1

Department of orthopaeDic Surgery

Print Application2 ColorPMS 7406 + PMS 288White Background

“Recent advances in biomedical science now permit us to identify gene pathways and thereby formulate targeted therapies which are vastly improving our ability to manage bone and joint diseases.” Thomas L. Clemens, PhD Lewis Cass Spencer Professor Director, Research Division

2 11

Department of orthopaeDic SurgeryriSing to the challenge

A CAll to ACtion

Rising to the Challenge: The Campaign for

Johns Hopkins will raise unprecedented

levels of support to attract, sustain, and

further empower the people of Johns

Hopkins—our students, faculty, and

researchers—who through their work

improve the lives of millions around the

world. Together with our philanthropic

partners we will:

AdvAnce discovery And creAtivity

through support of our exceptional faculty

and researchers. Their innovative work

drives the development of new knowledge,

new forms of expression, and new ways to

save lives and improve health, and furthers

progress across our core disciplines in

science and technology, the humanities

and arts, and public health and medicine.

enrich the student experience

by investing in scholarships and fellowships,

inspirational spaces for collaborative

learning and social opportunities, and

new programs that will enhance student-

faculty interactions, ensure diversity on

campus, link learning in the classroom

to life after graduation, and strengthen

connections between our students and

our surrounding communities.

solve GlobAl problems As one

university by creating new cross-

disciplinary solutions in crucial areas

such as sustaining global water resources,

revitalizing America’s cities, advancing

individualized health, understanding how

we learn and teach, and attacking the root

causes of global health problems.

Department of Orthopaedic Surgery is

committed to playing a key role in the

success of the campaign. Please join with

us in this important mission.

Humans depend, fundamentally, upon the body’s musculoskeletal system. Our daily activities, our physical experiences, our ability to engage meaningfully in the world around us, and thus our quality of life all hinge upon how well our bones, and the physical structures integrated with them (such as muscles, ligaments, and nerves), function. As individuals, we often neglect to appreciate the myriad ways in which our musculoskeletal system performs for us—until something goes wrong.

Musculoskeletal disorders and diseases are a leading cause of disability in the United States. Beginning at age 25 to 30 years, our muscles and bones steadily lose mass, an inexorable trend that erodes their strength, integrity, and functionality. This consequence of aging, together with accidents, injuries, disease-related causes, and congenital

disorders, cause more than one in four Americans today to suffer a musculoskeletal condition requiring medical attention.

The loss of bone (osteoporosis) and muscle (sarcopenia) rank among the most important global health problems. Over 10 million Americans have osteoporosis, and another 34 million have low bone density. As populations age in the US and worldwide, and as the sedentary “Western lifestyle” becomes predominant, the prevalence of musculoskeletal conditions will almost surely increase. The Centers for Disease Control and Prevention estimate that, while 27 million Americans currently suffer from osteoarthritis, by the year 2030, 25% of American adults, nearly 67 million people, will have this diagnosis.

2 3

Department of orthopaeDic SurgeryriSing to the challenge

orthopAedic surGery—meetinG

urGent needs

Orthopaedic surgeons step in when structures of the musculoskeletal system are damaged or impaired. The needs they meet arise in multiple ways: sports-related injury, degenerative diseases such as osteoarthritis, trauma (including accidents), infection, tumor, and congenital disorders and deformities. These conditions shatter health, reduce function, and diminish quality of life for vast numbers of people.

They also significantly burden society. In the US, annual direct and indirect costs for bone and joint health are approaching $900 billion, about 8% of the gross domestic product; osteoarthritis alone accounts for over $185 billion in expenses each year.

outpAcinG need with proGress

in clinicAl methods

While the need for orthopaedic care is undeniably expanding, so, too, is surgeons’ capacity to treat and cure many musculoskeletal conditions. In the 21st century, we are seeing the advent of a host of new medical and surgical methods—such as longer- lasting joint replacements—that bring new hope to orthopaedic patients. Johns Hopkins physician-scientists are leading many of these advances, through ground-breaking research and innovations in patient care.

JoHnS HoPKinS DEPARtMEnt oF oRtHoPAEDiC SURGERYWhen the forefather of surgery at Johns Hopkins Medicine, William Stewart Halsted, organized the fledgling institu-tion in 1900, Orthopedic Surgery was one of eight original specialty services. In the ensuing years, the Johns Hopkins Department of Orthopaedic Surgery has been continuously caring for patients, fostering innovation, and nurturing leaders in orthopaedic medicine and research.

Today, the Johns Hopkins Depart-ment of Orthopaedic Surgery comprises 52 full-time and 38 part-time faculty. Our clinical service treats patients of all ages, from newborns to the elderly, with a full complement of diagnostic and therapeutic services. In facilities spread across the Johns Hopkins Medicine campuses, we annually perform 6,800 surgeries and provide more than 64,000

RESEARCH AREAS important, impactful, translational

• osteoporosis, bone diseases

• peripheral nerve repair

• metastatic bone disease

• sports medicine

• shoulder surgery

• cartilage regeneration

• joint reconstruction

• pediatric conditions

• spine reconstruction

outpatient visits. Approximately 16% (10,000) of our patients are either unin-sured or qualify for medical assistance.

plAnninG for the future

Patients come to the Johns Hopkins Department of Orthopaedic Surgery with a broad range of musculoskeletal conditions, each of which exerts a major—often devastating—toll on the individual’s life. How can we best serve our patients, now and into the future?

The answer to this essential question lies in Hopkins’ time-honored trilogy: patient care that is optimally effective, comprehensive, compassionate, and individualized to meet the unique needs of each patient; research that illuminates underlying disease processes, and that guides treatment decisions; and educa-tion that prepares next generations of orthopaedic surgeons, capable of providing highest-quality patient care.

Johns Hopkins has a rich history of engaging in high-impact muscu-loskeletal research. Our approach is collaborative and multi-disciplinary, pooling expertise across disciplines and leveraging the many intellectual and scientific resources at Johns Hopkins. To provide comprehensive services, our scope is broad; this breadth is balanced by intensive focus in key areas in which we are poised to make substantial progress. The following pages describe our priorities for the Rising to the Challenge Campaign.

rxercise institute

In the industrialized world, a major threat to health—and perhaps the most important modifiable risk factor for numerous diseases—is physical inactivity. Heart disease, the #1 cause of death in the US, is closely linked to physical

CliniCAl SERviCES Safe, Effective, Personal

• spine service

• orthopaedic oncology

• sports medicine

• foot and ankle surgery

• hand surgery

• shoulder surgery

• reconstructive surgery

for hips and knees

• trauma surgery

• pediatric orthopaedic care

• management of musculo-

skeletal malfunction,

malalignment, and

defects of bone, joint,

and soft tissue

inactivity. Obesity, a risk factor for many chronic and degenerative condi-tions, has reached epidemic proportions; more than one third of American adults are now obese. Ten million people in the US have osteoporosis and 18 million more are at risk of developing it due, in part, to inactive lifestyles.

Many chronic and degenerative diseases can be prevented, better managed, or even cured through life-style changes that include exercise and other physical activities. For example, individuals at risk of developing osteoporosis can be identified by low bone density at age 20, and physical activity, particularly weight-bearing exercise, can help to maintain their bone density. Not only does exercise

4 5

on understanding, monitoring, and modifying a wide range of factors—such as disease, interventions, satisfaction with care, race/ethnicity, adherence to treatment plans, patients’ preferences, and cost—and their relationship to the outcomes of care.

As a recognized authority on patient outcomes, safety, and healthcare delivery in musculoskeletal medicine, the Center focuses on questions such as: • How do different surgical procedures

compare, in terms of patients’ outcomes?• How can we best involve patients

in their own health and recovery following surgery?

• What specific clinical interventions result in healthier and safer athletes?

What outcomes do patients with spine deformity correction, skeletal dysplasia, cerebral palsy, genetic disorders, and Perthes disease experience?

spine institute

Bridging the Departments of Ortho-paedic Surgery and Neurosurgery, the Spine Institute brings together a multidisciplinary team of clinicians and researchers with extensive experience in the full spectrum of spinal conditions. The Institute’s foundational principle is that spine care must be patient-centered, evidence-based, comprehensive, highly

riSing to the challenge Department of orthopaeDic Surgery

improve or prevent orthopaedic conditions, it also positively impacts other types of disease—gastrointestinal, neurological, endocrine/metabolic, and pediatric, as well as mental health and cancer.

To better understand the interface between lifestyle and health, and to harness this connection in order to achieve best results for patients, the Department of Orthopaedic Surgery proposes to establish an Rxercise Institute at Johns Hopkins’ Greenspring Station. The Institute’s approach to medicine will be transformative: Here, patients will receive the best possible care for inactivity-related disease and, through participating in cutting-edge research studies, they will simultaneously help our scientists determine how to promote optimal health for future patients.

The Rxercise Institute will comprise six disciplines, each focused on a critical area of lifestyle-related disease: ortho-paedics and sports medicine, cardiac disease, obesity, pediatric wellness, dia-betes, and osteoporosis. Faculty within Hopkins orthopaedics, cardiology, endocrinology, psychiatry, pediatrics, weight control, epidemiology, and exercise physiology programs will work together in this multi-disciplinary enterprise. Research will be its driving force, and excellent patient care and service will be at the heart of its mission.

center for musculoskeletAl reseArch

Discovery, in today’s medical research environment, seldom results from scientists working in isolation. Major breakthroughs require the collaborative efforts of brilliant individuals and teams, spanning backgrounds and

A generous gift from an anonymous donor endowed the Center for Musculoskeletal Research, allowing substantial leverage for further philanthropy.

areas of expertise. This is especially the case in musculoskeletal medicine, where new research illuminates, with ever greater intricacy, the interconnect-edness of muscles, bones, and joints with the immune, neuroendocrine, vascular, and metabolic systems.

Established in 2009, the Center for Musculoskeletal Research (CMR) within the Department of Orthopaedic Surgery is a research hub intentionally designed to promote interdisciplinary teamwork and expedite collaborative musculoskeletal research. The CMR environment encourages a comprehensive, integrated approach to important medical problems; creative solutions are developed and implemented, leading to better understanding of musculoskeletal disease and disorders, more effective treatments, and more powerful diagnostics. For the Rising to the Challenge Campaign, the Center’s strategic agenda encompasses focused initiatives in bone biology, peripheral nerve regeneration, bone oncology, and pediatric skeletal dysplasia.

pediAtric orthopAedics

Children come to Johns Hopkins with a wide range of orthopaedic conditions— some distinctly pediatric in nature, and others which mirror their adult counterparts but must be handled differently for the very young. Simply put, orthopaedic care for the pediatric patient is far more than just a pint-sized version of adult orthopaedics—and it is immensely important. Musculoskeletal conditions confronting children often have devastating impact on young lives; conversely, successful treatment can be life-changing.

are patient-focused; they include outreach to underserved areas, an additional Child Life Specialist, and a new Pediatric Waiting Room that creates a nurturing environment for children, adolescents, and families.

center for orthopAedic discovery

Decades of advances in healthcare have led to increased longevity. This progress, however, has a down side. Aging-related musculoskeletal disorders—osteoarthritis, osteoporosis, fractures among the elderly, and spinal stenosis, to name a few—limit the quality of life of burgeoning numbers of individuals as they grow older. As yet, relatively little is known about the true burden of these conditions.

The Center for Orthopaedic Discovery is a multidisciplinary group committed to improving the health and safety of patients with musculoskeletal disorders through outcomes research. Its broad purposes are to (a) elucidate the impact of musculoskeletal disorders on individuals and society, and (b) create approaches to minimize that impact through prevention and improved patient care. Affiliated faculty conduct outcomes research that can be rapidly and meaningfully applied to clinical practice. They focus

In addition to practicing general pediatric orthopaedics, the five faculty members who comprise the Johns Hopkins Division of Pediatric Orthopaedic Surgery each have an area of specialized expertise: care of the young athlete; treatment of skeletal dysplasias and spinal deformities; non- surgical and sports medicine orthopaedic care; treatment of cerebral palsy, neuromuscular disorders, and children’s hips and feet; and spine deformity and genetic disorders. By pursuing complementary interests, they maximize the breadth of the Division’s expertise and their capacity to provide best care to a wide range of young patients.

The Division continues to build upon its core assets: cutting-edge clinical research programs, exceptional staff, and patient education that improves the effectiveness of care. Particular strengths identified for advancement are its programs in Pediatric Spine Disorders, Genetic Disorders, and Neuromuscular Disorders. As always, the Division’s forward-looking priorities

integrated, and cost-effective. Its faculty share a commitment to developing novel medical and surgical treatments, disseminating those strategies, and testing them in the real world of medical practice; in the Spine Institute model, clinical practice and research iteratively inform one another, to the benefit of both orthopaedic science and patients.

Research, focused on the effective-ness of care, is the Spine Institute’s engine. Its faculty translate new research findings into improved clinical methods; better methods are then readied for replication through the development of clinical practice guidelines, and disseminated through multiple professional channels. Innovative, and profoundly hopeful, lines of inquiry pursued at the Spine Institute include exploration of research questions such as:• Can outcomes of spine surgery

be improved through motivational techniques?

• How does fear affect patients’ outcomes after spine surgery?

• Is vertebral augmentation an effective method in long spinal fusions?

• What peri-operative factors can be used to identify patients at risk for surgical site infection?

6 7

riSing to the challenge Department of orthopaeDic Surgery

division of sports medicine & division

of shoulder surGery The Sports Medicine and Shoulder Service at Johns Hopkins is a team of physicians dedicated to treating athletic injuries of the musculoskeletal system, with a special focus on shoulder, elbow, hip, knee and foot and ankle injuries. The Service is committed to providing a broad continuum of care to the athlete over the course of his or her career. We manage patient care through the consultation, surgical, and rehabilitation process, working to ensure the athlete’s current and future performance needs.

Building upon our strength in Sports Medicine & Shoulder Surgery, we aim to develop new therapies and surgical techniques, providing greater mobility and quality of life for our patients; and to expand the teaching capacity of our medical education program with fellowships and professorships.

The shoulder is the most complex and unstable joint in the body; not surprisingly, shoulder injuries are common. Within the Division of Shoulder Surgery, our patients—their comfort, functionality, and quality of life—are our first priority. Faculty in this Division use state-of-the-art techniques to repair the damaged muscles, connective tissues, and other physiological structures of the shoulder, resulting both from injuries, whether

trauma or overuse, and from congenital abnormalities. In the Hopkins tradition, a standard-setting history of conjoining clinical care with research and education, the Division of Shoulder Surgery’s faculty also conduct research focused on developing new, more effective, therapies and surgical techniques, and they actively involve themselves in educating young orthopaedic surgeons, teaching, mentoring, and training them to become highest caliber surgeons of tomorrow.

orthopAedic reGionAl centers

The Department of Orthopaedic Surgery is committed to maximizing its benefit to patients, our community, and society at large. To this end, our surgeons have offices throughout a large geographic region encompassing Baltimore and Washington, DC. To extend our reach, providing Hopkins-quality care to greater numbers of orthopaedic patients, we plan to strengthen the Orthopaedics programs at our regional centers—specifically, Bayview Medical Center, Good Samaritan Hospital, Johns Hopkins Health Care and Surgery Center at White Marsh, Suburban Hospital, and Sibley Hospital. Expansion of services provided through these sites will include programs in cartilage restoration and post-operative cognition, a surgical skills lab, and a state-of-the-art, interactive, patient education center.

WHY HoPKinS?Orthopaedic Surgery has been a pillar of Johns Hopkins Medicine since the Johns Hopkins Hospital first opened its doors in 1889. For well over a century, our Department’s activities at home have helped shape orthopaedic surgery around the world. We have every intention of sustaining this leadership role. We actively maintain our uninter-rupted trajectory of influence through research discoveries that define standards of care and underlie new clinical protocols, through unsurpassed clinical excellence, and through attentive training of future orthopaedic physician-scientists.

Our excellence is nationally recognized. U.S. News and World Report consistently ranks the Depart-ment of Orthopaedic Surgery among the top five orthopaedic practices in the country; we rank third in federal research funding—a measure of

Healthcare faces an increasingly competitive funding environment. In this context, partnerships with philanthropists who share our visions of ever-better medical care, and of cutting-edge research to improve outcomes for patients, are of critical importance. Philanthropic gifts—which honor our donors and bring their dreams to fruition —are, quite simply, our most successful strategy for advancing the state of the science, and the art, of Medicine. These flexible funds allow us to endow chairs for our most brilliant and productive physicians, create new programs and centers in response to emerging needs, nurture young physicians to become leaders in their fields, develop sophis-ticated infrastructure that supports leading research, and make transforma-tional advances in orthopaedic research and care that benefit patients locally, nationally, and globally.

excellence. Our faculty includes many of the most respected and successful orthopaedic surgeons in the country. For donors interested in maximizing the impact of their philanthropic gifts, in terms of benefit to patients and advancement of orthopaedic science, there is no better investment in the future than the Johns Hopkins Department of Orthopaedic Surgery.

tHE CRitiCAl RolE oF PHilAntHRoPYHistorically, orthopaedic research has been underfunded, in part due to a prevailing impression that musculo-skeletal disease is important—but not urgent. Even today, with the federal government declaring 2002-2011 “The Bone and Joint Decade,” and with projections showing an alarming increase in musculoskeletal conditions over the next ten to 20 years, musculo-skeletal research receives less than 2% of the NIH budget.

8 9

priority specific fundinG needs current use endowment funds needed

Rxercise Institute Research — $5,000,000 $ 5,000,000

Professorships (2) — $5,000,000 $5,000,000

Fellowships (4) — $4,000,000 $4,000,000

Program (naming) — $10,000,000 $10,000,000

Capital expenses — $1,000,000 $1,000,000

Center for Musculoskeletal Research

Bone Biology Center — $7,500,000 $7,500,000

Peripheral Nerve Regeneration $5,000,000 $2,500,000 $7,500,000

Bone Oncology Program $5,000,000 $2,500,000 $7,500,000

Pediatric Skeletal Dysplasia $4,000,000 $2,500,000 $6,500,000

Pediatric OrthopaedicsLaboratory research $4,350,000 — $4,350,000

Professorships (4)1 — $8,000,000 $8,000,000

Construction and renovation — $2,500,000 $2,500,000

Outreach to underserved areas $2,000,000 — $2,000,000

Pediatric Spine Center $750,000 — $750,000

Child Life Specialist $175,000 — $175,000

Orthopaedic Regional Centers Interdisciplinary research on post-operative cognition

$3,000,000 — $3,000,000

Cartilage repair $225,000 — $225,000

Professorships2 — $13,500,000 $13,500,000

Surgical Skills lab $2,000,000 — $2,000,000

Lectureship in cartilage repair — $100,000 $100,000

Cartilage repair lab equipment $500,000 — $500,000

Patient education program $500,000 $5,000,000 $5,500,000

Orthopaedic Surgical Skills Center $1,000,000 — $1,000,000

whAt will it tAke?

riSing to the challenge Department of orthopaeDic Surgery

priority specific fundinG needs current use endowment funds needed

Center for Orthopaedic Discovery $5,000,000 $20,000,000 $25,000,000

Spine Institute Research — $7,500,000 $7,500,000

Professorships (2) — $5,000,000 $5,000,000

Fellowships (2) — $3,000,000 $3,000,000

Division of Sports MedicineProfessorships (2) — $5,000,000 $5,000,000

Division of Shoulder SurgeryProfessorship (1) — $2,500,000 $2,500,000

Fellowship and Lectureship — $2,600,000 $2,600,000

Total $33,500,000 $114,700,000 $148,200,000

1. 2 Full Professorships, 1 Associate Professorship, 1 Assistant Professorship

2. 5 Full Professorships, 1 Assistant Professorship

10

Rising to the Challenge: The Campaign for Johns HopkinsDepartment of Orthopaedic Surgery Johns Hopkins Medicine 601 North Caroline Street, Suite 5241 Baltimore, Maryland 21287 410-955-6936 rising.jhu.edu

rev. 03/03/14