Adult Reconstruction & Joint Replacement Service
Chief:Mathias P. Bostrom, MD
Visit the Service Page for the full faculty listing.
The Adult Reconstruction and Joint Replacement (ARJR) Service at HSS has led the field since pioneering the first artificial human knee replacement more than four decades ago. Through a dedicated program of basic science and clinical research, the clinician-scientists on the ARJR Service are continually making discoveries relevant to improving outcomes for all joint replacement patients.
The service continues to grow and develop. Recent additions include William Long, MD, who is focused on hip and knee reconstruction, revision joint replacements and sports injuries of the knee. Our service now has 34 surgeons across our locations in Manhattan; Stamford, Connecticut; and West Palm Beach, Florida.
Michael P. Ast was named Chief Medical Innovation Officer at HSS. His appointment highlights the commitment of the ARJR Service to lead across all areas of innovation, including device development and value in medicine as well as biomedical research. Fred Cushner, MD, and Peter Sculco, MD, performed the first-ever knee replacement containing an implantable device approved to collect data on a patient’s progress after TKA. The embedded smart sensor measures steps taken, walking speed, knee range of motion and other indicators of knee function following surgery, securely relaying the data to a cloud-based platform for the orthopedic surgeon to review.
In addition, Mark Figgie, MD, and Alberto Carli, MD, were named co-directors of the PJI Research Initiative. This ongoing area of interest for our surgeon-scientists is focused on studying ways to prevent infections, enhancing diagnostic capabilities and improving treatment regimens and outcomes for patients who do go on to develop an infection. Our faculty published a number of important papers on the topic in 2021, including “Are Intraoperative Cultures Necessary If the Aspiration Culture Is Positive? A Concordance Study in Periprosthetic Joint Infection,” which appeared in the July edition of the Journal of Arthroplasty and earned the James A. Rand Young Investigator’s Award.
Our faculty also continue to play leadership roles in national and international associations. In 2021, Michael Parks, MD, was named treasurer-elect of the American Academy of Orthopaedic Surgeons; Steven Haas, MD, was selected to the presidential line of the Knee Society; William Long, MD, was in inducted into the Knee Society; and Edwin Su, MD, was inducted into the Hip Society.
Echeverria AP, Cohn IS, Danko DC, Shanaj S, Blair L, Hollemon D, Carli AV, Sculco PK, Ho C, Meshulam-Simon G, Mironenko C, Ivashkiv LB, Goodman SM, Grizas A, Westrich GH, Padgett DE, Figgie MP, Bostrom MP, Sculco TP, Hong DK, Hepinstall MS, Bauer TW, Blauwkamp TA, Brause BD, Miller AO, Henry MW, Ahmed AA, Cross MB, Mason CE, Donlin LT. Sequencing of Circulating Microbial Cell-Free DNA Can Identify Pathogens in Periprosthetic Joint Infections. J Bone Joint Surg Am. 2021 Sep 15;103(18):1705-1712. doi: 10.2106/JBJS.20.02229. PMID: 34293751.
Kunze KN, Fontana MA, MacLean CH, Lyman S, McLawhorn AS. Defining the Patient Acceptable Symptom State for the HOOS JR and KOOS JR After Primary Total Joint Arthroplasty. J Bone Joint Surg Am. 2021 Nov 1. doi: 10.2106/JBJS.21.00550. Epub ahead of print. PMID: 34958538.
Rodriguez S, Lebrun DG, Shen TS, Rodriguez JG, Della Valle AG, Rodriguez JA, Ast MP. Best Poster Award – Health Policy Category, 2021 Annual Meeting of the American Association of Hip and Knee Surgeons: Predicting Total Knee Arthroplasty Outpatient Discharge: Surgeons vs Insurance Companies. 2021 Nov. Vigdorchik JM, Sharma AK, Buckland AJ, Elbuluk AM, Eftekhary N, Mayman DJ, Carroll KM, Jerabek SA. 2021 Otto Aufranc Award: A simple Hip-Spine Classification for total hip arthroplasty: validation and a large multicentre series. Bone Joint J. 2021 Jul;103-B(7 Supple B):17-24. doi: 10.1302/0301-620X.103B7.BJJ-2020-2448.R2. PMID: 34192913.
Gkiatas I, Malahias MA, Xiang W, Meyers KN, Torres LA, Tarity TD, Rodriguez JA, Bostrom MP, Wright TM, Sculco PK. How Does Contact Length Impact Titanium Tapered Splined Stem Stability: A Biomechanical Matched Pair Cadaveric Study. J Arthroplasty. 2021 Sep;36(9):3333-3339. doi: 10.1016/j.arth.2021.04.013. Epub 2021 Apr 22. PMID: 33958253.
Sculco PK, Wright T, Malahias MA, Gu A, Bostrmro M, Haddad F, Jerabek S, Bolognesi M, Fehring T, DellaValle AG, Jiranek W, Walter W, Paprosky W, Garbuz D, Sculco T on behalf of Acetabular Bone Loss Work Group. The Diagnosis and Treatment of Acetabular Bone Loss in Revision Hip Arthroplasty: An International Consensus Symposium. 2021 Sept 28. doi.org/10.1177/15563316211034850.
Research within ARJR is focused on several thematic areas. In addition to our continuing focus on PJI, these include implant longevity and perioperative care. The aims of the perioperative initiative are to assess the impact of COVID-19 on joint arthroplasty patients; optimize the use of telemedicine; develop an opioid-free pathway for total joint arthroplasty patients through the use of alternative medications and predictive modeling; and improve our understanding of how preexisting conditions such as obesity can affect surgical outcomes, with the goal of enhancing the standard of care for patients who are at higher risk for complications.
Our implant longevity work is focused on the biological, biomechanical and surgical techniques that contribute to the long-term success of joint replacement surgery. Core areas of investigation include learning how we can promote better bone growth and healing, selecting increasingly personalized implant materials and designs and leveraging new technologies ranging from robotic approaches to wearable or implantable sensors, all in service of preventing implant failure for arthroplasty patients here at HSS and around the world.