A Letter from HSS Medical Leadership
Since its founding, HSS has been the foremost global leader in providing complex care to patients with musculoskeletal issues. Despite the challenges of the past year, we have continued to deliver on this mission through basic, translational and clinical research advances; the development and implementation of new technologies and techniques; investments in innovation and diagnostic capabilities; and community-focused projects and studies with the potential to have widespread impact both locally and beyond.
One example in the technology arena is the March 2021 opening of the first provider-based 3D design and printing facility, the ProMade Point of Care Center, at the HSS main campus in New York City. HSS surgeons and engineers are working with LimaCorporate’s engineers to best utilize the Italian company’s patented trabecular titanium technology to create custom complex joint replacement implants for patients with unique needs.
Another example concerns new basic science research into periprosthetic joint infection (PJI). In July, a team of HSS investigators led by Mathias P. Bostrom, MD, Chief of the Adult Reconstruction and Joint Replacement (ARJR) Service, and Laura Donlin, PhD, Co-Director of the Derfner Foundation Precision Medicine Laboratory, became the first to demonstrate that DNA from PJI-causing bacteria can be detected in circulating blood and sequenced to identify the microbe causing the infection. The innovative approach has the potential to help doctors treat patients who develop PJI with targeted antibiotics faster than is currently possible and monitor infection clearance before conducting revision surgeries.
We also continue to evaluate the effectiveness of cutting-edge technology in preventing complications and speeding recovery. In December 2020, spine surgeons Han Jo Kim, MD, and Matthew E. Cunningham MD, PhD, in collaboration with endocrinologist Emily M. Stein, MD, showed for the first time, using high-resolution peripheral quantitative computed tomography (HR-pQCT), that abnormalities in the microscopic structure of bone are directly related to the development of complications after spinal fusion. This year, the team continued that work, exploring new medications that may improve bone quality and outcomes after spinal fusion.
Furthermore, in September, Peter K. Sculco, MD, and Fred D. Cushner, MD, conducted a knee replacement surgery using a “smart” implant that connects and transmits data, enabling an orthopaedic surgeon to monitor a patient’s recovery from afar. An innovation in the growing field of remote patient monitoring, it is the first implantable device approved to collect data on an individual’s progress after a total knee replacement.
Lastly, surgeons across HSS, including those on the ARJR, Pediatrics, Spine, Sports Medicine and other services, continue to spearhead advancements in robotics, computer-navigated surgical techniques and augmented reality with the aim of improving precision, accuracy and predictability.
Their evidence-based approach is helping to ensure that cutting-edge technology is developed and deployed in a meaningful way, producing the data necessary to help us determine how to achieve better outcomes for patients.
These and other developments fall within the portfolio of the HSS Innovation Institute, which has benefited from the leadership of Michael P. Ast, MD, newly appointed Vice Chair of Innovation and Chief Medical Innovation Officer. The HSS Innovation Institute is singularly focused on advancing the field of musculoskeletal care by working closely with physicians, researchers, surgeons and scientists to support new, viable offerings that can improve clinical outcomes, enhance the patient experience or lower the cost of care delivery.
The superior diagnostic capabilities at HSS also continued to evolve in a major way over the past year. HSS became the first US hospital to implement integrated clinical diagnostics with the launch of a digital pathology solution that unites pathology images and reports with electronic medical record data and radiology images across the enterprise. Under the guidance of Thomas W. Bauer, MD, PhD, Pathologist-in-Chief at HSS, clinical and IT teams piloted the technology, allowing surgeons, radiologists and other physicians to view high-resolution digital images of scanned microscope slides in real time.
HSS Rheumatology saw similar groundbreaking achievements in 2021. In August, the US Food and Drug Administration approved the drug anifrolumab for the treatment of adult patients with moderate to severe systemic lupus erythematosus who are receiving standard therapy.
Anifrolumab is a monoclonal antibody that works by blocking the receptor for a family of molecules called type I interferon, which are essential for the body’s natural defense against viral infections. Much of the groundwork for the development of this drug was done at HSS in the early 2000s in the lab of Mary K. “Peggy” Crow, MD, Physician-in-Chief Emerita at HSS and Co-Director of the Mary Kirkland Center for Lupus Research at the HSS Research Institute.
Additionally, research at HSS continued to yield new perspectives in the understanding of patient outcomes. Rheumatologists Bella Y. Mehta, MBBS, MS, and Susan M. Goodman, MD, in partnership with orthopaedic surgeon Michael L. Parks, MD, are leading important work using big data to shed light on disparities in joint arthroplasty outcomes. The team has collaborated on an array of studies that explore the interconnectivity of race, socioeconomic status and community and how these factors may be contributing to the variances in outcomes for patients of African descent.
We were also thrilled to announce the return of Timothy B. Niewold, MD, to HSS as newly appointed Vice Chair of Research in the Department of Medicine, of which HSS Rheumatology is a part. An internationally recognized clinician-scientist focused on the pathogenic factors involved in autoimmune diseases such as lupus, Dr. Niewold completed a rheumatology fellowship at HSS in 2007. He rejoins HSS from NYU Langone Health, where he served as Director of the Colton Center for Autoimmunity. In this newly established role, he will play a vital part in accelerating translational research efforts at HSS.
Dr. Niewold’s appointment comes at a particularly exciting time for the research enterprise. In 2021, our investigators received significant recognition for their work, garnering the largest amount of external funding for research in the history of the organization. Among these recipients were Chitra Dahia, PhD, who received two large NIH grants to study the role of select proteins and signaling pathways in the regeneration of cervical spine disks; Dr. Donlin, who also received two NIH awards for her work in autoimmune diseases; and Baohong Zhao, PhD, who received an NIH grant for work examining the regulation of bone homeostasis and remodeling important for preventing bone loss in osteoporosis and arthritis. Surgeon-scientist Scott A. Rodeo, MD, Vice Chair of Orthopaedic Research and Director of the HSS Center for Regenerative Medicine, also received the first-ever Injectable Orthobiologics of Knee Osteoarthritis Grant from the Orthopaedic Research and Education Foundation and the American Academy of Orthopaedic Surgeons. The funding will permit the study of platelet-rich plasma in ACL injuries to decrease the risk of osteoarthritis.
The past year has also seen exciting growth in our capacity to bring our care to more patients. In January, we celebrated the first anniversary of HSS Florida; in June, HSS Midtown made its debut on Lexington Avenue in Manhattan; and in October, we marked significant milestones in the construction of the HSS Kellen Tower, a state-of-the-art, donor-funded facility that will rise over the East River upon its completion in 2024. The HSS Kellen Tower will expand care for joint replacement and spine conditions and allow HSS to convert from 30 to 70 percent private patient rooms across our main campus, an institutional priority underscored by the pandemic and necessary for optimizing the healing environment for our patients.
As has been the case throughout the entirety of our long and storied history, our guiding purpose remains the same: to improve care for people with musculoskeletal issues both routine and complex, whether within our walls or across the world. We have been and will continue to proceed undaunted on this mission.
Chief Emeritus, Sports Medicine Institute
Korein-Wilson Professor of Orthopaedic Surgery
Chief, Division of Rheumatology
Franchellie M. Cadwell Professor of Medicine
Richard L. Menschel Research Chair
David H. Koch Chair in Arthritis and Tissue Degeneration
Professor of Medicine and Immunology
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