Orthopedics This Week
Elizabeth Hofheinz, M.P.H., M.Ed.
Fri, April 30th, 2010
Yeast + grapes triggers a series of chemical interactions which make one of the most storied and interesting compounds known to man—wine. Dr. Arthur Bartolozzi, an orthopedist with Booth Bartolozzi Balderston Orthopaedics in Philadelphia, was always good at chemistry. This seasoned surgeon and wine aficionado has crafted a career treating professional athletes, advancing research, and paying tribute to his colleagues in sports medicine.
Born in Trenton, New Jersey, Arthur Bartolozzi played baseball and routinely brought home solid report cards. “My dad worked in public health and my mom helped out in our family store. While my parents encouraged me to study, it was my paternal grandparents who pointed me in the direction of medicine.”
While Arthur Bartolozzi was drawn to atoms and crystals, Caesar and Plato also held their allure. “History is fascinating, but I liked the fact that the sciences were more predictable. I took advanced science classes in high school and made a plan to apply to medical school one day.”
While pursuing a major in chemistry (de rigeur for all budding physicians), Dr. Bartolozzi continued to hear the siren song of the humanities and took a tour through the world of literature and foreign language. “At Brown University, I leaned toward the humanities and I enjoyed playing baseball and rowing crew. On a whim I applied to the University of California San Diego (UCSD). I really had no intention of going to the interview but my dad encouraged me to fly out there. Sunshine, 80 degrees, and the fact that they had one of the largest research endowments in the country flipped a switch in my head.”
It’s always good to spend time with one’s grandparents…you never know when they might teach you something useful for the OR. Dr. Bartolozzi: “While I found oncology and cardiology interesting, orthopedics was just miraculous in its ability to create dramatic effects on people’s lives. During those days joint replacement was coming into its own as a useful technique and I was amazed to see the transformation of people who had come in crippled and later walked out of the hospital. My grandmother had taught me to knit, which gave me a certain level of comfort when it came to manual surgical skills.”
“In 1982 I started a general internship at ‘Penn,’ which was followed by year of bench research looking at the mechanical properties of single osteons.”
With his eyes wide open and his future before him, Dr. Bartolozzi entered the world of sports medicine. “Dr. Joe Torg was the head of sports medicine at Penn and took care of all the university teams, in addition to the Philadelphia Eagles and Sixers. He was one of the originators of the idea of integrating the work of the doctor and the athletic trainer. My career was so enhanced by his mentorship that I started the ‘Philadelphia Sports Medicine Congress’ to honor doctors and athletic trainers while recognizing Dr. Torg.”
“Dr. Irwin Schmidt, an orthopedist and a true gentleman, taught me the magic of respectful patient and staff interaction. He was kind to everyone and acted in a manner that engendered trust. From a surgical perspective I learned excellence from Dr. Robert Booth, whose dedication and hard work motivated me to pursue knee surgery. He taught me how to do curative procedures with successful outcomes, which made it an exciting area to pursue. Years ago a serious knee injury would be a career ending event for an athlete…now tearing up one’s knee is almost a rite of passage.”
Dr. Bartolozzi got his own rite of passage when he headed out west. “I went to the University of California Los Angeles (UCLA) to interview for their sports medicine fellowship. While there I went to a game at the Rose Bowl, which was enormously exciting. As if that weren’t enough, UCLA had an excellent lab and a renowned fellowship director, Dr. Gerald Finerman (also from Penn). While there I met Dr. Bert Mandelbaum, who has become a great friend and mentor. His incessant energy and true love of sports medicine has made a lasting impact on me.”
Armed with research expertise and surgical savvy, Dr. Bartolozzi returned to Philadelphia.
I went to Pennsylvania Hospital to join Dr. Richard Rothman in practice as a specialist in sports medicine. It was important that I be near family and I was pleased to join a prestigious practice with a reputation for excellence. Under Dr. Rothman’s influence and guidance, and with the advantage of a reputable program and hospital, I was able to attract a number of professional and collegiate sports programs to Pennsylvania Hospital and our practice. In 1997, when Dr. Rothman left for Jefferson, along with my partners, Drs. Booth and Balderston, we formed 3B Orthopaedics. Our triumvirate has survived and flourished.
Like a business accelerator spins out companies, Dr. Bartolozzi has spun out sports medicine specialists—nearly 60 since the inception of the Pennsylvania Hospital training programs. “For 17 years I have been Director of the sports medicine orthopaedic fellowship program at Pennsylvania Hospital and Co-director of the primary care sports fellowship. During their time with us, each fellow does a research project and then presents their findings to the Philadelphia Orthopaedic Society for Sports Medicine. Year after year, our fellows have consistently had some of the best research projects as voted on by the sports medicine practitioners in the greater Philadelphia area. It has been exceptionally gratifying to see them build successful careers in academics and private practice. Jim Lubowitz, a former fellow, is now editor of the Journal of Arthroscopy and a number of our fellows have gone on to head fellowship programs of their own.”
As for his own research, Dr. Bartolozzi notes,
One memorable project was a review of ACL reconstruction in patients over 50 years old. When I trained, I was told that if you were over 35 years of age you were too old for ACL reconstruction. Now I consider that very young! We demonstrated that age was not the most important factor but rather it is the activity level—that simply being over 50 wasn’t a negative.
Dr. Bartolozzi can sometimes see around corners. “I saw a trend toward minimally invasive (MI) surgery during the nineties and because of my familiarity with arthroscopic techniques and working in small spaces, I tried to extend this concept to all of the surgeries that I performed. Fascinated, I delved into creating instruments that would permit an MI approach to knee replacements. I developed a minimally invasive tensioning device that has greatly improved my ability to accurately perform knee replacement with an approach that favors more rapid recovery. I also have a great interest in fluid and hydration and we are about to publish our research identifying the actual cause of cramping in athletes.”
If given his druthers—and a substantial grant—Dr. Bartolozzi has several ideas for new research pursuits. “I am very interested in injury prevention and would ideally like to accurately identify females who are at risk for ACL tears. In addition, I’m greatly interested in developing reliable interventions to better prevent these injuries. Another area I would love to be able to devote unlimited resources to is the development of scientific methods to replant and regrow human cartilage that closely resembles and functions like nascent cartilage. It is the future and in my opinion, the Holy Grail of Orthopedics.”
Many patients have brought significance to his work, says Dr. Bartolozzi.
Every day that I encounter patients who are gratified by my efforts is a meaningful day. I recall a basketball player in his last game of college who tore all the major ligaments in his knee. After three surgeries and extensive rehabilitation he went to play basketball on a professional team in Argentina and his team won the equivalent of the NBA championship. When he returned to the U.S. he came by my office, gave me a team photo, and thanked me for helping him.
“Another patient was a senior football player recruited by a big college football program. When he injured his knee the school rescinded its scholarship offer. This young man recovered, went to one of the best academic schools in the country, and set virtually every football record for the school. Most recently, a patient who had his knee replaced several years ago left a photo of himself and his son completing a marathon. He had not even been able to walk in the mall prior to his surgery. I don’t make a habit of telling knee replacement patients to run marathons.”
Dr. Bartolozzi has witnessed the toll that injuries take on athletes. He notes, “Players are often devastated by injuries; there is no way to measure the personal satisfaction that I have derived by interacting with athletes, their families and coaches and helping athletes return to pursue their passion.”
Describing standout moments with his children, Dr. Bartolozzi says, “My kids grew up in the training rooms of the Philadelphia Flyers and the Philadelphia Eagles; when they were younger, they would arrive an hour before game time, watch dad examine injured players and then wait in the training room for more injured players to file in! As my children have grown up, I made a conscious and personal decision to be home more and travel less. This necessitated that I relinquish the team physician responsibilities for the high demand professional teams.”
Dr. Bartolozzi’s two sons, one a sophomore at Harvard and one a junior in high school, got to see a lot of dad, both at home and on the road. “My wife and I have always enjoyed bringing the boys skiing, fishing and travelling. In particular, we have all enjoyed visits to Italy to practice speaking Italian, to study wine and eat gelato. My interest in chemistry triggered my passion for wine. I enjoy speaking with wine makers about the science of wine and I have great fun collecting and drinking great wines with friends and family.”
Dr. Arthur Bartolozzi…getting better with time.