceptional background as a physi-cian and researcher in arthritic con-ditions and bone and joint disordersmakes him uniquely qualified to leadHSS in these areas of investigation.His interests in bone loss around

prosthetic implants will greatlyenhance our research in this area andlead to prolonged survival of theseimplants in our patients.”

Dr. Goldring’s research effortshave focused on dissecting the mech-anisms of bone and cartilage loss inorthopedic conditions and joint dis-eases such as rheumatoid arthritis.The ultimate goal of his studies hasbeen to develop more effective and

direct strategies for the treatment ofdisorders such as osteoporosis,inflammatory arthritis, andosteoarthritis. Additional investiga-tions have included the study of fac-tors regulating the cellular responsesto orthopedic implant biomaterialswith the goal of translating thisinformation into improving outcomesafter total joint replacement.

Dr. Goldring has a history ofimpressive service on the nationallevel. He was chairman from 1997 to1999 for the Orthopedics and

Musculoskeletal Study Section,National Institutes of Health. He thenwent on, in 2000, to serve as vice-chairman for the National Institutesof Health Consensus DevelopmentPanel on Osteoporosis.

He has been continuously support-ed by NIH grants for almost 30years. The recipient of numerous

“Dr. Goldring’s exceptional background as aphysician and researcher in arthritic conditionsand bone and joint disorders makes himuniquely qualified to lead HSS in these areas of investigation.”

Thomas P. Sculco, MD, Surgeon-in-Chief

4

HAPPENINGS AROUND THE HOSPITAL

Team PlayersAs team physicians for the New YorkGiants, Drs. Russell Warren, Bryan Kelly,and Scott Rodeo have seen their share ofvictories on and off the field. Since 1984,when Dr. Warren was named team physi-cian, he and his HSS colleagues havetreated hundreds of NFL players withcareer-threatening injuries and guidedtheir successful return to the game. Dr. Warren has seen the Giants win twoSuper Bowl championships and accompa-nies the team for nearly every gamethroughout the country.

Training the Next Generation of Leaders in Orthopedics >Last year, the HSS orthopedic residencyprogram received over 400 applicationsfor only eight spots, making it one of themost competitive programs in the nation.Medical education is a critical focus ofthe HSS mission, and the residency program at HSS plays a crucial role intraining the next generation of leaders inorthopedics. Wakenda Tyler, MD, now inher fifth and final year, plans to special-ize in orthopedic oncology upon complet-ing her residency. Dr. Tyler says theeducational experience is unparalleled:“The residency program at HSS is unique because it has provided mewith an opportunity to collaborate withoutstanding physicians from a variety of disciplines within musculoskeletalmedicine.”

Calcium and Bottled Water >Studies have shown that high concentra-tions of calcium may have an adverseeffect on bisphosphonate drugs, whichare typically prescribed to osteoporosispatients. A recent survey conducted byresearchers at HSS and published in theHSS Journal: The Musculoskeletal Journalof Hospital for Special Surgery indicatesthat calcium concentrations vary among

>

THE PULSEdifferent brands of bottled and tap wateracross the U.S. and Canada. “We haveconcluded from this survey that it isadvisable for physicians to provide information about calcium concentra-tions in water to patients when pre-scribing this medication,” says Joseph Lane, MD, lead investigator for the study.

5

PULSE< Stereo X-Rays Track Patient ProgressRadiostereometric Analysis (RSA) is aunique x-ray research technique that is currently being used at Hospital forSpecial Surgery to study joint replace-ment patients. By tracking the motion of minute tantalum beads which havebeen implanted in the proximity of animplant, RSA enables HSS researchers toaccomplish two goals at once – whilecarefully following the patient’s progressfollowing surgery, they can also useinformation from this research toimprove implant design and technologyfor future patients.

Special Surgery’s PelotonEvery morning at the crack of dawn, agroup of HSS physician-cyclists meet inCentral Park for a vigorous bike ride. Special Surgery’s peloton (the Frenchterm for the main body of riders in abicycle race) includes (from left to right)Drs. Chris Dimeo, Leonardo Paroli,David S. Levine, Andrew Weiland, RileyWilliams, Brad Carson, Michael Gordon,and (not pictured) David Altchek andFrank Cordasco. Recently, the group traveled to Europe to ride a route included in the 2006 Tour de France.Although they didn’t compete for the yellow jersey, these physicians embodythe active lifestyle that they impressupon their patients.

IdentifyingArthritis Early >In collaboration withthe Cornell GeneralClinical Research Center, researcherswith HSS’s Gosden-Robinson EarlyArthritis Center and the Hospital’sDepartment of Radiology and Imagingrecently began a pilot study of possibleearly markers of inflammatory arthritis.Identifying arthritis in its earliest stagesmay help prevent the often severe jointdamage it can cause. The team hopes toshow that an increased number of newblood vessels around the affected jointsin those with early inflammatory arthri-tis can predict how severe the diseasemight be in the future, or which medi-cines might work best. The study willalso look at different tools for measuringabnormal blood vessels and blood flow:magnetic resonance angiography (MRA)and Power Doppler Ultrasound. Above,MRA reveals a proliferation of abnormalnew vessels in a patient with new onsetinflammation around the hand joints.

>

< Testing the ThumbThe widespread usage of handheld electronic devices such as PDAs, cell

phones, and MP3 players has led togrowing awareness of the impor-

tance of the thumb. Indeed, themedia has touted the incidence of

“TechnoThumb,” pain in thethumb caused by possible tendonitis or arthritis due to

stress on the joints. While current testingfor thumb function is a prolonged, potentially uncomfortable process, ateam of researchers at HSS and CornellUniversity are employing a new, multi-sensored single spring aimed at testingthumb strength and dexterity quicklyand simultaneously.

Root MotionAnalysis Lab Poised forthe Future

s one of the foremost centersof its kind in the country,

the Leon Root MotionAnalysis Laboratory

draws on the expertise of a multidis-ciplinary team of specialists inmobility to advance our understand-ing of gait and extremity disorders.Relocated and expanded into a 2,511square foot space, the Root Laboratoryalso aims to advance studies ofsports performance by analyzingsuch functions as pitching andthrowing in both professional andamateur athletes.

Using state-of-the-art tools andtechniques, investigators in the labo-ratory have contributed importantknowledge about how the humanbody moves through time and spacein both health and disability.

Honoring Dr. Leon Root, Directorof Rehabilitation Medicine and one ofthe Hospital’s most highly regardedsurgeons, the laboratory was mod-ernized and expanded with help froma number of generous donors.

Biomedical engineer HowardHillstrom, PhD, Director of the labo-ratory, explained, “The central themeof the lab is to study the relationships

Caring for Patients

between lower and upper extremitystructure and function. We believethat the key to understanding manyof the biomechanically related dis-eases and injury mechanisms is iden-tifying those relationships.”

Evaluating MotionThe lab plays a critical role in thecare of patients with conditions suchas cerebral palsy, where tests may beperformed to evaluate a patient’sfunctional limitations when perform-ing purposeful movements, such aswalking. Analysis of a patient’sstructure and alignment enables staffto better understand the cause of

impaired movement and determinean effective treatment.

The research goals of the labinclude developing methodsof tracking upper extremi-ty motions; studying theeffect of foot orthotics inpatients with kneeosteoarthritis; examin-ing the influence of shoedesign on feet; determin-ing the mechanics behindsports medicine injuries; andidentifying improved methods ofevaluating cerebral palsy. l

State-of-the-art tools evaluate how the body moves in space.

James Messina is back on the field

after undergoing a limb lengthening

procedure that strengthened and

lengthened his tibia.

New UltrasoundCenter ShapesPatient Care

Radiologists at Special Surgeryare now able to envision thediagnosis and care of muscu-loskeletal conditions like

never before. Marking the latest major step in

establishing HSS as the premier centerfor musculoskeletal imaging, theHospital recently opened the Centerfor Musculoskeletal Ultrasound andNuclear Medicine, enabling theDepartment of Radiology & Imagingto meet the growing demands for thediagnosis and treatment of muscu-loskeletal conditions using ultra-sound. Equipped with the latesttechnology and supported with expert

staff, the new Center alsoserves as an educa-

tional resourceand research

facility formedical pro-fessionals.

“The newCenter is

helping toexpand capacity,

reduce patient waittimes, and improve care

with enhanced diagnosis capabilitiesand specific treatment options,”explains Helene Pavlov, MD, FACR,Radiologist-in-Chief. “Our goal is forHSS to shape the current and futuredirection of ultrasound as it relates toorthopedics and rheumatology.”

The Center features three ultra-sound systems that are designed todecrease user fatigue while improvingworkflow. These new systems capturethe real-time motion of muscles andtendons and provide higher resolutionfor more well-defined images.

“Careful diagnosis and image-guided therapies offer many patientsimmediate relief and often delay oreliminate the need for surgery,” saidRonald S. Adler, PhD, MD, Chief ofthe Division of Ultrasound, who wasrecruited in 1998 specifically for hisexpertise in musculoskeletal ultra-sound. “The expansion is allowing usto focus our ongoing clinical workand research on innovative treat-ments, such as image-guided thera-peutic injections, for conditions suchas tendonitis and arthritis.”

Thomas P. Sculco, MD, Surgeon-in-Chief, congratulated Dr. Pavlov for having the foresight to introduceand sustain this innovative resource:“It took Dr. Pavlov’s initiatives, aswell as the support of the Board ofTrustees, to recognize the potentialthat ultrasound could have in diag-nosing and treating musculoskeletalconditions.” l

6

Harnessing the Power of Bone Healing

Pioneered in Russia over a halfcentury ago, limb lengthening,a surgical procedure thatrelies upon the body’s ability

to regenerate bone and tissues, hasdramatically changed the lives ofchildren and adults worldwide.

In the fall of 2005, HSS establishedthe Limb Lengthening & DeformityService to provide expert care topatients living with significant boneinjuries and deformities.

“We have one of the most compre-hensive limb lengthening programsin the U.S.,” says S. Robert Rozbruch,MD, Co-Chief of the new service andeditor of a recently published guide totreating patients with limb lengthconditions. “With this surgical prac-tice, we have been able to significant-ly improve the lives of our patients byreconstructing their limb deformities.In addition, the biology of limblengthening is fascinating and opensa window for us to better understandand radically improve bone healing.”

Accelerated Bone GrowthLimb length discrepancies may resultfrom traumatic injury, growth defor-mity, disease or congenital defects.Treatment includes cutting the boneto be lengthened and stabilizing it

using externalfixation framesor implantableinternal devices.Adjustmentsare made by thepatient to thedevice to gradu-ally pull apartthe bone at the

site of the cut, where new growthoccurs. As the bone and surroundingtissue strengthens, the patient learnsto walk without crutches. Bonegrowth can occur as rapidly as oneinch per month.

Transforming LivesIn 2001, James Messina, then 8, frac-tured the growth plate below hiskneecap in a trampoline accident.The growth plate regulates the lengthand shape of mature bone. As his leghealed, James’ mother noticed that itwas bowing, and not growing as fastas his right leg. They sought out Dr. Roger Widmann, Chief of PediatricOrthopedics and Co-Chief of the LimbLengthening & Deformity Service,who operated to correct the deformityand lengthen his leg. Today, James’tibia is perfectly straight and as longas his right leg.

“Limb lengthening and angulardeformity correction for congenitaland traumatic deformities is one ofthe most challenging and rewardingareas of pediatric orthopedic sur-gery,” Dr. Widmann remarked. “I amproud of the tremendous advances inthe field over the last decade, and thepositive impact on patient care.” l

A

7

Supporters of Our SuccessNews & Notes

The Rudolph Rupert MedicalFoundation has made anextraordinary $1 millionpledge to establish a

Scleroderma Research Center at HSS.An autoimmune disease of unknownorigin, scleroderma is a chronic con-nective tissue disease with symptomsthat vary greatly from individual toindividual. While some patients havelimited disease characterized by skinthickening, others have extensiveinternal organ damage that beginswith blood vessel alterations andthen extends to tissue fibrosis, result-ing in organ failure. Currently, thereare few satisfactory treatment optionsfor scleroderma patients.

Comprised of a multidisciplinarygroup of basic and clinical investiga-tors, Special Surgery’s SclerodermaResearch Center is part of HSS’sAutoimmune and InflammationProgram, directed by Peggy Crow,MD, Director of RheumatologyResearch and Benjamin M. RosenChair in Autoimmunity andInflammation Research. RobertSpiera, MD, an HSS rheumatologistwho is active in the care of patientswith scleroderma, both as a clinicianand a researcher, is the Center’sClinical Director. The overall goal ofthe Center is to better understand theunderlying disease mechanisms anddevelop new therapeutic approacheswith a high potential of improvingthe lives of patients with scleroder-ma. Pursuit of this mission isinformed by HSS’s experience in thestudy of inflammatory diseases likelupus. “While scleroderma and lupusare distinct diseases, they have simi-

RehabilitationDepartmentPublishesGuidelines

Hospital for Special Surgery’snewly published PostsurgicalRehabilitation Guidelines forthe Orthopedic Clinician is

the only one of its kind in the coun-try. Incorporating 45 comprehensiveguidelines, it is the first referencebook to cover all aspects of evidence-based postsurgical rehabilitation formusculoskeletal disease.

Therapists around the countrynow have the opportunity to followstep-by-step examples used atSpecial Surgery to develop their ownpostsurgical treatment plans.

Compiled by the RehabilitationDepartment at HSS, the textbook features easy-to-follow guidelinesthat enable practitioners and stu-dents to look up a procedure andquickly see the recommended reha-bilitation strategy. Clear photos andillustrations show how to correctlyperform the techniques described inthe book. The phases of treatmentare outlined in tables that depictgoals, precautions, treatment strate-gies and criteria for advancement.

A DVD accompanies the book, featuring more than 60 minutes ofrehabilitative demonstrations andinstructions. In addition, the DVDalso features an interview withDavid B. Levine, MD, who discussesthe rich history of HSS and theimportant role rehabilitation hasplayed since its inception in 1863.

Compiled by ExpertsPhysical therapists, occupationaltherapists, and athletic trainers affiliated with Special Surgeryplayed an integral role in developingthis valuable reference tool.

“Information wasdrawn from thebest practicesof experiencedpractitioners,evidenced-basedresearch,and themost currentliterature in the field,” said JeMeCioppa-Mosca, PT, MBA, AssistantVice President, Department ofRehabilitation.

Leon Root, MD, Medical Director of the Rehabilitation Department,applauded the team under Ms. Cioppa-Mosca’s leadership, “Challenging ourselves to continually improve andexcel is what HSS is all about. Thetextbook beautifully exemplifies thisphilosophy.” l

PromotingPatient Safety

With the lowest annualmortality ratio of any orthopedichospital in the U.S.,

HSS has made patient safety its top priority. This past year, with its participation in the Institute forHealthcare Improvement’s (IHI)100,000 Lives Campaign, HSS has ledthe way in the adoption of improvedlifesaving practices.

While HSS was already a leader inpreventing surgical site infectionsprior to the Campaign – initiated byIHI with a goal of reducing overallmorbidity and mortality in Americanhealth care – recent IHI-adopted ini-tiatives have propelled HSS to the top10 percent of hospitals nationallythat reliably administer the correctantibiotic, at the proper time, to pre-vent postoperative infection.

Interdisciplinaryteams have also devel-oped new processes totrack and communicatepatients’ medicationadministration before, during, and after their stay.In addition, HSS has

adopted IHI’s suggested criteria fordetermining when patients require arapid response to their unique needsduring their hospital stay.

“Even an institution like HSSneeds to aim for zero toleranceregarding adverse events,” explainsStephen A. Paget, MD, Physician-in-Chief. “HSS’s participation meansthat even the best can do better.” l

Annual Gala Honors Leaders andRaises Record-Breaking FundsOver 925 friends of HSS gatheredat Pier Sixty, Chelsea Piers in Junefor the Hospital’s 23rd annual trib-ute dinner. The successful event,which raised a record-breaking$2.1 million for the Hospital, honored Russell F. Warren, MD,Surgeon-in-Chief Emeritus, and Roland Betts, Founder andChairman of Chelsea PiersManagement. New York CityMayor Michael R. Bloombergmade a special appearance to present the 2006 Tribute Award toMr. Betts in recognition of his out-standing professional and person-al contributions to New York City.HSS Surgeon-in-Chief Thomas P.Sculco, MD, who served as toast-master for the evening, presentedthe 2006 Lifetime Achievement

Honoree Roland Betts and Mayor

Michael Bloomberg

Foundation Partners to EstablishNew Scleroderma Research Center

Award to Dr. Warren, paying trib-ute to his leadership and excep-tional 29-year commitment toSpecial Surgery. Guests includedformer New York City MayorDavid Dinkins, and entertainmentwas provided by Jonathan Pryceand Rachel Yorke, stars ofBroadway’s Dirty RottenScoundrels, and the MichaelCarney Orchestra. l

lar general disease mechanisms,”explains Dr. Crow. “Both haveautoimmune components, involvethe activation of the immune sys-tem, and result in tissue damage.”

Dedicated to advancing researchto prevent and cure scleroderma,the Rudolph Rupert MedicalFoundation is confident thatSpecial Surgery’s SclerodermaResearch Center will provide a wor-thy legacy for founder RudolphRupert, who wished to honor hismother who had the disease. “Weselected Hospital for SpecialSurgery to help us establish thecenter because of the quality andpassion of its investigators andstaff,” explains Foundation TrusteePeter Bloom. “Rudolph Rupertwould be proud of what the centeraims to accomplish with the knowl-edge that it will serve physicians,patients, and their families.” l

Photo above: © 1972-2004 American College ofRheumatology Clinical Slide Collection. Used with permission.

Above, a skin biopsy exhibits excess

collagen deposition and other signs of

scleroderma.

HSS Tops inNortheast For the 16thconsecutiveyear, U.S. News& WorldReport hasrecognizedHSS for itsexpertise inorthopedics andrheumatology in its 2006“America’s Best Hospitals”issue. Ranked second in ortho-pedics and third in rheumatol-ogy nationwide, HSS wasamong more than 5,000 hospi-tals included in the surveybased on reputation and othermeasures of quality includingpatient volumes and mortalityrates as well as nursing careand technology services. TheHospital ranked 23rd in neurolo-gy and remains number one inthe Northeast in its disciplines. l

8

KudosThe National Institute of Dental andCraniofacial Research of the NationalInstitutes of Health (NIH) has award-ed Adele Boskey, PhD, a five-year,$2.8 million grant to continue tostudy the mechanism of bone andhard tissue mineralization. TheNational Institute of Arthritis andMusculoskeletal and Skin Diseases(NIAMS) of the NIH has awarded Dr. Boskey a four-year, $1.5 milliongrant to study biological calcificationin vitro, a five-year, $300,000 grant to study mineral structure in osteo-porosis, and a five-year, $3.5 millioncore grant to provide facilities forinvestigations in this field.

Nancy Pleshko Camacho, PhD,received a one-year, $55,692 SmallBusiness Technology TransferProgram award from theNIH/NIAMS in collaboration withRemspec Corporation for a studyfocused on the spectroscopic identification and removal of PMMAfrom bone.

The American College ofRheumatology has awarded R.

Krishna Chaganti, MD, a $50,000Physician Scientist DevelopmentAward for salary support to continuea project focusing on clinical andserological risk factors associatedwith periprosthetic osteolysis.

C.T. Christopher Chen, PhD, hasreceived a three-year, $257,916 awardfrom the NIH/NIAMS for his studyfocusing on preventing cartilagedegeneration after traumatic injury.

Peggy Crow, MD, received a two-year, $85,000 award from theNational Institute of Allergy and

Infectious Disease (NIAID) of theNIH to investigate interferon respons-es in systemic lupus erythematosus.The award is part of a larger grantmade to the University of Alabama.

Matthew Cunningham, MD,received a one-year, $15,000Orthopedic Research and EducationFoundation (OREF) award to studythe development of a comparativemodel and pilot histological and bio-chemical evaluation of vascularizedbone grafts.

Lawrence Gullotta, MD, received aone-year, $50,000 OrthopedicFellowship Award from the NewYork Chapter of the ArthritisFoundation to study cell-mediatedtherapies in tendon to bone healing.

Brian C. Halpern, MD, has been re-elected President of the Foundationof the American Medical Society forSports Medicine.

Jo Hannafin, MD, PhD, has beennamed to the Board of Trustees ofthe OREF. She has been appointed tothe NIH/NIAMS Small Grants forNew Investigators study section.

Lionel Ivashkiv, MD, in collaborationwith Anne Davidson, MD, of theColumbia College of Physicians andSurgeons, has received a five-year,$2.1 million grant from theNIH/NIAID to study interferon regulation in systemic lupus.

The NIH/NIAMS (through Tepha,Inc.) has awarded Joseph Lane, MD,a $47,790 grant to study a newantimicrobial bone graft.

In June, Michael Lockshin, MD, was invited to speak at the meetingof the Regensburg RheumatologyAssociation, and was a visiting professor at Regensburg Universityin Germany.

The New York Chapter of theArthritis Foundation has awardedSuzanne Maher, PhD, a one-year$40,000 grant to study a novel hydro-gel for cartilage defect repair, Xiaoyu

Hu, PhD, a three-year, $75,000 awardto investigate homeostatic function ofinterferons in arthritis, and Melanie J.

Harrison, MD, MS, a one-year,$75,000 award for a pilot study focus-ing on cognitive rehabilitation in SLE.

Lisa Mandl, MD, Robert Marx, MD,and Stephen Lyman, PhD, received afive-year, $4 million award from theNIH/AHRQ in collaboration with theDepartment of Public Health of WeillMedical College of Cornell Universityto create a Center for Education andTherapeutics focusing on MedicalDevices. Dr. Marx served as thekeynote speaker at the biannualEuropean Society for Sports Medicine,Knee Surgery and Arthroscopy meet-ing in Austria held in May.

Mikhail Olferiev, MD, received theClinician-Scientist Fellowship Awardfrom the SLE Lupus Foundation,which will provide $150,000 overthree years to study receptor-depend-ent effector mechanisms in lupusmediated by subsets of T cells.

Margaret G.E. Peterson, PhD, served as an ad-hoc grant reviewerfor the United States Army MedicalResearch Program for the 2006Neurofibromatosis Research Program.

Eduardo Salvati, MD, Geoffrey

Westrich, MD, and Alejandro

Gonzalez Della Valle, MD, received a$20,000 grant from the AmericanKnee Society and the OrthopedicResearch Education Foundation tostudy the role of inherited throm-bophilia and hypofibrinolysis inpatients who develop thromboembolic

Recognition from Around the World

Continued from page 1

Editor-in-Chief: Josh Friedland

Associate Editor: Rachel Olszewski

Contributing Editors: Eleanor Berens,Michael Elvin, Linda Errante, ReesaKaufman, Dana Marion, Matt McMillen,Robin Merle

Design: Arnold Saks Associates

Photography: Jim Barber, Robert Essel, Don Pollard

Printing: Monroe Litho

Discovery to Recovery is published twice ayear by the Development Department,Hospital for Special Surgery, 535 East 70thStreet, New York, NY 10021. 212.606.1196

Hospital for Special Surgery is an affiliate ofNewYork-Presbyterian Healthcare System andWeill Medical College of Cornell University.

disease following total knee replace-ment. The New York Chapter of theArthritis Foundation presented Dr.Eduardo Salvati with the 2005Lifetime Achievement Award.

The National Institute of GeneralMedical Sciences has appointedMarjana Tomic-Canic, PhD, to theCenters for Innovative WoundHealing study section. Dr. Tomic-Canic was invited to serve on an NIH review committee for CareerDevelopment awards and ConferenceGrant applications, and a NIH/NIAMS Small Grant program forNew Investigators. She received aone-year, $244,414 NIH transferaward to study epidermal genes andtheir regulators in wound healing.

The American Society of MechanicalEngineering presented Peter A.

Torzilli, PhD, with the distinguished2006 H.R. Lissner Medal, recognizinghis outstanding contributions to the field of bioengineering and his commitment to mentoring young bioengineers. Dr. Torzilli gave a lecture about the mechanobiology ofosteoarthritis at RensselaerPolytechnic Institute in April.

The National Chapter of the ArthritisFoundation has awarded Lisa

Vasanth, MD, a two-year, $100,000renewable grant to assess synovialvascularity in early inflammatoryarthritis.

Timothy Wright, PhD, served on theNIH/NIAMS Loan RepaymentProgram study section in March.That same month, Dr. Wright wasinvited to speak at the CombinedOpen Meeting of the Knee Society,the American Association of Hip andKnee Surgeons, and at the AnnualMeeting of the National Associationof Orthopaedic Nurses in Chicago.

and staff, and greater patient satis-faction are among many factors thatare influenced by the hospital envi-ronment. An outward expansion ofthe 8th floor this fall and the addi-tion of two new floors (floors 10 and

11) in 2008 will increase the numberof staffed beds dedicated to inpatientcare from 146 to 188. Designed withpatient amenities in mind, spaciousnew private and semi-private roomswill feature three 8-foot walls ofglass windows. Every bed will bepositioned to allow each patient aspectacular view of the East River.Linens and fabrics have been chosenin warm, wood tones, and soft lighting will reflect off walls adornedwith metal sconces and colorfulpaintings. “Everything about thenew patient rooms – the décor, theview of the river, the lighting – wasdesigned to provide the patient witha sense of peace and calmness,” says Stephanie Goldberg, VicePresident of Nursing. “It will be abeautiful environment for patients to receive care.”

“As we expand our capacity and enrich our medical culture with

Patient Rooms Promote HealingStudies suggest that the healingenvironment surrounding a patientplays a measurable role in a speedyconvalescence. Reduced recoverytime, decreased stress for patients

New patient rooms, currently under construction, will overlook the East River.

young doctors, scientists, and specialists in allied services, patientswill benefit from tremendousadvances in care,” says StephenPaget, MD, Physician-in-Chief. “Ourhighest priority has been and alwayswill be to care for our patients andreturn them to their normal, activeroutine as rapidly as possible.” l

FINDING THE STRENGTH TO SUCCEED

Lauren DavidsonDiagnosed at birth with osteoge-

nesis imperfecta, Lauren

Davidson spent most of her

young life in and out of surgery.

At just 17 months old, she under-

went the first of 15 surgeries at

HSS with Leon Root, MD (see

other side), an operation that

involved inserting steel rods into

her legs. As Lauren grew, the

rods were replaced with longer

ones that enabled her to walk

without braces. Encouraged to

swim as way to strengthen her

bones and muscles, she became

the first disabled student-athlete

to swim for the University of

Illinois. In 2000, Lauren represent-

ed the U.S. at the Paralympic

Games in Australia, where she

set a new world record in the

400-Meter Freestyle and received

one gold medal and two silver

medals. Today, Lauren enjoys

recreational swimming, and is

completing a master’s degree in

speech-language pathology at

Kean University. “Dr. Root always

encouraged me to follow my

dreams,” she said. “He helped me

believe that there was nothing in

this world that I couldn’t conquer.”

Our Pat ients

Our Physic ians

A PIONEER IN OSTEOGENESIS IMPERFECTA

Leon Root, MDRecognized as one of the nation’s

foremost specialists in pediatric

orthopedics, Leon Root, MD, has

paved the way for advances in

treating and understanding the

brittle bone disease osteogenensis

imperfecta (OI). Dr. Root’s pio-

neering work with OI began over

30 years ago, when he estab-

lished the first specialized OI

clinic and a research program to

study the condition at Hospital

for Special Surgery. Since then,

he has collaborated with leading

scientists in pursuit of ground-

breaking research to develop

novel therapies for OI. During his

27-year tenure as Chief of

Pediatrics, a position he stepped

down from in 1997, Dr. Root

played a pivotal role in providing

individualized care to children

like Lauren Davidson (see other

side). “The aspect of my practice

that I have enjoyed most is the

strong personal relationships that

I’ve formed with many of these

children and their families,” says

Dr. Root. “I care about all of these

children as if they were my own.”