U.S. News evaluated nearly 4,500 hospitals in 14 specialties. Hospital performance was assessed based on various measures, including patient outcomes, level of nursing care, patient-reported experience, and available technology such as computer-assisted orthopedic surgery. The methodology factored in data from the Centers for Medicare & Medicaid Services, professional organizations, and medical specialists.

“We are proud to once again be recognized as a leader in orthopedics and rheumatology,” said HSS President and CEO Bryan T. Kelly, MD, MBA. “This distinction reflects the extraordinary expertise, dedication, and collaboration of the entire HSS team. For patients across the New York metropolitan region, it is also a powerful validation that the best orthopedic care in the country is available right here in their community. Through comprehensive musculoskeletal care, we help patients preserve mobility, enhance their quality of life, and extend their healthspan so they can continue doing what they need and love to do.”

“This recognition from U.S. News reflects HSS’s unwavering commitment to advancing musculoskeletal health through clinical excellence, innovation, and patient-centered care,” said Douglas E. Padgett, MD, surgeon-in-chief and medical director of HSS. “Perhaps the greatest measure of our impact is the trust of patients who travel to HSS from across the country and around the world seeking care have placed in us. This distinction reflects our dedication to achieving exceptional outcomes and our belief that preserving movement is the foundation of longevity and quality of life.”

Patients come to HSS from all 50 states and more than 100 countries, often for both common and complex medical conditions or challenging surgeries requiring highly specialized care. As a global destination for orthopedic and rheumatologic care, HSS brings together world-renowned physicians, advanced treatment approaches, and multidisciplinary teams dedicated to delivering personalized, evidence-based care for patients of all ages and activity levels.

“Our rankings reflect the extraordinary expertise, dedication, and innovation of the physicians, scientists, researchers, and care teams who make HSS a leader in rheumatology,” said Anca D. Askanase, MD, MPH, Chair of the Department of Medicine and Chief of the Division of Rheumatology at HSS. “Through groundbreaking research, advanced therapies, and highly personalized care, we are helping to transform the lives of patients living with complex autoimmune and inflammatory diseases.”

“The pace of discovery in musculoskeletal medicine is accelerating at an unprecedented rate,” said Joel Press, MD, Physiatrist-in-Chief at HSS. “Advances in artificial intelligence, data science, and precision medicine are helping researchers uncover new insights faster and translate those discoveries into more effective, personalized care. With HSS’s singular focus on musculoskeletal health and unmatched depth of clinical expertise, we are uniquely positioned to turn innovation into meaningful improvements in outcomes for patients everywhere.”

As the world’s leading academic medical center specializing in musculoskeletal health, HSS maintains among the lowest hospital readmission rates for orthopedics in the nation, and among the lowest rates for infection and complications. HSS is the worlds most awarded hospital in orthopedics by Newsweek each year since the “World’s Best Specialized Hospitals” survey was introduced in 2020.

In 2025, HSS clinicians and surgeons provided specialized care to more than 258,016 patients with orthopedic or rheumatologic conditions, such as pain or injury to the back, neck, or joints; osteoarthritis; rheumatoid arthritis; lupus; scleroderma; and psoriatic arthritis. HSS performed more than 45,864 orthopedic surgical procedures in 2025.

HSS is the official hospital of and provides team physicians to more than 25 high-performing sports teams and leagues, including the New York Giants, New York Knicks, New York Liberty, Brooklyn Nets, New York Mets, New York Red Bulls, TCS New York City Marathon, National Basketball Players Association, Major League Pickleball, US Youth Soccer, and UFC. It is designated a Medical Center of Excellence by Fédération Internationale de Football Association (FIFA).

ISOC was founded in 2006 by Thomas P. Sculco, MD, Surgeon-in-Chief Emeritus at Hospital for Special Surgery, and is currently led by Mathias P. Bostrom, MD, HSS Associate Surgeon-in-Chief. Though independently incorporated as a nonprofit organization, the society continues to draw significant administrative and intellectual support from HSS, including leadership from administrators Briana Bloom and Nicole Earley. Today, ISOC’s 23 member centers span multiple continents and represent a collaborative network committed to advancing musculoskeletal care through shared knowledge and collective ambition.

This year’s conference unfolded around the theme Beyond the Bone: The Power of Corporate Culture in Orthopaedic Care, reflecting a growing recognition that excellence in patient outcomes depends as much on institutional culture as on surgical technique. Led by Drs. Tim Simmers and Mark Stegman of the Sint Maartenskliniek, the program explored topics ranging from organizational identity and safety systems to physician well-being and workforce sustainability. Steven Forti, Chief Wellness and Resiliency Officer at HSS, presented the hospital’s widely recognized approach to clinician wellness, an area of increasing urgency across medicine.

Beyond the formal sessions—which included more than 100 presentations, research discussions, roundtables, and keynote lectures—the conference placed equal weight on conversation and connection. The result was both an exchange of ideas and a renewal of professional bonds across borders. With six ISOC centers ranked among the world’s top specialized orthopaedic hospitals by Newsweek, the meeting underscored the society’s role as a convening force for many of the field’s most influential voices.

Next year will mark a milestone for the organization. In 2027, ISOC will celebrate the 20th anniversary of its first conference, held in New York City in 2007 and hosted by HSS. To commemorate the occasion, member institutions will once again convene in New York, where HSS will host the 13th ISOC Conference—bringing the society back to where its global experiment in collaboration began.

Dr. Jonathan M. Vigdorchik, Chief Science, Technology and Medical Affairs Officer, Zimmer Biomet

In this role, Dr. Vigdorchik will oversee the strategy, delivery, and management of the company's global end-to-end technology portfolio, including AI, robotics, smart implants and data. He will also oversee Zimmer Biomet's Medical Education strategy and Global Advisory Board, helping further strengthen Zimmer Biomet's clinical engagement, innovation roadmap and external scientific leadership. Dr. Vigdorchik will report to Ivan Tornos, Chairman, President and Chief Executive Officer.

"Dr. Vigdorchik is a world-class orthopedic surgeon, and he brings exactly the kind of bold, future-focused leadership we need as we continue to shape the next era of musculoskeletal care," said Tornos. "He understands how to translate clinical insight into meaningful innovation, and his leadership will help us move faster, think bigger and continue advancing our broad suite of robotic and enabling technologies. I'm confident he will play a critical role in accelerating our portfolio strategy and further differentiating Zimmer Biomet in the market."

Dr. Vigdorchik previously served as Zimmer Biomet's Chief Medical Technology Advisor, Adult Reconstruction and Hip Implants. He is a board-certified, fellowship-trained orthopedic surgeon at Hospital for Special Surgery (HSS) in New York City, specializing in hip and knee replacement surgery. Dr. Vigdorchik held several prominent academic and clinical leadership positions, including serving as Division Chief for national/international reputation and academic promotion on the Adult Reconstruction and Joint Replacement service at HSS and Director of Bone Implant Longevity Research at HSS's Griffin Research Accelerator. In addition, he is currently an Associate Professor of Orthopaedic Surgery at Weill Cornell Medical College. He is active in professional societies including The Hip Society, The Knee Society, the American Academy of Orthopaedic Surgeons (AAOS) and the American Association of Hip and Knee Surgeons (AAHKS), where he served as the Education and Communications Council Chair and earlier served as Program Chair for the 2024 AAHKS Annual Meeting.

"As a surgeon and innovator, I believe we are at an inflection point where AI, data, and advanced technology will fundamentally redefine the future of orthopedics," said Dr. Vigdorchik. "I've dedicated my career to focus on preventing complications and achieving consistently better outcomes for patients. With strength across its product portfolio, a differentiated suite of robotic and enabling technologies, and a pathway toward fully autonomous robotic technology in orthopedics, Zimmer Biomet is poised to continue pushing the industry forward. I'm excited to join the talented team in this expanded role to help advance that vision and accelerate innovation for surgeons and patients around the world."

Dr. Vigdorchik earned his medical degree from the University of Missouri – Columbia School of Medicine, completed his orthopaedic surgery residency at the Detroit Medical Center / Providence Hospital, and received fellowship training in Adult Reconstruction and Joint Replacement at HSS. He also completed an international traveling fellowship in hip preservation surgery with training at centers in Switzerland, Boston Children's Hospital, and Washington University in St. Louis.

About Zimmer BiometZimmer Biomet is a global medical technology leader with a comprehensive portfolio designed to maximize mobility and improve health. We seamlessly transform the patient experience through our innovative products and suite of integrated digital and robotic technologies that leverage data, data analytics and artificial intelligence.

With 90+ years of trusted leadership and proven expertise, Zimmer Biomet is positioned to deliver the highest quality solutions to patients and providers. Our legacy continues to come to life today through our progressive culture of evolution and innovation. 

TKA, also known as total knee replacement, is one of the most common elective surgeries in the United States, with over 700,000 cases performed each year. In spite of advances in surgical techniques and antibiotic regimens, infection following TKA remains a devastating complication that has led to a greater focus on controllable risk factors.

“Historically, it’s been said that the higher a surgeon’s volume, the lower the rate of infection, and the corollary is that low-volume surgeons are considered to have a higher risk of infection,” says senior author Geoffrey H. Westrich, MD, hip and knee surgeon at HSS. “We wanted to take a closer look at this historic paradigm to determine if surgeon volume independently affects infection outcomes at a high-volume orthopedic center that places great importance on infection prevention.

“At HSS, we perform thousands of joint replacements each year and we have an incredibly robust infection prevention program that has resulted in infection rates that are among the lowest in the nation,” Dr. Westrich continues. “However, the biggest problem with infection research is that because our rates are so low, it’s hard to isolate the impact of individual surgeon volume from the many institutional factors that influence outcomes.”

The researchers conducted a retrospective review of prospectively collected data at HSS that included all TKA procedures (33,747) performed between January 1, 2018, and December 30, 2024. A total of 52 surgeons were stratified by annual TKA case volume into three categories: low (<50 cases/year), high (50–250 cases/year), and ultra-high (>250 cases/year). Infection outcomes, including superficial surgical site infections (SSI) and deep periprosthetic joint infections (PJI), were monitored for 90 days postoperatively using a dedicated surveillance program in accordance with National Healthcare Safety Network (NHSN) criteria.

The study found the low-volume group had an average operative time of 112.2 minutes, a PJI rate of 0.3%, and an SSI rate of 0.2%. The high-volume group had an average operative time of 96.5 minutes, a PJI rate of 0.3%, and an SSI rate of 0.1%. The ultra-high-volume group had an average operative time of 90.5 minutes, a PJI rate of 0.2%, and SSI rate of 0.1%. Despite differences in operative time, there were no statistically significant differences in infection rates across the three surgeon volume groups with respect to both SSI and PJI.

Dr. Westrich notes that infection rates for TKA across the surgeon volume groups are extremely low compared to other hospitals in New York State. “Our HSS  infection rates, which range from 0.1% to 0.3%, are among the lowest in the New York State and in our country,” he says. “At other New York State hospitals, infection rates can be as high as 2.0% or ten times higher than our institution.”

“Our findings demonstrate that at a high-volume academic orthopedic center, infection rates following total knee replacement remain uniformly low regardless of individual surgeon volume,” says Dr. Westrich. “This flies in the face of what we’ve been told historically about surgeon volume and infection rates. It’s not just the surgeon, it’s the institution that drives safety.”

“At HSS, controlling the risk of infection is among our highest priorities and most important accomplishments,” explains Dr. Westrich.  “Our low infection rates are achieved with a robust infection-control committee, extensive patient education, state-of-the-art operating rooms, infection-reducing surgical practices, enhanced sterilization methods, and highly disciplined infection-control practices. Together, these factors outweigh the volume of the individual surgeon.”

To improve patient safety and quality care at orthopedic centers, Dr. Westrich emphasizes the importance of strengthening institutional infrastructure and quality-improvement programs, rather than limiting low-volume surgeons’ access to TKA.  “Our study shows that even if you bring a surgeon on staff who is just starting out in their career, that doesn’t mean a patient going to that surgeon is at a greater risk of infection.  A rigorous, comprehensive approach to patient care with relentless focus on infection control at every stage provides the greatest protection from infection.”

Authors:  Josef Jolissaint, MD; Andrew Thomson, BA; Alexandra Grizas, MPH; Andy Miller, MD; and Geoffrey H. Westrich, MD

The first of the three studies, “Aspirin Versus Potent VTE Chemoprophylaxis (VTEC) in Total Knee Arthroplasty: Reduced Postoperative Pain and Complications with Aspirin Use,” examined the experience of total knee arthroplasty (TKA) patients with postoperative pain who were also taking blood thinners. The study included 28,169 patients treated between 2016 and 2023; 18,413 received aspirin while 9,756 received a potent VTE.. Patients were monitored for 90 days following their procedure. The findings suggest that aspirin should be considered the preferred option for reducing postoperative pain in TKA patients.

Patients on more-potent blood thinners tend to experience more pain, swelling and inflammation after surgery, said Brian P. Chalmers, MD, a hip and knee surgeon at HSS and one of the study’s authors. “We have always known that non-steroidal anti-inflammatory medications can improve patients’ swelling and inflammation after surgery. However, the traditional thought and belief has been that we should avoid those in patients on anticoagulation. Our data show there is less risk and less postoperative pain when these patients are utilizing aspirin.”   

A second study, “The Effect of Concomitant Use of Potent Anticoagulation and Anti-Inflammatories on Early Outcomes of Total Hip Arthroplasty,” retrospectively evaluated 5,881 total hip arthroplasty patients who were on anticoagulation. The surgeries were performed between 2016 and 2023; of those patients, 4,867 were concomitantly prescribed NSAIDs and 1,040 received anticoagulation alone. Researchers concluded that the concomitant use of NSAIDs in patients on anticoagulants did not increase the risk of wound-related bleeding complications.

“The conventional thinking has often been that patients on an anticoagulant should not be on an NSAID, that there is going to be bleeding, more risk of wound problems and additional complications. But based on our retrospective data, we did not see increased risk in patients using both anticoagulation and NSAIDs. We did see some additional benefits, including less pain and a somewhat easier recovery,” Dr. Chalmers stated. “NSAIDs appear to be safe in this setting and may help decrease postoperative pain and reduce opioid use following surgery.”

The final study, “Cefazolin and the R-1 Side Chain: Why Your Joint Arthroplasty Patients With Cephalosporin Allergy Can Safely Be Given Cefazolin,” assessed the safety and effectiveness of the antibiotic Cefazolin in patients with documented cephalosporin allergies. This is the first study to evaluate these questions.

From 2016 to 2024, researchers compared patients with a reported cephalosporin allergy who received perioperative cefazolin with those who received alternative antibiotic prophylaxis. This study included 89,993 hip and knee arthroplasty patients. Of these, 1,267 had a documented allergy. The study resulted in zero incidence of IgE-mediated or “severe” type IV allergic reactions, concluding that cefazolin can be safely administered to most patients with an existing cephalosporin allergy.

“When patients have a mild allergic reaction, there is often a reflex to give them another antibiotic in a different family of drugs. However, alternative options aren’t always as effective,” said Matthew S. Austin, MD, hip and knee surgeon at HSS and a study author. “Clear protocols should be put in place to guide decision-making when managing these types of allergies.”

These findings underscore HSS’s ongoing commitment to challenging conventional assumptions and using data-driven research to refine perioperative care. The studies highlight how targeted medication strategies can improve safety, reduce complications and enhance outcomes for patients undergoing hip and knee arthroplasty.

Study Details 

“Aspirin Versus Potent VTE Chemoprophylaxis in Total Knee Arthroplasty: Reduced Postoperative Pain and Complications with Aspirin Use”

 Alex Anatone, Alexis Gabriel Gonzalez, Richard Hwang, David Andrew Kolin, Aaron Ira Weinblatt, Amar S Ranawat, Alejandro Gonzalez Della Valle, Brian Chalmers

“The Effect of Concomitant Use of Potent Anticoagulation and Anti-Inflammatories on Early Outcomes of Total Hip Arthroplasty”

Alexis Gabriel Gonzalez, Aaron Ira Weinblatt, Agnes Cororaton Jones, Stephen Lyman, Richard Hwang, Alex Anatone, Carlo Marega, Alejandro Gonzalez Della Valle, Brian Chalmers

“Cefazolin and the R-1 Side Chain: Why Your Joint Arthroplasty Patients With Cephalosporin Allergy Can Safely Be Given Cefazolin”

Josef Jolissaint, Katherine E Mallett, Andrew Thomson, Alberto V Carli, Matthew Austin

Read the full article at healio.com.

A recent study conducted by researchers at HSS and presented at the American Association of Hip and Knee Surgeons (AAHKS) annual meeting demonstrated that there is a way for outcomes following hip and knee replacement surgeries to be measured more efficiently without compromising accuracy. Alexander S. McLawhorn, MD, MBA, hip and knee surgeon at HSS and one of the authors of the study, shared his perspective.

At HSS, we are dedicated to ensuring patient experience and safety remain our top priorities, while also reducing the unnecessary regulatory burden for the hospital. This study indicated that outcome measurement after hip and knee replacement can be accurate and reliable even if hospitals don’t collect PROMs for a majority of patients. More than 740,000 Medicare beneficiaries undergo primary total hip or knee replacement each year, that number is expected to increase to 1.2 million by the year 2030, making this a critical time to address this topic.

 Capturing feedback from as many patients as possible can become an administrative burden for everyone involved. There are many different stakeholders when it comes to PROMs, including regulatory, research and clinical teams. Each of these areas requests PROMs from patients at different points in their journey, uses PROMs differently, and requires different levels of reporting for their needs.

-Alexander S. McLawhorn, MD, MBA

Our proposed solution is collecting carefully chosen samples, which can still lead to accurate results. For very high-volume institutions like HSS, you are not losing any accuracy in terms of your measurement by measuring fewer patients. Our research also suggests that this more efficient approach could result in a significant overall reduction in administrative burden, particularly since most total hip and knee replacements are performed at high-volume centers. The net effect would be a large reduction in unnecessary data collection, an increase in operational efficiency and cost savings.

This approach is not applicable to all institutions. In fact, our findings revealed that lower-volume institutions may not experience the same benefit of a streamlined process. If a low-volume hospital only submits 50% of their cases, you may have very inaccurate assessment of quality. In some cases, you may need 100% reporting for some very low volume institutions.

HSS undertook this research because of our dedication to advancing patient safety and care quality. It is important that patients know the measures of quality for different institutions. What we are proposing is a strategy that will allow patients to receive information in a more efficient way. This research is intended to move a very important policy conversation forward. Changes involving CMS can take a significant amount to implement.  If we are able to adapt this common-sense approach patients and healthcare institutions everywhere will benefit.

HSS has been and will continue to be a leader in this space and instrumental in defining these tools now and well into the future.  

The Quiet Knee protocol, which some HSS surgeons began implementing several years ago, takes a more conservative approach to knee replacement recovery than traditional clinical protocols. This new technique focuses on controlling inflammation and swelling postoperatively through restricted mobility and passive range of motion (ROM) and aggressive cryotherapy (icing) for the first 10 days immediately following surgery. This contrasts with standard protocols, which often emphasize early and aggressive movement that can cause inflammation in surgical tissue that is healing.

All HSS total knee replacement patients from 2020 to 2024 were retrospectively reviewed as part of the study. A Quiet Knee group consisting of 271 patients received structured postoperative care and monitored telerehabilitation. One comparison group was given Quiet Knee guidance verbally, while a second cohort followed traditional early motion postoperative therapy.   

 “Patients are told they have to work really hard to get motion back after surgery—the no pain, no gain type of mentality,” said Brian P. Chalmers, MD, a hip and knee surgeon at HSS and one of the authors of the study. “The problem with that is that the more patients do in the early period of recovery—the more they bend, the more they are up and walking—the more the knee will swell.”

Every person undergoing TKA experiences pain and swelling after surgery, but the intensity differs, making the patient’s recovery process more challenging and often more painful than most other surgeries.

“It’s not uncommon to see a counterproductive early physical therapy program that is too aggressive,” Dr. Chalmers said. “In these cases, the knee becomes very swollen, which causes patients to have more pain. As the knee becomes more inflamed and patients are able to bend it less, it just becomes a cycle.”

Under the Quiet Knee protocol, patients avoid intensive physical therapy immediately after surgery, allowing the body time to heal before progressing to motion and other strength work. Early results suggest this approach helps set the stage for a smoother long-term recovery. The study also showed that the protocol significantly reduced 90-day opioid exposure by more than 25%.

“This isn't a surgeon-driven protocol or a research-driven protocol. It's a physiology-driven protocol,” said Michael P. Ast, MD, Chief of the Knee Service and Chief Medical Innovation Officer at HSS and co-author of the study. “It is a recognition of what the human body goes through in recovery from surgery. It is a very logical way of respecting the body's inflammatory response to trauma. Early on after surgery, less really is more. That is really the guiding principle of this protocol.”

Study Details

A Retrospective Cohort-Based Analysis of the “Quiet Knee” Protocol After Primary Total Knee Arthroplasty

Pravjit Bhatti, Lauren Moeller, Michael P Ast, Tony Sicheng Shen, Peter Keyes Sculco, David Jacob Mayman, Brian Chalmers

HSS researchers piloted and evaluated a custom-tailored AI (CTAI) platform that was trained on patient education content developed and approved by HSS surgeons. They found that patients were able to easily access and interact with the chat bot, which provided on-demand, personalized, accurate information about their surgery.

“Our study showed that most patients found the technology easy to use and helpful in making them feel ready and confident going into surgery,” says Eytan M Debbi, MD, PhD, hip and knee replacement surgeon at HSS and senior author of the study.

HSS investigators partnered with Aidify to develop the CTAI agent to address patient questions related to total joint arthroplasty (TJA) procedures such as hip and knee replacement surgery. Orthopedic surgeons at HSS trained the chat bot with their specific surgical protocols so that patients could receive personalized content that reflects their expertise.

Patients undergoing orthopedic procedures frequently face confusion and anxiety before surgery and are often dissatisfied with printed educational materials that can be hard to understand and not tailored to their needs. However, patients in the study gave Aidify high marks for responses that were useful, understandable, and complete.

“This platform can provide round-the-clock access to reliable, doctor-specific guidance and reduce the risk of getting inaccurate or irrelevant information from other general-purpose tools like Google or Chat GPT,” says Karlos Zepeda, DO, clinical research coordinator at HSS and lead author of the study.

The study included 40 patients scheduled to undergo TJA at HSS. Among the 32 patients who used the chat bot, about 85% said they understood the responses to their questions and 75% reported that it helped them feel well prepared for surgery. More than 80% of patients stated they would recommend the platform to others.

“I think patients get a lot of comfort knowing they have access to the chat bot because it gives them the sense that they can always be in contact with our office and get their questions answered whenever they need it,” explains Dr. Debbi.

Patients in the study were emailed a link to the interactive platform trained on information about the surgery they were going to have. They could then type their questions into the chat bot and get responses instantly.

The CTAI tool addressed a wide range of questions that focused mostly on concerns leading up to surgery and on recovery. These included activity guidelines, medications, what to expect after surgery, dietary guidance, pain management, wound care, and potential complications. The bulk of patients’ questions came in before surgery, while the number and frequency of questions diminished after surgery.

“Our findings show that CTAI improves patients’ health literacy, which enables more understanding, confidence, and preparedness before surgery,” says Dr. Zepeda. “This directly impacts patients’ overall satisfaction and care experience.”

The most unexpected finding, according to the authors, was the number of study participants who were able to access and navigate the platform. Most people who need TJA are over the age of 55, so there was a concern that older patients in the study might have some difficulty using AI technology.

“I was surprised that older patients were able to deal with the technology as easily as they did and be as satisfied as they were with it,” observes Dr. Debbi, who adds that some patients preferred interacting with the chat bot over their surgeon. “Surgeons cannot be available to patients 24 hours a day, but AI can review things with multiple patients at a time, whenever and as many times as they want without physician burnout, so that’s a huge benefit.”

CTAI streamlines communication and reduces the burden of repetitive or nonurgent questions on busy clinical staff. “The power of AI can extend the surgeon and their team to more patients by efficiently addressing patient concerns in real time and ensuring that they consistently receive the right information exactly as their surgeon intended,” explains Dr. Zepeda.

If the platform doesn’t know the answer to a question or there is an emergency, it will prompt the patient to contact their doctor’s office, call 911, and/or use the My Chart/Epic patient portal to send in their question to the appropriate provider, who would be notified of the issue and respond or escalate as needed. 

“We are still in the research phase and very carefully monitor every question that comes in to make sure nothing slips through the cracks,” notes Dr. Zepeda.

The study authors agree that their findings support continued refinement of CTAI as a tool to improve the delivery of patient education and care at HSS, but more research is needed to expand its use. For example, the technology does not currently have access to specific patient information.

“Only when we are confident in the technology and that patient information is secure will we enable AI to fully interact with patients’ electronic medical record and integrate it as standard of care at HSS,” says Dr. Debbi. “The potential of CTAI is unlimited. The sky’s the limit and we’re just scratching the surface right now.”

Hospital for Special Surgery (HSS), the world’s leading academic medical center specialized in musculoskeletal health, has expanded access for people in Northern New Jersey with the opening of two new facilities: HSS Paramus – Midland Ave, a full-service outpatient center (OPC) in Paramus; and the HSS Northern NJ Surgery Center in Mahwah, which marks the first-ever HSS surgery center dedicated to ambulatory procedures in the state. The facilities offer Bergen County residents greater access to world-class surgical and non-surgical care across a broad range of specialties.

“HSS has led the fields of orthopedics and rheumatology in quality and patient experience for 161 years,” said HSS President and CEO Bryan T. Kelly, MD, MBA. “The HSS Northern NJ Surgery Center in Mahwah and HSS Paramus – Midland Ave are more than just facilities—they're purpose-built extensions of the main hospital, offering the same sophisticated, highly specialized care but in a more accessible location. They reflect our commitment to serving communities by expanding care through innovation and strategic growth across the tri-state region and beyond.”

The HSS Northern NJ Surgery Center is a 7,700-square-foot facility conveniently located at 400 Franklin Turnpike, just 10 miles away from HSS Paramus – Midland Ave. The center features three operating rooms, eight pre- and post-surgical bays and on-site central sterile processing.

The Mahwah surgery center will focus on specialized care for conditions and injuries of the hip and knee, spine, foot and ankle, hand and wrist, as well as sports medicine surgery. Michael P. Ast, MD, chief of the Knee Service, Chief Medical Innovation Officer and Director of Ambulatory Surgery Center Strategy at HSS, serves as the Medical Director.

“With the advanced technologies we’ve implemented at our ambulatory surgery center, we’re now able to safely perform a wider range of complex procedures that were once only possible in a hospital setting,” said Dr. Ast. “By expanding access in New Jersey, more patients can receive timely outpatient procedures, reducing wait times, hospital burdens, and the need to travel into New York City. At the same time, our new center is fully integrated with our main hospital, ensuring patients benefit from the same world-class diagnosis and treatment options.”

HSS Paramus – Midland Ave, located at 15 E. Midland Ave, Suite 1A, features 23 exam rooms and highly specialized physicians and staff to offer care for conditions and injuries of the foot and ankle, hand and upper extremities, hip and knee, and spine; endocrinology/metabolic bone diseases; pediatric orthopedics; physiatry; rheumatology; and sports medicine.

The nearly 31,000-square-foot facility is double the size of the existing OPC, HSS Paramus – Ridgewood Ave, allowing for an expansion of services and a state-of-the-art imaging suite including MRI, x-ray, and EOS low-dose radiation imaging. A special procedures unit for injection therapy and other advanced interventions is also available at this site. Additionally, HSS Orthopedics Now, providing quicker access to orthopedic care for sudden injuries and pain for patients 12 years and older, is available.

“I am deeply honored to lead HSS Paramus into its next chapter,” said Anil S. Ranawat, MD, sports medicine surgeon at HSS and medical director of HSS Paramus – Midland Ave. “This new facility is an exciting milestone in our unending pursuit to make comprehensive care even more accessible, enabling patients to complete their entire care journey—including testing, surgery, and more—right here in New Jersey.”

The new sites join the existing HSS location in Paramus on East Ridgewood Avenue. For more information about HSS Paramus-Midland Ave and HSS Northern NJ Surgery Center, visit www.hss.edu/locations.

“As an increasing number of younger adults in their 40s and 50s consider total knee replacement, many wonder how long knee implants last before requiring a revision procedure,” says William J. Long, MD, FRCSC, an HSS hip and knee surgeon and the senior author of the study. “The findings from our study—the largest and longest follow-up of patients under 55 undergoing total knee replacement—confirm that young patients can be confident their initial knee implants will allow them to pursue a high level of activity and more than likely last the rest of their lives.”

HSS orthopedic surgeons designed the longitudinal study to track outcomes for patients 55 years of age and younger who had total knee replacements between 1977 and 1992. During that period, they used knee prostheses known as the Insall-Burstein I and Insall-Burstein II—predecessors of implants used today that provide posterior stability. Both designs were conceived and developed at HSS. Previously, the investigators conducted patient follow-ups at 10, 25, and 30 years following surgery.

For this final report, Dr. Long and colleagues analyzed outcomes after 40 years for 81 patients aged 33 to 55 years. The analysis included 107 knees in total. Overall, 70% of patients in the study had no revision procedures in their lifetime. Patients were three to four times more likely to have passed away after 40 years than to have required a revision. Remarkably, among the 49 patients who received the original Insall-Burstein I prostheses, 80% did not have any revision surgeries.

“Considering that today's knee replacements have addressed the pitfalls leading to the majority of revisions for mechanical issues in Insall-Burstein I and Insall-Burstein II implants, these are very reassuring findings," says Dr. Long.

Dr. Long also examined six patients (eight knees) in person, and lead and presenting author Aaron Weinblatt, BA, contacted many more patients by phone. There were no signs of loosening nor were there any changes in symmetry or alignment of the original components. Additionally, patients reported an ongoing improved level of activity after surgery.

This was supported by patient-reported activity data collected for eight patients (10 knees) and measured using the Tegner Activity Scale (TAS). Before undergoing total knee replacement, the average TAS score was only 1.5, indicating they could work in a sedentary job and walk on uneven ground but not hike or backpack. At 40 years, their average TAS score was 2.7, indicating the ability to work in light labor occupations and participate in recreational activities such as swimming and walking in forests.

“Patients requiring a total knee replacement should not delay having surgery,” Dr. Long says. “Our study results highlight that those who undergo knee replacement sooner are more likely to maintain a high level of activity that contributes to a healthy, longer-term lifespan.”

Dr. Long adds that a previous HSS study published in 2014 at the 30-year follow-up showed that for the small percentage of patients who required revisions, the vast majority were doing well, with an average TAS score of 3.0, a good range of motion and no signs of loosening. ²

Authors: Aaron I. Weinblatt, BA, Victoria E. Bergstein, BA, Walter L. Taylor, MPhil, BS, Stephen Lyman, PhD, Felix C. Oettl, MD, W. Norman Scott, MD, FAAOS, William J. Long, MD, FRCSC.

Reference:

¹ Weinblatt AI, Bergstein VE, Taylor WL, Lyman S, Oettl FC, Scott WN, Long WJ. Total knee replacement in young, active patients: long-term follow-up and functional outcome: A final follow-up of previous report. Accessed February 10, 2025, at https://submissions.mirasmart.com/AAOS2025/Itinerary/PresentationDetail.aspx?evdid=2532

² Long WJ, Bryce CD, Hollenbeak CS, Benner RW, Scott WN. Total knee replacement in young, active patients: long-term follow-up and functional outcome: a concise follow-up of a previous report. J Bone Joint Surg Am. 2014 Sep 17;96(18):e159. Accessed February 19, 2025, at  https://pubmed.ncbi.nlm.nih.gov/25232089/  

“These distinguished individuals embody the highest ideals of our profession,” said AAOS President Paul Tornetta, III, MD, PhD, FAAOS. “Through their leadership, service and unwavering commitment to excellence, they have not only improved patient outcomes but also inspired the next generation of orthopaedic surgeons. Their contributions are a testament to the profound impact our field has in enhancing lives globally.”

AAOS Diversity Award Recipient

Thomas P. Sculco, MD, FAAOS, surgeon-in-chief emeritus, Hospital for Special Surgery and professor of Orthopaedic Surgery at Weill Cornell Medical College in New York, was presented with the AAOS 2025 Diversity Award in recognition of his outstanding commitment to promoting diversity at the local, institutional and national level. Dr. Sulco’s dedicated and visionary leadership over the past five decades has thoughtfully shaped and established lasting infrastructures that have enhanced diversity among orthopaedic surgeons, addressed healthcare disparities and elevated the quality of patient care.

According to orthopaedic spine surgeon and President of the J. Robert Gladden Orthopaedic Society Susan E. Stephens, MD, FAAOS, “Dr. Sculco has embodied and lived diversity in orthopaedics. He has trained under his leadership more Black and Women Orthopaedic surgeons than any other majority training program in the world. The excellence of his trainees speaks for itself in their success by all standards. Dr. Sculco never stops leading by example and continues through his personal mission to impact healthcare disparities by creating an honorable legacy of excellence in diversity in orthopaedic surgery.”

AAOS Humanitarian Award

The AAOS honored Coleen S. Sabatini, MD, MPH, FAAOS, with the 2025 Humanitarian Award for her exceptional dedication to caring for children with musculoskeletal conditions both domestically and abroad. A pediatric orthopaedic surgeon based at the University of California San Francisco Benioff Children’s Hospital Oakland in Oakland, Calif., Dr. Sabatini believes that all children should have access to high quality, safe and affordable orthopaedic care. Her work abroad has focused on pediatric orthopaedic education and capacity-building to improve access to quality care for children with musculoskeletal conditions, along with conducting research on treatment of musculoskeletal problems for children in resource-limited settings.  Her efforts have had a profound impact worldwide, particularly in Uganda, where she has focused much of her work since 2013.

According to Lisa L. Lattanza, MD, FAOA, FAAOS, chair of Yale Medicine Orthopaedics & Rehabilitation, “While I admire all the work Dr. Sabatini does in the United States, Uganda and other countries, I believe her greatest contribution will be the legacy she leaves as a mentor. She has formally and informally mentored dozens of other orthopaedic surgeons, promoting her values of domestic and international care equity to the next generation. Dr. Sabatini’s career based on selflessly supporting international pediatric musculoskeletal health, addressing disparity issues in the United States, promoting those values in service of the AAOS volunteer structure.”

William W. Tipton, Jr., MD, Leadership Award

The Tipton Leadership Award recognizes AAOS members who have demonstrated outstanding leadership qualities that have benefitted the orthopaedic community, patients and/or the American public. The award honors and celebrates the life, accomplishments and qualities of the late William W. Tipton Jr., MD, an orthopaedic surgeon, educator and former AAOS chief executive officer.

The 2025 recipient of the William Tipton leadership award is Steven Gitelis, MD, FAAOS, Rush Medical College Endowed Professor of Orthopedic Oncology and Director of the Rush Musculoskeletal Oncology Program. A leading expert in Orthopaedic oncology and limb reconstruction, Dr. Gitelis is celebrated for his pioneering surgical treatment of bone and soft tissue sarcomas and steadfast commitment to patient care. Currently he serves as the Chief Medical Officer of Onkos, a company focused on innovative cancer care. When he joined Rush more than 40 years ago, the institution lacked a dedicated sarcoma program—under his leadership, it has grown into one of the largest in the region. He created and mentored the Rush Multi-Specialty Musculoskeletal tumor board to optimize patient care. During his long career, he was elected and served as President of seven Medical Organizations including the Musculoskeletal Tumor Society.  He also founded Illinois’ first tissue bank and has served as its medical director for over 30 years, overseeing its growth into one of the largest in the United States. Beyond his clinical and research contributions, Dr. Gitelis has been a dedicated mentor, shaping the next generation of Orthopaedic leaders. He served in the United States Navy during the Persian Gulf War where he provided cancer care and educated military Orthopaedic surgery residents. Through collaboration and education, he continues to bridge the gap between research, practice and training to ensure a strong future for the field.

“As I embark on this four-year term, my priority is to champion and listen to our members, ensuring they have the resources, education and support necessary to navigate the evolving healthcare landscape,” said Dr. Parks. “Alongside my fellow AAOS Board members, I am committed to improving musculoskeletal health through collaboration, innovation and patient focus. I am honored to serve in this role and to advance AAOS’ mission of serving our profession to provide the highest quality musculoskeletal care.”

Dr. Parks has made a significant and lasting impact as a physician, advocate and mentor. Among his many AAOS volunteer positions, Dr. Parks served as treasurer, BOD member-at-large, chair of the AAOS Resolutions Committee, chair of the AAOS Finance Committee and chair of the Workgroup on Obesity. He was also a member of the Board of Councilors, AAOS Annual Meeting Committee and Communications Cabinet and selected to the 2003 class of the AAOS Leadership Fellows Program. His leadership was recognized with the AAOS’ Diversity Award in 2019 and Achievement Award in 2012.

Read the full article at aaos-annualmeeting-presskit.org/. 

A specialist in the surgical treatment of arthritis in adults, Dr. Parks is highly regarded for his expertise in reconstructive procedures for the hip and knee. His clinical research focuses on joint replacement surgery and emphasizes reducing health disparities and addressing socio-economic factors affecting healthcare outcomes. His insights have been featured in leading publications, including New York magazine, The New York Times Magazine, Black Enterprise magazine and Money magazine.  Dr. Parks also has appeared on the NBC-TV TODAY show where he discussed treatment alternatives for knee arthritis in baby boomers.

In addition to his leadership within the AAOS, Dr. Parks is a past president of the Orthopaedic Research and Education Foundation and the New York State Society of Orthopaedic Surgeons. He served as a member of the BOD of the American Association of Hip and Knee Surgeons and has been actively involved in the Movement is Life Caucus, a multi-stakeholder group devoted to decreasing musculoskeletal health disparities.

Dr. Parks graduated from Duke University with a Bachelor of Arts in chemistry and went on to earn his medical degree from the Medical University of South Carolina in Charleston, where he received the President’s Clinical Science Award. After completing an internship in general and thoracic surgery, followed by an orthopaedic residency at Duke University Medical Center, he continued his training at Hospital for Special Surgery in New York with a fellowship on the Hip and Knee Service where he remains in practice today.

What follows are highlights from these studies:

Limiting Use of Tourniquets During Knee Replacement Surgery Improves Patient Outcomes

Tourniquets have traditionally been used during TKA to reduce blood loss and the need for transfusions. However, a new study of almost 18,000 patients from 2019 to 2023 found that prolonged tourniquet use was linked to increased pain, higher opioid use, and a longer recovery. 

“We found that limiting tourniquet use was associated with slightly lower rates of opioid use to control pain after surgery and a quicker ability to complete physical therapy and leave the hospital,” said Brian P. Chalmers, MD, hip and knee surgeon at HSS and co-senior author of the study.

Thanks to advances in medicine and technology, tourniquets may not be needed as often. For example, tranexamic acid (TXA) is now commonly used to effectively reduce bleeding and lower the likelihood of patients requiring a blood transfusion.

“If you have a drug that has this beneficial effect, then the need for a tourniquet may be reduced,” explained Alejandro Gonzalez Della Valle, MD, hip and knee surgeon at HSS and co-senior author of the research. “If you limit tourniquet use, patients will hurt less and will move sooner, and that will allow patients to go home sometimes the same day.” 

Dr. Della Valle notes that limiting tourniquet use can also reduce opioid consumption. The reason that tourniquet use during TKA has been associated with increased post-operative pain is because the device compresses the quadricep and hamstring muscles to restrict blood flow during the operation. The increased pain may impact the time it takes to complete rehabilitation.

Surgeons have also traditionally used tourniquets to keep the area between the knee implant and the bone as dry as possible, which helps bone cement create a stronger bond between the bone and the implant, potentially reducing the risk of loosening over time.

“Recent studies have shown that you can obtain a dry field without using a tourniquet, reducing its necessity during TKA,” explained Dr. Chalmers.  

Another development that has lessened the need for the use of tourniquets is cementless fixation, in which a specially-designed implant that allows the bone to grow into the implant and achieve long-term fixation without the use of cement.

There is currently no consensus in the literature or among surgeons throughout the country on the use of tourniquets during TKA. Surgeons use these devices differently based on individual patient needs. Some use a tourniquet from the time of incision until the implant is fixated to the bone, while others use it only during cementation or throughout the entire procedure until the wound is closed and the dressings are in place. Some surgeons may opt not to use a tourniquet at all. 

“What sets this study apart is that it captures what surgeons are doing in their daily practice,” said Dr. Chalmers. “To our knowledge, this is the only paper that addresses several different ways surgeons use tourniquets during TKA, including no usage, limited usage, and full usage.”

The study’s authors conclude that reduced tourniquet use should be considered within the realm of multiple advances that help patients recover faster after surgery and with less pain. These include newer drugs and tools used to reduce pain and blood loss during surgery, two major factors that often prolong hospital stays.

“Any measures we can take around the time of surgery to help those factors can significantly improve patient outcomes,” said Dr. Della Valle.

NSAIDs Reduce Risk of Fibrosis Needing Further Treatment after Knee Replacement Surgery

A new study led by surgeons at HSS shows that patients who were prescribed a non-steroidal anti-inflammatory drug (NSAID) after TKA had a reduced risk of developing painful scar tissue, a condition known as arthrofibrosis, which often requires additional procedures. The findings also shed light on the durations for NSAID use to prevent fibrosis following surgery.

In arthrofibrosis, excessive scar tissue forms in and around a joint after an operation. It can lead to stiffness, pain and reduced range of motion in the joint. Approximately 2% to 6% of patients require a minimally invasive procedure called manipulation under anesthesia (MUA) to treat this complication.

The researchers found that patients who were prescribed an NSAID had a significantly lower incidence of MUAs (5.3%) 90 days after surgery compared to those who did not have an NSAID prescription (12.6%). The study included more than 23,000 people who had TKA at HSS between 2017 and 2021.

“This study highlights the importance of NSAID use for early recovery after TKA,” says Peter K. Sculco, MD, hip and knee surgeon at HSS and senior author of the study. “These medications are associated with lower rates of fibrotic pain and stiffness requiring an intervention such as MUA.”

He added that decreased risk was not seen in patients who used NSAIDs for more than four weeks, suggesting patients stop within one month’s time to get the most benefit.

Some patients, however, cannot use NSAID medications due to risk of bleeding or gastrointestinal or kidney issues.

“We now use steroids for one week after TKA in patients who are unable to take NSAIDs,” explained Dr. Sculco. “However, further research is necessary to determine the effect of steroids on MUA rates and the appropriate dose and duration for this group of patients.”

Local Anesthetic Leads to Better Patient Outcomes after Revision Knee Replacement Surgery

A new study led by surgeons at HSS found that the use of a new local anesthetic at the time of revision TKA enabled patients to leave the hospital sooner and recover faster.

According to the findings, a recently introduced pain medication known as extended-release, dual-acting local anesthetic (ERDALA) used at the time of aseptic revision TKA was associated with better patient outcomes. These included completing physical therapy sooner, shorter hospital stays, and more patients being discharged within one day after surgery.

Approximately 5% to 10% of patients need aseptic revision TKA, a surgical procedure done to address loosening, stiffness, or instability of a non-infected knee joint that was previously replaced with TKA.

The study reviewed outcomes of 171 patients who had aseptic revision TKA at HSS between January 2021 and May 2023. Patients either received ERDALA (51.5%) or standard of care periarticular injections (PAI) (48.5%) during surgery. The researchers found that patients who received ERDALA went home nearly a day sooner and cleared physical therapy approximately 20 hours faster than those who received PAI.

“ERDALA did not reduce pain scores or the total amount of opioids prescribed in this study but was associated with helping patients reach early recovery milestones sooner,” noted Dr. Peter Sculco, who is also senior author of this study. “This medication can be a valuable tool in rapid recovery strategies used in aseptic revision TKA, which can lead to patients walking better and getting home faster.”

He added that further research is needed to explore these strategies in the revision population, especially as more revision surgeries are performed in the outpatient setting.