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.

Through the HSS Innovation Institute, HSS and MARS will collaborate to advance musculoskeletal imaging and diagnosis, including evaluation of specific aspects of the MARS 5x120 Extremity Scanner and potential co-development of new scanning technologies and systems.

The MARS 5x120 Extremity scanner is based on detector technology that was initially developed as part of ongoing particle physics research at the European Laboratory for Particle Physics (CERN), where the Higgs Boson was discovered. The MediPix3 detector technology previously enabled MARS’s development of the world’s first commercial (2010) photon counting 3-D color x-ray, producing high contrast images of bone detail and assessment of bone density at a fracture site at a significantly reduced radiation dose compared to traditional CT. The MARS 5x120 Extremity scanner is designed as a “point-of-care” system, intended for use in clinical office and ambulatory settings, addressing clinical needs such as pre- and post-surgical planning, assessment of fracture healing, and identification of implant complications.

HSS Department of Radiology and Imaging Chairperson Hollis Potter, MD is enthusiastic about the HSS- MARS collaboration: “Our team looks forward to collaborating with MARS to assess the technology and pursue other new applications and development opportunities. We see this type of imaging modality and detector technology as the next evolution in CT scanners; as HSS physicians and innovators, our goal of continuously improving patient care and outcomes includes identifying and pursuing new technologies, as well as developing partnerships that leverage HSS’s expertise and innovative spirit with cutting-edge industry advancements to drive innovation.”

“We’re pleased that a world-class clinical organization like HSS sees the potential for the MARS CT scanning technology,” says MARS CEO Mark Figgitt. “Given their substantial experience and expertise in the field of musculoskeletal health, including the volume of orthopedic surgeries performed there, we are confident that HSS is the right partner to help us evaluate and develop our technology and clinical applications. We believe this will be a true collaboration where the complimentary expertise of both organizations come together to improve clinical care and lower costs.”

Michael Campbell, Spokesperson for the Medipix3 collaboration at CERN, said, “it is great to see the efforts of CERN and the Medipix3 Collaboration playing a pivotal role in bringing innovations in medical imaging for the benefit of the global medical community”.

 About MARS Bioimaging Limited

MARS Bioimaging was launched in 2007 by father and son team Professor Phil Butler, then Head of the New Zealand CERN research group, and his son Professor Anthony Butler, a clinical radiologist and Director of Radiology at the University of Otago, Christchurch. MARS was formed to commercialize the ground breaking MARS technology and bring photon counting CT to the clinic. To achieve this the company brought together an interdisciplinary research and development team of physicists, radiologists, engineers, computer scientists, orthopaedic and other surgeons, mathematicians, biologists, and cancer researchers. MARS systems are based on next generation x-ray detectors (Medipix3RX) developed under the Medipix3 collaboration hosted by CERN, and other partners, including the University of Canterbury (UC). In association with UC and University of Otago, Christchurch (UOC), MARS now has a team working on developing new preclinical and clinical applications for photon-counting technology. This includes, but is not limited to, bone and joint health, cancer, cardiovascular disease, and infectious disease. MARS has established itself as the world’s leading research and development group in spectral molecular imaging and to-date has delivered the world’s first commercial pre-clinical spectral CT scanner (MARS Microlab 5X120), as well as a compact human system for upper extremity evaluation (MARS Extremity 5X120). 

MARS’s technology and company have received several awards, including: HealthTech Award for Best Translational Project in HealthTech Week; Supreme Small Enterprise in the Champion Canterbury Awards; and Best Health and Science Innovation and Best Emerging Innovation at the NZ Innovation Awards.

The study, published yesterday in Clinical Orthopaedics and Related Research, is the first to evaluate the presence and risk of local tissue complications after hip replacements made of different materials in patients, including those who are asymptomatic. Previous studies have been limited to metal-on-metal implants.

Hip replacement parts are made of plastic, ceramic, metal or a combination of these materials. The components move against each other and wear down slowly through regular use. Small wear particles can break free from the hip replacement material over time and damage local joint tissues. MRI is a non-invasive imaging technique that uses a large magnet and radiofrequency energy to produce digital images without the use of ionizing radiation. MRI is often used in orthopedics to visualize the soft tissues around total hip replacements that are affected by the small wear particles.

“We found that patients can be completely asymptomatic and have high-functioning hip scores while harboring reactions that could start to destroy the soft tissues around the hip,” said Hollis G. Potter, MD, chairman of the Department of Radiology and Imaging and the Coleman Chair in MRI Research at HSS and the study’s senior author. “This finding is important because tissue reactions typically worsen over time. Delayed detection results in unnecessary pain, longer and more complicated revision operations and more challenging recoveries.”

Matthew F. Koff PhD, the lead study author said, “The study also indicates that MRI is clinically useful for patients who receive a ceramic-on-polyethylene or metal-on-polyethylene implant, in addition to patients who received a hip resurfacing arthroplasty.”

Drs. Potter and Koff and HSS colleagues prospectively evaluated 206 patients (243 hip replacements) at least one year after having hip resurfacing arthroplasty or total hip replacement. The researchers examined the volume of joint tissue reaction using MRI images, levels of metal particles in the blood and patients' responses on a survey called the Hip Disability and Osteoarthritis Outcome Score annually over the course of 3 years. The researchers compared results for patients who received hip resurfacing arthroplasty (HRA) with patients who received ceramic-on-polyethylene and metal-on-polyethylene total hip replacements.

During the study, MRI identified adverse local tissue reactions in 25 percent of patients who had hip resurfacing arthroplasty. This finding was surprising, since these patients reported symptoms similar to or less severe than patients with ceramic-on-polyethylene and metal-on-polyethylene total hip replacements implants. Patients who received hip resurfacing arthroplasty had a significantly larger volume of joint tissue reaction on MRI, a nearly five-times-higher risk of having tissue complications than patients who had a ceramic-on-polyethylene total hip replacement. Metal ion levels were inconsistently elevated in the patients with these reactions.

“By sharing our findings, we hope physicians will start incorporating MRIs into patient assessments, leading to earlier detection of issues and better outcomes for patients,” Dr. Potter said. “Widespread use of MRI to assess soft tissue damage may also help identify patterns that could ultimately improve implant design in the future.”

She writes that the benefit of MRI following cartilage repair is to provide an objective assessment of the biologic integration of the tissue, as well as any host-mediated response. 

"It is not uncommon that objective outcome variables do not correlate with more subjective patient-reported outcome measures (PROMs)," she explains. The discordance between clinical (subjective) and imaging (objective) results is often a result of individuals who report good function and limited symptoms despite the presence of suboptimal graft appearance on imaging.

Read the full perspective at Healio.com.

This article appeared in the August 6, 2018 print issue.

While historically used to determine SLAC progression, plain radiographic methods are not always sensitive. Researchers from Hospital for Special Surgery assessed the prevalence of radiolunate (RL) ligament wear in SLAC/SNAC patients by comparing operative findings to MRI and plain radiographs to determine diagnostic accuracy.

This retrospective study looked at 41 patients who underwent wrist surgery between 2006 and 2016 and were diagnosed with SLAC or SNAC with preoperative imaging. This ten-year review utilized operative reports as well as radiographs graded by radiologists using the Kelgran Lawrence Joint Grading Scale.

According to operative and MRI findings, the study found that RL wear occurs in late SLAC/SNAC patients. It was determined that plain radiograph findings underestimate the degree of involvement and that MRI has a potentially higher diagnostic accuracy for detection of RL wear. MRI findings had a stronger correlation with operative pathologic findings than radiograph (p = 0.158 vs. p = 0.337).

The study’s results suggest that surgeons should consider taking a high-resolution MRI prior to joint preserving surgery in the wrist. This knowledge can potentially change the surgical management of SLAC/SNAC osteoarthritis.

Abstract Title: Magnetic Resonance Imaging Findings Correlate with Operative Findings in Patients with SLAC/SNAC Osteoarthritis

Authors: Danielle Christine Marshall, BA; Schneider K. Rancy, BA; Alissa J. Burge, MD; Hollis G. Potter, MD; Scott W. Wolfe, MD; Steve K. Lee, MD.