HOSPITAL HOSPITAL FOR SPECIAL FOR SPECIAL SURGERY SURGERY: 535 EAST 70TH STREET SPECIALISTS NEW YORK, NY 10021 IN MOBILITY 212.606.1000 www.hss.edu SPRING 2009

OIO PIG2009 SPRING HORIZON Horizon 2008 ANNUAL Hospital for Special Surgery is an affiliate of NewYork- REPORT Presbyterian Healthcare System and Weill Cornell Medical College.

Team Players Hospital for Special Surgery’s sports medicine professionals oversee care for competitive athletes and teams in virtually every sport. Middle: Brandon Jacobs, New York Giants Clockwise, from the top: Devin Harris, Nets Basketball; Sarah Bates Johnson, US Rowing Team; Andy Roddick, ATP; Wilson Chandler, New York Knicks; Seth Stammler, New York Red Bulls; Adenike Oyesile, St. Peter’s College; Richard Kiplagat, Iona College; and Success Michael Phelps, USA Swimming team in Sports – and Sports Medicine William R. Salomon: Thoughtful Giving with a Charitable Lead Trust

n the 1970s William R. Salomon decid- Almost 10 years ed he had been suffering too long with ago, the Salomons Horizon Ihip pain. Knowing that hip replacement created a Charitable surgery could be the answer, he sought to Lead Trust – a planned find an orthopedic surgeon who didn’t giving method that IN THIS ISSUE: think that at age 60 he was too young for provides critical sup- the procedure. He found that physician in port for the Hospital’s Success in Sports and Sports Medicine 1 Cover: New York Mets Philip D. Wilson, Jr., MD, then Surgeon-in- research efforts. pitcher Johan Santana Chief of Hospital for Special Surgery. At Their gift included the Our Professional Teams 4 returns to the mound after that time, hip replacement in the United establishment of an successful surgery at HSS The Professional Athlete 7 States was still very new, and surgeons endowment fund to to repair a torn meniscus. were reluctant to perform the procedure create the Virginia F. The School Athlete 13 At right: Dr. David Altchek in someone in their sixties. But Dr. Wilson and William R. reviews the pre-operative and his colleagues at HSS were at the Salomon Chair in Rehabilitation and Recovery 17 MRI images of the torn forefront of hip replacement surgery, Musculoskeletal having traveled to England to learn from Research. “When I Science and Sports 21 meniscus in Santana’s left knee in preparation for Sir John Charnley, the “father of modern wanted to make a William R. Salomon and his late wife, Virginia. Sports Medicine and Shoulder Service 24 arthroscopic surgery. total hip replacement,” who had originat- contribution to Special ed the procedure in the early 1960s. Surgery, I learned that the charitable lead tive now is an historically low special 2008 Annual Report 26 Below: Santana warms up “My wife, Virginia, happened to be at trust was a very rewarding method by rate that the Internal Revenue Service during the Mets spring the Hospital seeing Dr. Lee Ramsay which a person could make a gift,” says uses to predict how much your assets Leadership Report 26 training in Port St. Lucie, Straub, and he saw me limping away,” Mr. Salomon. “I also wanted it to do the will grow in the trust.” This potentially Florida. recalls Mr. Solomon. “He said to Virginia, most good for the Hospital.” allows heirs to receive substantial gains William and Carolyn Stutt: ‘Why doesn’t Billy have that repaired? Today, charitable lead trusts are tax-free. Friends for Quality of Life 32 and she said, ‘He would love to.’ So he becoming popular additions to donor “Hospital for Special Surgery is a very sent me to Dr. Wilson, and I had the oper- retirement planning as they offer attrac- personal place that takes an interest in Philanthropic Highlights 33 ation. Obviously it was quite successful.” tive, fixed, secure payments donors can the patient,” says Mr. Salomon, whose Mr. Salomon’s new hip served him well count on, even in an unpredictable mar- generosity has also supported the Virginia Finance Report 34 for 22 ½ years before he needed revision ket. They provide the donor with control F. and William R. Salomon Rehabilitation Professional Staff, Management, and Volunteers 36 surgery – performed at HSS by Douglas over the investment and an opportunity Department at HSS. “All the people that I E. Padgett, MD, a protégé of Dr. Wilson. to balance what they want to leave for have come in contact with here over the Benefactors 42 Wanting to do something for the their heirs with their philanthropic goals. years are enthusiastic about what they Hospital, Mr. Salomon, Honorary With a charitable lead trust, a donor can are doing and there is a warmth about the Officers and Board Members 52 Chairman of Citigroup and former transfer assets (including cash, art, and Hospital that is quite unusual in this day Managing Partner at Salomon Brothers, stocks) to a trust for a set term of years and age. I think most people who have a William R. Salomon: Inc., recalls, “Dr. Wilson asked me if I and receive preferential tax treatment, serious operation there would somehow Thoughtful Giving with a Charitable Lead Trust 53 would be interested in going on the including current income tax deductions or another like to become involved. I’ve Board and I said I would love to.” Mr. and a reduction of capital gains taxes. enjoyed the privilege.” Salomon became a member of the Board Annual payments – as either a fixed Executive Editorial Board Design of Trustees in 1979, with he and his amount or a set percentage of the trust’s If you would like more information Steven R. Goldring, MD Arnold Saks Associates Edward C. Jones, MD wife becoming among the Hospital’s most value each year – are made from the trust on planned giving opportunities, please Printing Stephen A. Paget, MD generous and devoted benefactors. to a designated charity or charities. The contact Rachel Cameau, Associate Monroe Litho Aldo Papone, Chairman charity is the beneficiary throughout Director, Planned Giving, at Deborah M. Sale Cover Photography the term of the trust. At the expiration of 212.774.7252 Thomas P. Sculco, MD Marc Levine/Getty Louis A. Shapiro the trust, the heirs inherit the assets. Major Photography Philip D. Wilson, Jr., MD According to a recent article in the Robert Essel Director of Marketing Wall Street Journal, “What makes them Other Photography Rachel Sheehan [charitable lead trusts] especially attrac- Brad Hess Assistant Director, Sports Photography Credits Sponsorship Marketing See page 51 Michelle Mulbauer Horizon is published twice a year Editor-in-Chief by the External Affairs Department, Sara Kosowsky Hospital for Special Surgery, Managing Editor 535 East 70th Street, New York, NY 10021. Linda Errante 866.976.1196 | [email protected] Assistant Editor Rachel Jager ©2009 Hospital for Special Surgery. All rights reserved. n October 1, 2008, Johan Santana – the New York OMets ace left-hander pitcher – underwent successful arthroscopic surgery at Hospital for Special Surgery by the team’s Medical Director David W. Altchek, MD, and Head Team Physician Struan H. Coleman, MD, PhD, to repair his torn meniscus. The meniscus is the cartilage between the moving surfaces of the knee. Along with knee ligaments, the meniscus contributes to knee stability. Remarkably, Santana had pitched the season’s final month with the injury, and few people knew he had been doing so with pain in his push-off leg. “I didn’t think the knee was that serious because I was able to pitch with it, but, of course you never know,” said Santana. “There is always the anxiety of having surgery and how you are going to come out of it, but one of my agents told me how good HSS is. Dr. Altchek put me at ease from the very beginning. He told me what rehab I would have to do to get back to be ready for spring training. He gave me a lot of confidence that I wouldn’t have any problems at all this year. All the doctors I’ve met have a deep understanding of what an athlete needs to do to get ready.”

Less than five months later, and a few weeks away from his 30th birthday, Santana arrived at spring training in Port St. Lucie, Florida for his second season with the Mets, “looking limber and fit – in better shape than pitchers six or seven years younger,” reported the Associated Press.

1 David Altchek, MD, is no ordinary “You might do some things differ- ance. By learning how we can maxi- fan when he is watching Johan Santana ently for the pro footballer whose liveli- mize outcomes in the pro athlete, we throw out the first pitch at a New York hood is the game than you would for can then translate that to our recre- Mets game. During the past 17 years, the 16-year-old high school student,” ational athletes.” Dr. Altchek has served as a Team says Dr. Rodeo. “You might let the pro The camaraderie and team effort Physician and most recently as Medical take more chances as long as it’s an that Drs. Altchek, Rodeo, and their Director for the New York Mets. informed decision. Nuances come in colleagues find among athletes on Dr. Altchek, along with his colleague to play with athletes at that level. competitive teams also defines their Scott A. Rodeo, MD, Associate Team However, with all of that being said, own relationships on the Sports Physician for the New York Giants, you are still treating the athlete. Their Medicine and Shoulder Service. “We are Co-Chiefs of Hospital for Special health is the most important thing. have a lot of talented men and women Surgery’s Sports Medicine and Shoulder You have to divorce yourself from the on the Service, and our goal is to Service – one of the largest sports excitement of the event and ask, ‘what make sure that everybody is harness- medicine departments in the country. is the best thing for my patient?’” ing their potential in clinical practice, Together with some 40 orthopedic Treating champion competitors also in the lab, and in collaboration with surgeons, primary care physicians, provides the Hospital’s sports medicine each other,” says Dr. Altchek. “We and rehabilitation professionals, they professionals with incredible insight spend a lot of time together – in meet- provide the very best care to athletes, into injuries and recovery potential. ings, in the ORs, while seeing patients. whether their injury was sustained “You learn a lot by treating elite ath- It’s rare to find this level of interaction during a major league game, on a letes because they have incredible mo- in other institutions.” Little League field, or on a driveway tivation to get better,” says Dr. Rodeo. while shooting a few hoops. In fact, “These are the athletes who are going Covering All Bases the hallmark of Special Surgery’s sports to push the limits – of your surgery, of “Last year our physicians provided care medicine physicians and health pro- your rehabilitation. For them, good is and consultation to professional and fessionals is that injured athletes – at often not good enough. You need to be elite athletes in some 3,000 instances – any level of talent – are patients first, very, very good to allow these athletes whether it be pre-season evaluations, all comparable when it comes to care to get back to high demand perform- on-site visits to our offices, or on the in the exam room. sidelines of games,” says Thomas P. Sculco, MD, Surgeon-in-Chief. “The Hospital is a premier institution for sports medicine because we have a group that is focused on all aspects of

Above: Dr. Answorth Allen and Kellie Ann Gallagher, (center) performs an ACL PA-C, physician assistant, revision surgery on 34- can care for athletic year-old Sandra Sirota patients such as Dr. Diane for knee injuries resulting Lombardi closer to their from gymnastics as a teen. home in the Hospital’s Right: Dr. Stephen O’Brien, Affiliate Physician Offices. 2 the care of sports injuries. This begins University, Dr. Warren was all too aware Shortly thereafter, the Service es- in the laboratory, where we are trying of the potential for getting hurt. “Sports tablished a sports medicine fellowship to define how tendons heal and how medicine as a specialty was just getting training program. Unique in its traumatic events to soft tissues can started. I had a lot of injuries. I thought approach, the fellowship required be addressed surgically with better the care could be better, and I thought physicians to divide their time be- outcomes. Since we see more muscu- I could do something about that.” tween the laboratory and the operat- loskeletal patients than any other place In 1977, Dr. Warren joined Special ing room. This combination of science in the world, we have acquired a Surgery, working alongside John and medicine became the fellowship’s tremendous amount of information on Marshall, MD, a pioneer in sports trademark, making it one of the most the outcomes of surgeries for sports- medicine, who had recently started a sought after in the country. related injuries, which we can use to sports medicine clinic at HSS. He had Today, the Service has seven accred- improve techniques. Physicians also just returned from fellowship training ited sports medicine fellowship posi- come here from around the world to be under the world-renowned shoulder tions, an international fellow, and offers educated in procedures that we’ve surgeon, Charles S. Neer, MD, who a two-year fellowship position with a developed and then they return to their had, in fact, operated on Dr. Warren’s dedicated research year. Dr. Thomas homelands to improve care globally.” shoulder. With Dr. Marshall’s death in Wickiewicz organized and leads a “In many ways sports medicine was 1980, Dr. Warren became the only weekly CORE Series covering major born at Special Surgery,” adds Stephen physician on the Service. Soon he was sports medicine conditions; HSS ortho- A. Paget, MD, Physician-in-Chief and joined by Thomas L. Wickiewicz, MD, pedic surgeon Sabrina M. Strickland, Chief of Rheumatology. “And the field Stephen J. O’Brien, MD, David W. MD, is Chief of Orthopedics at the has been brought to the highest level Altchek, MD, Scott A. Rodeo, MD, and Bronx Veteran’s Affairs Medical Center, in the world by the experience of our Jo A. Hannafin, MD, PhD. responsible for the education and su- doctors and their integration of science At the same time Dr. Warren was pervision of Special Surgery residents into care. That is what an academic expanding the now combined Sports who rotate there; and Anne M. Kelly, institution is all about. That’s really Medicine and Shoulder Service, he was MD, chairs the Hospital’s Medical what makes us the best.” very interested in having a research Students Advisory Committee. “On basis on which to provide better clini- Mondays and Tuesdays, we hold a The Evolution of Sports Medicine cal care. He began to develop what is Fellows Conference, and on Thursday Russell F. Warren, MD, HSS Surgeon- today a major laboratory for soft tissue mornings, we hold the CORE confer- in-Chief Emeritus, came to sports med- research with clinicians and scientists ences that involve residents, fellows, icine when the field was in its infancy. seeking a better understanding of how and physical therapists,” says Dr. Kelly. A star athlete in both football and base- tendons and ligaments work, looking at ball while a student at Columbia how cells can be manipulated to pro- mote healing, and determining what you might do to replace them. Rotator cuff muscles Clavicle not shown – Teres minor Sports Injury Areas of and supraspinatous the Knee and Shoulder Acromion The anterior cruciate liga- ment, one of four major Infraspinatus ligaments in the knee, has a Femur muscle – part of rotator cuff primary role in maintaining Iliotibial knee stability. The rotator band Humerus cuff is a complex of four muscles and tendons in Anterior the shoulder that provide Medial cruciate meniscus stability to the ball-and- ligament Scapula socket joint. Injuries to (ACL) these soft tissues are the Fibula Tibia most prevalent among athletes across all types of sports and helping them to heal is a major focus of HSS clinicians. Subscapularis muscle – part of rotator cuff 3 New York Our Giants Professional Russell F. Warren, MD Team Physician Scott A. Rodeo, MD Teams Associate Team Physician Bryan T. Kelly, MD Associate Team Physician The Hospital’s Sports Brandon Jacobs Medicine and Shoulder Running Back Service works with teams and individuals in virtually every sport – from baseball to basket- ball, football to soccer, swimming to tennis, golf, rowing, and cricket. Team physicians from HSS have been present at Super Bowl championships and Olympic victories. To the physicians and therapists of Special Surgery, it really is ‘how you play the game,’ making sure the athlete, if injured, is optimally treated, rehabilitated, and Nets physically ready to return to Basketball his or her sport. David W. Altchek, MD Medical Director An impressive group of professional Riley J. Williams III, MD sports teams and organizations have Head Team Physician partnered with Hospital for Special Devin Harris Surgery for care of their athletes. Guard Among them are the New York Mets, the New York Football Giants, the New York Knicks, the New York Liberty, New York Nets Basketball, and the New York Liberty Red Bulls. Lisa R. Callahan, MD Director, Player Care Jo A. Hannafin, MD Team Physician Ashley Battle Forward

4 New York Knicks Lisa R. Callahan, MD New York Director, Player Care Answorth A. Allen, MD Red Bulls Team Orthopedist Riley J. Williams III, MD Wilson Chandler Team Physician and Forward Medical Director Juan Pablo Angel Forward

New York Mets David W. Altchek, MD Medical Director Struan H. Coleman, MD, PhD Head Team Physician Andrew D. Pearle, MD Associate Team Physician David Wright Third Baseman

5 “Our educational programs address 1980s, Ronnie P. Barnes, MS, ATC, The Sports Medicine and Shoulder everything from caring for knee and Vice President of Medical Services for Service has many reasons to be proud. shoulder injuries to intraoperative the New York Giants, who was then Its leadership, beginning with Dr. decision-making, and even practice the organization’s head athletic Warren, followed by Dr. Wickiewicz, management issues.” trainer, asked Dr. Warren to work with who served as Chief of the Service As sports medicine began to the Giants, thus launching Special from 1993 to 2005, and today with evolve, arthroscopy for the knee was Surgery’s relationship with pro teams. Drs. Altchek and Rodeo, continues to also coming into its own. In 1985, As word of mouth spread about the push the envelope and encourage Dr. Warren and his colleagues began expertise HSS could offer athletes, each member of the Service to engage doing reconstruction of the anterior other major league teams followed in all levels of research to improve cruciate ligament (ACL) arthroscopi- suit, as did many college athletics de- patient outcomes. cally, rapidly adding meniscus repair partments, requesting the Hospital’s “I think we’ve been made better as and transplants, as well as posterior sports specialists to “join” their teams. an institution because we have a cruciate ligament reconstruction, global experience across many profes- to their repertoire of arthroscopic Continuing a Tradition of Excellence sional sports,” says Dr. Rodeo. “At the procedures. “Arthroscopic applica- Stephen J. O’Brien, MD, MBA, who end of the day, we want to translate tions for the shoulder came later,” joined HSS in 1982, had been an ath- all that we have learned into providing notes Dr. Warren, “but today the bulk lete both in high school and at Harvard the best quality of care for any person of shoulder procedures we do in the University, where he played football who walks through our doors.” athlete are done arthroscopically.” and baseball. “I was always interested The care that Hospital for Special in sports medicine, and I was very ex- Surgery provides to athletes is the Going to the Source cited to see that HSS actually had a focus of this issue of Horizon. ACL As so many of the Hospital’s sports clinic for that,” says Dr. O’Brien. “I was and shoulder injuries are among the medicine physicians are athletes so inspired by Russ’s enthusiasm and most frequent injuries occurring in themselves, they know full well the his vision for the field that I changed nearly every sport. In the sections value of applying their expertise to my career to be part of it. I’ve now that follow, you will learn more about taking care of teams, while at the been at HSS for 26 years. I was very these injuries and why athletes of all same time gaining greater insight into blessed to be able to be on the ground levels come to HSS for care. the causes of sports-related injuries floor of a tremendous tradition and by watching players in action. In the history. We’re all very proud of it.”

Dr. Jo Hannafin, who was a three-time gold medalist at the U.S. National Rowing Championships, performs a shoulder arthroscopy. As an athlete, Dr. Hannafin fully understands the impact sports injuries can have on soft tissues.

6 Eli Manning New York Giants Quarterback

1. The Professional Athlete

7 Keeping Athletes at the Top of Their Game

he Red Bulls will play their who serves as Head Team Physician changes that have occurred from the first-round MLS Cup matchup for Nets Basketball, the New York Red stresses of throwing a ball over time, T with Houston without Seth Bulls, and the Iona College Department and we have to differentiate those Stammler. The midfielder had of Athletics. adaptive changes from actual injury. surgery last night at the Hospital “The football field provides a tremen- That’s the constant challenge we have.” for Special Surgery to repair a torn dous learning environment,” says Dr. lateral meniscus in his right knee. Scott Rodeo. “By being at the game, you A Closer Look at the ACL – Blogs.NYPost.com, October 31, 2008 see injuries in the moment, and you can I saw a young woman today who evaluate them right then and there.” said ‘I went up for a rebound, I con- When a professional athlete is injured In the nearly two decades that Dr. tacted someone in the air, I came and sidelined for any period of time, David Altchek and his colleagues have down on my leg, and I was off bal- the consequences can be devastating been caring for the Mets, they have ance.’ It’s a classic story for tearing to his or her career, as well as to the gained tremendous experience with an ACL. – Dr. Jo A. Hannafin, Team team on which they play. No one ‘throwing’ athletes. “We tend to see Physician, New York Liberty knows this better than the team their injuries evolve over time. They physicians of these major league or- are almost always microtraumatic,” ACL tears usually occur when an ganizations, who are often at the crux says Dr. Altchek. “What’s fascinating is athlete stops suddenly and changes of decisions regarding the careers of when we examine a player and look direction as when running, pivoting, professional athletes. “The expecta- at his elbow and shoulder, we see or landing after a jump – especially tion for recovery for athletes is mas- evidence of chronic changes for which in the female athlete. sive,” says Riley J. Williams, III, MD, you might say ‘how can he pick up a “If you watch women play basket- baseball?’ But these are just chronic ball compared to men, they land differently,” notes Lisa R. Callahan, MD, Co-director of the Hospital’s Women’s Sports Medicine Center, and Director of Player Care for the New York Knicks and New York Liberty basketball teams. “They don’t go down with a deep crouch, but are more likely to land with a straighter knee, which may contribute to a greater frequency of ACL injuries.”

Left: During the New York Above: Dr. Hollis Potter, Giants Training Camp, a specialist in orthopedic Dr. Bryan Kelly, Associate MRI, frequently collabo- Team Physician, attends to rates with the sports medi- Na’Shan Goddard, a 6'4", cine physicians on soft 310 pound guard. tissue injuries in athletes.

8 Orthopedic surgeon Beth E. Shubin to prevent that damage or to mitigate approach the femur from the front Stein, MD, agrees, having seen similar it is to reconstruct the ACL.” of the knee, allowing the surgeon to issues in professional female soccer The most common corrective control the positioning of the graft. players. “ACL injuries are actually four procedure for severe ACL injuries is Clinical and biomechanics studies are to nine times more common in women.” reconstructive surgery – a procedure ongoing at HSS to determine optimal According to Dr. Shubin Stein, women that HSS surgeons have been perform- femoral tunnel placement. soccer players turn and pivot with ing, evaluating, and refining for According to Jo A. Hannafin, MD, much more of an upright posture and decades. Because the ACL cannot be PhD, Co-director of the Women’s less bend in their knee than men. It reattached once it is torn, surgical Sports Medicine Center, who is Team is the bend in the knee that protects reconstruction requires the grafting Physician to the U.S. Rowing Team the men from these high risk, high of replacement tissue in its place. and to the New York Liberty women’s impact injuries and the straight leg “We have worked very hard to basketball team, recovery from an ACL that puts women at a higher risk. understand the weaknesses of ACL injury or reconstruction is different for “With a bent knee the muscles con- reconstruction and how we could every athlete. “It is based on the sport, tract around the knee and work to improve the procedure,” says Dr. the athlete, their mechanics, and how protect the ACL,” explains Dr. Shubin Altchek. “The challenge in recent quickly they get their strength back,” Stein. “In a more upright position, the years was to find a way to reproduce says Dr. Hannafin. “You want to make ACL is less shielded by the muscles so the normal functioning of the knee.” sure that the patient has a functional it tears more easily.” However, evidence In the traditional arthroscopic oper- knee, and a functional knee is very has shown that rigorous retraining on ation, a tunnel is drilled in the tibia to different in a 6'2" 170 pound profes- how to land and jump dramatically gain access into the knee for insertion sional female basketball player.” reduces ACL injuries in women. of the ACL graft. But, explains Dr. “The ACL injury is a pre-arthritic Altchek, in a small subset of patients Understanding Shoulder Injuries event,” says Dr. Williams. “The injury with this approach the repaired knee “Athletes in collision sports have higher has disrupted the normal kinematics of was not as stable as a normal knee. velocity impact injuries to their shoul- the knee. Removing the ACL will result “We realized that in order to better ders in contrast to throwing athletes in increasing forces on the meniscus replicate the anatomy, we would have who experience repetitive stresses,” or the articular cartilage. The best way to reach the femur in a different way,” says Dr. Russell Warren. “These says Dr. Altchek. The solution was to

Below: New York Liberty forward Ashley Battle is examined by Dr. Lisa Callahan during training. Right: Last year, New York Red Bulls defender Seth Stammler underwent successful knee surgery by Dr. Riley Williams.

9 extreme impacts can cause injury of Taylor Dance Company. “Professional Team. “At HSS, however, and selected shoulder cartilage, shoulder dislocation, dancers are a pleasure to work with institutions throughout the country, the and extensive rotator cuff injuries.” because they know their bodies well repair is performed with arthroscopy In throwing athletes, rotator cuff and they are very motivated when it yielding excellent results.” problems often begin with the ligaments comes to treatment and rehabilitation.” Athletes who develop severe arthri- in the shoulder becoming stretched Dr. Warren and Dr. Cordasco, along tis after years of chronic injuries find from overuse. This allows the shoulder with John D. MacGillivray, MD, and help with total shoulder replacement. a greater range of movement in the Edward V. Craig, MD, MPH, are lead- “Total shoulder replacement is a socket, causing instability. This instabil- ers in the field of shoulder surgery – tremendously successful procedure ity puts greater tension on the rotator pioneering techniques ranging from for treating the pain and stiffness that cuff and can result in impingement and shoulder arthroscopy to total shoulder accompany degenerative joint disease partial or complete tears. replacement to treat complex shoul- of the shoulder joint,” says Dr. Craig. Rotator cuff repair is performed der injuries in athletes. “The primary goal is pain relief, with a with arthroscopy in order to visualize “Instability of the shoulder, which secondary benefit of restoring motion, the inside of the shoulder and correct includes dislocations and separations, strength, and function.” the bone and tendon problems is a common injury in the professional, without damaging associated muscles. collegiate, and high school athlete,” To Play or Not to Play “Arthroscopy is particularly useful says Dr. Cordasco, who also treats pro- Tom Coughlin announced this for throwers,” says Dr. Warren. “It fessional football players. “When the morning that [David] Tyree will decreases trauma to the shoulder and ligaments and labrum are torn, they remain on the Giants’ Reserve List. avoids chronic loss of joint motion, do not heal on their own. The goal is to Tyree…underwent knee surgery allowing them to regain throwing restore the anatomy by reconstructing in April and was placed on the velocity to a greater degree.” the labrum and ligaments. Surgical physically unable to perform list. Many of the Hospital’s sports reconstruction, which in most cases is – Giants.com, November 5, 2008 medicine specialists have extensive performed arthroscopically, provides expertise with shoulder injuries. The the optimum outcome.” “One of the toughest tasks of the team father-son team of David M. Dines, MD, According to Dr. MacGillivray, in physician is to bar a player from par- and Joshua S. Dines, MD, serve the the past, open surgeries were used to ticipating,” says Dr. Warren. “Usually, professional tennis community. Dr. repair shoulder separation and often in- the athlete knows whether they are fit David Dines, a renowned shoulder sur- volved transfer of tissue to support the to play. The discussion is candid, and geon, has just been renamed Medical joint. “These efforts met with variable all concerned parties are involved.” Director of the ATP Worldwide Tennis outcomes and had a higher failure “Sometimes you have to make Tour for 2009 – 2010 for men’s profes- rate,” says Dr. MacGillivray, who serves decisions in the training room, and it’s sional tennis. His son, Josh, Assistant as a Team Physician to the U.S. Ski very chaotic,” says Dr. David Altchek. Team Physician for the United States “The key is to slow it down, perform a Davis Cup Tennis Team, pursues re- thorough physical exam, consider search on tendon injuries. Howard A. their history, get the relevant imaging Rose, MD, performs the latest arthro- tests, and gather all the information scopic procedures for rotator cuff re- you’ll need to make the best decision. pairs and shoulder stabilizations. He is It’s a challenging environment, but a former Assistant Team Physician for when you make the right decision, Harvard University Athletics. you gain the player’s trust over time.” Frank A. Cordasco, MD, MS, has a particular expertise in treating the pro- During the 2008 Super fessional dance athlete. “Professional Bowl, Dr. Russell Warren male dancers are at risk for shoulder checks in with New York injuries because they depend on both Giants linebacker Antonio shoulder strength and function to Pierce. Dr. Warren and his lift their female partners,” says Dr. HSS colleagues were on Cordasco, who has treated dancers the sidelines closely moni- from the New York City Ballet, the toring players for potential American Ballet Theatre, and the Paul injuries occurring during the game. 10 On Call at the Gold medalist swimmers Michael Phelps (above) Beijing Olympics and Natalie Coughlin (at right and below), as well Olympic swimmer Michael Phelps came as all members of the USA home with a record eight gold medals; Swimming team had Natalie Coughlin was the first U.S. female Special Surgery’s sports to win six medals at an Olympics. While or- medicine expertise pool- thopedic surgeon Scott A. Rodeo, MD, and side at the 2008 Summer athletic trainer/physical therapist John T. Olympics through athletic Cavanaugh, PT, MEd, ATC, were not there trainer John Cavanaugh to win medals, they were very much a part (photo below, left) and of the competitive events taking place at Dr. Scott Rodeo. the 2008 Summer Olympics in Beijing. Dr. Rodeo and Mr. Cavanaugh were among role was to advise on injury prevention, a select group of healthcare professionals to assess injuries, and take care of the in- chosen by the U.S. Olympic Committee juries on the spot. to protect the health of the nation’s elite The big issue, acknowledges Dr. Rodeo, athletes at the August 8-24 games. is how you get an athlete back to playing On call or on duty 24/7 during the as soon as possible when they do suffer an Games, Dr. Rodeo and Mr. Cavanaugh injury. The sports medicine experts are worked with USA athletes in all sports at challenged to use all their skills to address the walk-in clinic in the Olympic Village. pain and injury in the moment. “These “Over the course of the month, we got to athletes are obviously on a very short time see nearly every athlete – some 600-plus – frame,” says Dr. Rodeo. “Part of our role is on the U.S. team,” says Dr. Rodeo, who, to treat and rehabilitate them to get them along with Mr. Cavanaugh, had primary back as fast as possible, while at the same responsibility for events involving the time truly knowing when someone should aquatic athletes, gymnasts, and track and be disqualified or when they shouldn’t com- volleyball athletes. “At times, you’re doing pete. That’s a big decision. Some of these everything but orthopedics. The athletes was on the lookout for shoulder injuries, injuries could be life altering.” come to you with every medical concern – primarily, as well as knee injuries in breast “We worked with a tremendous medical to them, you’re just ‘Doc.’” stroke swimmers due to the heavily repeti- staff from multiple disciplines and from all On the orthopedic side, taking care of tive nature of competitive swimming. corners of the country,” says Mr. Cavanaugh. the “greatest swimmers ever,” Dr. Rodeo A certified athletic trainer on the “The experience was incredible.” Olympics medical team, Mr. Cavanaugh’s 11 Healthy Goals “MRI has become an invaluable tool in St. John’s University. “This challenges Osric S. King, MD, Brian C. Halpern, evaluating tendons and ligaments, and us to do even better. The way I treat MD, and Lisa R. Callahan, MD, provide more recently to ascertain the degree the professional athlete is the way I expertise in primary care and non- of traumatic or degenerative injury to treat all my patients. You bring the surgical management of the athlete. articular cartilage,” says Dr. Potter. breadth of all your years of experi- “Ninety-five percent of sports According to Dr. Potter, the ability ence to each individual case.” medicine is non-operative,” notes Dr. to image cartilage has changed their “Our nearly two decade involvement Halpern. “We see sprains and strains, ability to diagnose sports injuries. with the Hospital has been a very suc- lower back pain, and tendonitis in “Athletes put so many abnormal cessful one,” says Ronnie Barnes, Vice the knee, elbow and Achilles tendon stresses on the joint that unfortunately President of Medical Services, New York related to overuse.” To help address a lot of them develop early arthritis,” Giants. “The athletes at the New York overuse syndromes, Dr. Halpern uses notes Dr. Potter. “MRI provides an Giants are very fortunate to have this platelet-rich plasma therapy. “By in- objective look at cartilage and the great team in our backyard. Hundreds jecting the patients’ own platelet cells, severity of joint damage, providing us of people call our office annually look- which contain growth factors, into with some ability to predict function.” ing to receive the same care as the New their tendon injury, we have been able York Giants. We immediately refer them to rekindle a healing response.” Transfer of Knowledge to Hospital for Special Surgery.” Dr. Callahan assesses the athlete Each and every member of the for anemia, thyroid problems, depres- Hospital’s Sports Medicine and Extending Our Reach sion, asthma, sleep disturbances, and Shoulder Service universally agree With patients traveling longer distances other medical concerns. “All of the that working with the professional to come see the Hospital’s sports medi- issues that might affect an athlete af- athlete provides them with a perspec- cine specialists, it became clear that fect people day to day, but if athletes tive on treatment, rehabilitation, and establishing affiliate physician offices lose their edge, their performance and recovery that is an important part of in the community would be of great the team’s performance can really how they develop clinical protocols benefit. Nearly 10 years ago, Dr. suffer,” says Dr. Callahan. and assess outcomes for the benefit Stephen O’Brien helped open HSS’ first of all their patients. “With professional Affiliate Physician Office in Uniondale, A View from Within athletes, the expectations for recovery Long Island. Additional offices opened Hollis G. Potter, MD, Chief of Magnetic are greater,” says Answorth A. Allen, in Greenwich, Connecticut, and Resonance Imaging, has been a major MD, Team Orthopedist to the New Princeton, New Jersey. “These off-site participant in the development of York Knicks and Medical Director for offices give us an opportunity to imaging capabilities in orthopedics, provide the same expert level of care particularly for sports-related injuries. patients receive at the Hospital closer to home,” says Dr. Anne Kelly, who also sees patients in the Uniondale office. HSS physicians are also bringing their musculoskeletal expertise to Wall Street. Stephen Fealy, MD, ortho- pedic surgeon, Jennifer L. Solomon, MD, physiatrist, and Arthur M. Yee, MD, PhD, rheumatologist, travel to Merrill Lynch weekly to see employ- ees on-site. Dr. Fealy and Christopher Lutz, MD, physiatrist, also attend to employees at Goldman Sachs.

Dr. Riley Williams, Head Team Physician, Nets Basketball, evaluates the progress of Nets forward Jarvis Hayes at HSS.

12 2.The School Athlete

Richard Kiplagat Graduate Iona College

13 The School Athlete: Same Goals, Different Challenges

s a sophomore on the professional – who have undergone It wasn’t until a few weeks later that women’s basketball team of surgery for either a shoulder instability Daniel learned how bad his injury was. A St. Peter’s College, Shatira or an ACL tear have found a pretty sig- “From the MRI, the doctors said one Miller, a forward, played in 26 out nificant rate of re-injury in the school of his rotator cuff tendons was badly of 30 games, defending some of the athlete as compared to athletes playing torn,” says his mother, Freddi Kadden. conference’s best players. The fol- in the majors. Why does the pro athlete The family was told by surgeons lowing season, she was limited to get hurt so much less frequently? “It’s locally that the tendon could be action in just two games due to knee because pro athletes have a different repaired with open surgery through a injuries. – Stephanie DeWolfe, Head Coach, biological make-up,” explains Dr. large incision, but Mrs. Kadden was Women’s Basketball, St. Peter’s College Wickiewicz. “Their motivation, pain reluctant to have Daniel undergo such response, and muscular control are a major operation. At Hospital for As a physiatrist at HSS, Joseph H. different. Despite these differences, Special Surgery, Struan H. Coleman, Feinberg, MD, has specialized expert- the goal of the sports medicine special- MD, PhD, was able to provide Daniel ise in peripheral nerve injuries in the ist is to get athletes of every level back with the option of repairing the tear athlete. He has been a Team Physician to participation – whether they are using the minimally invasive proce- at St. Peter’s College in New Jersey senescent or prepubescent – but also dure of arthroscopy. since 1992, and currently is the Head to provide them with realistic expecta- Daniel underwent the procedure Team Physician there. tions about what the injury means for with Dr. Coleman on August 19. “We In the 26 years since Thomas L. their future in sports.” were able to bring him home that Wickiewicz, MD, joined Special Surgery night,” says Mrs. Kadden. After six as one of the original orthopedic High Hopes weeks in a sling to allow the tendon to surgeons in the Sports Medicine and As a seventh grader, Daniel Kadden heal, Daniel had physical therapy for Shoulder Service, he served as Chief participated in wrestling, lacrosse, another 10 weeks. of the Service for 12 years and spent and basketball. But in the summer “As of now I can shoot a basketball eight years as Assistant Team Physician before eighth grade, while wrestling perfectly just like I did before,” says for the New York Giants. He now serves for fun with some friends at camp, Daniel. “I can jump up for a rebound as the Team Orthopedic Surgeon Daniel ended up at the bottom of just like before. Everything is going for all Division 1-AA College sports at a pile. “My arm winged out and back to normal.” St. Peter’s. I heard something in my shoulder For over a decade, Michael J. tear,” recalls Daniel. Maynard, MD, has been Team Physician for thousands of athletes at Marist and Vassar Colleges. “At HSS, we see a pyramid of ath- Daniel Kadden (below) letic ability from the school-aged ath- was given the go-head by lete to the professional athlete,” says Dr. Struan Coleman (at right) to return to play with Dr. Wickiewicz. “When you’re working his school lacrosse team with the pro athlete, you’re caring for after recovering from a someone who is about as good as you rotator cuff repair. can be for that particular sport. But when you’re taking care of a collegiate team, you’re working with a spectrum of athletes who are going to vary in physical size and ability. However, sports are every bit as important to them. You manage their injuries and their training very similarly to the way you would for the pro athlete.” According to Dr. Wickiewicz, studies that have looked at re-injury in athletes across the board – from school level to

14 “The results were fabulous,” says Mrs. Kadden. “I told Dr. Coleman that ‘you are so nice, and we don’t ever want to have to use you again, but if anyone in my family has a problem… you are our doctor for life!’” “Taking care of baseball players has helped me to better understand the mechanics of the shoulder,” says Dr. Coleman, who is the Head Team Physician for the New York Mets. “This knowledge not only benefits professional athletes, but athletes at any level with shoulder injuries.”

Playing it Safe “We’ve seen some real fundamental changes in the way youth sports have been conducted in the past 10 to 15 years,” says Jordan D. Metzl, MD, a primary care sports medicine physi- cian at HSS. “We now spend as much time taking care of female athletes as male athletes in the high school and junior high group. And sports have become much more competitive, with kids specializing in only one sport. While this can make a better athlete in that sport, it usually tends to create injuries if they just play that one sport year-round.” To help the public understand this and other issues of sports safety, community outreach to parents and coaches is an important focus of the Hospital’s sports medicine professionals. Left: Dr. Thomas Above: A sophomore Wickiewicz, Team and communications Orthopedic Surgeon, and major at St. Peter's Elizabeth Kennedy, Head College in New Jersey, Trainer for the Women’s Adenike Oyesile also Basketball Team at St. plays forward on the Peter’s College, evaluate Women’s Basketball Team the strength and range of and is considered by her motion of Janesia Smith. coach to be a tenacious rebounder.

15 For the past 11 years, HSS also has Beth E. Shubin Stein, MD, also sees Adds Dr. Solomon, “An important sponsored what is now the longest run- many more young females than males aspect of what we do is providing ning and best attended sports medicine with patellar instability and multiple integrated health care. We look at the conference on young athletes in the knee cap dislocations. “Women in patient’s entire well being. What’s nice country. The program has attracted general are more predisposed to this about the Women’s Sports Medicine well over 4,000 health professionals. injury then men are,” says Dr. Shubin Center is that we have multiple spe- For the past several years, members Stein, “and it is a very debilitating cialties practicing together to help the of the Women’s Sports Medicine Center problem for young women. Ten years patient in the best way that we can.” at HSS have presented a program on ago, if the problem continued to recur, Andrew D. Pearle, MD, Associate injury prevention in young female these young women would have had Team Physician for the New York athletes – created by physical therapist to undergo bone cutting procedures Mets, also directs coverage of three Theresa Chiaia, PT, and her rehabilita- in order to stabilize their knees with New York City high schools in the tion colleagues – to parents and coaches almost a year of recuperation.” Public School Athletic League. “We to an all-girls school in Manhattan. More Today, these women benefit from a cover their games and hold a clinic recently, they have created a prevention new surgery – medial patella femoral once a week for players,” says Dr. program to specifically address the ligament reconstruction – that has Pearle who, along with several of the higher incidence of ACL injury in girls. revolutionized care for patients with Hospital’s orthopedic residents, make “Much of ACL injury prevention has patella instability. “It has changed the sure that a team of HSS doctors is to do with training,” says Jennifer L. rehabilitation for these injuries,” says affiliated with each high school team. Solomon, MD. “Boys know how to Dr. Shubin Stein. “Rather than having “We develop a relationship with the land because they receive much more to cut bone, the procedure is a soft players and coaches, and when play- specific sports training than girls. tissue reconstruction much like the ers get hurt we make sure that they They go into a squat position. Girls are ACL reconstruction. Patients can walk are seen here at HSS. If the players not taught how to land correctly. They after surgery as opposed to being on need surgery or rehabilitation, we all land in a stiff legged position, which crutches for six to ten weeks, and the come together to make sure that hap- puts a lot of stress on their knees.” return to sport is between four and pens. We’ve worked very hard through six months rather than a year.” the Hospital to deliver comprehensive care to these teams. Our goal is to provide kids from public schools that have limited resources access to the same type of care that the profes- sional athlete receives.”

Above: Athletes like of HSS doctors. Right: Victor Gonzalez at Dr. Beth Shubin Stein (far Queensborough right), a Team Physician Community College and for the U.S. Federation other members of the Cup Tennis Team, uses CUNY Athletic Conference arthroscopy to treat ACL benefit from the expertise injuries.

16 3.Rehabilitation and Recovery

Physical therapist Greg Fives, PT, MSPT, SCS, works with Kate Brownson on rehabilitation exercises to strengthen her legs.

17 Achieving Optimal Outcomes

ne major difference between tions of the therapists, we were able “We have good relationship with professional and amateur to greatly reduce the recovery time. our doctors,” says Mr. Cavanaugh. “We Oathletes is the time they can I never feel like I’m more than half understand the surgery, we under- devote to training and rehabilita- the equation. The therapist is a full stand the pathology. They know that tion. When combined with their partner, and just as important as the when they send their patients to us, advanced physical condition going surgeon for the patient’s recovery.” they are in good hands.” into a rehabilitation program, John T. Cavanaugh, PT, MEd, ATC, The Hospital’s physical therapists a professional athlete’s efforts gener- Clinical Supervisor, has been with the and athletic trainers play a huge role in ally result in a much quicker rate Sports Rehabilitation and Performance the prevention and treatment of sports of recovery. Center since 1985. Mr. Cavanaugh is injuries. The physical therapist devel- credentialed as a certified athletic ops specific rehabilitation guidelines “Our physical therapists are key to trainer and physical therapist. A com- for patients following a comprehensive what we need to achieve with ath- petitive soccer player in college, he has evaluation and works collaboratively letes,” says Dr. Scott Rodeo. “Many of served on the medical staff of the Pan with surgical and medical colleagues, our therapists are pioneers in all American Games in Rio, Brazil; as Head pre- and post-surgery to get the athlete forms of physical therapy treatment Athletic Trainer for the USA Swimming back on the field. Athletic trainers and contribute to advancing the field team at the 2006 World Short Course work side-by-side with the athletes at of sports medicine.” Championships in Shanghai, China, and the clubhouse and on the field, giving “Physical therapists are integral to most recently on the U.S. Olympics advice on how to prevent injuries, the progression of the field,” adds medical staff in Beijing. assessing the injury if and when it Dr. Stephen O’Brien. “When we asked happens, and taking care of it at that the question of how we could improve immediate point in time. recovery from ACL reconstruction, Left: Physical therapist “It is very important for us to not due in large part to the recommenda- Mickey Levinson super- only instruct the patients in the right vised the post-operative exercises,” says Mr. Cavanaugh, rehabilitation program of “but to help them understand how to Dave Lipson, a college modify their activities based on their pitcher who underwent surgery at HSS for an symptoms and functional limitations. elbow injury. Below: If a patient doesn’t have the motion or Exercise physiologist Polly the strength to negotiate stairs, we DeMille, RN (left), and show them how to do stairs without physical therapist Theresa irritating the injury.” Chiaia, PT, demonstrate Mr. Cavanaugh and his colleagues how video analysis can tailor their treatment plan to the guide fitness and condi- individual patient. “You progress them tioning exercise protocols for athletes.

18 from here to there if they meet certain criteria as opposed to following a pre-set timeline for reaching certain recovery points,” he says. “For example, there might be an exercise a patient is ready to do at six weeks even though the standard protocol says 10 weeks. We would have this patient move ahead.”

Peak Performance “What makes us unique is that Sports Rehabilitation and Performance is a collaborative team. Our physical therapists and exercise specialists work together to develop a tailor-made therapy or fitness program that will achieve the best result for our patients and clients,” says Theresa Chiaia, PT, Section Manager, Sports Rehabilitation and Performance. In the Hospital’s new Performance Center, Polly de Mille, RN, RCEP, CSCS, Coordinator of Performance, and a performance team work with patients who have had phys- ical therapy and want to work on over- all fitness, and with clients who want to improve their level of fitness and maxi- mize performance. Exercise specialists are also involved in injury prevention. In addition, video analysis in combina- tion with a comprehensive interview with the team, a musculoskeletal as- sessment by the physical therapist, and a fitness assessment by the exercise specialist provides the athlete with a customized results package.

The Spine in Sports As a physiatrist with HSS, Peter J. Moley, MD, specializes in non-operative treatment focused on restoring func- tion. Dr. Moley has a particular interest in spine injuries of athletes. “The lum- Jaime Edelstein, PT, bar spine is a very important joint used MSPT, CSCS, Assistant by athletes for competition and return Section Manager of to play,” notes Dr. Moley. “It is just as Sports Rehabilitation and important to performance as hip Performance, instructs Casey Maxwell on a train- strength, quad strength, and hamstring ing pulley to help increase strength. You also have to consider the range of motion of whether a bad back may have played a her shoulder. role in causing a hip or knee injury or

19 how low back pain may be affecting an go and sit for hours on the water row- Dr. Moley. “We make sure they nor- athlete’s overall performance.” ing, causing the back problem to flare.” malize rotation of the thoracic spine Dr. Moley, a former rower, has par- According to Dr. Moley, studies of while we work on lumbar spine ticular expertise in caring for oarsmen rowers have shown that they have strength. We also work on their hip with back pain. In fact, lower back very strong thighs, but their abdomi- strength. When we have the rowers pain is prevalent among intercolle- nal and lower back strength is no bet- stronger in supine and standing, we giate rowers. “Sitting is the highest ter than an average college student. get them back to sitting positions dur- pressure you can have in a disc,” says “We therefore try to exercise muscles ing exercising. Our goal is to build all Dr. Moley. “Rowing affects a very spe- that aren’t often used, including some the musculature and strength around cific part of the spine. Rehabilitating a of their rotational muscles,” explains the involved disc. These patients do rower is challenging because they then very well.”

The Hospital’s sports med- icine physical therapists, certified athletic trainers, exercise physiologists, and conditioning specialists are skilled professionals who provide rehabilitative care for patients of all ages and abilities. Row 1: Phaeleau Cunneen, PT, MSPT; Janet Cahill, PT, CSCS; and Cara Senicola, PT, DPT Row 2: Jaime Edelstein, PT, MSPT, CSCS; Jessica Graziano, PT, DPT; and Lee Rosenzweig, PT, DPT, CHT Row 3: Victoria Moran, PT, DPT; Rob Maschi, PT, DPT, CSCS; Theresa Chiaia, PT; Diana Zotos, PT, MSPT, CSCS; Mickey Levinson, PT, CSCS; Greg Fives, PT, MSPT, SCS; John Cavanaugh, PT, MEd, ATC; and Polly DeMille, RN, RCEP, CSCS

20 4. Science And Sports

Dr. Scott Rodeo investi- gates how to promote healing in injured soft tissues at the basic science level.

21 Advancing the Field of Sports Medicine

he past three decades have at both the mechanisms of short term NIH grant is supporting investigations seen a revolution in the treat- repair and the role of inflammation, to determine how to stimulate ACL T ment of sports-related knee joint mechanics, and genetic influ- repair or regeneration. “The ACL is and shoulder injuries, with much ences in the long term outcomes.” notorious for its failure to heal,” says of the pioneering work taking place Dr. Hannafin. “The question is why? in the laboratories and operating Understanding ACL Research If Scott and I can both be successful rooms of Hospital for Special A clinician-scientist, Dr. Scott Rodeo in what we do, we may ultimately be Surgery. Improved understanding spends several hours each week in his able to optimize ligament healing or of ligaments and tendons, methods laboratory investigating the cellular to accelerate repopulation of the ACL to promote healing, and refinement and molecular processes in ligament graft with normal cells. This would in arthroscopic techniques have healing with support from a $1.4 mil- permit refinement of current ACL made it possible for athletes to lion, four-year National Institutes of reconstruction techniques to promote return to peak performance levels. Health (NIH) grant. “As a clinician, improved recovery and determine a you know what the problems are scientific basis for the design of post- The Hospital’s scientists are address- and you know what questions need operative rehabilitation.” ing two basic questions in sports answering in the laboratory,” says medicine. How do you take care of Dr. Rodeo. “How do ligaments heal A Step Ahead of Arthritis the acute injury and restore function? or why don’t they heal? How does Peter A. Torzilli, PhD, Program How do you prevent the premature mechanical load affect ligament Director, Tissue Engineering, development of osteoarthritis and reconstruction? When can patients Regeneration, and Repair Program, joint destruction? “An injury to a start bending their knee? These are and his colleagues are looking at the ligament sets up a cascade of events very relevant clinical questions that influence of trauma on the articular that can lead to joint destruction,” relate to how we treat patients who cartilage in the knee. “If you have an says Steven R. Goldring, MD, Chief have had ligament surgery.” anterior cruciate ligament rupture, Scientific Officer. “So we have to look Dr. Jo Hannafin is also a clinician- whether it’s repaired or not, it is now scientist. Her three-year, $1.1 million well known that anywhere from five to 15 years after the injury, the person will develop osteoarthritis in the knee. Left: Dr. Jo Hannafin ap- What we want to know is, given an plies the clinical knowledge injury to an ACL, do patients change gained when working with their kinematics of walking or knee athletes, such as the motion that can cause damage to the New York Liberty’s Leilani cartilage and lead to osteoarthritis? Mitchell, to her basic And, was there damage done to the car- research studies. Below: tilage at the time of injury that can also Dr. Robert Marx studies a lead to osteoarthritis? These are the patient’s preoperative questions that everyone is asking now.” radiology images prior to performing an ACL revi- sion procedure.

22 Improving Surgical Outcomes applicability in ACL surgery. “We have Robert G. Marx, MD, MSc, orthope- Dr. Andrew Pearle directs the devised models of the ACL to under- dic surgeon, and Dr. Hannafin are Hospital’s Computer Assisted Surgery stand kinematics in the normal knee, collaborating with the American program, which is helping to make in the ACL injured knee, and after Orthopaedic Society for Sports surgical procedures more precise. various types of ACL reconstruction,” Medicine to better understand factors “Computer assisted surgery uses navi- says Dr. Pearle. “We’ve also been test- that affect outcomes after revision gation that is like a Global Positioning ing ACL reconstructions to determine ACL reconstruction. “Revision ACL re- System for orthopedic surgery,” says which procedure best reproduces construction is much more technically Dr. Pearle. “The computer displays a the intact normal knee and ways to demanding compared to primary ACL three-dimensional virtual image of the precisely angle the new graft.” reconstruction because of previously patient’s anatomy on a screen, allowing Anil S. Ranawat, MD, an orthopedic placed screws, staples, and tunnels,” you to see exactly where you are put- surgeon with expertise in meniscal and explains Dr. Marx. “Placing the new ting a tunnel, a drill hole, or a screw.” ligament surgery, including revision ACL graft where there has been prior Surgeons have been using these ACL surgery, is evaluating robotic surgery is challenging. Detailed preop- tools in the OR to perform joint surgery, partial knee replacement, and erative planning with x-rays, CT scans, replacement surgery. More recently, mobile-bearing technology to improve and MRI images helps plan for poten- Dr. Pearle has been investigating their patient outcomes. tial scenarios interoperatively, but one must also be flexible to adjust depend- ing on what is found during surgery.”

Saving the Shoulder A recent study by HSS orthopedic surgeons showed that patients who un- derwent a rotator cuff repair experi- enced pain relief and improved shoulder function, even after a tear re- currence. The study evaluated a group of 15 patients approximately eight years after their rotator cuff repair. None of the patients needed further treatment or surgery, and none had experienced persistent shoulder pain. Dr. Struan Coleman is looking at how to facilitate recovery from rotator cuff repair at a basic science level. The tendons in the rotator cuff are connected to short, but very impor- tant, muscles. “In chronic rotator cuff problems, very often the muscle does not function,” says Dr. Coleman. “We are investigating the role that stem cells may play in regenerating these muscles and in facilitating the healing process.”

Dr. Andrew Pearle is advancing the role of com- puter-assisted orthopedic surgery to help improve sur- gical precision and ultimately patient outcomes in ACL reconstruction and other procedures in the knee. 23 Sports Medicine and Shoulder Service

The Sports Medicine and Shoulder Service at Hospital for Special Surgery is one of the oldest, largest, and most highly respected departments in the field. This distinguished group of physicians, individually and together, provide outstanding care to athletes with all levels of skill representing virtually every professional and recreational sport. For information on each of the physicians of the Sports Medicine and Shoulder Service, please visit www.hss.edu/sports.

6

9 4 7 12

11 3 15

13 5 8

2 10

1 14

1 Scott A. Rodeo, MD Co-Chief, Sports Medicine and Shoulder Service 2 Beth E. Shubin Stein, MD3 Peter J. Moley, MD 4 Riley J. Williams III, MD5 Robert G. Marx, MD, MSc6 Bryan T. Kelly, MD7 Frank A. Cordasco, MD, MS8 Answorth A. Allen, MD 9 Joshua S. Dines, MD10 Joseph H. Feinberg, MD11 Michael J. Maynard, MD12 Thomas L. Wickiewicz, MD13 Stephen Fealy, MD 14 Jennifer L. Solomon, MD15 John D. MacGillivray, MD

24 22 25

21 27 28 23 30 18

19 26

24 17 29 20

31

16

16 David W. Altchek, MD Co-Chief, Sports Medicine and Shoulder Service 17 Lisa R. Callahan, MD18 Anne M. Kelly, MD19 David M. Dines, MD 20 Russell F. Warren, MD21 Jordan D. Metzl, MD22 Osric S. King, MD23 Jo A. Hannafin, MD, PhD24 Howard A. Rose, MD 25 Brian C. Halpern, MD26 Edward V. Craig, MD, MPH27 Struan H. Coleman, MD, PhD28 Stephen J. O’Brien, MD29 Andrew D. Pearle, MD 30 Anil S. Ranawat, MD31 Sabrina M. Strickland, MD (Not shown) Hollis G. Potter, MD, and Rock G. Positano, DPM, MSc, MPH

25 2008 Leadership Report

Left to right: Stephen A. P. Sculco, MD, Surgeon-in- Paget, MD, Physician-in- Chief and Medical Director; Chief; Aldo Papone, Co- Dean R. O’Hare, Co-Chair, Chair, Board of Trustees Board of Trustees (seated); (seated); Louis A. Shapiro, and Steven R. Goldring, MD, President and CEO; Thomas Chief Scientific Officer 26 s the largest musculoskeletal specialty hospital in measure satisfaction in several areas as compared to our the world, Hospital for Special Surgery has a re- peer hospitals. In the fourth quarter of 2008, HSS ranked in Asponsibility to also be the best – with more than the 99th percentile of 1,025 hospitals nationwide on 250,000 patient visits for musculoskeletal disorders and the Press Ganey patient satisfaction survey question of in- autoimmune diseases; for the 3,000 employees who carry patient likelihood to recommend the Hospital to others. out our mission each and every day; and for the trustees, The results of the patient satisfaction surveys we conduct volunteers, and many, many friends who embrace our vi- provide an important benchmark to assess and assist us in sion and provide support in varied and extraordinary ways. our ongoing goal to improve the patient experience. In 2008, we continued to stay focused on meeting the needs of patients who, in growing numbers, chose Special Advancing a Culture of Quality and Service Surgery for their care. At the same time, our physicians These acknowledgements are a tribute to the experience, and scientists have maintained their commitment to find- skills, and commitment of all of our staff and the impor- ing solutions in the laboratories and at the bedside for tance of the patient-centered care environment in which complex clinical problems and providing unparalleled we are able to deliver the highest quality musculoskeletal educational opportunities for residents and fellows who care. As we go forward, our goal is to continue to build on come here to train. our accomplishments in quality and service, focusing on We are pleased to report that 2008 was one of our opportunities that will enable us to do even better. Our strongest years of operational performance. The Hospital Strategic Plan identifies an important imperative for suc- continued to increase its patient volume and, at the same cess in the way we provide care, in the service we deliver, time, made great progress in further enhancing our pa- and in the way we drive quality overall. tients’ experience. And our quality outcomes, which are so Through our Elevating Quality initiative, created under well-regarded throughout the medical community, im- the Hospital’s Strategic Plan, we are establishing the high- proved from an already impressive level of performance. est standards in clinical quality and operational excellence We are honored that for the second consecutive year, in the field of musculoskeletal medicine. Our entire U.S.News & World Report recognized Hospital for Special organization, including the Board of Trustees, is working Surgery as the number one hospital in orthopedics in the towards setting, meeting, and exceeding quality and country, while rheumatology remained among the top- service expectations. In 2008, we completed the reorgani- ranked in the nation. For the 18th consecutive year, Special zation of our quality process, including the creation of the Surgery was top ranked in the Northeast in orthopedics Hospital’s Quality Coordinating Committee, co-chaired and rheumatology. In 2009, the Hospital sustained its first by Dr. Steven B. Haas and Dr. Steven K. Magid, and the place position in New York State for Joint Replacement creation of an oversight group – the Hospital Quality Surgery and received the HealthGrades Joint Replacement Council – co-chaired by Louis A. Shapiro, President and Excellence Award. CEO, and Thomas P. Sculco, MD, Surgeon-in-Chief, with We also scored in the top 15 percent nationwide in representation from the Board of Trustees and medical both overall patient satisfaction and patient willingness to staff leadership. In addition, individual Hospital depart- recommend the Hospital to others on the first Hospital ments are determining the most important quality indica- Consumer Assessment of Healthcare Providers and tors in their respective areas and identifying ways to Systems. Released by the Hospital Quality Alliance, the measure their successes. assessment looked at different aspects of patient care as The new quality review infrastructure, under the out- rated by patients themselves. HSS is the only hospital in standing leadership of Dr. Magid, and Michelle Horvath, New York City that will receive the Outstanding Patient Assistant Vice President, Quality Management, has been Experience Award in 2009 based on this assessment. Using embraced by all members of the staff. As a result, the surveys designed by Press Ganey Associates, Inc., the in- Hospital is very focused on ways to drive and measure dustry leader in patient satisfaction assessments, we can quality, how it can be more responsive to identifying trends, and can more quickly implement programs to improve performance.

27 The Hospital’s overall As we expanded our clinical capacity throughout the surgical site infection rate year, we were very successful in recruiting nursing staff to was reduced from 0.35 meet this increased demand and continue to serve patients percent to 0.26 percent – with the highest level of quality. Over the course of 2008, compared to a national we hired 51 full-time RNs and by November 2008, our rate of more than 2 per- RN vacancy rate was 4 percent – significantly lower than cent; overall pulmonary the 13 percent average RN vacancy rate for the Greater embolus rate decreased New York area. from 0.48 percent to 0.25 In October 2008, the Hospital’s building plan was ap- percent; and overall deep proved by the City of New York, bringing us one step closer vein thrombosis rate to expanding our hospital in order to accommodate the showed a reduction from growing number of patients seeking our care. This spring, Steven K. Magid, MD, co-chairs 0.96 percent to 0.43 per- we will complete work on our new lobby, which has been the Hospital’s Quality Coordinating cent. We continue to Committee. enlarged to create a spacious, more welcoming, and com- work on reducing our fortable environment for patients and visitors. infection rate to an absolute minimum, and our best prac- Technology plays an increasingly important role both in tices in infection control have positioned us as a hospital the provision of high-quality care and in promoting opera- that is likely to have the lowest infection rate for orthope- tional efficiencies throughout the organization. With the in- dics in the world. stallation of CliniCIS in mid-2007, many benefits accrued to clinical practice in 2008 from the availability of elec- Measures of Excellence tronic patient orders, test results, medication alerts, and In addition to the Hospital’s major undertaking in quality chart documentation. The Picture Archiving and and safety, a number of other noteworthy accomplish- Communication System (PACS), now accessible in the op- ments allowed us to improve and build upon our founda- erating rooms and physician offices, enables the viewing of tion of excellence in musculoskeletal care. Our financial digital images on computer screens and allows manage- foundation remains strong, with volume increasing by ment of medical images in an electronic format. We also 12 percent in 2008 over 2007. And, in an era in which the improved efficiencies in the operating rooms with the im- National Institutes of Health (NIH) had less funding to pro- plementation of a new state-of-the-art Instrument Tracking vide for research, HSS increased its federal grant system in Central Sterile Supply. Using barcode technol- portfolio by 14.6 percent over 2007, with awards totaling ogy, the tracking system can identify the location of any in- $22.4 million. Total active awards for 2008 totaled strument used in the OR at any point during the cleaning $32.7 million, an increase of 14.2 percent or $4.1 million and sterilization process. over the previous year. Our clinicians and scientists regularly distinguish them- Our extraordinary orthopedic surgical outcomes reflect selves, and HSS, by serving in leadership roles of orthope- a vital collaboration that is ongoing among our orthopedic dic and rheumatology societies and associations; through surgeons, rheumatologists, and anesthesiologists. The the delivery of major presentations at professional meet- Hospital’s Center for Musculoskeletal Perioperative ings, including the American Academy of Orthopedic Medicine, led by rheumatologist C. Ronald MacKenzie, MD, Surgeons and the American College of Rheumatology; in and anesthesiologist Michael K. Urban, MD, PhD, assures the awarding of numerous national and international the best results for our patients – many of whom present honors; and as authors, editors, and reviewers of the most with complex clinical issues. In 2007-2008, physicians in prominent medical and scientific journals. In 2008, our the Hospital’s Division of Rheumatology served as the physicians and scientists had 256 articles published in such musculoskeletal perioperative specialists for over 12,000 or- leading, peer-reviewed publications as the Journal of Bone thopedic surgery patients. The involvement of our rheuma- and Joint Surgery, Chemical Reviews, Clinical tologists and internists in the care of patients undergoing Orthopaedics and Related Research, Journal of Clinical surgery helps to ensure the best possible outcomes. Investigation, Journal of Immunology, Arthritis and Rheumatism, Immunity, and Nature to name a few.

28 In addition, two books for the consumer – Dancing Welcome to New Doctors at the River’s Edge: A Patient and Her Doctor Negotiate Hospital for Special Surgery continues to recruit outstanding Life with Chronic Illness, co-authored by Dr. Michael physicians who enable us to remain the leader in our fields and Lockshin with one of his patients, has been published to serve the ever-increasing number of patients who come to us for wide acclaim, and Say Goodbye to Knee Pain, co- musculoskeletal care. Please join us in welcoming: authored by Dr. Jo Hannafin, is now available in a Kindle Michael J. Klein, MD, a distinguished edition. bone pathologist and gifted educator, has joined Hospital for Special Surgery as the Director of Laboratory Medicine and Spotlighting Translational Research Pathologist-in-Chief. He succeeds Peter G. Bullough, MD, who retired as Director For the past two years, the Hospital has been moving and Chief after 40 years of service. Dr. forward with an ambitious plan to integrate its basic, trans- Michael J. Klein, MD Klein comes to us from the University of Alabama, where he was the Director of lational, and clinical research efforts to allow us to main- Surgical Pathology. tain dynamic cutting edge research and sustain our level of scientific excellence into the future. The objective is to Dale J. Lange, MD, a distinguished neurologist, has been selected to succeed create a platform for insuring the translation of basic sci- Moris Danon, MD, as the Chief of ence findings to patient care. Translational research calls Neurology. Prior to joining HSS, Dr. Lange was Director of the Division of on the tools of modern science and cellular and molecular Neuromuscular Disease and the Director biology to understand disease and to develop novel and of the EMG Laboratory at Mount Sinai Dale J. Lange, MD Hospital, and Chief of Neurology at the unique approaches for treatment. By closely aligning re- Bronx Veterans Administration Hospital. search and clinical priorities, we can expedite the applica- tion of new therapies to the treatment of patients with Chitranjan S. Ranawat, MD, a world- renowned orthopedic surgeon specializing musculoskeletal and autoimmune diseases. in total hip and total knee joint replace- To this end, scientists at Special Surgery are working ment procedures, who was with Special Surgery from 1969 to 1994, has returned together across disciplines to demonstrate how scientific to HSS. For the past 15 years, Dr. Ranawat discovery in the laboratory can ultimately affect clinical served as the James A. Nicholas Chairman of the Department of Orthopaedic Surgery situations, incorporating a multidisciplinary bench-to-bed- Chitranjan S. Ranawat, MD at Lenox Hill Hospital. side approach to understanding disease. Translational We are also pleased to welcome: research teams, made up of clinicians and basic scientists, have targeted a number of areas to address, including complications of total joint arthroplasty; facilitating bone healing; and soft tissue repair, to name a few. One of our largest translational research efforts to date focuses on systemic lupus erythematosus and complications of the Jonathan C.Beathe, MD Semih Gungor, MD Evette Ferguson, MD disease related to pregnancy, neurocognitive function, and Anesthesiology Anesthesiology Medicine cardiovascular disease. At HSS, the Center for Education and Research on Therapeutics (CERT), funded by the Agency for Healthcare Research and Quality, is obtaining outcomes data on the thousands of patients each year who undergo joint replacement surgery at HSS and supporting clinical Scott J. Ellis, MD Amar S. Ranawat, MD Elizabeth M. Manejías, studies to determine the clinical, patient demographic, and Orthopedic Surgery Orthopedic Surgery MD, Physiatry prosthetic device characteristics associated with improved outcomes in total joint replacement. Our comprehensive Total Joint Replacement Registry continues to exceed enrollment targets with over 9,000 patients enrolled to

Anthony Chang, MD Juliet Aizer, MD Emma Jane MacDermott, Radiology Rheumatology MD, Rheumatology

29 date. This progress has also generated eight pilot research studies based on the data collected regarding outcomes, In Memoriam: Patricia Mosbacher variations, and economic impacts of total joint surgeries. t is with deep sorrow Registries, such as the one used in CERT, provide the that we note the mechanism for acquiring and storing information, process- passing of Patricia Mosbacher,I a cherished member ing data, and applying knowledge to patient care. As the and Vice Chair Emerita of our largest provider of musculoskeletal care, we are in a piv- Board of Trustees. A committed otal position to be able to document what works and what member of the Board since 1987, does not, understand why, and then, when we institute an Mrs. Mosbacher played a pivotal intervention, evaluate the outcome. The Hospital currently role in raising funds for the Hospital as the longtime chair of has more than 30 patient registries that range from very our Annual Tribute Dinner and a specific conditions such as basal joint arthritis to those Co-chair of the Development Committee. In addition to her more broad-based such as the Autoimmune Disease work with the Hospital, Mrs. Mosbacher was a trustee of the Registry and Repository. Freedom Institute of New York, where she had also served as Chair. She was a former trustee of New York Medical College Recently, the Hospital created an unprecedented re- and the South Street Seaport Museum, and a former member search program to better understand, prevent, and treat of the national Board of Directors of Project Hope. She also osteoarthritis – the most common cause of disability and served as a Chair of United Hospital of Port Chester. She was a loss of work, and a frequent reason for joint replacement. graduate of the Dwight School in Englewood, New Jersey and attended Bennington College. The Osteoarthritis (OA) Initiative is an integrated basic, At Hospital for Special Surgery, her memory lives on with translational, and clinical research program that focuses on the annual Patricia Mosbacher Honorary Lecture in identifying risk factors for OA, prevention or reduction of Orthopaedic Trauma and the Patricia Mosbacher Flower Fund inflammation at the onset of the disease, medical interven- that were created in her honor. She will long be remembered for her grace and wit, as well as her style and dedication to our tion to slow its progression, and surgical solutions when mission. In the Hospital’s new lobby, a permanent fresh flower OA has damaged joint structure. display, generously supported by members of the Board and In 2008, Lionel B. Ivashkiv, MD, Senior Scientist and the Mosbacher family, will allow all who come to HSS to re- Director of Basic Research, was appointed Associate Chief member this most elegant, kind, and dedicated woman. Scientific Officer. In this newly created position, Dr. Ivashkiv, who holds the David H. Koch Chair in Arthritis Enhancing Care of International Patients and Tissue Degeneration, is charged with developing a In 2008, our International Center arranged 456 initial con- long-term strategic plan for basic science research pro- sultations for patients with our physicians, and there were grams; fostering collaborative research among the basic 284 International Center inpatient and ambulatory surgery science programs; and enhancing translational research. procedures, including physiatry and pain management He will work with Steven R. Goldring, MD, Chief Scientific procedures. Officer, to develop and execute this plan, which will In addition, we approved a strategic plan for expanding enhance HSS’ position as a leader in musculoskeletal and our clinical and educational initiatives abroad. We continue autoimmune disease research. Dr. Ivashkiv has an out- to engage in dialogue with organizations abroad who are in- standing record of NIH funding and has made major contri- terested in forming a collaborative relationship that focuses butions to the understanding of inflammatory mechanisms on developing their orthopedic capability locally. We have in autoimmune and musculoskeletal disorders. also developed an International section of our Web site One of the criteria for a successful and sustainable (www.hss.edu/international.asp), which highlights the academic institution is that it provides tenured security depth and breadth of our current international activity. and support for its scientists. The Hospital’s Division of Members of the Hospital community are also involved in Research now has a tenure program in place for the philanthropic and volunteer projects throughout the world, academic scientific track, further enabling us to recruit including those who have founded international charitable research faculty of the highest caliber. organizations dedicated to providing quality medical care where access to care is often difficult. Many members of our Sports Medicine and Shoulder Service serve as team physicians and medical advisors for international sporting 30 events, including the summer Olympics held in Beijing, achieve the Hospital’s long term financial goals and strate- highlighted in this issue of Horizon. gies for continued growth. In addition, the group ad- In October, the second International Society of dressed promising opportunities in translational research Orthopedic Centers (ISOC) meeting was held at the so that discoveries in the laboratory can be applied more Schulthess Klinik in Zurich. The Society, which was quickly to benefit patient care. founded by HSS, has senior physician representation from In 2008, we were pleased to welcome several new the leading orthopedic centers around the world. The mis- trustees – Atiim (Tiki) Barber, Michael Brooks, Leslie sion of this new organization is to facilitate the exchange Cornfeld, Gordon Pattee, and Ellen Wright – who will help of ideas and best practices among the premier orthopedic further our mission and guide our future. We also welcomed institutions and to collaborate on patient care, education, Stephan Feldgoise, Rachel Grodzinsky, Henry U. Harris III, and research to affect improvement in orthopedic care on and Carter Brooks Simonds to our Board of Advisors. a global scale. The third ISOC meeting is planned for spring 2010 at Istituto Ortopedico Rizzoli in Bologna, Italy. Looking Forward The accomplishments of Hospital for Special Surgery in The Importance of Philanthropy 2008 were achieved as a result of the incredible efforts of Philanthropy is critical to Special Surgery and the work that an extraordinarily talented HSS family – our employees, we do. The generosity of our grateful patients, corporate volunteers, management team, medical staff, and Board of donors, and foundations, as well as the support of our Trustees. We are all part of a tremendous team and we are trustees and medical staff, help ensure that our patients re- extremely proud of the role each of our employees plays in ceive the highest level of care possible, that our research the care of our patients and the strengthening of our insti- continues to advance the understanding of musculoskeletal tution. disease, and that our facilities can expand to accommodate Current local, national, and global conditions pose very demand. In 2008, we raised over $22.5 million – an excel- real concerns for the healthcare industry, but HSS remains lent achievement in this financial environment. a committed, focused institution dedicated to improving On June 16, 900 guests gathered at the World Financial the health and mobility of patients with diseases and disor- Center Winter Garden for the Hospital’s 25th Annual Gala, ders of the musculoskeletal system. 2009 will indeed be a honoring GE CEO Jeffrey Immelt and the late Richard year of change, challenge, and opportunity. We are ex- Laskin, MD. Chaired by Mrs. Douglas A. Warner III, the tremely fortunate to be entering this very important year Gala raised over $2 million in unrestricted support. Our with the absolute best team in health care. We now look Autumn Benefit Committee, chaired by Cynthia Sculco, forward, rededicating ourselves to pursuing opportunities hosted the first Magical Evening at the Rainbow Room in that will allow us to improve and build upon a foundation November. Attracting a crowd of 380 people, the evening of excellence and remain an established leader in muscu- raised over $400,000 for medical education. In December, loskeletal medicine around the world. pediatric care and research were the focus of a Big Apple Circus Benefit, a sold-out event raising over $95,000. Trustee Susan W. Rose served as Honorary Chair; Drs. Michelle Carlson and Daniel W. Green served as Co-Chairs. Dean R. O’Hare Aldo Papone Co-Chair Co-Chair Leading the Way Our Hospital is extremely fortunate to have a visionary and engaged Board of Trustees whose expertise and commit- ment to Special Surgery are invaluable. In November 2008, Louis A. Shapiro Thomas P. Sculco, MD members of the Hospital’s Board, along with medical and President and CEO Surgeon-in-Chief and Medical Director scientific leadership and senior managers, participated in a day-long retreat focused on two major topics: institutional economics and translational research. Participants held an in-depth discussion on the development of a plan to Stephen A. Paget, MD Steven R. Goldring, MD Physician-in-Chief Chief Scientific Officer

31 William and Carolyn Stutt: Friends for Quality of Life

illiam Stutt is a downhill skier, likes to windsurf and golf, and “bikes pretty hard.” Carolyn Stutt Wusually walks four to five miles a day, is an avid gardener, and even enjoys shoveling snow. And they very much enjoy their quality of life. But both have had their share of orthopedic injuries and passionately agree that if your quality of life is suffering from pain and immobility as- sociated with a musculoskeletal condition, “don’t delay – get help, get it fixed.” Mr. Stutt’s injuries date back to the late 1940s – the re- sult of playing lacrosse while a midshipman at the United William and Carolyn Stutt credit the expertise they found at Hospital States Naval Academy. “I’d had an ACL that had not been for Special Surgery for being able to enjoy a very vital quality of life. intact for all those years and a meniscus that had been removed years ago,” says Mr. Stutt. “By 2000, I had devel- people from using the step, but I stepped right in.” Mrs. oped a pretty severe arthritic condition, and my knee was Stutt tore ligaments involving four toes. This surgery was steadily getting worse. I exercised regularly and played much more complex, requiring pins to repair the damage. sports, but it was more and more difficult.” Just five months later, Michelle G. Carlson, MD, a hand Mr. Stutt contacted Richard L. Menschel, his long time specialist with HSS, removed a cyst and bone spurs from friend and partner at Goldman Sachs, who was then a finger in Mrs. Stutt’s right hand, returning her hand to Chairman of the Board of Trustees at Hospital for Special normal function. Surgery. Mr. Menschel put him in touch with Thomas P. “So we feel quite indebted to HSS,” says Mr. Stutt. Sculco, MD, who replaced Mr. Stutt’s left knee in April of “We’ve supported Johns Hopkins because of the good ex- 2001. “It worked out so well that I decided to do something periences we’ve had there. We decided that we wanted to with my right shoulder, which had been dislocated a num- continue to support institutions which are number one in ber of times – again from lacrosse,” says Mr. Stutt. “I their fields and that has been a large part of our philan- thought why put up with that? The shoulder was becoming thropic outlook.” very arthritic just as the knee had.” Mr. Stutt went to see The Stutts’ contributions to Hospital for Special Surgery Russell F. Warren, MD, of the Hospital’s Sports Medicine have included gifts to arthroplasty and sports medicine and Shoulder Service. Just five months following Mr. Stutt’s research, including support of the Russell F. Warren Chair knee replacement, Dr. Warren replaced his shoulder. “Both in Research. “It is getting increasingly difficult for these worked out very, very well,” says Mr. Stutt. institutions to have the flexibility in funds to do the Mrs. Stutt also came to know Special Surgery not long research, either developmental or basic,” says Mr. Stutt. after her husband’s experiences. In fact, she injured “Therefore it becomes more and more important to have herself while Mr. Stutt was recuperating from his knee private funds to address those needs. We strongly believe replacement at their home in Florida. “I slipped on a rug that the money should go to those institutions that are at and crashed my right foot into the support for the bed. the top of their game.” My second toe immediately pointed straight to the ceiling.” “If more discoveries can lead to improvements in quality Mrs. Stutt returned to New York two months later to of life as we all get older – isn’t that wonderful?” says have surgery with Jonathan T. Deland, MD, Chief of the Mrs. Stutt. “We both believe in that because we were Hospital’s Foot and Ankle Service. “In May 2007,” says helped to regain our own quality of life through procedures Mrs. Stutt, “I was back for my left foot. The hurricanes of that would not have been possible that many years ago. ’06 took a chunk out of a door sill step. We tried to prevent My husband is the best example – he’s going to be 82. I’m going to be 67. We continue to be very active and are grateful to HSS for enabling that to happen.”

32 Philanthropic Highlights – More than $22 Million Raised in 2008

ospital for Special Surgery continued to thrive in Among them are Ellen and Joe Wright, who made a gift of 2008, thanks to the thousands of individuals, $2.5 million to the Children’s Pavilion, a ‘pediatric hospital Hfoundations and corporations that supported us within a hospital’ that will consolidate our pediatric services throughout the fiscal challenges we faced as a nation. With in an environment uniquely designed and built for children the help of dedicated friends, HSS raised nearly $22.5 mil- and their families. This gift brought the Wright’s total com- lion to support patient care, research, education, and the mitment to the Capital Campaign to $3 million. renovation and expansion of our clinical facilities. Principal support was also received from an anonymous We cannot emphasize strongly enough the importance donor who contributed over $1.7 million in support of the of our individual donors to our success as an institution. Richard S. Laskin, M.D. Chair in Musculoskeletal Education More than 75% of the funds raised in 2008 came from and the Division of Arthroplasty Endowment Fund, while individuals and their bequests, a continuing trend at HSS Rheuminations, Inc., made a gift of $1.4 million to benefit and for philanthropy nationwide. the Mary Kirkland Center for Lupus Research. Gifts of $1 million came from an anonymous donor and HSS 2008 Giving by Source the Li Ka Shing Foundation, whose first-time commitment will support the Osteoarthritis Initiative. The OA Initiative is an unprecedented collaboration of our clinicians, basic Individuals 73% scientists, and clinical researchers, undertaken to find new Foundations 16% ways to diagnose and treat this disease. Corporations 8%

Bequests 3% Total Number of Donors Total Number of Gifts (amounts in thousands) (amounts in thousands)

7000 7000

For each of the last three years, both the number of 6000 6000 gifts and the number of donors have grown. In 2008, HSS 5000 5000 received over 6,600 contributions from more than 5,200 4000 4000

donors, an increase of 15% over 2007. 3000 3000

Our success in 2008 was bolstered by the extraordinary 2000 2000 generosity of several donors, some making their first gift, 1000 1000 others continuing a long tradition of support for HSS. 0 06 07 08 0 06 07 08

Building on Success: The Campaign for the Future of HSS Approaches $100 Million Mark uilding on Success: The Campaign for the the strength of our leadership and the extraordinary Future of Hospital for Special Surgery remains a volume of patients we serve to significantly advance Btop priority, dedicated to the expansion of our evidence-based medicine in orthopedics, rheumatology clinical facilities and the development of a robust clinical and related disease. The David H. Koch Medical Building, research program. HSS raised $17.2 million for the the first new clinical structure at HSS in a decade, will campaign in 2008, including almost $5 million for capital play a critical role in these endeavors. expansion and close to $10 million for research. This Building on Success is dedicated to improving the brings the total raised for Building on Success to nearly quality of life for patients today and for generations to $98 million since it began in September 2005. come. It is a testament to the generosity of our supporters As the largest capital renovation and expansion in the and to Special Surgery’s commitment to providing the best Hospital’s history, the campaign will help us to meet the care to each person who passes through our doors. needs of increasing numbers of patients and build upon

33 Finance Report

n 2008, surgical volume grew by over 12 percent and ment to both basic and clinical research is an important outpatient visits for non-surgical services such as radiol- component of the overall Hospital mission and is critical Iogy and rehabilitation grew by over 11 percent. The to Special Surgery maintaining and enhancing its status as quality of our care continues to be outstanding, and we a premier institution in orthopedics, rheumatology, and were successful in recruiting the physicians, nurses, and related disciplines. The close relationship between our other staff needed to keep pace with this growth. The scientists and medical staff enables a rapid application of consistent volume growth over the past 10-plus years is scientific discovery to the patient care setting. During 2008, attributable to a number of factors, including increased $31.7 million was dedicated to a wide variety of research awareness of the Hospital’s unique services and outstand- initiatives and programs. The ongoing recruitment and ing outcomes; continued and growing acceptance of retention of gifted scientists and clinicians will enable the orthopedic procedures due to superior implants and high Hospital to continue to expand the scope of its research success rates; the general aging of the population; and the activities and maintain its leadership position in its fields. growing number of younger individuals electing to have With a history of achieving positive operating margins orthopedic procedures to maintain their active lifestyles. through strong volume and revenue growth, successful The Hospital continues to operate in an environment fundraising, and an organization-wide emphasis on that poses numerous financial challenges. The challenges efficiently managing financial resources, the Hospital is that the Hospital has historically faced such as reductions positioned to respond to its current challenges. We will to Medicare and Medicaid reimbursement, complex and continue to monitor economic trends closely and prudent- costly regulatory requirements, and the high cost of labor, ly invest the resources and take the steps necessary to real estate, and construction in the New York City metro- continue to provide the highest quality musculoskeletal politan area are now exacerbated by significant declines in care, train top physicians, conduct pacesetting research, the investment markets, tight credit markets, and a deep- and accommodate the demand for our services. Our major ening economic recession. The New York State budget for facility expansion will continue through 2012 and provide the upcoming fiscal year will result in reductions to the additional operating rooms, inpatient beds, a pediatric Hospital’s revenues substantially in excess of historical pavilion to serve the unique needs of our youngest levels. As we move ahead to 2009, the impacts on patients, doctor offices, and expanded space for radiology fundraising, volume growth, access to credit markets, and and other outpatient services. This expanded capacity, revenue remain uncertain; however our stellar reputation along with an ongoing focus on efficiency, will enable the and solid financial foundation have positioned us to Hospital to keep pace with the anticipated growth in our respond to these impacts. patient population. In addition, we are committed to Our consistently strong operating results in past years developing and implementing technology that will enhance provided the resources to make the significant investments our ability to deliver care in a safe and efficient manner. in personnel and capital infrastructure that were needed to Now, more than ever, we remain focused on investing the accommodate the demand for the Hospital’s services and resources to build upon our foundation of excellence in advance the strategic goals of our mission. The first phases musculoskeletal care, research, and education. of a major facility expansion and renovation, which includ- ed additional operating rooms, inpatient beds, doctor offices, and magnetic resonance imaging (MRI) units, were completed during 2006 and 2007. Other accomplishments in recent years include the implementation of an inpatient clinical information system, digital radiology, and other Stacey L. Malakoff advanced information technology systems. Executive Vice President and The Hospital’s Research Division is internationally Chief Financial Officer recognized as a leader in the study of musculoskeletal disorders and related autoimmune disease. Our commit-

34 (1)(2) Financial Information Hospital for Special Surgery and Affiliated Companies

Statement of Income(3) Year Ended, (In Thousands) 2008 2007(4)

Hospital for Special Surgery Total Revenue(5,6) $515,892 $470,711 Total Expenses(7) 507,103 456,240 Operating Income from Hospital for Special Surgery $ 8,789 $ 14,471

Affiliated Companies Total Revenue(7) $ 47,030 $ 48,205 Total Expenses(6) 44,933 46,869 Operating Income from Affiliated Companies $ 2,097 $ 1,336 Operating Income $ 10,886 $ 15,807

Statement of Financial Position December 31, (In Thousands) 2008 2007

Assets Current Assets (Excluding Investments) $114,304 $ 98,972 Investments(8) Current 120,402 168,923 Long Term 74,956 60,924 Assets Limited as to Use 36,574 29,699 Property, Plant and Equipment – Net 307,671 310,236 Other Non-Current Assets 30,481 38,010 Total Assets $684,388 $706,764

Liabilities and Net Assets Current Liabilities $143,993 $136,405 Long Term Debt 185,041 189,045 Other Non-Current Liabilities 68,373 22,326 Total Liabilities 397,407 347,776 Net Assets 286,981 358,988 Total Liabilities and Net Assets $684,388 $706,764

(1) Includes activities relating to Hospital for Special Surgery and its affiliates (Hospital for Special Surgery Fund, Inc., HSS Properties Corporation, HSS Horizons, Inc., HSS Ventures, Inc., and Medical Indemnity Assurance Company, Ltd). (2) Complete audited Financial Statements of both Hospital for Special Surgery and affiliates are available upon request from the HSS Development Department at 212.606.1196. (3) Excludes $18.0 and $43.0 million of restricted philanthropic contributions in 2008 and 2007, respectively. (4) For purposes of comparison, certain reclassifications have been made to the 2007 column to conform with the 2008 presentation. Such reclassifications had no effect on changes in net assets. (5) Excludes changes in unrealized gains and losses on investments. (6) Includes $1.1 million of transactions between affiliates that are eliminated in consolidation in 2008 and 2007. (7) Includes $35.5 million and $32.7 million of transactions between affiliates that are eliminated in consolidation in 2008 and 2007, respectively. (8) Hospital for Special Surgery is the beneficiary in perpetuity of income from an outside trust. The fair values of investments in the trust are not included above and were $26.7 million and $41.3 million at December 31, 2008 and 2007, respectively.

35 Professional Staff (April 1, 2009)

Medical Board Allan E. Inglis, MD Assistant Attending Orthopedic Surgeons to Lewis B. Lane, MD Orthopedic Surgeons Ambulatory Care Center Chairman David B. Levine, MD Michael M. Alexiades, MD Consulting Staff Thomas P. Sculco, MD Peter J. Marchisello, MD Scott W. Alpert, MD Steven Z. Glickel, MD Secretary Richard R. McCormack, Jr., MD David E. Asprinio, MD (Pediatric Hand) Thomas D. Rizzo, MD Friedrich Boettner, MD Paul M. Pellicci, MD Fellows in Orthopedic Surgery Michelle G. Carlson, MD Attending Orthopedic Surgeons Timothy Achor, MD Board Members Struan H. Coleman, MD, PhD Mathias P. Bostrom, MD David W. Altchek, MD (Trauma) Matthew E. Cunningham, MD, PhD Charles N. Cornell, MD Oheneba Boachie-Adjei, MD Jaimo Ahn, MD, PhD Aaron Daluiski, MD Theodore R. Fields, MD Mathias P. Bostrom, MD (Trauma) Joshua S. Dines, MD Stephanie Goldberg, Charles N. Cornell, MD Kashif Ashfaq, MBBS Shevaun M. Doyle, MD MS, RN, CNA Edward V. Craig, MD (Limb Lengthening and Andrew J. Elliott, MD Lisa A. Goldstein, MPS Jo A. Hannafin, MD, PhD Reconstruction) Scott J. Ellis, MD Marion Hare, MPA, RN John H. Healey, MD Olufemi Ayeni, MD Stephen Fealy, MD David L. Helfet, MD David L. Helfet, MD (Sports Medicine/Shoulder) Austin T. Fragomen, MD Winfield P. Jones, Trustee Joseph M. Lane, MD Asheesh Bedi, MD Alejandro Gonzalez Della Valle, MD Richard L. Kahn, MD Paul M. Pellicci, MD (Sports Medicine/Shoulder) Charles B. Goodwin, MD Michael J. Klein, MD Chitranjan S. Ranawat, MD Patrick Birmingham, MD William G. Hamilton, MD Gregory A. Liguori, MD Scott A. Rodeo, MD (Sports Medicine/Shoulder) Russel C. Huang, MD Gregory E. Lutz, MD Leon Root, MD Yossef Blum, MD Edward C. Jones, MD Constance Margolin, Esq. Eduardo A. Salvati, MD (Adult Reconstruction) Lana Kang, MD Stephen A. Paget, MD Thomas P. Sculco, MD Edwin Cadet, MD Anne M. Kelly, MD Helene Pavlov, MD (Surgeon-in-Chief) (Sports Medicine/Shoulder) Bryan T. Kelly, MD Paul M. Pellicci, MD Russell F. Warren, MD Gilbert Chan, MD John G. Kennedy, MD Laura Robbins, DSW (Surgeon-in-Chief Emeritus) (Pediatrics) Alejandro Leali, MD Leon Root, MD Andrew J. Weiland, MD Christopher Dodson, MD David S. Levine, MD Thomas P. Sculco, MD (Surgeon-in-Chief Emeritus) (Sports Medicine/Shoulder) John C. L’Insalata, MD Louis A. Shapiro, Thomas L. Wickiewicz, MD Mark Dolan, MD Dean G. Lorich, MD President and CEO Philip D. Wilson, Jr., MD (Adult Reconstruction) Patrick V. McMahon, MD Scott W. Wolfe, MD (Surgeon-in-Chief Emeritus) Mark Drakos, MD David J. Mayman, MD Russell E. Windsor, MD (Sports Medicine/Shoulder) Michael J. Maynard, MD Scott W. Wolfe, MD Marco Ferrone, MD Medical Staff Michael L. Parks, MD (Spine/Scoliosis) Associate Attending Andrew D. Pearle, MD Surgeon-in-Chief and David Gay, MD Orthopedic Surgeons Cathleen L. Raggio, MD Medical Director (Hand) Answorth A. Allen, MD Amar S. Ranawat, MD Thomas P. Sculco, MD A. Ylenia Giuffrida, MD Edward A. Athanasian, MD Anil S. Ranawat, MD (Hand) Surgeons-in-Chief Emeriti John S. Blanco, MD Daniel S. Rich, MD Matthew Hepinstall, MD Russell F. Warren, MD Walther H.O. Bohne, MD Matthew M. Roberts, MD (Adult Reconstruction) Andrew J. Weiland, MD Robert L. Buly, MD Jose A. Rodriguez, MD Alexander Hughes, MD Philip D. Wilson, Jr., MD Frank P. Cammisa, Jr., MD Howard A. Rose, MD (Spine/Scoliosis) Frank A. Cordasco, MD Andrew A. Sama, MD Executive Assistant to Antony Kallur, MBBS Jonathan T. Deland, MD Mark F. Sherman, MD Surgeon-in-Chief (Spine/Scoliosis) David M. Dines, MD Beth E. Shubin Stein, MD Mathias P. Bostrom, MD Aleksandr Khaimov, DO James C. Farmer, MD Sabrina M. Strickland, MD (Adult Reconstruction) Mark P. Figgie, MD Edwin P. Su, MD Department of Jonathan Lam, MD PhD Federico P. Girardi, MD William O. Thompson, MD Orthopedic Surgery (Hand) Daniel W. Green, MD Kurt V. Voellmicke, MD Aamer Malik, MD Clinical Director Steven B. Haas, MD Steven B. Zelicof, MD, PhD (Adult Reconstruction) Charles N. Cornell, MD Robert N. Hotchkiss, MD Associate Attending Surgeons Theodore Manson, MD, MS John P. Lyden, MD Academic Director Gary A. Fantini, MD (Adult Reconstruction) John D. MacGillivray, MD Mathias P. Bostrom, MD (Vascular Surgery) Satyajit Marawar, MBBS Robert G. Marx, MD Francis W. Gamache, Jr., MD (Spine/Scoliosis) Orthopedic Research Director Bryan J. Nestor, MD (Neurosurgery) Daniel Markowicz, MD Jo A. Hannafin, MD, PhD Stephen J. O’Brien, MD Lloyd B. Gayle, MD (Adult Reconstruction) Patrick F. O’Leary, MD Faculty Development Director (Plastic Surgery) Volker Musahl, MD Martin J. O’Malley, MD Scott W. Wolfe, MD (Sports Medicine/Shoulder) Douglas E. Padgett, MD Assistant Attending Surgeons Irvin Oh, MD Orthopedic Surgeons Emeriti Bernard A. Rawlins, MD Lloyd A. Hoffman, MD (Foot/Ankle) Stanley E. Asnis, MD S. Robert Rozbruch, MD (Plastic Surgery) Kenneth Park, MD Stephen W. Burke, MD Harvinder S. Sandhu, MD Kenneth O. Rothaus, MD (Foot/Ankle) Michael J. Errico, MD David M. Scher, MD (Plastic Surgery) Mark Prasarn, MD Geoffrey H. Westrich, MD (Trauma) Roger F. Widmann, MD Riley J. Williams III, MD 36 Catherine Robertson, MD Department of Applied Associate Attending Physicians Fellows in Rheumatic Disease (Sports Medicine/Shoulder) Biomechanics in Anne R. Bass, MD Sabeen Anwar, MD James Ryan, MD Orthopedic Surgery Harry Bienenstock, MD Kun Chen, MD, PhD (Adult Reconstruction) Lisa R. Callahan, MD Diana Goldenberg, MD, MPH David Schroder, MD Director (Sports) Jessica Gordon, MD (Adult Reconstruction) Timothy M. Wright, PhD Theodore R. Fields, MD Suhail Hameed, MBBS Raheel Shafi, MD Associate Engineers Lionel B. Ivashkiv, MD Arundathi Jayatilleke, MD, MS (Limb Lengthening and Joseph Lipman, MS C. Ronald MacKenzie, MD Neal Moskowitz, MD, PhD Reconstruction) Darrick Lo, MEng Steven K. Magid, MD Dana Orange, MD Amit Sharma, MBBS Carol A. Mancuso, MD Ora Singer, MD (Spine/Scoliosis) Department of Medicine Jordan D. Metzl, MD Antigoni Triantafyllopoulou, MD Aasis Unnanuntana, MD (Sports) Weijia Yuan, MB (Metabolic Bone Diseases) Physician-in-Chief and Martin Nydick, MD Fellows in Pediatric Adam Wagshul, MD Director of Medicine (Endocrinology) Rheumatology (Foot/Ankle) Stephen A. Paget, MD Sergio Schwartzman, MD Risa Alperin, MD Hiroyuki Yoshihara, MB Robert F. Spiera, MD Physician-in-Chief Emeritus Jennifer Belasco, MD (Spine/Scoliosis) Richard Stern, MD Charles L. Christian, MD Julie Cherian, MD Physicians Emeriti Assistant Attending Physicians Anusha Ramanathan, MD Residents Alexa B. Adams, MD PGY5 Klaus Mayer, MD Juliet Aizer, MD Neurology Joseph Barker, MD William C. Robbins, MD Ernest Schwartz, MD Dalit Ashany, MD Lawrence Gulotta, MD Laura V. Barinstein, MD Chief R. Frank Henn, MD Peri-operative Center Jessica R. Berman, MD Moris Jak Danon, MD Benton Heyworth, MD Director Matthew L. Buchalter, MD Christoper Mattern, MD, MBA Neurologist Emeritus C. Ronald MacKenzie, MD Gina DelGiudice, MD Peter Tsairis, MD Michael Shindle, MD Stephen J. DiMartino, MD, PhD Adrian Thomas, MD Rheumatology Faculty Attending Neurologists Practice Plan Doruk Erkan, MD James Voos, MD Evette Ferguson, MD Abe M. Chutorian, MD Director Moris Jak Danon, MD PGY4 Theodore R. Fields, MD Richard A. Furie, MD Cassie Gyuricza, MD Jacobo Futran, MD Associate Attending Neurologists Carolyn Hettrich, MD, MPH Rheumatology Training Program Flavia A. Golden, MD Barry D. Jordan, MD Christopher Kepler, MD, MBA Director Susan M. Goodman, MD Howard W. Sander, MD Anna Noel Miller, MD Anne R. Bass, MD Stewart G. Greisman, MD Assistant Attending Neurologists Ngozi Mogekwu, MD Brian C. Halpern, MD Inflammatory Arthritis Center Bridget T. Carey, MD Andrew Neviaser, MD (Sports) Director Carl W. Heise, MD Daryl Osbahr, MD Wesley Hollomon, MD Sergio Schwartzman, MD Brion D. Reichler, MD Bradley Raphael, MD Michael I. Jacobs, MD Teena Shetty, MD Seth Sherman, MD Associate Director (Dermatology) Allan Gibofsky, MD, JD Osric S. King, MD Gerald J. Smallberg, MD PGY3 (Sports) Dexter Y. Sun, MD, PhD Haydee Brown, MD Mary Kirkland Lupus Center Kyriakos K. Kirou, MD Anita T. Wu, MD Michael Cross, MD Co-Directors Mary J. Kollakuzhiyil, MD Fellow in Neurology Demetris Delos, MD Doruk Erkan, MD, MPH Emma Jane MacDermott, MB, BCh Reza Zarnegar, DO Duretti Fufa, MD Kyriakos A. Kirou, MD Lisa A. Mandl, MD Sommer Hammoud, MD Attending Physicians Jaqueline M. Mayo, MD Patrick Jost, MD Pediatric Service Richard S. Bockman, MD, PhD Charis F. Meng, MD Han Jo Kim, MD (Endocrinology) Sonal S. Parr, MD Chief Travis Maak, MD Barry D. Brause, MD Edward J. Parrish, MD Lisa S. Ipp, MD Daniel Osei, MD (Chief, Infectious Disease) Jill M. Rieger, MD Attending Pediatrician Mary K. Crow, MD PGY2 Linda A. Russell, MD Thomas J.A. Lehman, MD Allan Gibofsky, MD Constantine Demetracopoulos, MD Lisa R. Sammaritano, MD (Chief, Pediatric Lawrence J. Kagen, MD Kristofer Jones, MD Ariel D. Teitel, MD Rheumatology) Alison Kitay, MD Thomas J.A. Lehman, MD Lisa C. Vasanth, MD Dennis Meredith, MD (Chief, Pediatric Rheumatology) Mary Beth Walsh, MD Associate Attending Pediatricians Curtis Mina, MD Michael D. Lockshin, MD Arthur M.F. Yee, MD, PhD Jessica G. Davis, MD Denis Nam, MD Joseph A. Markenson, MD Diana A. Yens, MD (Genetics) Keith Reinhardt, MD Irwin Nydick, MD Wendy S. Ziecheck, MD Donna DiMichele, MD Mark Schrumpf, MD (Cardiovascular Disease) Nunzia Fatica, MD Stephen A. Paget, MD Physicians to Jordan D. Metzl, MD Ambulatory Care Center PGY1 (Physician-in-Chief) (Sports) Francis Perrone, MD James P. Halper, MD Gail E. Solomon, MD Marschall Berkes, MD Bento R. Mascarenhas, MD Tai-Li Chang, MD (Cardiovascular Disease) (Neurology) Richard S. Rivlin, MD Lakshmi Nandini Moorthy, MD Christopher Dy, MD, MS Assistant Attending Pediatricians Jane E. Salmon, MD Hendricks H. Whitman III, MD Peter Fabricant, MD Alexa B. Adams, MD James P. Smith, MD Dee Dee Wu, MD Milton Little, MD Laura V. Barinstein, MD (Pulmonary Medicine) David A. Zackson, MD Benjamin McArthur, MD Susan B. Bostwick, MD Moira McCarthy, MD Harry Spiera, MD Consulting Staff Samuel Taylor, MD Thomas M. Novella, DPM (Podiatric Medicine) 37 Hyun Susan Cha, MD David L. Lee, MD Associate Attending Physiatrists Fellows in Mary F. DiMaio, MD Yi Lin, MD Joseph H. Feinberg, MD Musculoskeletal Radiology Lisa S. Ipp, MD Daniel Maalouf, MD Gregory E. Lutz, MD Timothy Deyer, MD Emma Jane MacDermott, MB, BCh Stavros Memtsoudis, MD Cono Gallo, MD Assistant Attending Physiatrists (Rheumatology) John G. Muller, MD Kevin Johnson, MD Vincenzo Castellano, MD Stephanie L. Perlman, MD Joseph A. Oxendine, MD Valeriy Kheyfits, MD Paul M. Cooke, MD Leonardo Paroli, MD, PhD Michael Ngo, MD Stephen G. Geiger, MD Psychiatry Service Thomas J. Quinn, MD Anuraag Sahai, MD Christopher Lutz, MD Daniel I. Richman, MD Elizabeth M. Manejias, MD Chief and Attending Psychiatrist James J. Roch, MD Department of Peter J. Moley, MD J. Warren Brown, MD Lauren H. Turteltaub, MD Alex C. Simotas, MD Rehabilitation Medicine Philip J. Wagner, MD Assistant Attending Psychiatrist Jennifer L. Solomon, MD Seth A. Waldman, MD Director and Chief Ruth Cohen, MD Vijay B. Vad, MD (Director, Pain Management) Leon Root, MD Consulting Psychiatrist David Y. Wang, MD Consulting Staff Allan M. Lans, DO Jacques T. YaDeau, MD, PhD Rock G. Positano, DPM Honorary Staff (Podiatric Medicine) Department of Anesthesiology Fellows in Anesthesiology Peter G. Bullough, MD Daniel Chen, MD Fellows in Physiatry (Laboratory Medicine) Anesthesologist-in-Chief Christopher Cook, DO Carroll Cooper, MD Stephen W. Burke, MD and Director Pratima Gondipalli, MD Stefan Muzin, MD (Orthopedic Surgery) Gregory A. Liguori, MD David Kim, MD Kevin Pak, MD Charles L. Christian, MD (Medicine) Education Director Kanupriya Kumar, MD Jeffrey Radecki, MD David L. Lee, MD Edward Lin, MD Robert H. Freiberger, MD Vrunda Pandya, MD Department of (Radiology) Clinical Research Director Radiology and Imaging David B. Levine, MD Jaques T. YaDeau, MD, PhD Department of (Orthopedic Surgery) Radiologist-in-Chief Attending Anesthesiologists Laboratory Medicine Klaus Mayer, MD and Director Spencer S. Liu, MD (Laboratory Medicine) Pathologist-in-Chief and Director Helene Pavlov, MD (Director, Acute and Robert C. Mellors, MD, PhD Michael J. Klein, MD Recuperative Pain Services) Academic Director (Laboratory Medicine) Nigel E. Sharrock, MD Pathologist Emeriti Carolyn M. Sofka, MD Peter Tsairis, MD Peter G. Bullough, MD (Neurology) Associate Attending Research Director Klaus Mayer, MD Anesthesiologists Hollis G. Potter, MD NewYork-Presbyterian Stephen N. Harris, MD Surgical Pathology Director Radiologist Emeritus Hospital Consultants Gregory A. Liguori, MD Edward F. DiCarlo, MD Robert H. Freiberger, MD to Department of Orthopedic Jeffrey Y.F. Ngeow, MD Attending Pathologists Surgery Cephas Swamidoss, MD Attending Radiologists Manjula Bansal, MD Michael K. Urban, MD, PhD Ronald S. Adler, MD, PhD Cardiothoracic Surgery Michael J. Klein, MD (Medical Director, PACU) (Chief, Ultrasound and Leonard N. Girardi, MD William F. Urmey, MD Associate Attending Pathologist Body CT) Charles A. Mack, MD Victor M. Zayas, MD Edward F. DiCarlo, MD Bernard Ghelman, MD General Surgery (Director, Pediatric Anesthesia) Richard J. Herzog, MD Assistant Attending Pathologist Philip S. Barie, MD (Chief, Teleradiology) Assistant Attending Giorgio Perino, MD Soumitra R. Eachempati, MD Theodore T. Miller, MD Anesthesiologists Faith A. Menken, MD Chief of Blood Bank, Helene Pavlov, MD Jonathan C. Beathe, MD Kevin P. Morrissey, MD Attending Hematologist and Hollis G. Potter, MD James D. Beckman, MD Immunohematologist (Chief, Magnetic Neurosurgery Devan B. Bhagat, MD David L. Wuest, MD Resonance Imaging) Mark H. Bilsky, MD Bradford E. Carson, MD Robert Schneider, MD Jam Ghajar, MD Mary F. Chisholm, MD Associate Attending Hematologist (Chief, Nuclear Medicine) Roger Hartl, MD Kathryn DelPizzo, MD and Immunohematologist Michael H. Lavyne, MD Christopher Dimeo, MD Lilian M. Reich, MD Associate Attending Radiologists Benjamin Levine, MD Chris R. Edmonds, MD Douglas N. Mintz, MD Consulting Neurologist Howard A. Riina, MD Michael A. Gordon, MD Carolyn M. Sofka, MD in Pathology Theodore H. Schwartz, MD Enrique A. Goytizolo, MD Moris Jak Danon, MD Assistant Attending Radiologists Robert B. Snow, MD Douglas S.T. Green, MD Eric A. Bogner, MD Mark M. Souweidane, MD Semih Gungor, MD Department of Physiatry Anthony Chang, MD Philip E. Stieg, PhD, MD Michael Ho, MD Li Foong Foo, MD Ophthalmology Kethy M. Jules, MD Physiatrist-in-Chief and Director Gregory R. Saboeiro, MD Edward Lai, MD Richard L. Kahn, MD Gregory E. Lutz, MD (Chief, Interventional (Medical Director, Jason A. Liss, MD Academic Director Procedures and CT) Ambulatory Surgery) Sophia Pachydaki, MD Paul M. Cooke, MD Richard S. King, MD Radiologist to Scott Warden, MD Vincent R. LaSala, MD Fellowship Director Ambulatory Care Center Otorhinolaryngology Andrew C. Lee, MD Christopher Lutz, MD Bonnie G. Lemberg, MD Max M. April, MD EMG Laboratory Director Jacqueline E. Jones, MD Joseph H. Feinberg, MD Ashutosh Kacker, MD

38 William I. Kuhel, MD Daniel Krauser, MD Jia Ruan, MD Neurology David I. Kutler, MD David Lefkowitz, MD Andrew I. Schafer, MD Russell L. Chin, MD Anthony N. LaBruna, MD Lawrence F. Levin, MD Jeffrey Tepler, MD Murray Engel, MD Mukesh Prasad, MD (Chief) Babette B. Weksler, MD Erik J. Kobylarz, MD, PhD William Reisacher, MD Norman M. Magid, MD Barry E. Kosofsky, MD Infectious Disease Rita M. Roure, MD David H. Miller, MD Norman Latov, MD Lewis M. Drusin, MD Samuel H. Selesnick, MD Robert M. Minutello, MD Michael Rubin, MD Marshall J. Glesby, MD Michael G. Stewart, MD Elizabeth C. Muss, MD John A. Schaefer, MD Linnie M. Golightly, MD Lucian Sulica, MD Martin R. Post, MD Nicholas D. Schiff, MD Roy M. Gulick, MD Erich Voigt, MD Mary J. Roman, MD J. Patrick Stubgen, MD Barry J. Hartman, MD Robert F. Ward, MD Allison Spatz, MD Jonathan D. Victor, MD David C. Helfgott, MD Theodore I. Tyberg, MD Pediatric Surgery John L. Ho, MD Pediatrics Craig H. Warschauer, MD Michael P. La Quaglia, MD Sian Jones, MD Alexander Aledo, MD Stephen R. Weiss, MD Nitsana A. Spigland, MD Jason S. Kendler, MD (Hematology-Oncology) Hooman Yaghoobzadeh, MD Laura A. Kirkman, MD Rubin S. Cooper, MD Plastic Surgery Gerardo L. Zullo, MD George V. Lombardi, MD (Cardiology) John G. Hunter, MD Michael A. Zullo, MD Kristen Marks, MD Patricia A. DeLaMora, MD Mark H. Schwartz, MD Dermatology Henry W. Murray, MD (Infectious Disease) Jason A. Spector, MD John A. Carucci, MD Thomas W. Nash, MD Murray Engel, MD Urology Maria Colavincenzo, MD Anthony Ogedegbe, MD Alfred Gilbert, MD Jerry G. Blaivas, MD Anjali Dahiya, MD Kyu Y. Rhee, MD (Genetics) Benjamin Choi, MD Jalong Gaan, MD Howard E. Rosenberg, MD Valerie L. Johnson, MD Scott G. David, MD Richard D. Granstein, MD Lawrence Siegel, MD (Nephrology) Marc Goldstein, MD Peter S. Halperin, MD Harjot K. Singh, MD Gerald M. Loughlin, MD Steven A. Kaplan, MD Henry Lee, MD Paul T. Smith, MD (Pulmonology) Marcus H. Loo, MD Neil S. Sadick, MD Rosemary Soave, MD Aeri Moon, MD Thomas P. McGovern, MD Mathew Varghese, MD Carlos M. Vaamonde, MD (Gastroenterology) Carlos Medina, MD Horatio F. Wildman, MD Mary A. Vogler, MD Roja Motaghedi, MD Dix P. Poppas, MD Scott Weisenberg, MD (Endocrinology) Endocrinology Rajveer S. Purohit, MD Timothy Wilkin, MD Eduardo M. Perelstein, MD Jason C. Baker, MD Howard I. Schiff, MD Cecilia Yoon, MD (Nephrology) Barry J. Klyde, MD Jonathan D. Schiff, MD Gianna J. Zuccotti, MD Maria G. Vogiatzi, MD Richard J. Mahler, MD Peter N. Schlegel, MD (Endocrinology) Andrew J. Martorella, MD Internal Medicine Alexis E. Te, MD Richard P. Cohen, MD Pulmonary Medicine Family Practice Vascular Surgery Mark S. Dursztman, MD David A. Berlin, MD George J. Kessler, DO Anthony C. Antonacci, MD Daniel Goldin, MD Joseph T. Cooke, MD John Karwowski, MD Gastroenterology Christina Harris, MD Ronald G. Crystal, MD (Chief) Brian P. Bosworth, MD Keith A. LaScalea, MD Brian Gelbman, MD Bradley A. Connor, MD Samuel J. Mann, MD Robert J. Kaner, MD NewYork-Presbyterian John E. Franklin, Jr., MD Mark S. Pecker, MD Thomas King, MD Hospital Consultants to Christine Frissora, MD Jacek J. Preibisz, MD Daniel M. Libby, MD Department of Medicine Howard Goldin, MD R.A. Rees Pritchett, MD Abraham Sanders, MD Arthur D. Heller, MD Richard F. Scofield, MD Anne E. Tilley, MD Allergy-Immunology Ira M. Jacobson, MD Carolyn R. Steinberg, MD Meredith Turetz, MD Daniel A. Burton, MD Arnon Lambroza, MD Nephrology Psychiatry Barton Inkeles, MD Brian R. Landzberg, MD Nathaniel Berman, MD John W. Barnhill, MD Gillian M. Shepherd, MD Charles Maltz, MD Jon D. Blumenfeld, MD Stephan J. Ferrando, MD Paul F. Miskovitz, MD Cardiovascular Disease Roxana M. Bologa, MD Jerry Nagler, MD James A. Blake, MD James Chevalier, MD Robert A. Schaefer, MD NewYork-Presbyterian David S. Blumenthal, MD David L. Globus, MD Michael J. Schmerin, MD Hospital Consultants to Jeffrey S. Borer, MD Choli Hartono, MD Arnold L. Weg, MD Department of Radiology Robert D. Campagna, MD Jun B. Lee, MD Gil Weitzman, MD and Imaging Richard B. Devereux, MD Frank Liu, MD Timothy C. Dutta, MD Hematology-Oncology Jonathan A. Lorch, MD Joseph P. Comunale, MD Frederick J. Feuerbach, MD Mark S. Brower, MD Alan S. Perlman, MD Linda A. Heier, MD Jeffrey D. Fisher, MD Maria DeSancho, MD John S. Rodman, MD (Neuroradiology) Kenneth W. Franklin, MD Jonas M. Goldstone, MD Stuart D. Saal, MD Carl E. Johnson, MD Richard M. Fuchs, MD Bruce R. Gordon, MD David Serur, MD (Neuroradiology) Harvey L. Goldberg, MD Barbara L. Hempstead, MD Raymond L. Sherman, MD Apostolos J. Tsiouris, MD Edmund M. Herrold, MD Charles I. Jarowski, MD Jeffrey L. Silberzweig, MD (Neuroradiology) Clare A. Hochreiter, MD Jeffrey Laurence, MD John F. Sullivan, MD Robert D. Zimmerman, MD Lawrence A. Inra, MD Margaret Lewin, MD Manikkam Suthanthiran, MD (Neuroradiology) Erica C. Jones, MD David M. Nanus, MD John Wang, MD Mazen O. Kamen, MD Allyson J. Ocean, MD Alan M. Weinstein, MD Lawrence A. Katz, MD Mark W. Pasmantier, MD Robert O. Kenet, MD Raymond D. Pastore, MD Roger N. Pearse, MD 39 Research Division Guillermina Girardi, PhD Bernard A. Rawlins, MD Scientists Emeriti Jo A. Hannafin, MD, PhD Scott A. Rodeo, MD Albert H. Burstein, PhD Chief Scientific Officer John H. Healy, MD Inez Rogatsky, PhD Charles L. Christian, MD Steven R. Goldring, MD David L. Helfet, MD Andrew A. Sama, MD Leonhard Korngold, PhD Associate Chief Scientific Officer Robert N. Hotchkiss, MD Lisa R. Sammaritano, MD Robert C. Mellors, MD, PhD and Director of Basic Research Spencer Liu, MD Harvinder S. Sandhu, MD Aaron S. Posner, PhD Lionel B. Ivashkiv, MD C. Ronald MacKenzie, MD Gisela Weskamp, PhD Adjunct Senior Scientists Carol A. Mancuso, MD Geoffrey H. Westrich, MD Donald L. Bartel, PhD Director of Clinical Research Robert G. Marx, MD Riley J. Williams, MD Robert N. Hotchkiss, MD Joseph Mansour, PhD Hollis G. Potter, MD Scott W. Wolfe, MD Carl F. Nathan, MD Paul Edward Purdue, PhD Jacques Yadeau, MD Senior Scientists Margaret G.E. Peterson, PhD Carl Blobel, MD, PhD Laura Robbins, DSW Instructors Francesco Ramirez, PhD Adele L. Boskey, PhD Eduardo A. Salvati, MD Matthew E. Cunningham, MD, Thomas H. Santer, PhD Peter G. Bullough, MD Michael Urban, MD PhD Marjolein C.H. van der Mullen, Mary K. Crow, MD William F. Urmey, MD Wei Zhu, PhD PhD Stephen B. Doty, PhD Thomas L. Wickiewicz, MD Mary Goldring, PhD Visiting Scientists Adjunct Associate Scientists Assistant Scientists Richard Herzog, MD Itzhak Binderman, DDS Robert Blank, MD, PhD Mathias P. Bostrom, MD Lionel B. Ivashkiv, MD Yingxin Goa, PhD Lawrence Bonnassar, PhD Chih-Tung Chen, PhD Joseph M. Lane, MD Francisco Valero-Cuevas, PhD Philip Giampietro, MD, PhD Charles N. Cornell, MD Thomas J.A. Lehman, MD Elizabeth Kozora, PhD Aaron Daluiski, MD Fellows in Research Michael D. Lockshin, MD Mark Lachs, MD Xianghua Deng, MD Danieli C. Andrade, MD, PhD Stephen A. Paget, MD Daniel MacDonald, DDS Mark P. Figgie, MD Yuri Chinenov, PhD Helene Pavlov, MD Nancy Pleshko, PhD Federico P. Girardi, MD Samuel Gourian, PhD Jane E. Salmon, MD Luminita Pricop, MD Qiu Guo, PhD Victor Guaiquil, PhD Thomas P. Sculco, MD Animesh Sinha, MD, PhD Steven B. Haas, MD Jing Hua, MD, PhD Nigel E. Sharrock, MD Marjana Tomic-Canic, PhD Chisa Hidaka, MD Carl Imhauser, PhD Peter A. Torzilli, PhD Xiaoyu Hu, MD, PhD George Kalliolias, PhD Adjunct Assistant Scientists Russell F. Warren, MD Russell Huang, MD Sylvain LeGall, PhD Robert Closkey, MD Andrew J. Weiland, MD Kyriakos Kirou, MD Thorsten Maretzky, PhD Thombai Dorai, PhD Philip D. Wilson, Jr., MD Matthew F. Koff, PhD Mikhail Olferiev, MD Lara Estroff, PhD Timothy M. Wright, PhD Gregory A. Liguori, MD Seonghun Park, PhD Melanie Harrison, MD Associate Scientists Theresa Lu, MD, PhD Eric Pourmand, MD Peter Kloen, MD, PhD Ronald S. Adler, MD, PhD Suzanne A. Maher, PhD Anju Roy, PhD Eric Meffre, PhD David W. Altchek, MD Joseph A. Markenson, MD Marie K. Reumann, MD Martin Sanzari, PhD Madhu Bhargava, PhD Philipp Mayer-Kuckuk, PhD Irina Z. Sagalovskiy, PhD Licia Selleri, MD, PhD Oheneba Boachie-Adjei, MD Stavros Memtsoudis, MD, PhD Steven Swendeman, PhD Lance D. Silverman, MD, PhD Richard S. Bockman, MD, PhD Bryan J. Nestor, MD Konstantinos Verdelis, DDS Adjunct Instructor Stephen J. O’Brien, MD Milena Vukelic, MD Frank P. Cammisa, Jr., MD Hassan Ghomrawi, PhD Frank A. Cordasco, MD Cathleen L. Raggio, MD Lu Wang, PhD Jonathan T. Deland, MD Bruce Rapuano, PhD Xu Yang, MD Edward DiCarlo, MD Anna Yarilina, PhD

Research Division: Achievements of Note Members of the Hospital’s Mathias P. Bostrom, MD, was Medicine, which is given to an Joseph M. Lane, MD, was Research Division are awarded the prestigious Career outstanding scientist in the area appointed to a four year term routinely recognized for their Development Award from the of connective tissue diseases on a Study Section for the NIH/ achievements with awards Orthopedic Research and and arthritis. National Institute of Arthritis and election to national and Education Foundation, which is and Musculoskeletal and Skin international leadership given annually to one orthopedic Jo A. Hannafin, MD, PhD, was the Diseases (NIAMS). positions. Following are just surgeon in the country. 2009 recipient of the Orthopaedic a few of the individuals who Research Society’s Women’s Stephen A. Paget, MD, has been have recently been honored. Mary Goldring, PhD, was elected Leadership Forum Award. elected as the Rheumatology to the Board of Directors of the Dr. Hannafin was also named Member American Board of Adele L. Boskey, PhD, was Osteoarthritis Research Society Vice Chair for Development Internal Medicine and also as a elected a Fellow of the International. for the Orthopaedic Research Board of Trustees Member of American Institute for Medical Educational Foundation. the American College of and Biomedical Engineering. Steven R. Goldring, MD, Chief Rheumatology’s Research and Dr. Boskey also received the Scientific Officer, was appointed Lionel B. Ivashkiv, MD, Senior Education Foundation. Orthopaedic Research Women’s Chairman of the Research Scientist and Director of Basic Leadership Award honoring Committee of the National Research, has been appointed Russell F. Warren, MD, was her contributions to science Arthritis Foundation. Dr. Associate Chief Scientific Officer inducted into the American and mentoring of women in Goldring was recently awarded at HSS. Dr. Ivashkiv has an out- Orthopaedic Society for orthopaedics. the Paul Klemperer Award from standing record of NIH funding Sports Medicine Hall of Fame. the New York Academy of and publication.

40 Management and Volunteers (April 1, 2009)

Executive Officers Ronald Perez Nursing Ken Osorio Perioperative Clinical Services Anne LoBasso Special Procedures Unit President and Inpatient Chief Executive Officer Operations Imsoo Park Louis A. Shapiro Susan Flics Patricia Quinlan Perioperative Services Nursing Education, Quality Executive Vice President and Patient Accounting Julie Pollino-Tanner and Research Chief Operating Officer Janit Maguire Rheumatology Lisa A. Goldstein Pastoral Care Physician Services Noreen Ryan Sr. Margaret Oettinger Executive Vice President Richard Crowley PACU/4 East for Finance and Patient Access Quality Management Anne Stroud Services/Admitting Chief Financial Officer Michelle Horvath 8 East Stacey L. Malakoff Gwendolyn Rhoss Radiology and Imaging Pharmacy Hospital Chaplains Executive Vice President Edward White Tina Yip for External Affairs Rev. Arnd Braun-Storck Deborah M. Sale Rehabilitation Services Physician Assistants Chaplain Chenault Conway JeMe Cioppa-Mosca Senior Vice President for Legal Pamela Katkin Rabbi Ralph Kreger Affairs and General Counsel Fr. Louis Mason Directors Public Relations Constance B. Margolin, Esq. Fr. Jordan McConway Phyllis Fisher Ambassador Services Sr. Margaret Oettinger Vice Presidents Roberta Mignone Risk Management Fr. Carlos Quijano Joanne Melia Ambulatory Care Services Corporate Compliance and Volunteers External Audit Virginia Forbes Safety Sharon Kurtz Giovanni Abbruzzese 50 years or over Ambulatory Surgery Chief Compliance Officer Mrs. Charles Bannerman Lisa Autz Security Donald J. Foiles Development Anesthesia 30 years or over Robin Merle Roberta Stack Service Excellence Mrs. John W. Fankhauser Chao Wu Mrs. Robert H. Freiberger Education and Academic Affairs Biomedical Engineering Laura Robbins Paul Sloane Social Work/Staff Development 25 years or over Roberta Horton Mrs. Bernard Aronson Finance Case Management Marc Gould Ms. Rose Ponticello Rachelle Schwartz Standards and Accreditation Mrs. John Steel Gayle White Human Resources Communications Bruce Slawitsky 20 years or over Sara Kosowsky Strategic Planning Ms. Maria Elena-Hodgson and Business Development Information Technology Education Ms. Brunilda Itturaldi Laura Dicker John P. Cox Martha O’Brasky Ms. Judith Johnston-Grogan Chief Information Officer Web Ms. Lisa W. Rosenstock Environmental Services Julie Pelaez Operations Joseph Pobliner 15 years or over Ralph J. Bianco James Streeter Ms. Margaret Collison Nurse Managers Marion Hare Ms. Anita Cruso Finance Geri Dilorenzo Ms. Lauren Fox Patient Care Services George Spencer Stephanie Goldberg 6 East Mrs. James Graham, Jr. Food and Nutrition Services Ms. Barbara Groo Chief Nursing Officer Catherine Drumm Eden Kalman Ms. Geraldine McCandless Private Ambulatory Research Administration Ms. Mary Murphy Vincent Grassia Health Information Management Maryann Eisele Ms. Dola Polland Glenn Rispaud Service Lines Private Duty Liaison Ms. Theresa Tomasulo Infection Control/ Ms. Doris Wind Catherine Krna Alicia Fisher Occupational Health Services 7 East Assistant Vice Presidents Eileen Finerty 10 years or over Debbie Harris Ms. Ethel Albert Managed Care Finance Ambulatory Surgery Ms. Doris Barth Stephen Bell Ross Sadler Mr. Victor Bozzuffi Jayne Hoffmann Brian Fullerton Marketing Ms. Barbara Brandon Pre-Surgical Ms. Elisa Clarke Laboratories Rachel Sheehan Screening/Holding Area Ms. Aseye Demasio Stephanie Lovece Materials Management Maura Keenan Ms. Frances Frank Peter Zenkewich Nursing 5 East Ms. Shirley Hyppolite Mary McDermott Medical Staff Services Ms. Marie Sherry Linda Leff William McDonagh Maureen Bogle Dr. Beth Viapiano Perioperative Support Services Infusion Therapy Neurology Elizabeth Pinkhasov 41 Officers and Board Members (As of April 1, 2009)

Officers Board Members Life Trustees Board of Advisors Co-Chairs Atiim “Tiki” Barber Loring Catlin Erick Bronner Dean R. O’Hare James M. Benson Mrs. James D. Farley Mary Ann Deignan Aldo Papone Richard A. Brand, MD Kathryn O. Greenberg Anne Ehrenkranz Peter L. Briger, Jr. J. Peter Hoguet Stephan Feldgoise Vice Chair Michael C. Brooks Carl B. Menges Rajesh K. Garg Daniel G. Tully Finn M.W. Caspersen David M. Mixter Earl G. Graves, Sr. President and Charles P. Coleman III John J. Phelan, Jr. Rachel Grodzinksy Chief Executive Officer Charles N. Cornell, MD Samuel S. Polk Kenneth V. Handal Louis A. Shapiro Leslie Cornfeld Katherine O. Roberts Henry U. Harris III Barrie M. Damson Donald Stone Holly Johnson, MD Surgeon-in-Chief and Melvin J. Glimcher, MD Mrs. Ezra K. Zilkha Kurt Johnson Medical Director Steven R. Goldring, MD Douglas L. Sacks Thomas P. Sculco, MD David L. Helfet, MD Carter Brooks Simonds Executive Vice President James R. Houghton Jonathan Sobel Lisa A. Goldstein Winfield P. Jones Robert D. Yaffa Monica Keany Executive Vice President David H. Koch International and Treasurer Lara R. Lerner Advisory Council Stacey L. Malakoff Marylin B. Levitt Finn M.W. Caspersen Executive Vice President Alan S. MacDonald Andreas C. Dracapolous Deborah M. Sale C. Ronald MacKenzie, MD David M. Madden Dr. Henry A. Kissinger Senior Vice President and Richard L. Menschel Sir David Li Secretary Carl F. Nathan, MD Richard L. Menschel Constance B. Margolin, Esq. Dean R. O’Hare David Rockefeller Stephen A. Paget, MD Paul Volcker Chairman, Emeritus The Honorable John C. Richard L. Menschel Aldo Papone Gordon Pattee Whitehead Charlton Reynders, Jr. Torsten N. Wiesel, MD Scott A. Rodeo, MD Susan W. Rose William R. Salomon Thomas P. Sculco, MD Louis A. Shapiro Daniel G. Tully Mrs. Douglas A. Warner III Russell F. Warren, MD Gene Washington Torsten N. Wiesel, MD Henry A. Wilmerding, Jr. Kendrick R. Wilson III Philip D. Wilson, Jr., MD Ellen M. Wright

Printed on recycled paper 2525 William R. Salomon: Thoughtful Giving with a Charitable Lead Trust

n the 1970s William R. Salomon decid- Almost 10 years ed he had been suffering too long with ago, the Salomons Horizon Ihip pain. Knowing that hip replacement created a Charitable surgery could be the answer, he sought to Lead Trust – a planned find an orthopedic surgeon who didn’t giving method that IN THIS ISSUE: think that at age 60 he was too young for provides critical sup- the procedure. He found that physician in port for the Hospital’s Success in Sports and Sports Medicine 1 Cover: New York Mets Philip D. Wilson, Jr., MD, then Surgeon-in- research efforts. pitcher Johan Santana Chief of Hospital for Special Surgery. At Their gift included the Our Professional Teams 4 returns to the mound after that time, hip replacement in the United establishment of an successful surgery at HSS The Professional Athlete 7 States was still very new, and surgeons endowment fund to to repair a torn meniscus. were reluctant to perform the procedure create the Virginia F. The School Athlete 13 At right: Dr. David Altchek in someone in their sixties. But Dr. Wilson and William R. reviews the pre-operative and his colleagues at HSS were at the Salomon Chair in Rehabilitation and Recovery 17 MRI images of the torn forefront of hip replacement surgery, Musculoskeletal having traveled to England to learn from Research. “When I Science and Sports 21 meniscus in Santana’s left knee in preparation for Sir John Charnley, the “father of modern wanted to make a William R. Salomon and his late wife, Virginia. Sports Medicine and Shoulder Service 24 arthroscopic surgery. total hip replacement,” who had originat- contribution to Special ed the procedure in the early 1960s. Surgery, I learned that the charitable lead tive now is an historically low special 2008 Annual Report 26 Below: Santana warms up “My wife, Virginia, happened to be at trust was a very rewarding method by rate that the Internal Revenue Service during the Mets spring the Hospital seeing Dr. Lee Ramsay which a person could make a gift,” says uses to predict how much your assets Leadership Report 26 training in Port St. Lucie, Straub, and he saw me limping away,” Mr. Salomon. “I also wanted it to do the will grow in the trust.” This potentially Florida. recalls Mr. Solomon. “He said to Virginia, most good for the Hospital.” allows heirs to receive substantial gains William and Carolyn Stutt: ‘Why doesn’t Billy have that repaired? Today, charitable lead trusts are tax-free. Friends for Quality of Life 32 and she said, ‘He would love to.’ So he becoming popular additions to donor “Hospital for Special Surgery is a very sent me to Dr. Wilson, and I had the oper- retirement planning as they offer attrac- personal place that takes an interest in Philanthropic Highlights 33 ation. Obviously it was quite successful.” tive, fixed, secure payments donors can the patient,” says Mr. Salomon, whose Mr. Salomon’s new hip served him well count on, even in an unpredictable mar- generosity has also supported the Virginia Finance Report 34 for 22 ½ years before he needed revision ket. They provide the donor with control F. and William R. Salomon Rehabilitation Professional Staff, Management, and Volunteers 36 surgery – performed at HSS by Douglas over the investment and an opportunity Department at HSS. “All the people that I E. Padgett, MD, a protégé of Dr. Wilson. to balance what they want to leave for have come in contact with here over the Benefactors 42 Wanting to do something for the their heirs with their philanthropic goals. years are enthusiastic about what they Hospital, Mr. Salomon, Honorary With a charitable lead trust, a donor can are doing and there is a warmth about the Officers and Board Members 52 Chairman of Citigroup and former transfer assets (including cash, art, and Hospital that is quite unusual in this day Managing Partner at Salomon Brothers, stocks) to a trust for a set term of years and age. I think most people who have a William R. Salomon: Inc., recalls, “Dr. Wilson asked me if I and receive preferential tax treatment, serious operation there would somehow Thoughtful Giving with a Charitable Lead Trust 53 would be interested in going on the including current income tax deductions or another like to become involved. I’ve Board and I said I would love to.” Mr. and a reduction of capital gains taxes. enjoyed the privilege.” Salomon became a member of the Board Annual payments – as either a fixed Executive Editorial Board Design of Trustees in 1979, with he and his amount or a set percentage of the trust’s If you would like more information Steven R. Goldring, MD Arnold Saks Associates Edward C. Jones, MD wife becoming among the Hospital’s most value each year – are made from the trust on planned giving opportunities, please Printing Stephen A. Paget, MD generous and devoted benefactors. to a designated charity or charities. The contact Rachel Cameau, Associate Monroe Litho Aldo Papone, Chairman charity is the beneficiary throughout Director, Planned Giving, at Deborah M. Sale Cover Photography the term of the trust. At the expiration of 212.774.7252 Thomas P. Sculco, MD Marc Levine/Getty Louis A. Shapiro the trust, the heirs inherit the assets. Major Photography Philip D. Wilson, Jr., MD According to a recent article in the Robert Essel Director of Marketing Wall Street Journal, “What makes them Other Photography Rachel Sheehan [charitable lead trusts] especially attrac- Brad Hess Assistant Director, Sports Photography Credits Sponsorship Marketing See page 51 Michelle Mulbauer Horizon is published twice a year Editor-in-Chief by the External Affairs Department, Sara Kosowsky Hospital for Special Surgery, Managing Editor 535 East 70th Street, New York, NY 10021. Linda Errante 866.976.1196 | [email protected] Assistant Editor Rachel Jager ©2009 Hospital for Special Surgery. All rights reserved. HOSPITAL HOSPITAL FOR SPECIAL FOR SPECIAL SURGERY SURGERY: 535 EAST 70TH STREET SPECIALISTS NEW YORK, NY 10021 IN MOBILITY 212.606.1000 www.hss.edu SPRING 2009

OIO PIG2009 SPRING HORIZON Horizon 2008 ANNUAL Hospital for Special Surgery is an affiliate of NewYork- REPORT Presbyterian Healthcare System and Weill Cornell Medical College.

Team Players Hospital for Special Surgery’s sports medicine professionals oversee care for competitive athletes and teams in virtually every sport. Middle: Brandon Jacobs, New York Giants Clockwise, from the top: Devin Harris, Nets Basketball; Sarah Bates Johnson, US Rowing Team; Andy Roddick, ATP; Wilson Chandler, New York Knicks; Seth Stammler, New York Red Bulls; Adenike Oyesile, St. Peter’s College; Richard Kiplagat, Iona College; and Success Michael Phelps, USA Swimming team in Sports – and Sports Medicine