Trends in Attendance at Scoliosis Research Society Annual Meetings (SRS AM) and International Meeting on Advanced Spine Techniques (IMAST): Location, Location, Location.

STUDY DESIGN: Descriptive, respective. OBJECTIVE: Although overall membership in Scoliosis Research Society (SRS) has grown over the years, we were curious to see the effects of changing event venue location and timing on conference attendance. SUMMARY OF BACKGROUND DATA: Every year, the SRS hosts two major meetings: the Annual Meeting (SRS AM) in the autumn, and the International Meeting on Advanced Spine Techniques (IMAST) in the summer. Sites have alternated from within and outside North America. Often, these meetings have also overlapped with several holidays in certain countries. METHODS: This was an observational study of attendance from past SRS AM and IMAST meetings. Fourteen years of AM and 8 years of IMAST data were made available from the SRS. Participation based on delegate type and countries were tallied. Details from the 10 most represented nations and host nations per year were also tallied, and their national holidays were reviewed for overlaps with the AM. RESULTS: Membership in AM and IMAST increased from 820 in 2003 to 1,323 in 2016. Attendance at the AM has increased, whereas attendance at IMAST has declined, even after adjusting for membership size. Trends in participation were highly influenced by location. Participation by attendees from the host continent, and especially the host country, is generally high. The negative impact of distant meetings is profoundly seen with North Americans, whereas the positive impact of a nearby meeting was mostly clearly demonstrated by South Americans. Although SRS AM overlapped with holidays in China, Japan, or Korea nearly 50% of the time, this did not influence participation by delegates from these countries. CONCLUSION: Participation in the AM is highly influenced by location. Although North Americans represented the largest constituency, their presence was not needed to drive total attendance and was not sufficient to turn around the downturn in IMAST attendance. Choice of location can encourage the participation of delegates from the host and neighboring nations; through strategic selection of location, a balance can be reached between participation and global representation.

The Hospital for Special Surgery 1972-1989; Philip D. Wilson, Jr., Eighth Surgeon-in-Chief.

After nearly a decade as the seventh Surgeon-in-Chief (1963-1972) of The Hospital for Special Surgery (HSS), Robert Lee Patterson, Jr., MD (1907-1994) retired, having repaired adverse relations between HSS and the New York Hospital-Cornell Medical Center. Patterson, who had first joined the staff of The Hospital for the Ruptured and Crippled in 1936 as a Visiting Surgeon, was able to accomplish this very challenging task mainly through his close relationship with Preston Wade, MD (1901-1982), a general surgeon who had served with Patterson as Co-Chief of the combined New York Hospital-HSS Fracture service. The Board of Trustees of the New York Society for the Relief of the Ruptured and Crippled appointed Philip D. Wilson, Jr. MD, as the eighth Surgeon-in-Chief of The Hospital for Special Surgery. He assumed that office on July 1, 1972. Wilson, who had joined the staff as an Orthopaedic Surgeon to the Out-Patient Department in 1951, had trained as an orthopaedic resident at HSS from 1948 to 1950 and in 1951, finished his residency at the University of California Hospital Medical Center, San Francisco. During his 17 years as Surgeon-in-Chief, he led the hospital into the advanced field of implant research and development and building a world-class center for patient care. Additionally, many other orthopaedic services such as Sports Medicine, Scoliosis and Metabolic Bone Diseases became the leaders in their fields. Supporting Departments of Rheumatology, Anesthesia and others were likewise recognized foremost in the country.

The Hospital for Special Surgery 1955 to 1972: T. Campbell Thompson Serves as Sixth Surgeon-in-Chief 1955-1963 Followed by Robert Lee Patterson, Jr. the Seventh Surgeon-in-Chief 1963-1972.

After two decades as the fifth Surgeon-in-Chief (1935-1955) of The Hospital for Special Surgery (HSS), Philip Duncan Wilson, MD (1886-1969) retired, having implemented, during his administration, major changes in the hospital. The first most important accomplishment was finalizing a formal affiliation with New York Hospital-Cornell Medical Center in 1955 and moving adjacent to the medical campus at 535 East 70th Street. The second was changing the name of the Hospital in 1940 from The Hospital for the Ruptured and Crippled to The Hospital for Special Surgery. During the two decades as Surgeon-in-Chief, Dr. Wilson was able to reestablish the hospital as a foremost hospital in the orthopedic world. The Board of Managers of the New York Society for the Relief of the Ruptured and Crippled appointed T. Campbell Thompson, MD (1902-1986), as the sixth Surgeon-in-Chief of The Hospital for Special Surgery. He assumed that office on July 1, 1955. During the previous year, Dr. Thompson served as President of the American Academy of Orthopaedic Surgeons. Philip D. Wilson, upon his retirement as Surgeon-in-Chief, took on a newly created role as Director of Research at HSS. In 1962, adverse relations between The Hospital for Special Surgery and New York Hospital-Cornell Medical Center seriously threatened the continued affiliation agreement between the two hospitals. Because of difficulties over a faculty and staff appointment, Dr. Thompson resigned from the office of Surgeon-in-Chief. He was replaced in1963 by Robert Lee Patterson, Jr., MD (1907-1994), who had first joined the staff of The Hospital for the Ruptured and Crippled in 1936 as a Visiting Surgeon.

The Hospital for Special Surgery affiliates with Cornell University Medical College and New York Hospital, 1951; Philip D. Wilson retires as Surgeon-in-Chief, 1955.

When World War II ended in 1945, the Hospital for Special Surgery (HSS), the oldest orthopedic hospital in the country, was entering its eighth decade. Only 5 years previously, its name was changed from the Hospital for the Ruptured and Crippled (R & C). In 1934, Dr. Philip D. Wilson (1886-1969) had been recruited to fill the office of the fifth Surgeon-in-Chief with a key charge to restore the hospital as the leading orthopedic institution in our country, a role it originally held for over half a century since its founding in 1863. Wilson believed that a close affiliation with a university center having a medical school and hospital, while maintaining independence, was vital to achieve this objective. In 1948, negotiations between representatives of the Board of the New York Society for the Relief of the Ruptured and Crippled and representatives of the Society of the New York Hospital and Cornell Medical Center began and a preliminary written agreement was reached in March, the next year. The affiliation called for construction of a new building to house approximately 170 inpatient beds for orthopedics and arthritis. The land on the East River between 70th and 71st Streets, owned by New York Hospital, was to be given, without monetary exchange, to the Hospital for Special Surgery for construction of its new hospital. Finally, on November 1, 1951, a new non-proximate agreement was ratified. On May 25, 1955, after 43 years at 321 East 42nd Street, the Hospital for Special Surgery moved to its new six million dollar building at 535 East 70th Street where it formally became affiliated with New York Hospital-Cornell Medical Center. Two months later, on July 1, 1955, Philip D. Wilson retired as Surgeon-in-Chief to become the Hospital for Special Surgery's new Director of Research and Surgeon-in-Chief Emeritus.

The Hospital for the Ruptured and Crippled renamed the Hospital for Special Surgery 1940; the war years 1941-1945.

In 1939, the 75th anniversary program marking the founding of the Hospital for the Ruptured and Crippled (R & C), the oldest orthopaedic hospital in the nation, was held at the hospital site in New York City. Dr. Philip D. Wilson, Surgeon-in-Chief since 1935, used this event to mark the return of the hospital to its leadership role in the country. When the Hospital for the Ruptured and Crippled first opened its doors on May 1, 1863, the name of the hospital was not unusual; it described the type of patients treated. In 1940, the Board of Managers with guidance from Dr. Wilson changed the name to the Hospital for Special Surgery (HSS). In 1941, with Britain engaged in a European war, Dr. Wilson felt there was a need for the Americans to support the British. He personally organized the American Hospital in Britain, a privately funded voluntary unit, to help care for the wounded. After the United States actually entered World War II in December 1941, HSS quickly organized support at all levels with a significant number of professional and auxiliary staff, eventually enlisting in the military. Even with such staff turnover, the hospital continued to function under Dr. Wilson's leadership. After the war ended in 1945, Wilson forged ahead to further restore HSS as a leader in musculoskeletal medicine and surgery.

The Hospital for the Ruptured and Crippled Eugene H. Pool, fourth Surgeon-in-Chief 1933-1935 followed by Philip D. Wilson, fifth Surgeon-in-Chief 1935.

In 1933, for the second time in the history of the Hospital for the Ruptured and Crippled (R & C), a general surgeon, Eugene Hillhouse Pool, MD, was appointed Surgeon-in-Chief by the Board of Managers of the New York Society for the Relief of the Ruptured and Crippled. R & C (whose name was changed to the Hospital for Special Surgery in 1940), then the oldest orthopaedic hospital in the country, was losing ground as the leading orthopaedic center in the nation. The R & C Board charged Dr. Pool with the task of recruiting the nation's best orthopaedic surgeon to become the next Surgeon-in-Chief. Phillip D. Wilson, MD, from the Massachusetts General Hospital in Boston and the Harvard Medical School was selected and agreed to accept this challenge. He joined the staff of the Hospital for the Ruptured and Crippled in the spring of 1934 as Director of Surgery and replaced Dr. Pool as Surgeon-in-Chief the next year. It was the time of the Great Depression, which added a heavy financial toll to the daily operations of the hospital. With a clear and courageous vision, Dr. Wilson reorganized the hospital, its staff responsibilities, professional education and care of patients. He established orthopaedic fellowships to support young orthopaedic surgeons interested in conducting research and assisted them with the initiation of their new practices. Recognizing that the treatment of crippling conditions and hernia were becoming separate specialties, one of his first decisions was to restructure the Hernia Department to become the General Surgery Department. His World War I experiences in Europe helped develop his expertise in the fields of fractures, war trauma and amputations, providing a broad foundation in musculoskeletal diseases that was to be beneficial to him in his future role as the leader of R & C.

The Hospital for the Ruptured and Crippled: William Bradley Coley, third Surgeon-in-Chief 1925-1933.

In January 1925, the Board of Managers of the New York Society for the Relief of the Ruptured and Crippled appointed William Bradley Coley, M.D., age 63, Surgeon-in-Chief of the Hospital for the Ruptured and Crippled (R & C) to succeed Virgil P. Gibney who submitted his resignation the month before. It would be the first time a general surgeon held that position at the oldest orthopedic hospital in the nation, now known as Hospital for Special Surgery (HSS). Coley had been on staff for 36 years and was world famous for introducing use of toxins to treat malignant tumors, particularly sarcomas. A graduate of Yale College and Harvard Medical College, Coley interned at New York Hospital and was appointed, soon after, to the staff of the New York Cancer Hospital (now Memorial Sloan Kettering Cancer Center) located at that time at 106th Street on the West Side of New York. With his mentor Dr. William Bull, Coley perfected the surgical treatment of hernias at R & C. He was instrumental in raising funds for his alma maters, Yale, Harvard and Memorial Hospital. His crusade in immunology as a method of treatment for malignant tumors later fell out of acceptance in the medical establishment. After his death in 1936, an attempt to revive interest in use of immunotherapy for inoperable malignancies was carried out by his daughter, Helen Coley Nauts, who pursued this objective until her death at age 93 in 2000. Coley's health deteriorated in his later years, and in 1933, he resigned as chief of Bone Tumors at Memorial Hospital and Surgeon-in-Chief at R & C, being succeeded at Ruptured and Crippled as Surgeon-in-Chief by Dr. Eugene H. Pool. William Bradley Coley died of intestinal infarction in 1936 and was buried in Sharon, Connecticut.

The Hospital for the Ruptured and Crippled, entering the twentieth century, ca. 1900 to 1912.

The continuing story of Hospital for Special Surgery (HSS) from its origin in 1863 as the Hospital for the Ruptured and Crippled (R&C) on lower Second Avenue in New York saw expansion at its second site. A new 200-bed hospital was constructed and opened in 1870 on the corner of 42nd street and Lexington Avenue. Converted by the second surgeon-in-chief, Virgil P. Gibney, M.D., from a 28-bed home for the incurables to a modern orthopedic and surgical hospital with outstanding professional staff, the R&C emerged into the 20th Century as a unique treatment center for disabled children and adults and a foremost training center for young orthopedic surgeons. The interaction of the New York Central Railroad and support of a very influential and philanthropic Board of Managers helped promote the growth and development of this institution. In 1912, it relocated for the third time in its history to 321 East 42nd Street, just east of Second Avenue. That same year the HSS Alumni Association was founded as the Alumni Association of the R&C.

Gibney as Surgeon-in-Chief: the earlier years, 1887-1900.

Dr. James Knight's death in 1887 resulted in a change of course for the Hospital for the Ruptured and Crippled (renamed the Hospital for Special Surgery in 1940). The Board of Managers appointed Dr. Virgil Pendleton Gibney as the second Surgeon-in-Chief. The hospital's professional staff was expanded with introduction of surgical procedures. Gibney, raised in Kentucky, was trained under Lewis H. Sayre, M.D., a prominent orthopaedic surgeon at Bellevue Hospital. Dr. Gibney introduced the first residency training, expanded the physical plant, and continued to care for the disabled children in the hospital while maintaining a private practice outside the hospital. He was one of the founding members of the American Orthopaedic Association and served as its first president. He was the only member ever to serve as president twice, the second time in 1912.

The Hospital for the Ruptured and Crippled: Knight to Gibney, 1870-1887.

In 1870, R&C moved to its second site on the corner of Lexington Avenue and 42nd Street. A newly constructed building designed by a specialist in ecclesiastical architecture became the home of a 200-bed children's hospital planned entirely by Dr. James Knight, founder of the hospital and its first Surgeon-in-Chief. Expansion of the facilities and of the professional staff, although needed and welcomed, brought new challenges, changes, and conflicts. The root of these was to lie in the complex character of James Knight with his dogmatic approach to patient care vs the open nature of his newly appointed assistant, Virgil Gibney, who was to become his successor and eventually the second Surgeon-in-Chief. How these two personalities worked together for 13 years, abruptly parted, and then after Knight's death, the reappearance of Gibney, is a fascinating story of the early development of the first orthopedic hospital in this country. It was a period after the Civil War described as the "Gilded Age," where not only the country, but the city, was going through its own challenges, changes and conflicts. Emerging was a new era for R&C introducing surgery, postgraduate medical education, and eventually, clinical and basic research.

Hospital for Special Surgery: origin and early history first site 1863-1870.

Hospital for Special Surgery (HSS) originated as the Hospital for the Ruptured and Crippled (R&C) 142 years ago in New York City. As the first and only orthopaedic hospital of its kind in this country, it was located in the residence of its founder James Knight on Second Avenue, south of Sixth Street, and started with 28 inpatient beds for children but no operating facilities. The history of this institution has been documented in two books and occasionally published and unpublished papers. Many of these accounts have been limited by time, focus on a particular subject, or overall reviews. The emergence of such a specialized facility in the middle of the 19th century during a time of medicine in its infancy, our country at war and the city of New York racked in poverty, disease, civil riots, and political corruption is a story not necessarily appreciated in our day. The vision of one little-known physician and the cooperation and support of a small group of prominent New Yorkers and philanthropists were responsible for the origin of this hospital and particularly for its survival in such troubled times when most small hospitals of this period lasted only for a few years. Fortunately, almost all of the original Annual Reports of the Board of Managers, photographs, manuscripts, personal records, and newspaper clippings have been saved. They are now being collected, preserved, catalogued, and displayed in the newly formed HSS Archives from which this material has been taken.