AN EVENING RECOGNIZING EXCELLENCE IN MUSCULOSKELETAL MEDICINE

At HSS’s premier fundraising event recognizing physicians and philanthropists making an impact in the field of musculoskeletal medicine, Mr. Griffin was presented with the 2024 HSS Tribute Dinner Award by Robert K. Steel, Co-Chair of the HSS Board of Directors. Dr. Haas was presented with the HSS Lifetime Achievement Award by baseball legend Bernie Williams, and Dr. Potter was presented with the HSS Lifetime Achievement Award by Chase Coleman, founder of Tiger Global and an HSS Trustee.

The evening, which featured a musical performance by five-time Grammy Award-winner Jon Batiste, was attended by over 750 guests and raised more than $5 million for patient care, research and medical education.

“The Lifetime Achievement Award is our highest recognition for an outstanding healthcare leader at HSS,” said Douglas E. Padgett, MD, Surgeon-In-Chief and Medical Director. “Both Drs. Haas and Potter exemplify the qualities that make HSS unique: their unwavering dedication to providing the highest quality of care; consistent efforts to advance the science in their respective fields; and their leadership in developing new techniques, technologies and treatment advances that have transformed the lives of patients around the world.”

An Extraordinary GIFT

With the new transformational gift from Mr. Griffin announced at the event, HSS will establish the Kenneth C. Griffin Research Accelerator to accelerate the pace of innovative research to help millions of people regain their mobility and quality of life. Mr. Griffin’s donation will advance work to better personalize treatment to the unique clinical needs of each patient and will also support construction of the HSS Kellen Tower, a new headquarters for joint replacement surgery and global destination for the treatment of complex orthopedic problems that is expected to open in 2025.

“We are privileged to honor Ken with the Tribute Dinner Award and to have his incredible support,” said Bryan T. Kelly, MD, MBA, President and CEO at HSS. “As one of the country’s foremost philanthropists, Ken has demonstrated outstanding leadership in his efforts to improve quality and access to healthcare. His support of cutting-edge research drives progress in science and medicine that will have a global impact.”

Joint pain affects more than 80 million adults in the United States, with nearly 1 in 2 people experiencing chronic pain in the knee. HSS performs more than 12,000 hip and knee replacement surgeries annually, more than any other hospital in the United States. The breadth of expertise and high patient volume uniquely position HSS to drive innovative investigations for joint disease so that patients can achieve the mobility and function they desire, with results that will last a lifetime.

“The extraordinary scientists, physicians, and healthcare professionals at the Hospital for Special Surgery lead the world in the research and treatment of orthopedic care,” said Mr. Griffin. “I am proud to support HSS in its broad impact that stretches from helping elite athletes get back on the field to enabling seniors to actively engage with their grandchildren. The research and innovation at HSS is changing the lives of people around the world.”

Mr. Griffin has previously supported vital investigations in knee replacement surgery and precision medicine, as well as the expansion of facilities for care and research at HSS.

“We are deeply grateful for Ken’s remarkable generosity. This gift will help us establish how to personalize every aspect of knee replacement surgery for maximum benefit,” said Dr. Haas.

“Ken’s generous contribution and partnership will have significant impact in creating the best environment for joint replacement care at HSS and in shaping the standards of care globally,” said Mr. Steel.

 Three studies focus on how to optimize total knee arthroplasty (TKA) surgery using biomechanics and computer modeling, while another study discusses how three-dimensional (3-D) modeling can improve total hip arthroplasty (THA).

 What follows are some highlights from the meeting:

Undersizing Tibial Baseplates in Cementless TKA Has Negative but Small Impact for Bone–Implant Interaction: A Computational Biomechanical Study

Computational biomechanical modeling is useful for taking a closer look at how making changes to orthopedic surgery techniques affects patient outcomes. A study led by Fernando J. Quevedo-González, PhD, assistant scientist in the Department of Biomechanics at HSS, and HSS hip and knee surgeon Jonathan M. Vigdorchik, MD, used these kinds of models to determine how best to minimize the risk of complications in cementless TKA. The model was developed using preoperative scans from 12 female patients about to undergo robotic TKA and was used to ask questions about how sizing the tibial baseplate (the metal part of the prosthesis that connects to the shin bone) affects outcomes. The investigators found that, in general, decreasing the size of the baseplate increased the amount of bone at risk of failure, but this risk was small compared with normal variability of bone quality among patients and how their individual knee joints were loaded as they used their knee in performing activities of daily living. Based on this result, they concluded that baseplate undersizing can be done to optimize the placement of the tibial component of the TKA without increasing the risk of bone failure.

Authors: Fernando J. Quevedo-González, PhD, Peter K. Sculco, MD, Cynthia Kahlenberg, MD, Joseph D. Lipman, MS, Timothy M. Wright, PhD, Jonathan M. Vigdorchik, MD.

Posterior Tibial Slope in Total Knee Arthroplasty: The Transmalleolar Sagittal Axis Underestimates Slope Compared to Traditional Intramedullary Axis

The tibial slope, one of multiple angles used to place a TKA, defines how the tibial component meets the knee and impacts the knee’s ability to bend and the strain that’s put on the ligaments throughout range of motion. A study led by HSS hip and knee surgeons Brian P. Chalmers, MD, and Steven B. Haas, MD, looked at how robotics and computer navigation influence the tibial slope in TKA. Historically, knee implants were designed using what is called the intramedullary axis to measure the tibial slope, but technology-assisted knee replacement operations determine the slope in a different way. The investigators retrospectively reviewed preoperative CT scans from 40 TKA procedures and reconstructed the 3-D geometry of the tibia and fibula to determine the slope based on the intramedullary axis. They determined that in many cases, the alternate calculation of the slope used in technology-assisted procedures resulted in a different slope in the newly implanted knee. This difference could have a negative effect on the knee’s movement and mechanics, suggesting that as more procedures are performed using robotic-assisted technology, the need to re-think implant designs to incorporate these changes is likely.

Authors: Brian P. Chalmers, MD, Fernando J. Quevedo-González, PhD, Michael P. Ast, MD, Steven B. Haas, MD.

The Initial Fixation of Cementless TKA Is Associated with the AP Translation During Gait: A Computational Study

The two main goals of TKA surgery are restoring the motion of the knee joint to as close to a native knee as possible, and ensuring that the implant is properly attached to the bone so that it lasts as long as possible and does not loosen. A novel study led by Jonathan Glenday, PhD, a postdoctoral fellow, and Fernando J. Quevedo-González, PhD, assistant scientist, both in the Department of Biomechanics at HSS, looked at the intricate relationship between attachment to the bone and joint motion, and how these two aspects of joint mechanics are related. The investigators used a computational model that included gait mechanics and anatomic information from CT scans to look at whether the anterior-posterior (AP) translation (front-to-back movement) of the femur with respect to the tibia while walking was correlated with bone-implant micromotion after surgery. Based on their models, they determined that the AP translation significantly related to the peak micromotion throughout gait, especially in the lateral portion of the knee; greater AP translation resulted in larger micromotions. This study highlights the connection between joint-level mechanics and fixation-level mechanics in TKA surgery and is the first time researchers at HSS have been able to look at both in tandem.

Authors: Jonathan Glenday, PhD, Peter K. Sculco, MD, Jonathan M. Vigdorchik, MD, Joseph D. Lipman, MS, Cynthia Kahlenberg, MD, David J. Mayman, MD, Timothy M. Wright, PhD,  Fernando J. Quevedo-González, PhD.

Three-Dimensional Functional Impingement in Total Hip Arthroplasty: A Biomechanical Analysis

Impingement after THA can lead to pain and, in the worst case, a dislocation of the prosthesis. Offset of components, which is related to the width of the hip, directly affects the impingement of the hip after surgery. Surgeons have multiple ways to alter offset during THA surgery; however, these alterations have only been studied in two dimensions. A team led by HSS hip and knee surgeon Jonathan M. Vigdorchik, MD, and former clinical fellow Eytan Debbi, MD, PhD, used 3-D models created from pre- and postoperative CT scans of 16 patients who underwent the procedure to retrospectively analyze the relationship between offset and impingement. They compared cup/liner (acetabular) offset to head/stem (femoral) offsets and looked at the effects that these configurations had on the patient’s range of motion and incidence of impingement after surgery. The investigators found that in all cases, increasing the offset reduced the amount of impingement, and increased the full range of motion of the hip. Acetabular offsets had greater impact than femoral offsets in the range of motion because they affect the offset of the center-of-rotation.

Authors: Eytan Debbi, MD, PhD (Cedars-Sinai), Fernando J. Quevedo-González, PhD, Seth A. Jerabek, MD, Timothy M. Wright, PhD, Jonathan M. Vigdorchik, MD.

"Initially not resurfacing the patella leads to higher revision rates and equal or more pain. So, why are we doing it? A meta-analysis (Nizard et al., CORR 2005) shows that un-resurfaced patellas had increased pain, greater reoperations, greater anterior knee pain," said Dr. Haas during the debate at the Annual Current Concepts in Joint Replacement (CCJR) Winter meeting in Orlando, Florida.

According to recent studies, Dr. Haas stated that non-resurfaced patellas required re-operation compared to those with a resurfaced patella.  

"If 3-5% [of patients] are going to go back, my patients are not going to be happy. I think that if you resurface them you're going to be happier with that result and not have to go back and re-operate," he said.

The debate was moderated by HSS surgeon-in-chief emeritus Thomas P. Sculco, MD.

Read the full article at ryortho.com [subscription required].