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Orthopaedic
Connections
The newsletter of the Carl J. Shapiro Department
SUMMER 2021 of Orthopaedics at Beth Israel Deaconess Medical Center
BIDMC research projects aim to optimize exosuits for
improving work performance, preventing back injury
Researchers at Beth Israel Deaconess passive exosuit to aid older workers according to Walsh. The suit, which is
Medical Center are embarking on two whose jobs entail lifting. Both projects light and doesn’t restrict movement,
projects to advance the development will examine how effective the devices straps on like a backpack. It applies
of wearable exosuits that could help are at offloading weight to prevent forces via cables that work with the
individuals carry loads at work with back injury and lay the groundwork for back and hip muscles to help with
greater ease and avoid back injury. better, more versatile versions. bending and lifting.
An exosuit is an artificial version of an The U.S. Department of Defense
exoskeleton—the organic, nearly rigid recently awarded a three-year partner
covering that protects arthropods like grant to Walsh and Dennis Anderson,
lobsters and helps them move. These PhD, research scientist at CAOS, to
wearable devices can be powered, study the exosuit. “It’s clear there are
with controls guided by sensors on many DoD-related tasks and activities
the suit, or passive, with spring-like that cause injuries on the back, so
rods responding to the wearer’s we wanted to develop a solution that
movements. Scientists have been could reduce the strain. We are excited
Wyss Institute at Harvard University
developing exosuits with the goal of to leverage the generous support
increasing the ability for workers to from this award to initiate a new
lift heavy loads more safely with less collaboration where we can further the
effort and for longer as well as helping understanding of how exosuits interact
individuals whose strength or mobility with the body,” Walsh stated.
is impaired by medical conditions.
The DoD study is a partnership,
Recently, biomechanical researchers at explained Anderson. “The Harvard
BIDMC’s Center for the Advancement Biodesign Lab brings the exosuit
of Orthopaedic Studies (CAOS) technology and an interest in
The soft back exosuit by the Harvard
received government funding developing it, and we bring the
Biodesign Lab is designed to relieve some
for research designed to expand of the strain of heavy lifting. expertise in biomechanical modeling
knowledge in this evolving field. to evaluate spine and muscle loading.”
One study will look at how soft back
Soft, lightweight back exosuit Over the past 10 years, Anderson has
exosuit could help soldiers as they lift
Conor Walsh, PhD, a professor at been focused on taking biomechanical
and move heavy items, while the other
Harvard’s School of Engineering and measurements of the spine as
will test the effectiveness of a novel
Applied Sciences, and his research people move and stand, and creating
group in the Harvard Biodesign Lab sophisticated computational models
INSIDE have made considerable progress on a that can provide insights into a range
back exosuit that provides support to of orthopaedic issues—from vertebral
Dr. Rodriguez named Chief of help avoid back injury. fracture in older people to spinal
Orthopaedic Surgery 2
stenosis—and areas for improving
“We’ve been developing the back
Addition of total spine care treatment outcomes. The exosuit
exosuit for about three years and now
makes orthopaedic services for study further expands the application
have a robust prototype that we are
Brockton area residents all- of this work.
evaluating in human subjects studies,”
inclusive 4 continued on page 6
bidmc.org/orthopaedics
Orthopaedic Dr. Edward Rodriguez named
Connections
is published by the Carl J. Shapiro
Chief of Orthopaedic Surgery
Department of Orthopaedics at Beth
Israel Deaconess Medical Center for Edward K. Rodriguez, MD, PhD, was
primary care providers, patients, faculty, named Chief of the Department of
trainees, staff, alumni, affiliates and Orthopaedic Surgery at Beth Israel
friends.
Deaconess Medical Center (BIDMC)
Sponsor Edward K. Rodriguez, MD, PhD, and took the helm in September. He
Chief of the Department of Orthopaedic succeeds Mark Gebhardt, MD, who
Surgery and Orthopaedic Surgeon-in-
Chief, Beth Israel Deaconess Medical
continues his commitment to treating
Center patients as well as his research,
teaching and leadership activities at
Editor/Writer Marian Mostovy
BIDMC.
Designer Ricki Pappo
“We are very pleased to welcome
Please send comments or requests to be Dr. Rodriguez, an outstanding
added or removed from the mailing list
to: gpatton@bidmc.harvard.edu
surgeon, researcher and educator,
nothing. We have built a strong, busy
into his new role,” said BIDMC
clinical group with over 28 physicians
bidmc.org/orthopaedics President Pete Healy. “We are
and 19 advanced practice providers
confident that his thoughtful
and have succeeded at patient care
leadership and commitment to his
and clinical excellence. For the next
patients, colleagues and mentees will
10 or 15 years, hopefully, of my tenure,
further enhance BIDMC’s mission of
I would like to increase our focus on
extraordinary patient care supported
further improving the research and
by world class education and
educational aspects of our mission.
research.”
We need to improve the volume and
Rodriguez began his training in quality of our clinical research, invest
bioengineering, receiving a PhD in further in our basic science research,
that discipline from the University of and develop a stronger national voice
California at San Diego before earning and presence. The plan is to create—
his medical degree from Harvard in parallel to our clinical practice—a
Medical School at the Harvard-MIT tripod consisting of a basic science
CONTACT US HST program. He completed his and engineering laboratory, which
PHONE: orthopaedic residency at the Harvard we have had in place for many years;
617-667-3940 Combined Orthopaedic Residency a clinical core research group to
Monday – Friday Program followed by an orthopaedic support our faculty, which we need to
8:30 a.m. – 4:30 p.m. trauma fellowship at the University of build from scratch; and a translational
Maryland’s R Adams Cowley Shock innovation initiative, which we recently
After hours/weekends: Leave a detailed
Trauma Center in Baltimore. Rodriguez launched in collaboration with Dr.
message including patient’s name and
is board-certified in orthopaedic Gyongyi Szabo, BIDMC’s Chief
phone number and a brief description of
their condition.
surgery. He joined the orthopaedic Academic Officer.
department at BIDMC in 2004 as chief
ONLINE: bidmc.org/orthopaedics So, basic research, clinical research
of orthopaedic trauma.
Click “Request an Appointment.” and translational initiatives are the
Six months into his role, Rodriguez three legs, or cores, of the research
Referring physicians: shared his thoughts about his new tripod?
orthoappointments@bidmc. position and plans for the future.
Harvard.edu Yes. Our Center for Advanced
What do you envision accomplishing Orthopaedic Studies will remain
In addition to phone and online in the department? our engineering and basic science
requests, referring physicians can send core. The expansion of the clinical
I came into my new role putting
an email Including the patient’s name, research program involves hiring
forward a new vision for the way we
birth date or BIDMC medical record a clinical scientist to manage our
number, phone number and presenting
should work and some new priorities
clinical research activities and building
problem, and we will contact the patient we should embrace. Over the last 16
up additional services for grant
within one business day to schedule an years under Mark Gebhardt’s tenure,
writing, manuscript development
appointment. we have done an incredible job of
and statistical support. We’re also
building a department from essentially
2 | Orthopaedic Connections Summer 2021
Dr. Edward Rodriguez
planning on having a total of three sense for an orthopaedic department with complex and high morbidity
clinical research assistants who because orthopaedics is often about patients. I would like us to embrace
will be available to support all the engineering, surgical instrument that role fully within the system. For
clinicians. That will be the clinical and implant design, or therapeutics example, BIDMC has a full spectrum
core. And we now also have the newly technology—endeavors that are of orthopaedic specialties including
formed Musculoskeletal Translational amenable to industry support and oncology and trauma, and Lahey also
Innovation Initiative, headed by Ara collaboration. has expertise in acute and complex
Nazarian. I also named Dr. Nazarian care in these areas, so we could
We have had some experience in
our Vice Chair of Research Affairs, potentially work together to define
translational initiatives and have
a position I created, to manage the combined or more integrated BILH-
learned along the way how to take an
interaction between these three level services in subspecialties such
idea from a concept to a patentable
entities and guide our entire research as these.
design, working with the BIDMC’s
venture.
technology ventures office to take that I would also like all orthopaedic
The whole idea behind uplifting our idea all the way to a small startup. We services to become more collaborative
laboratory, creating a translational wanted to harness that experience and and integrated across the system in
initiative and improving the resources make it more accessible, not just to all a way that is beneficial to everyone.
for clinical research is to help us all the members of the department but to This might include, for example,
be as productive in research as we anyone in the greater musculoskeletal establishing common evidence-
possibly can for being one of the Beth Israel Lahey Health community. based performance and quality
smaller departments at BIDMC. That is what the translational standards, streamlining inter-
innovation initiative is about. hospital credentialing to enable
How do you plan to enhance clinical
surgeons to practice at any BILH site,
research? You mentioned the lab has been
opening access to BIDMC research
successful, but do you see areas
We have already interviewed a infrastructure to BILH partners,
where it could be even better?
statistician and additional research or creating systems that expedite
assistants, and have added more Under the direction of Dr. Mary referrals between orthopaedic
resources for support, such as for Bouxsein, the Center for Advanced practices anywhere in the system.
grant writing and preliminary grant Orthopaedic Studies has done I would like us to communicate that,
reviewing. We are also in the process remarkably well over the years. She here at BIDMC, we are ready to
of hiring a clinical scientist to become has continued its long tradition of offer support when complexity and
a primary administrative leader for the excellence going back to 1979, when morbidity merit a transfer to improve a
clinical research core. Many studies it was established by Drs. Augustus patient’s outcome.
initiated by residents or fellows often White and Toby Hayes. The one thing
To help me improve our network-
die on the vine when the fellows we could do better is increase active
building with the other members of
and the residents move on. So, we collaborations with our clinicians. To
the musculoskeletal community within
need someone whose mission is to achieve this we not only need to invest
BILH, I promoted Dr. Arun Ramappa
coordinate and move the clinical in upgrading the lab’s resources but
to be Vice Chair of Clinical Affairs.
research forward and prevent the also boost the level of interaction by
The mission of this position is to
loss of momentum in any given study. creating ongoing opportunities to
contribute to a more unified delivery
One important point of the clinical exchange ideas and develop projects
of musculoskeletal care across the
research program is to facilitate the of mutual interest.
system, sharing leadership of the
participation of all our divisions in
BIDMC has become part of the Beth initiative with both New England
multicenter studies that can potentially
Israel Lahey Health (BILH) system Baptist Hospital and Lahey.
offer some kind of financial support.
of academic medical centers and
In addition to enhancing research,
Tell me a little more about the hospitals. How will that play into your
you mentioned advancing the
impetus for the Musculoskeletal plans for the department?
department’s educational mission.
Translational Innovation Initiative.
I expect our department to play a
There are a few educational goals
The initiative focuses on harnessing key role in our BILH orthopaedic
I’m working on. One of the things the
the innovative thinking of the faculty community. We already have strong
department has been highly successful
into projects that could potentially partners at Lahey Hospital and New
at under Mark Gebhardt is becoming
have not just a research, clinical or England Baptist Hospital as well
one of the preferred training sites for
basic science benefit and interest, but as in our affiliates at Needham and
the Harvard Combined Orthopaedic
also some commercial outcome that Milton. However, we have a unique
Residency. The residents love us, in
could be helpful to further support position in the system given our
part because we have few fellows,
the departmental and institutional academic and research role as well
missions. Translational activities make as our institutional capability to deal continued on page 7
Summer 2021 Orthopaedic Connections | 3
Addition of total spine care makes orthopaedic
services for Brockton area residents all-inclusive
With the expansion of the orthopaedic at Signature Healthcare—such as non-surgical spine physician without
team at Signature Healthcare to rotator cuff repair, hip replacement, prior imaging or physical therapy,
include specialist physicians and other carpal tunnel release, ACL repair, and which some centers require. That
staff who treat neck and back pain, arthroscopy—patients can receive physician assesses patients, learns
residents of the Brockton area now the entire menu of treatment options what their goals are, and then helps
have access to a complete range of for their spine care, according to them to avoid spine surgery for as
care for their spine health care needs Mulroy. That menu includes injections, long as possible or prevent the need
close to home. physical therapy, bracing, medications for it altogether. They often work in
and, when needed, surgery. conjunction with physical therapists
Signature Healthcare, which includes
and use other modalities such as
Brockton Hospital and Signature
Medical Group, is clinically affiliated
with Beth Israel Deaconess Medical
Center (BIDMC) for orthopaedic
services, cancer care and other
specialties. With the two entities
working together, Brockton and
nearby communities can get the
quality of care available in an
academic medical center without
traveling to Boston.
The BIDMC Department of
Orthopaedics and Signature
Healthcare, a not-for-profit,
community-based hospital, first linked
forces in 2014, when they embarked
on establishing state-of-the-art
orthopaedics care at Signature. Part
of that vision included a robust
spine service with diagnostics, non-
operative care and surgical care, which
hadn’t been available in the Signature
network for more than 15 years. Spine specialists at Signature Healthcare Spine Center offer individuals in the Brockton
area care close to home.
In just a few years, Richard Mulroy, MD,
FACS, a joint replacement specialist New faces, new skills
injections and ultrasound treatments.
and BIDMC faculty member who As chief of the new spine service,
Importantly, the non-surgical spine
heads the orthopaedic service at White brought expertise, support and
physician knows when a patient may
Signature Healthcare, succeeded in cutting-edge thinking in this specialty.
benefit from surgery, and quickly refer
bringing all the subspecialties live— He has been instrumental in recruiting
them to a surgeon if needed.
except spine care. Then in 2018, he providers, mentoring and training
started to establish the hospital’s first staff, and putting processes and Orthopaedic surgeon Sapan Gandhi,
comprehensive spine program, naming outcome measures in place. MD, takes a conservative approach
Andrew White, MD, Chief of the Spine with his patients. “I treat people the
“Besides recruiting for the specialty
Division at BIDMC Orthopaedics, to way I would want care for myself or
of spine physiatry, we were also able
lead it. With the guidance of White one of my family members, which is
to train midlevel providers—we now
and others at BIDMC, Mulroy brought to only recommend surgery when it’s
have three physician assistants with
in non-surgical orthopaedic specialists, needed,” he said. “When surgery is
good spine experience,” said White.
or physiatrists, to meet the outpatient indicated, we do the least amount that
“The last piece of the puzzle was to
needs of the community and a spine will help the patient get better.”
introduce spine surgery to Brockton
surgeon for patients who could benefit
Hospital. We ultimately recruited The surgeries Gandhi most commonly
from surgical interventions.
Sapan Gandhi for that role” performs are to alleviate arthritis,
Now, in addition to orthopaedic ruptured (herniated) disc, pinched
Primary care physicians can refer
procedures that were already available nerve and spinal stenosis of the neck
patients with back or neck pain to the
4 | Orthopaedic Connections Summer 2021
or back. More complex procedures, “Over several years, I held a series of
such as those for back trauma, calls, meetings and training programs
scoliosis and tumors, are available at to familiarize them and other care
BIDMC Boston by Gandhi and White, providers to advance their knowledge
providing seamless continuity of care. of our spine program.”
When a patient’s issues are more Close to home
complex, such as those for back For many patients, convenience is
trauma, scoliosis or tumors, Gandhi a key factor in their decisions about
and White operate at BIDMC Boston. healthcare.
“I see myself as a link between the
“Many patients don’t want to leave
care that can be provided locally in
their community to be treated; they
Brockton and care that requires more
find it disconcerting,” White said.
specialized infrastructure in Boston,”
There are different reasons for that.
Gandhi said.
Sometimes it’s about their identity—
Gandhi often consults with the non- they were born in a community and
surgical spine physicians at Signature they want all their treatment there,
Healthcare or the surgeons at BIDMC’s from cradle to grave.
Spine Center when a patient’s
Another often-cited reason people
diagnosis or treatment plan is not clear
prefer local care is the impracticality
cut. And he is transparent about it. “I
of going into Boston. Although the
will tell a patient, ‘You have kind of an
Brockton area is just 25 miles south
unusual case. I’m going to show this to
of the city, traveling is wrought with
my partners at our Monday morning
challenges. “Many people find the trip
meeting and let’s have you come back
to be daunting, with traffic, parking
in a couple of weeks and we can talk
and not being familiar with where
about what they said.’ Patients seem
they’re going on a day that’s already
to like that openness,” Gandhi related. Drs. Sapan Gandhi (top) and
ridden with anxiety because they’re
Andrew White provide surgical
having an operation,” added White.
spine care in Brockton, and when
“Part of the goal is to keep people in
appropriate, at BIDMC in Boston.
their community where they might be
most comfortable.”
Care pathways are also shared,
That goal is now being met. The
according to White. “For example,
spine team sees patients at Signature
many years ago I helped develop a
Healthcare’s multispecialty site
spinal fusion pathway. Putting this
on Liberty Street near Rt. 24, and
pathway in front of Brockton clinicians
performs interventions and surgery
makes their familiarity as good as ours
at Brockton Hospital. Since the
and allows them to accelerate the
collaboration between BIDMC and
maturity of the program.”
Signature Healthcare was established,
Signature’s orthopaedic outpatient In addition to its clinical knowledge
visit and surgical volume has doubled. contributions, BIDMC’s academic
affiliation helped in the recruitment of
Sharing strengths
highly qualified physicians for the new
Collaboration between BIDMC and
spine service. “Dr. Gandhi is interested
Signature Healthcare continues to
in doing research with us, in helping
Surgeon Sapan Gandhi, MD, performs spine be key to the success of the Spine
us with training fellows and residents,
surgery at Brockton Hospital. Center at Signature Healthcare. The
and participating in our weekly
new center uses dozens of protocols
In addition to hiring an excellent care conferences,” said White. “That part of
developed at BIDMC. Such protocols
team, implementing the spine program professional fulfillment is meaningful
are important to patient safety, which
required giving Signature Healthcare to him and people like him. That’s
was key to Signature Healthcare from
providers in affiliated services the tools why the affiliation between Signature
the beginning. “Signature takes special
specific to spine care. “For example, Healthcare and our orthopaedic group
pride in their patient safety, improved
there are terrific radiology techs, is so important. It has allowed us to
outcomes and reduced risks,” said
radiologists, and anesthesiologists at recruit terrific people who are doing
White. “These are areas that benefit
Signature, but many had not worked great work.”
from experience, familiarity and
with spine patients,” said White. knowledge about systems practices.” continued on back page
Summer 2021 Orthopaedic Connections | 5
Optimizing exosuits to prevent back injury continued from page 1
Walsh’s team has shown the back- computer simulation tool so we can try injury due to reduced strength and
support exosuit reduces muscle different scenarios more easily and see osteoporosis.
activation, or the amount of effort if we can predict what would happen.
“We’re going to conduct a
required to lift materials while wearing That might point us toward a better
comprehensive biomechanical
it. “In our lab,” said Anderson, “we approach.”
evaluation to find out if this
want to enhance that analysis to
Ultimately, the Harvard Biodesign exoskeleton can reduce spinal loading
understand the effect of this suit on
Lab exosuit could benefit not just during lifting tasks, a key factor in
the actual loads applied to the spine or
soldiers but also others who perform vertebral fracture in older adults,”
the muscles of the spine.”
repetitive lifting tasks at work or have said Alemi. “Our findings will inform
To kick off the study, Walsh’s group health conditions for which back our long-term goal of developing a
will recruit 32 healthy men and women support would provide more mobility. new generation of passive exosuits for
to perform lifting tasks that replicate And Anderson’s biomechanical older adults that are comfortable and
lifting and material handling tasks computations in this arena may help effective for injury prevention during
Assistive Robotics Laboratory (ARL)@Virginia Tech.
Lowe’s
Lowe’s
A passive back-support exosuit designed by Virgina Tech and Lowe’s uses flexible carbon fiber beams to ease bending and lifting.
The exoskeleton applies forces to the front of the chest, top of the thighs and seat area.
of military personnel, both with and other researchers working on similar routine workplace tasks and activities
without exosuit. As they do so, the devices. “There are quite a few groups of daily living.”
team will measure their movements around the world developing this kind
The lightweight, wearable exosuit
and muscle activity. of technology, but there are many
was designed and developed at
unanswered questions about how
Then, using the data collected, Virginia Tech in collaboration with
effective they are in doing what we
Anderson will create computer home improvement retailer Lowe’s.
think they should be doing.”
models for each subject. From there, It reinforces proper lifting form and
he will use the models to analyze the Lift assistance for older adults is intended to lower the risk of back
effect the suit has on the loads on the In a parallel study, postdoctoral injury by storing energy during
muscles and joints. research fellow at CAOS, Mehdi Alemi, lowering and returning it back to the
PhD, will evaluate a passive back- user during lifting. As the user bends
The co-investigators are looking
support exosuit he helped develop and stands, flexible carbon fiber
to improve the suit’s design and
while a doctoral student. The device beams in the suit’s legs and back act
functionality, starting with how the suit
has been tested on young adults; like a taut bow ready to launch an
is controlled. “Right now, the design
now, Alemi will look at its potential arrow, helping them spring back up
team has various control parameters
for helping older adults avoid back more easily.
to describe when and how much force
injury. It is expected that 13.4 million
the suit generates when it’s trying to “We know the majority of workers are
people age 65 and over will be in
help somebody, but doesn’t yet know at risk of back pain or fatigue since
the workforce by 2024, and this
which one is best,” said Anderson.
population is at greater risk of back continued on back page
“We’re working on developing a
6 | Orthopaedic Connections Summer 2021
Dr. Edward Rodriguez
continued from page 3
so when residents come to our
rotations they are the primary trainees
a freedom of operation they don’t
always enjoy at the other institutions.
Doubling down on our strength, I want
to increase the number of residents
that come from the Harvard program
to BIDMC.
Also, I appointed Dr. Paul Appleton
to be our Vice Chair of Education.
In this new role, when combined
with his duties as BIDMC Associate
Program Director for our combined
residency, he will be empowered to
seek and implement opportunities to
further improve resident and medical Rodriguez, right, has been actively engaged in translational research. Here he is pictured
student education and wellness. He with Ara Nazarian, DSc, left, and Miguel Perez, MD, in BIDMC’s biomechanical lab.
will be designing new rotations for the
additional residents coming to BIDMC leaders have placed in me to lead the so far has been the realization that
and creating programs to improve Department of Orthopaedics toward unanimous consent is not always
resident well-being. For example, we the future that I envision. possible, even in a relatively small
just finished remodeling our new West department.
Campus work area, which has been I understand you have also been
a critical need for many years. Dr. involved with translational work for You began your new role in the midst
Appleton is also working on enhancing many years. of a pandemic. How has that affected
our resident curriculum across all your first few months as chair?
Yes, I have worked collaboratively
divisions at BIDMC and integrating our with Dr. Nazarian on a number of It has required adjustment of many
didactics with the other institutions translational projects. Probably priorities. I came with ideas and
within the Harvard system. the most important one is the goals that I wanted to implement
Could you recount your journey here development of the natural hormone immediately, but because of the
at BIDMC? relaxin, a potential therapeutic for COVID-19 pandemic, we have had to
preventing joint stiffness after injury focus on critical patient-care issues
I’ve been part of the Harvard system or trauma, with Boston University. and deal with limitations in OR access.
since 1993—I went to medical school There have been many other projects We have had to prioritize and triage
here at HMS, then did my residency in over the years ranging from fracture properly the cases that we can do, and
the Harvard Combined Orthopaedic prevention devices to infection explain to patients why they can’t have
Program. I was an intern the year BI preventing implant coatings. their surgeries as they had initially
and the Deaconess merged so I have been planned. While we are trying
had a connection with BIDMC for What is your leadership style?
to manage patient-care operations,
about 23 years. My first 16 years in I put the most effort into being I’m still trying to implement many of
the Orthopaedic Surgery Department accessible to anyone who has the changes that I had planned. I’ve
were spent managing the orthopaedic questions or concerns—be it in been fortunate that my colleagues
trauma service, which has now grown the department, the institution or have been incredibly supportive. And
to three fellowship-trained faculty an affiliated hospital. I’ve always thankfully, the leadership teams at
members, an RN, a PA and several done that, not just because it’s BIDMC and Harvard Medical Faculty
residents—not just orthopaedic the right thing to do, but because Physicians are remarkable and have
residents but also emergency it’s offered me so many learning been wonderfully welcoming during
medicine and podiatry residents. I am opportunities along the way. Also, I this transition.
still practicing trauma. I have fewer don’t believe in exercising leadership
clinical hours, but I still take call and Overall, these first six months have
by micromanaging folks into doing
work weekends. been challenging at times, but it
what I think is best but rather by
has been an honor and a rewarding
BIDMC is not just where I work, it is trying to learn what motivates my
learning experience, despite the
really my second home and family, so colleagues and then finding a way
difficulties of the pandemic.
I care deeply about who we are and to communicate how what I am
where we are going. I am very honored proposing can support their career
by the confidence our institutional goals as well. The biggest challenge
Summer 2021 Orthopaedic Connections | 7
Brian D. Snyder, MD, PhD, and PhD
NEWS AND NOTES candidate Taylor Lawson, CAOS, were
authors of a two-part article in the
Signature Healthcare
continued from page 5
Journal of Orthopaedic Research titled
AWARDS Signature Healthcare, which remains
“Nanotechnology and osteoarthritis,”
an independent organization, provides
Edward Rodriguez, MD, PhD, chief of published in March 2021.
facilities that include state-of-the-art
the Department of Orthopaedics, was
Ron Alkalay, PhD, CAOS, co-authored operating rooms as well as MRI, CT,
selected as a recipient of the 2021 A.
“Conventional finite element models and other diagnostic tools.
Clifford Barger Excellence in Mentoring
estimate the strength of metastatic
Award at Harvard Medical School (HMS)
human vertebrae despite alterations of Since the collaboration between
in April. Award recipients are selected by
the bone’s tissue and structure,” which BIDMC and Signature Healthcare
an HMS and affiliated hospital advisory
appeared in the December 2020 issue was established, the orthopaedic
committee from nominations by faculty
of Bone. outpatient visit and surgical volume
members, house officers, fellows and
students of individuals who provided Ara Nazarian, DrSc, CAOS, and Edward has doubled.
sponsorship, encouragement and support Rodriguez, MD, PhD, Orthopaedic
for their own and others’ careers. Trauma, were co-authors of “Clinical “Prior to this partnership, the people
management of arthrofibrosis: state of of Brockton could get excellent spine
the art and therapeutic outlook,” which care but they had to travel to Boston,”
PUBLICATIONS appeared in the Journal of Bone & Joint said Mulroy. “Together, Signature and
The BIDMC Center for Advanced Surgery Reviews last July. BIDMC are now providing top-notch
Orthopaedic Studies (CAOS) researchers spine care in their neighborhood or in
A multidisciplinary team that included
and Department of Orthopaedics their home. Looking into the future,
Nazarian, members of his CAOS team
physicians publish their work regularly
Robert Spang, MEng; Johnathan Egan, we will continue to grow and add the
in academic journals. Here are a few
MD; Philip Hanna, MD; Aron Lechtig, latest advances in treatments to meet
recent samples.
MD; and Daniel Haber, MD, along with their needs.”
surgeons Joseph P DeAngelis, MD, and
Fjóla Jóhannesdóttir, PhD, Dennis The spine team sees patients at
Arun Ramappa, MD, Sports Medicine,
Anderson, PhD, and Mary Bouxsein, PhD,
published their study “Comparison of the Signature Healthcare facility at
CAOS, were authors on “Bone density
patellofemoral kinematics and stability 110 Liberty Street in Brockton. For
and strength from thoracic and lumbar
after medial patellofemoral ligament referrals or appointments, call 508-
CT scans both predict incident vertebral
and medial quadriceps tendon-femoral 565-3055 or visit MySignatureCare.
fractures independently of fracture
ligament reconstruction” in the July org/Spine.
location,” published in Osteoporosis
2020 issue of American Journal of
International in February 2020.
Sports Medicine.
Optimizing exosuits to prevent back injury continued from page 6
they are exposed to the repetitive questions such as, “Does the wearer Like Anderson’s project, this study
lifting and lowering and other static lift differently with and without the focuses on healthy people avoiding
tasks,” said Alemi. “The exoskeleton exoskeleton? Does the exoskeleton back injury. But the next frontier for
is helping them to offload the weight help the wearer have more balance? a passive exosuit may be a design for
of the torso, significantly reducing the Help them have less muscle exertion those who already have back issues.
amount of force on the spine. So when and spinal loading?” “If it works for these healthy people,
you are picking up a 30-pound box, it we can modify this exoskeleton or
To find out the answers, Alemi
feels like 20 pounds.” develop a new generation of the
will employ a combination of
exoskeleton that also helps people
The study, funded by the National biometric measuring techniques
who have walking or back injury
Institutes of Health, involves 12 and qualitative measures gathered
problems,” said Alemi.
subjects between 65 and 80 years from questionnaires. “We’ll use
old who will perform lifting and static electromyography, 3D motion analysis, Perhaps further in the future, the
holding tasks with and without the and subject-reported outcomes—that exosuit’s functionality will expand to
exosuit. The recruited participants is, how the subject perceives exertion, aid older people in their homes and
will be gender-balanced and have balance, comfort and usability.” with daily activities like shopping
no recent history of musculoskeletal or gardening. As one YouTube
With the collected data and the
disorders or low back pain. commenter noted, the exosuit may
unique musculoskeletal model of
become the supermarket scooter of
The aim of Alemi’s research is to the spine developed by Anderson,
the millennial generation.
understand how the exoskeleton Alemi will then create new advanced
impacts activity of the muscles, musculoskeletal models that calculate See the passive exosuit demonstrated
especially the back muscles, as well as the trunk muscle forces. These will on YouTube at www.youtube.com/
how it affects the behavior of lifting, enable him to verify if the exosuit helps watch?v=zpLU04A9ySQ.
known as kinematics. He will pose reduce the spinal loading.
bidmc.org/orthopaedics
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