Medical and legal expert Joseph Harvey Gaines, III, M.D., former chief of orthopedic surgery at Harris Hospital, passed away on Friday, April 12, 2024.
Former Chief of Orthopedic Surgery at Harris Hospital Dies at 81

Dr. Gaines earned his medical degree from Louisiana State University Medical School in New Orleans. He was third in his class. Gaines completed his orthopedic residency while working at Tulane University and later he was on staff at Fort Leonard Wood Army Hospital, Brooke Army Medical Center, Santa Rosa Medical Center, University of California and The Armed Forces Institute of Pathology in Washington, D.C.
While in the U.S. Army, Dr. Gaines earned the rank of major. Once discharged, he moved his family to Fort Worth, Texas, so he could join the Fort Worth Bone & Joint Clinic. He led the clinic for many years.
While at the Fort Worth Bone & Joint Clinic, he, along with Dr. John Richardson set up a scoliosis screening program for both public and private schools in the Fort Worth area. Gaines served as Board Examiner and Case Selector for over 15 years and worked with several companies to design orthopedic implants, instruments, and surgical techniques.
Gaines also loved to teach future generations of doctors. He was an adjunct clinical professor at The University of Texas, Arlington, and a clinical instructor in the Department of Orthopedic Surgery at John Peter Smith Hospital.
He had the distinct honor of being 1 of 15 orthopedic surgeons invited by the U.S. State Department to go to China for six weeks to teach when the country opened its borders in 1979.
He was the only layperson to serve on the board of Directors of the State Bar of Texas. He also served as a Trustee of the Texas Center for Legal Ethics and as a Trustee of the Texas Bar Foundation.
Gaines was born on December 13, 1942, to Annette and Joseph Harvey Gaines, Jr. in Baton Rouge, Louisiana. He graduated from Istrouma High School and earned his bachelor’s degree from Louisiana State University. He and his wife loved to travel and spend time on the lake and their place at The Jax in the French Quarter New Orleans.
Gaines was preceded in death by his parents, Annette and Joseph H. Gaines, Jr. He is survived by his wife, Jane Ann and his seven children and ten grandchildren.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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