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Rizzoli Orthopaedic Institute delivers quality clinical care, education, research
Famed center, with its acclaimed library and art, gained a reputation as Italy’s orthopaedic mecca.
Editor’s note:
This is the first installment of our new series, Pioneer Clinics, on the sites that played a key role in the development of orthopaedic medicine.
The Rizzoli Orthopaedic Institute in Bologna, Italy, opened in 1896 as a specialized hospital for orthopaedics and traumatology and evolved into a musculoskeletal center that distinguishes itself from others in Italy and Europe through pioneering clinical and research advancements.
“It was the first Western health care institute specialized in orthopaedic pathologies,” Sandro Giannini, MD, said.
Rizzoli Orthopaedic Institute (ROI) consists of the Rizzoli Orthopaedic Hospital and Codivilla-Putti Research Centre. ROI is also where the University of Bologna’s orthopaedic curriculum is taught.
Partially housed in Bologna’s historic monastery of San Michele in Bosco, which contains frescoes by Bolognese painters Carracci and Reni and artwork by Vasari, ROI physicians see about 150,000 patients and perform about 18,000 surgeries annually.
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Images: Rizzoli Orthopaedic Institute |
Center of excellence
The ROI philosophy merges scientific research with patient treatment to achieve optimal clinical outcomes.
“The Rizzoli Orthopaedic Institute is a center of excellence on several fronts,” said ROI Chief General Officer Giovanni Baldi, MD. Among its specialties are scoliosis and spine deformity treatments, addressing sports injuries that affect tendons, joint capsules and articular surfaces, pediatric musculoskeletal disease and oncology, and primary and revision total joint reconstruction.
About 20% of hospital patients undergo hip or knee arthroplasties.
“The clinical work on prosthesis implantation and revision is supported by the scientific research of several laboratories, where research is done to improve the design, prosthetic materials and techniques used in these operations,” Baldi said. This exemplifies how the clinic cooperates with its research arm, he noted.
Specialization, high standards
“The ROI has earned its international reputation as one of the best orthopaedic centers in the world because the boundaries of care have always been stretched in a pursuit of excellence,” according to Antonio Moroni, MD, an orthopaedic hip surgeon at Rizzoli since 1986.
ROI has established a model that is nearly impossible to imitate, added Giancarlo Puddu, MD, an Orthopaedics Today International editorial board member from Rome. “The secret of Rizzoli has been to have a series of very good teachers and clinicians serving a vast quantity of patients with the rigor and severity of an old-style English college.”
The institute offers patients, physicians and researchers an extreme level of specialization in orthopaedics and traumatology that is unmatched, he said. Puddu described the ROI reputation as being so good that “half the Italian patients judged Rizzoli as an orthopaedic Mecca.”
Clinical achievements
Some notable clinical achievements from ROI involve foot and ankle, osteoporosis and fracture care. It has established itself as a prominent center for the study and treatment of tumors of the musculoskeletal system, particularly in children and adolescents.
Baldi said new surgical techniques to emerge include full knee and ankle joint osteochondral transplants. Interest in advanced cartilage repair has permeated many areas of the institute.
Other widely recognized developments include the bone tumor classification and management described by M. Campanacci, MD, and spine grafting techniques for spondylolisthesis that P. Marchetti, MD, developed.
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Directors’ work
The skeletal traction that the first director of the ROI, Alessandro Codivilla, MD, developed revolutionized skeletal fracture care, according to Moroni.
“Another historical achievement was the operation described 100 years ago by Prof. Codivilla for treatment of congenital club foot, which is still in use today,” he said.
The second director of the ROI, Vittorio Putti, MD, is credited with moving skeletal fracture care into the orthopaedist’s realm and introducing concepts that surgeons still follow today, like keeping hematomas intact and not exposing fracture sites whenever possible.
“Prof. Putti’s contribution … includes the procedure for surgical treatment of shoulder instability, the Putti-Platt procedure, which is still widely performed,” Giannini said.
Research collaboration
Research conducted in the institute’s nine laboratories includes projects in oncology, reconstructive prosthetic surgery, computer-aided medicine, regenerative medicine, orthopaedic pathology, and general orthopaedics and trauma.
The Orthopaedic Research Laboratories headed by scientific director Prof. Francesco Antonio Manzoli, MD, PhD, have “created a tremendous opportunity for researchers, scientists and orthopaedic surgeons interested in the advancement of bone research to gather together to exchange scientific ideas and data,” Moroni explained.
“The university [orthopaedics] department, in my opinion, is one of the best in the world because all major orthopaedic disciplines are represented with a great combination of surgical, teaching and research efforts. The medical students and orthopaedic residents provide new blood, dedication and enthusiasm. These are important in maintaining traditions and for the growth of the institute,” he said.
Patent work
ROI operates one of Italy’s largest musculoskeletal tissue banks and is a regional and national reference center for musculoskeletal tissue transplantation, according to Baldi.
The institute’s regional Register of Orthopaedic Implants was established in 1990. “This database allows us to trace rigorously the survivorship of the implanted prostheses and provide precious indications for the improvement of prosthetic surgery,” he noted. The register contains data for over 60,000 hip and 20,000 knee arthroplasties.
ROI’s involvement in patents is expanding. Baldi said they help it gain greater recognition and foster collaboration in producing medical and technological innovations that improve people’s health and quality of life. Two of the center’s most recent patents include a demineralized bone matrix product developed by the Rizzoli Musculoskeletal Tissue Bank and a private company, and a skin transplantation method that uses tissue engineering to avoid rejection.
Giannini cited bioresorbable materials for correcting flat foot and first metatarsal joint deformity among areas in which he has been heavily involved. A champion of less invasive procedures for hallux valgus and other conditions, he recently developed the BOX total ankle replacement prosthesis in conjunction with scientists at University of Oxford, England.
“The exchange of ideas and data is the key point for the cultural and scientific growth of the institute,” Giannini said.
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For more information:
- Giovanni Baldi, MD, is chief general officer of the Rizzoli Orthopaedic Institute (ROI). He can be reached at +39-516-366-703.
- Sandro Giannini, MD, is professor of orthopaedics and chair of the ROI Orthopaedic and Traumatology Clinic and Bologna University School of Orthopaedics and Traumatology. He can be reached at +39-51-636-6827; e-mail: Giannini@ior.it.
- Antonio Moroni, MD, is associate professor of orthopaedics at ROI. He can be reached at +39-51-6366215; e-mail: a.moroni@ior.it. They can also be reached at ROI, via G.C. Pupilli, 1, 40136 Bologna, Italy.
- Giancarlo Puddu, MD, can be reached at Clinica Valle, Via G. De Notaris, 2B, 00197 Rome, Italy. +39-6-855-2982; e-mail: giapu@tin.it.
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