Oscar H. Allis, M.D.

   H. Augustus Wilson M.D.

   James T. Rugh, M.D.

   James R. Martin, M.D.

   Anthony F. DePalma, M.D.

   John J. Gartland, M.D.

   Richard H. Rothman, M.D., Ph.D.
John J. Gartland, M.D. (1918-)
Fifth Chairman
Fourth James Edwards Professor (1970-1985)
Dr. John J. Gartland joined the Department as an Instructor after completing his orthopaedic residency at the Columbia-Presbyterian Medical Center in 1952. DePalma invited him back to Jefferson to become his first associate in practice. This association lasted only one and a half years because of philosophical differences that developed between them. DePalma was primarily a clinician with a huge practice. Gartland, although he also considered himself a clinician, believed a large overwhelming practice stifled academic achievements and took time away from educational pursuits. Their parting was cordial and Gartland retained his faculty appointment, progressively rising through the ranks to be made Associate Professor in 1968. Like other young orthopaedists who followed him on the faculty, Gartland found it difficult to develop much of a clinical practice of his own at Jefferson during those years and did most of his clinical work at other hospitals. He was an attending orthopaedic surgeon at Fitzgerald Mercy Hospital (1954-1960), Chief of Orthopaedics at Methodist Hospital (1960-1968) and Chief of Orthopaedics at Lankenau Hospital (1968-1970).

Gartland had a deep interest in orthopaedic education. He wrote Fundamentals of Orthopaedics a textbook for medical students, in 1965, that received national acceptance and by 1986 was in its fourth edition. He was a faculty member in many of the continuing education courses sponsored by the American Academy of Orthopaedic Surgeons and was a frequent contributor to the orthopaedic literature. In 1966 he was invited to become an associate editor of the Journal of Bone and ]oint Surgery the official publication of the English-speaking orthopaedic world. He was the first Jeffersonian to be so honored, and he remained active on the editorial board until 1978. Gartland's reputation as an educator grew, and he was elected to membership in the American Orthopaedics Association in 1968.

When Dr. Gartland accepted the Chairmanship in 1970 he became the first full-time Professor of Orthopaedic Surgery and the fourth James Edwards Professor. He saw as his immediate task the need to strengthen the full-time orthopaedic faculty component to complement the volunteer faculty already present and to restructure the residency program to correct the educational imbalance previously noted by the Residency Review Committee for Orthopaedic Surgery. Rather than build an educational structure around the clinical practice of one physician, Gartland believed in a broader based educational program in which the students and residents could be exposed to many teachers, but still one in which the Chairman retained a directing and supervising role.

By 1970 Thomas Jefferson University Hospital had become a sophisticated medical center with a significant level of tertiary care demands. The medical college student body had been enlarged, leading to an increase in the number of affiliated hospitals required for the undergraduate teaching programs. In orthopaedics, specialized care was required for children's orthopaedic problems and for surgery of the hand. The University Hospital was well suited to provide this specialized care. As noted previously, James Hunters group of hand surgeons was formally incorporated into the department structure as the Division of Hand Surgery. By 1985 this division was supporting four fellowships in hand surgery and was totally incorporated into the teaching programs of the Department.

Dr. Roshen N. Irani was brought from Children's Hospital in 1972 as the full-time Chief of a Division of Pediatric Orthopaedics within the Department. An affiliation agreement was negotiated with the A.I. dupont Institute in Wilmington, Delaware, to provide an additional rotation in pediatric orthopaedics for Jefferson residents. In 1982 an additional rotation for Jefferson residents in pediatric orthopaedics was negotiated with Shriners Hospital of Philadelphia when it became apparent that the Children's Hospital at Elizabethtown might be incorporated into the structure of the new medical school at Hershey, Pennsylvania.

Three men who had trained in orthopaedic surgery at Jefferson under DePalma now headed the orthopaedic services in three of Jefferson's major affiliated hospitals. Phillip J. Marone was Chief at Methodist Hospital, Dr. Hal E. Snedden took over at Bryn Mawr Hospital, and Dr. John J. Dowling replaced Gartland at Lankenau Hospital in 1970.

These affiliated hospitals were incorporated into the newly designed program to provide an experience for the residents in community orthopaedics and trauma. Jefferson's additional agreement with the Wilmington Veterans Hospital allowed orthopaedic resident rotations to that facility for further broadening of the resident educational experience. Cooperative programs were arranged with the Department of Rehabilitation Medicine and the Division of Rheumatology of the Department of Medicine at Jefferson. By 1974 the restructuring of the resident education program was complete and was renamed the Thomas Jefferson University Affiliated Hospitals Program, with a total complement of 24 residents. The new program received full approval from the Residency Review Committee for Orthopaedic Surgery. The restructuring proved successful and gradually developed a national reputation for its excellent clinical and academic background. By 1980 the program was regularly receiving in excess of 350 applications yearly for the six first-year positions from students of the best medical schools in the country.

Gartland viewed himself as orchestrating the best out of all the component parts of the Department. He believed that all the available strengths should be used adequately and fully to provide a well-balanced education for students and residents. He encouraged and supported the development of special clinical interests among his faculty members.

Dr. Jerome M. Cotler became the third full-time member of the orthopaedic faculty in 1973. Cotler had finished his residency under DePalma in 1957 and opened a private practice in Bridgeton, New Jersey. Because of an interest in academic orthopaedics, he gave up private practice to join Gartland as a full-time general orthopaedic surgeon. He proved to be a hardworking and effective member of the faculty, rising eventually to Professor of Orthopaedic Surgery and Vice-Chairman of the Department. He added many clinical strengths, particularly his involvement with the Spinal Cord Injury Center; Thomas Jefferson University Hospital had been designated the regional Spinal Cord Injury Center of the Delaware Valley in 1979. This was a multidisciplinary team effort involving the Departments of Rehabilitation Medicine, Neurosurgery, and Orthopaedic Surgery. Cotler was appointed a CoDirector of this Center and supervised the orthopaedic aspects of the patient care programs.

Cotler was well regarded nationally and served in many important posts, including Chairman of the Board of Councilors of the American Academy of Orthopaedic Surgeons in 1975 and President of the American Board of Orthopaedic Surgery in 1982. He was a frequent contributor to the medical literature and received the Christian R. and Mary F. Lindback Award for Distinguished Teaching in 1979. He remained active in the continuing education activities of the Academy for many years and was elected to membership in the American Orthopaedic Association in 1979.

Gartland turned his attention to reorganizing the orthopaedic research laboratory that had been acquired a decade before, but which had not been effectively utilized in the period 1970-1974. He recruited Peter Frasca, Ph.D., who was a postdoctoral research fellow at Albany Medical College. Frasca's doctorate was in biophysics but his research interest was in bone as a tissue. He joined the Department in 1975 as Research Assistant Professor of Orthopaedic Surgery and Director of the Orthopaedic Research Laboratory. He later obtained a secondary appointment in the Department of Anatomy that enabled him to involve graduate students in his research projects. He was able to obtain National Institutes of Health funding for many of his research efforts and subsequently obtained the first scanning electron microscope on the Jefferson campus.

The care of the feet for such things as the clipping of nails and the trimming of calluses was an area that most physicians were willing to relegate to podiatrists. There had been a question about which of those procedures constituted foot surgery and whether such procedures could be safely and legally performed at Jefferson by podiatrists. Dr. Arthur E. Helfand, Professor and Chairman, Department of Community Medicine, Pennsylvania College of Podiatric Medicine, had been providing podiatric services in the hospital and clinics for several years but there was no clearly defined program for him, and therefore his teaching activities were casual. In March of 1977 negotiations were started to integrate him and his work into the Jefferson Medical College and Thomas Jefferson University Hospital Staff. Considerable opposition was met, but because his services and teaching were valuable, particularly to the Division of Endocrinology and Metabolic Diseases, Dr. Gray, Chairman of Medicine, persisted. An arrangement was completed whereby Dr. Helfand received a hospital appointment in the Department of Orthopaedic Surgery in the category of Specified Professional Personnel, to provide consultative services on inpatients and perform minor procedures under local anesthesia at the bedside or in his clinic. His academic appointment was Adjunct Professor of Medicine (Podiatry). His Ambulatory Clinic was established in the area of the Division of General Medicine. Residents in Medicine and students, during their medical clinic clerkship or while on their elective program had the opportunity of working with Dr. Helfand. He authored Clinical Podogeriatrics (1981), Rehabilitation of the Foot (1984), and Public Health and Podiatric Medicine (1987). In March 1985, his appointment was changed to Adjunct Professor of Orthopaedic Surgery (Podiatry).

Further Departmental Expansion
The full-time component of the orthopaedic faculty was raised to four when William C. Hamilton (Jefferson, 1971) became Assistant Professor of Orthopaedic Surgery in 1978. Hamilton had received his orthopaedic education at Jefferson, completing the program in 1976. In the spring of that year he was selected by the American Orthopaedic Association as one of its four North American Traveling Fellows. These fellowships, sponsored by the American Orthopaedic Association and awarded yearly to senior orthopaedic residents selected by a committee as the best in the country, included a four-week tour of selected orthopaedic centers in North America and Canada. A group of these Traveling Fellows visited Jefferson twice during Gartland's term as Chairman. Hamilton left the full-time faculty in 1982 to go into private practice at Lankenau Hospital but remained active in the Department's teaching activities.
The position of Assistant Professor of Orthopaedics on the full-time faculty was again filled in 1983 with the recruitment of Eric L. Hume. Hume had graduated in medicine from Syracuse but had come to Jefferson to obtain his graduate education in orthopaedic surgery, completing the program in 1983. He proved a happy choice because of his interest in academic orthopaedics. He reorganized the resident teaching program, assisted in teaching biomechanics and psychomotor skills and, in 1985, organized and directed Jefferson's tirst metabolic bone disease clinic.

Gartland inherited a volunteer group of the orthopaedic faculty who had been working at Jefferson since Dr. DePalma's time. Among them were Drs. John M. Fenlin (Jefferson, 1963), J. David Hotfman (Jefferson, 1956), and Renato J. Nardini. These men joined enthusiastically in the Department restructuring and contributed a great deal of time to the teaching programs. Fenlin developed a special interest in the shoulder joint, including clinical and basic research.

Dr. Scott Jaeger (Jefferson, 1972) joined the Division of Hand Surgery in 1979 after completing his orthopaedic residency at Jefferson and a hand fellowship at the University of Louisville. Dr. Sanford H. Davne, who finished the orthopaedic program at Jefferson, joined the volunteer faculty in 1981 and confined his clinical work to Thomas Jefferson University Hospital. Dr. Mario J. Arena, who finished the Jefferson Residency in 1984, joined Drs. Fenlin and Nardini in practice in 1985, thus further swelling the ranks of the volunteer faculty and contributing to the teaching program and clinical volume.

Physicians involved with teaching orthopaedics to Jefferson students or residents at the affiliated hospitals were offered faculty rank within the Department. A strong and loyal affiliated faculty resulted. By 1985 there were eight affiliated faculty members at Bryn Mawr Hospital, seven at Lankenau Hospital, three each at Methodist Hospital and the A.I. DuPont Institute, and two at the Wilmington Veterans Hospital. Seven of these affiliated faculty members were orthopaedic surgeons who received their orthopaedic education at Jefferson during Gartland's Chairmanship.

In 1971 the senior orthopaedic resident, Dr. S. Terry Canale, now a prominent orthopaedic surgeon in Memphis, Tennessee, persuaded Gartland to undertake the publication of a Department orthopaedic journal as part of the resident's learning process. It was planned that residents would serve as editor and editorial board, negotiate with the printer, plan the layout, and solicit some advertising, with the assistance of a small faculty committee. The idea took hold, and the first issue of the Jeffirson Orthopaedic Journal appeared in 1972. It has been published yearly since then under the same guidelines. In 1973 the Jefferson Orthopaedic Society adopted the Journal as its official publication. Since 1973 the cost of publishing the Journal has been divided equally between the Jefferson Orthopaedic Society and the Department. The Journal is distributed free to members of the Jefferson Orthopaedic Society and a large group of persons known simply as "Friends of Jefferson." Since the Jefferson Orthopaedic Journal has appeared, the Orthopaedic Departments at the University of Iowa and the University of Pennsylvania have begun similar Department journals modeled on the Jefferson publication.

The Jefferson Orthopaedic Society, founded in 1960 by DePalma, had lost most of its forward momentum by 1970. It had deteriorated into a parochial format depending upon orthpaedic residents, Jefferson orthopaedic faculty, and local speakers to put on the yearly program. As a consequence the meetings became less interesting and attendance dropped off alarmingly. Between 1970 and 1974 Gartland and Cotler, because of their national contacts, were able to reverse this trend by the use of all. outside invited faculty. The Society membership was persuaded to build its program around a specific orthopaedic theme selected by the Society officers in collaboration with the Chairman. National authorities in the selected area were then invited to come to Jefferson to present their material. Between 1974 and 1985 some of the most prominent orthopaedic surgeons in North America and Canada spoke at the annual Jefferson Orthopaedic Society meetings. Interest in the Society quickened and registrations of 175 to 200 people for the meeting became common. As an additional aid to the resident education program, a Visiting Professor Program started in 1972 was scheduled for the spring of each year. The senior residents chose the Visiting Professor who canle for a two-day visit.

In September, 1976, Dr. Everett J. Gordon (Jefferson, 1937), an orthopaedic surgeon then practicing in Washington, D.C., gave the Chairman a significant contribution to establish the Everett J. Gordon Fund for orthopaedic resident education. Proceeds from this fund allowed the orthopaedic faculty ro select the "best resident" each year and recognize the selected resident at the annual Jefferson Orthopaedic Society banquet. In addition to this recognition, the selected resident received an appropriate plaque and an expenses-paid trip to the Annual Meeting of tlle American Academy of Ordlopaedic Surgeons.

During 1981 Dr. and Mrs. Thurman Gillespy generously initiated the Gillespy Fund in the Department to be used for special resident educational needs for which no other funds were readily available. Dr. Thurman Gillespy (Jefferson, 1953) completed the orthpaedic residency at Jefferson in 1958 and subsequently practiced in Daytona Beach, Florida.

In 1984 Dr. Richard D. Lackman was recruited to start an adult musculoskeletal tumor service, the first such service in Philadelphia. Lackman had received his orthopaedic education at the University of Pennsylvania followed by a Fellowship in musculoskeletal oncology at the Mayo Clinic. The service flourished, and Jefferson gained additional stature as a center for adult musculoskeletal tumors. Lackman proved a hard worker and entlmsiastic teacher.

Gartland was elected President of the Pennsylvania Orthopaedic Society in 1961 and the Philadelphia Orthopaedic Society in 1970. He served as President of the Jefferson Alumni Association in 1974. In 1977 he was elected Second Vice President of the American Academy of Orthopaedic Surgeons, the largest orthopaedic organization in the world. He became First Vice President in 1978 and assumed tlle Presidency in 1979, considered the key leadership position in American orthopaedics. He was the second Philadelphian and the first Jeffersonian elected to a leadership position in this organization since its founding in 1933.

Gartland represented orthopaedic surgery in the Council of Medical Specialty Societies from 1980 until elected to the Board of Directors of that organization in 1984. From 1980 to 1985 he was a member of the Board of Trustees of the Journal of Bone and Joint Surgery, serving as Treasurer (1982-1983) and Chairman of the Board (1984-1985). With these elections and appointments he represented Jefferson in the highest orthopaedic organizational circles. During 1981 his friends and associates at Jefferson presented his portrait to the University. The excess funds were donated to the Philadelphia Orthopaedic Society to support a yearly Gartland Lecture.

The period 1980 to 1985 was an exciting time for orthopaedic surgery at Jefferson and provided visible evidence of the tremendous growth that had occurred in the Department since its founding in 1904. During one four-year period, 1979 to 1982, members of the Jefferson orthopaedic faculty held the three most highly regarded positions in organizational orthopaedics. Gartland was President of the American Academy of Orthopaedic Surgeons in 1979, G. Dean MacEwen (affiliate faculty) was President of the American Orthopaedic Association in 1981, and Jerome Cotler was President of the American Board of Orthopaedic Surgery in 1982.

Dr. Gartland retired on December 31, 1985, to become the James Edwards Professor Emeritus of Orthopaedic Surgery. He then continued his academic career at Jefferson as Director in the Office of Departmental Review.

Richard H. Rothman, M.D., Ph.D.

Thomas Jefferson University Hospital Department of Orthopaedic Surgery.