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DMS Back Pain Expert Named to Head New Orthopaedics Department

Hanover, NH -- Dartmouth Medical School has established a new department of orthopaedics to help augment its leadership in research and education and meet an increasing demand for services in the growing specialty that treats bone, muscle and associated soft tissue injuries as well as joint problems, spinal disease and arthritis.

Dr. James Weinstein, professor of surgery and of community and family medicine, recognized for his expertise in low back pain and other musculoskeletal disorders, is inaugural chair of the new department, an outgrowth of the section that he recently headed within the department of surgery.

Injuries to the musculoskeletal system --bones, joints, muscles, ligaments, tendons--along with arthritis, osteoporosis and related conditions are the nation's chief cause of disability, says Weinstein, with back pain being the most common reason patients visit a doctor. The new department, which uses the American Academy of Orthopaedic Surgeons (AAOS) spelling for its name, strengthens Dartmouth's ability to take advantage of emerging opportunities to expand and develop new programs. Plans include integrated clinical, basic and prevention studies, coordinated teaching initiatives, new models for community and regional patient care, and development of a regional musculoskeletal arthritis center at Dartmouth-Hitchcock Medical Center.

Dartmouth is headquarters for a landmark National Institutes of Health (NIH) back pain study that Weinstein heads. The five-year multi-site Spine Patient Outcomes Research Trial (SPORT), totaling over $14 million, compares surgery versus non-surgical treatment for certain back problems and is expected to have a major impact on clinical practice and on the cost of medical services. Recently, Weinstein and his colleagues were awarded an NIH Musculoskeletal Clinical Research Center grant for nearly $7 million to study the implications of musculoskeletal disease in America.

Moreover, Dartmouth is prominent in research to improve joint replacement, and to understand practice variation. It maintains a leading retrieval laboratory for joint repair and has produced the Dartmouth Atlas of Musculoskeletal Health Care using Medicare claims data. The DHMC orthopedics graduate training program has led the way with a new program initiative for residents and fellows. It is a model for the new core competencies and incorporates a year of education in the evaluative clinical sciences and public health through the internationally recognized Center for the Evaluative Clinical Sciences (CECS) at DMS.

Prevalence of musculoskeletal disorders, which impair an estimated one in seven Americans, is likely to surge as active baby boomers age. Such disorders now cost the US more than $250 billion annually, according to the AAOS. Arthritis, the leading chronic condition of the elderly, afflicts one in eight Americans and osteoporosis affects about one in 30 Americans, primarily women. With an aging world population, chronic diseases and degenerative illnesses will move into leading causes of death, representing a new challenge for public health.

Weinstein, whose research focuses on understanding and treating spinal disease and injury as well as pain mechanisms, has received numerous awards for his work, including the AAOS' highest award in 1997 for orthopedic research. He serves as a member of the AAOS board of directors and as a director of the American Board of Orthopaedic Surgery, and has been recognized around the world as visiting lecturer.

An advocate of evidence-based medicine and conservative treatment measures for low back pain, he directs the multidisciplinary Spine Center and the Center for Shared Decision Making at DHMC and collaborates with Dartmouth's Foundation for Informed Medical Decision-Making. He also is editor of Spine, the journal for a consortium of national and international spine societies, considered one of the world's leading subspecialty journals. A graduate of Chicago College of Osteopathic Medicine, Weinstein completed his residency in orthopedics at the Rush-Presbyterian-St. Luke's Medical Center in Chicago and served on the faculty at the University of Iowa with an endowed professorship before joining Dartmouth in 1996.