Nationwide, women constitute about 6% of the practicing orthopedic surgeon workforce, but at the Department of Orthopaedic Surgery at Brigham and Women’s Hospital, the ratio is 6 out of 34, or 17.6%.
The Brigham is committed to a diverse workforce and to providing career advancement and professional development opportunities for women through programs such as the Women’s Leadership Program and the Women in Medicine & Science Symposium.
Here, we introduce three of the Brigham’s female orthopedic surgery faculty, all of whom are blazing new trails in research and clinical care.
Antonia Chen, MD: Leading Trend to Same-Day Discharge for TJA
Total joint arthroplasties (TJAs) are some of the most commonly performed orthopedic operations in the United States. Historically an inpatient procedure, TJAs were recently removed from the U.S. Centers for Medicare & Medicaid Services’ inpatient-only list. Today, the Brigham is leading the trend toward same-day discharge TJA thanks to a team approach (published in JBJS Reviews) championed by Antonia F. Chen, MD, director of research for the Division of Adult Reconstruction and Total Joint Arthroplasty in the Department of Orthopaedic Surgery, Dr. Vivek Shah and Dr. Wolfgang Fitz.
“At first, the idea of transforming TJAs from an inpatient procedure to a same-day discharge procedure was met with a degree of skepticism from clinicians and patients alike,” Dr. Chen says. “However, as we got everyone on board with the idea, we determined that same-day discharge TJAs can be done safely, without increased complication rates, and can satisfy patients’ needs.”
Dr. Chen’s groundbreaking work and leadership in hip and knee replacement has been recognized by a variety of national and international professional organizations and societies. Most recently, she became the first female orthopedic surgeon accepted into the Hip Society, an invitation-only membership organization of 213 internationally recognized thought leaders, innovators, mentors, researchers, and educators. She was also the second female orthopedic surgeon inducted into the 201-member Knee Society.
“Dr. Chen is among the youngest surgeons to ever be accepted into both societies,” says Richard Iorio, MD, chief of the Division of Adult Reconstruction and Total Joint Arthroplasty Service. “That is a testament to the high quality of her research work, her skill as a surgeon, and her role as a mentor, leader and teacher in the world of adult reconstruction orthopedic surgery.”
Dr. Chen called both organizations great societies of members who want to move the needle. “It is encouraging to see changes both within the Brigham and the field as a whole,” she says. “Women are breaking through barriers in orthopedics, and I’m honored to play a role in inspiring other women to join the field.”
Elizabeth Martin, MD, ScM: Demand for Expertise in Foot and Ankle Tendoscopy
Elizabeth Martin, MD, ScM, of the Brigham’s Foot and Ankle Center, recently delivered an instructional course lecture on foot and ankle tendoscopy at the American Academy of Orthopaedic Surgeons’ annual meeting. The minimally invasive procedure is challenging to perform and takes more time than large-open surgery. However, under Dr. Martin’s leadership, the Brigham is increasingly adopting the technique for its patient-centered benefits.
“The working space is tight due to the angles at which tendons travel, making it difficult to suture,” she says. “Knowing exactly where to make the minimal incision and being deliberate about instrumentation and the operative setup are crucial. The learning curve can be steep, but it’s really no different than other scope-based procedures.”
Dr. Martin says the Brigham has been an ideal setting in which to hone her tendoscopy technique, thanks in part to a wealth of smart minds dedicated to innovation, including other female surgeons who have served as mentors and role models.
The Brigham also has afforded her an endless array of leadership opportunities through the Women’s Leadership Program and has supported her as she expands those opportunities nationally through groups such as the Women’s Leadership Committee of the Foot & Ankle Society.
“Since joining the Brigham, my career has blossomed and I’ve had opportunities to build my branding and marketing skills,” she says. “I’m especially proud of the inroads I’ve helped to make for women in industry relations groups, where women have historically made up only about 0.5% of surgeons invited to speak about innovation and product development.”
Elizabeth Matzkin, MD: Leveling the Playing Field for Female Athletes
Anterior cruciate ligament (ACL) injury is common, and female athletes have up to nine times higher incidence rates than that of males. They also have a higher risk of ACL retear, a lower chance of returning to sports or activity at the same level, and a tenfold increase in osteoarthritis of the knee later in life.
Elizabeth G. Matzkin, MD, chief of Women’s Sports Medicine, seeks to narrow that disparity by calling for larger graft sizes (minimum of 9 mm) which can be accomplished using an all-inside quadrupled semitendinosus technique (published in Arthroscopy) that helps to ensure female patients have outcomes equivalent to male patients. “Smaller grafts are an unintended consequence of a smaller patient, and that often means young female athletes,” she says. “As orthopedic surgeons, we need to find ways to avoid using smaller grafts.”
Dr. Matzkin says that her lifelong participation in sports and her role as mom to three athletic daughters has strengthened her interest in orthopedic problems that impact women disproportionately.
“Historically, the sports medicine field has understudied and underrepresented female athletes,” she says. “The Brigham is changing that paradigm through our dedicated Women’s Sports Medicine Program, where we care for competitive athletes, recreational athletes and women who want to be more active.”
Like Dr. Martin, Dr. Matzkin praised the collaborative environment at the Brigham—a place where she can “walk down the hall and find a world expert on almost anything”—as well as the leadership opportunities offered to her and other female physicians.
“The Brigham is ahead of the curve when it comes to growing the pipeline for females and underrepresented minorities in orthopedics,” she says. “In my department alone, I have four female partners and we’re building a world-class women’s sports medicine program. The Brigham clearly recognizes the importance of women’s health and the benefit of providers who reflect the unique needs of the patients we serve.”