Jonathan D. Main, MD, with a few of his many designs.


Published 10/1/2007
Peter Pollack

Orthopaedic art with ties to fashion

Orthopaedic surgeon turns medical images into artistic clothing accessories

Ask Jonathan D. Main, MD, about how he became interested in his avocation, and the first name he’ll mention is Jerry Garcia. But Dr. Main doesn’t tour the United States fronting a psychedelic rock band; he designs neck ties, just as the late Grateful Dead guitarist did.

“I’ve always liked ties,” he explains. “During the Jerry Garcia tie craze about 10 years ago, I bought a lot of them. One day, I was looking at a magnetic resonance imaging (MRI) scan and I thought it might look good on a tie. So I scanned and manipulated a knee MRI to make my first design.”

Once Dr. Main had his tie design, he turned to the Internet and began searching for a way to turn it into something he could actually wear. He found Brent W. Carmack, MD—an ophthalmologist with his own tie manufacturing company who was willing to make Dr. Main’s tie a reality.

“I sent the file to him to put the design on a tie,” says Dr. Main. “It took about six weeks to get the tie back because it’s silk screened. I liked it and I made some more, and people started commenting on them, so I decided to make a number of other designs.

“Once I had about seven or eight, I started a Web site. I sold several online and through word-of-mouth. I also applied for an exhibitor’s booth at the AAOS Annual Meeting. It took time, but once I had the booth, the ties became very popular.”

Branching out
As his business has grown, Dr. Main has added to his collection, which now numbers about 45 designs. He works on a tablet computer to develop the design before submitting it to the manufacturer.

Although orthopaedics continues to be his primary focus, Dr. Main has branched out into a number of nonorthopaedic radiologic designs as well. In addition to appearing at the AAOS Annual Meeting, he now rents a space at the annual meeting of the Radiological Society of North America.

“For the radiologists, we do a breast—a mammogram tie,” says Dr. Main. “It’s not an image of the cancer, but it has a little breast cancer logo ribbon. A portion of the proceeds are donated to breast cancer research. That was my wife’s idea, and I think it’s a good one. Hopefully we’ll be able to raise some money that way.

“We make scarves now, too,” he continues. “But because there are fewer women orthopaedists, we don’t do scarves in all of the designs.”

Four types of people
Like many other silk items, Dr. Main’s products are manufactured in Asia. Dr. Carmack, who owns the factory, maintains strict control to make sure that the product is not produced under sweat shop conditions—an approach Dr. Main strongly supports.

“Dr. Carmack probably visits the factory two or three times a year, because, like me, he doesn’t want to have a product that’s manufactured by children or anything like that,” explains Dr. Main. “It’s a modern, well-run, all-adult facility, and he pays probably about three times the prevailing wage. He wants to have a good product, and we can still get them made for a reasonable price. I end up paying a bit more, but at least I know that my business isn’t exploiting anybody.”

Although Dr. Main has had his exhibitor’s booth at the AAOS Annual Meeting for several years, he still sees a variety of reactions when attendees spot the clothing accessories squeezed in among the giant displays of orthopaedic technology.

“I would say there are four types of people,” he explains. “Our regulars seek us out every year to see if there’s something new. Others walk by, do this big double-take and keep walking another 10 steps, then come back and take a look. Some people are in a hurry and just walk by without doing anything.

“Maybe one out of a thousand people comes up to us and says, ‘What are you doing selling ties here?’ I tell them they’re orthopaedic ties. I get a lot of really good patient interest. If patients have a little bit of interest in them, it could help the communication between the surgeon and the patient.’ Most of those people end up buying ties.”

Peter Pollack is a staff writer for AAOS Now. He can be reached at