>> Good evening.

Welcome to "MetroFocus."

I am Jack Ford.

New York is home to some of the world's top health care providers.

One organization that has turned the city into a go to destination for treatment is Hospital for special surgery.

Celebrating its 160th anniversary this year, HSS has been ranked number one in orthopedics in the nation for 13 years in a row by U.S. news and world report.

The hospital treats everyone from celebrities and sports stars to everyday New Yorkers.

We are going behind the curtain for a closer look at the future of medicine and what makes HA S so successful -- makes HH as so successful.

Keep in medical director will be taking over as CEO later this year.

Dr. Thomas's cocoa is a surgeon in chief marriages and director of the foundation complex joint reconstruction center at HHS -- at HSS.

Let me start off with a full disclosure.

I have been a patient at HSS on a number of different times.

I have had a knee replaced, spinal fusion surgery done.

I will give you an unsolicited testimonial, my results have been nothing short of miraculous.

Let's talk now about what you do and how you do it.

Dr. Kelly, let me start with you.

I mentioned the great success HSS has had in terms of rankings , my question to you is this.

For somebody who is not familiar with the hospital, tell us about its mission, its specialties, and how it has been able to continue its successes over the years?

>> Thank you very much for having us.

HSS, otherwise known as Hospital for special surgery, is an orthopedic muscular skeletal hospital that has been around for 160 years.

We are celebrating our 160th anniversary this year.

It started off in 1863 as a bracing hospital for young children with deformities, and has evolved over the last 160 years to a specialty hospital, focused on all aspects of muscular skeletal health.

We do close to 40,000 orthopedic surgery here per year.

But we also have impressive rheumatology department, mythology, radiology, anesthesia, and what is unique about HSS and one of the reasons why we have been fortunate enough to be able to continue to provide extraordinary care for our patients is because of the singular focus.

The ability for us, regardless of the specialty area, different departments, we are all focused on the same thing.

It is maximizing mobility for patients and allowing them to have as active of a lifestyle as they can and enjoy movement.

I think, aside from the specialty nature of it, the other thing that sets us apart is the culture and the people.

It is an environment that is focused on patient care first, highest quality care possible.

It is focused on making sure it is the best environment for clinicians to provide care, so make sure everyone has the resources they need.

And you really feel that culture of excellence and pride about the organization, at every level of the organization, whether it is the security guard when you first come in, all the way off to the senior surgeons and everything in between.

It is singular focus for high quality patients excellence.

Jack: I can attest to that, tonight unsolicited testimony, having spent a lot of nights and days there.

The quality of the people from the surgeons down.

Let me ask you about this.

People might look at the name, Hospital for special surgery and think, all they do there is surgery.

Names are interesting.

I had seen this when I first went looking at its history.

As you said, 1863, the oldest orthopedic hospital in the country.

It's name was the New York Society for the relief of the ruptured and crippled, which I thought was very curious to see how it has evolved.

Somebody might be watching this and say, the only thing you do there is surgery, nothing else?

That is not really true, right?

>> We are a muscular skeletal hospital, both surgical and nonsurgical.

For example, we have 40 rheumatologists at work here.

We have for Zaia trusts, probably 25 for Zaia just.

These are non-operative specialists in the care of buoyant -- of bone, joint, arthritis, that sort of thing.

We do a great deal of surgery, when nonsurgical treatment does not work, then we are here to deal with problems surgically.

As Brian pointed out, we are about largest muscular skeletal orthopedic Center in the world by far.

For example, a big hospital might do 1000 joint replacements a year.

.

We do 13,000.

The scale of it is tremendous.

Just to reiterate about the culture, people who work here, I'm talking from the top to the bottom, never leave.

They are committed to the care of the patients.

They love working here.

Even though we have grown significantly, it is a family.

And when you come here, they have a great deal of pride in what they do.

That makes it a special hospital.

Jack: Dr. Kelly, I want to talk a little bit about the future of medicine, orthopedic medicine.

All the things you do.

We mentioned the work you do, surgical, nonsurgical, the research done there.

From your perspective, in sports medicine, talk about what you have seen change over your time and what you are looking at the future.

When I played football at Yale back in the early 1970's, if you blew out your knee, generally speaking, you were done.

People did not come back from A.C.L.

tears.

Talk about the progress you have seen and where you think all of this is going in the future.

>> When I think about what are the core foundational pillars upon which our institution since,, the first is patient experience in quality.

The second is academic and teaching.

The third is research.

When I think -- my area of specialization, which is sports medicine, sports medicine focusing on hip injury and athletes.

The field did not exist when I was in residency programs.

When you think about the evolution of the knee replacement, or the hip replacement, much of the progress and even some of the verse knee replacements ever performed in the world occurred here.

The research component of what we are doing is not just research for writing papers and -- but to really change the future of the field of orthopedics.

We have seen a tremendous amount of progress in all aspects of orthopedics.

With much better outcomes.

At the end of the day, the reason why we are focused on research is to improve outcomes, so we can improve not just how we can help patients in the immediate present, but to make sure it is sustainable improvement in their life over time, and that requires a lot of research.

I think the future orthopedics is going to be molded by technology and innovation.

We seen this dramatically increase over the last 10 years with the implementation of robotics surgery and other surgical enabling technology that we are bringing, augmented reality and virtual reality.

We are able to train our young orthopedic residents and fellows in virtual settings.

We can actually hold conferences now and do surgery while people are observing halfway across the world.

We can actually, with virtual reality no, in simulation, we can bring other surgeons into the operating room and stand next to you virtually while you are performing a procedure.

I think it is a really exciting time for orthopedics because of all of the innovation that is occurring and the transformation that is occurring.

I think one of the reasons HSS is such an exciting place is a lot of that innovation occurs here.

We have a large orthopedic staff, incredibly talented, incredibly productive, but also incredibly inquisitive and trying to push the envelope.

We are going to continue to see that transformation.

The biggest change we are going to see is the transition from inpatient surgery to outpatient surgery.

Jack: I will come back to that in a second.

I want to come back to you, something Dr. Kelly talked about, and that is innovation.

I mentioned the complex joint reconstruction center.

You are the director, fairly new.

I know a lot of your research has to do with improvements in surgical techniques and try to eliminate failures in hip and knee replacements.

We seem to be seeing more and more, in terms of technology, the idea of 3D imaging and construction.

And patient specific implants.

Tell us where we are going on that.

>> That is a great point.

If you look at the field of joint replacement, most orthopedic surgeons are trained to do a primary or hip or knee replacement.

This center is unique in the world and that as part of our mission at the hospital, do you want to take care of the most complex problems which other centers are probably not as equipped to do.

We created a center, and it was supported to a large extent by the New Yorkers foundation.

It is the only one in the world.

The center is devoted to caring for patients who oftentimes cannot get access to care.

These are people who have bad infections after a joint replacement.

These are there complications, but they do occur.

To get back to your point about 3D, we use 3D modeling a great deal, because many of them have bone loss problems which are unique to the individual patient.

We can actually make a model.

I did a patient two weeks ago, we made a model of their pelvis, we did a mock operation on the model, and then we created an implant and used it, first on the model, then in the operating room.

That technology has enabled us to tackle the most difficult problems.

This center particularly dedicates itself to that.

Jack: Back to you, Dr. Kelly, for a second.

You mentioned, and people may find this fascinating, that the particular subspecialty did not exist when you were training.

Is your view looking forward, let's say you are looking back 20 years, now let's take 20 years forward, and some of the technology that he mentioned, will that even be essentially old-school 20 years from now?

>> I would never say anything Doctors Coco -- his career, it will always be cutting.

No, I think there will be continued evolution.

There will be improvements in technologies.

Then a example in the joint replacement world, when I was a resident, we always did total knee replacements.

The concept of a partial -- even though there are three compartments in the knee, one of them, sometimes all a three of them are diseased, but other times it is only one.

Eight used two not matter.

You would replace all three compartments.

Now it has evolved, patient specific.

What does that patient need?

Can we do a partial replacement and just address the area that is diseased?

I think -- we deal with broken bones I don't think we will ever change that.

There may be different techniques to do that which are less invasive.

I think arthritis is a very interesting one.

The disease part of arthritis has to do with the loss of cartilage in the knee.

Terror is a lot of research going on, other ways that we can grow cartilage in a laboratory, other ways we can grow cartilage in a joint.

And will there be a way in the future where we can deal with arthritic changes, at least on some level, without doing surgery, by letting the body heal itself?

It is hard to know what the future is going to look like, but I'm sure it will look different from the present.

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