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Applying Clinical Findings to the Practice of Medicine
Date:2/25/2009

New research offers hope, propels treatment for common orthopaedic conditions

LAS VEGAS, Feb. 25 /PRNewswire-USNewswire/ -- The Kappa Delta Sorority and the Orthopaedic Research and Education Foundation (OREF) presented four research awards to scientists who are closing the gap between basic research and clinical medicine, at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) (http://www.aaos.org/) . Award winners have been working towards new treatment for the following areas of musculoskeletal health:

In 1947, at its Golden Anniversary, the Kappa Delta Sorority announced the establishment of the Kappa Delta Research Fellowship in Orthopaedics, the first award ever created to honor achievements in the field of orthopaedic research. The first annual award, a single stipend of $1,000, was made available to the Academy in 1949 and presented at the AAOS meeting in 1950. The Kappa Delta Awards have been presented by the Academy to persons who have performed research in orthopaedic surgery that is of high significance and impact.

The sorority increased the number of awards from one to three, and increased the dollar amount. At present three annual awards of $20,000 each are given. Two awards are named for the sorority national past presidents who were instrumental in the creation of the awards: Elizabeth Winston Lanier and Ann Doner Vaughn. The third is known as the Young Investigator Award.

The fourth award, also providing $20,000, is the OREF Clinical Research Award. Established in 1995, the award recognizes outstanding clinical research related directly to musculoskeletal disease or injury.

Torn rotator cuffs

The 2009 Young Investigator Award, given to outstanding authors who are under 40 years of age or no more than seven years beyond training, was presented to Washington University researcher Stavros Thomopoulos, Ph.D.

Dr. Thomopoulos and his research team knew that torn tendons cause a severe amount of pain and disability, and fixing them through orthopaedic surgery is no easy task. Fascinated by tissue engineering, his team took on the challenge of re-attaching tendon to bone.

"One of the challenges of my research is that connecting tendon to bone is like connecting rope to cement," stated Dr. Thomopoulos. "The mechanical properties of the two tissues are that different."

His award-winning paper, "Structure, Biomechanics, and Mechanobiology in the Attachment of Tendon to Bone" aims to understand how cells at the tendon-to-bone insertion respond to changes in their mechanical environment. "My hope is that this research provides guidance for tissue engineering efforts to improve healing and surgical repair of the tendon-to-bone insertion," stated Dr. Thomopoulos.

Osteoporosis and Osteoarthritis

Hiroshi Kawaguchi, MD, Ph.D. and co-authors at the University of Tokyo won the 2009 Kappa Delta Ann Doner Vaughan Award. Takashi Yamada, MD, Ph.D., Toru Akune, MD, Ph.D., and Naoshi Ogata, MD, Ph.D. worked with Dr. Kawaguchi on "Mouse Genetic Studies on Molecular Mechanisms Underlying Bone and Cartilage Disorders."

This research outlines mouse genetics studies on the molecular backgrounds of representative degenerative skeletal disorders, like debilitating conditions such as osteoporosis and osteoarthritis, which are suffered by millions of people. The molecular mechanisms of both conditions have not been identified, although this promising research attempts to reveal the molecular mechanism. The potential of this research may have the power to stop these bone and cartilage conditions before beginning.

Skeletal Deformity

The third Kappa Delta Award, named in honor of Elizabeth Winston Lanier, went to Michael J. Yaszemski, M.D., Ph.D. and co-author Lichun Lu, Ph.D., of the Mayo Clinic College of Medicine for the paper "Osteoinductive Injectable Degradable Polymeric Scaffolds for Osseous Defect Repair." This research team studied the field of bone tissue engineering and set out to develop orthopaedic biomaterials for treating skeletal disorders. "Bone, after blood, is most commonly transplanted tissue worldwide," the paper stated.

The team used two strategies - one for contained defects, which are holes contained within the bone, and another for segmental defects, which are gaps between bones. The composite biomaterial, consisting of polymers, metals, ceramics, drugs and biologics, used in either clinical strategy induced bone regeneration by providing an osteoconductive scaffold and by releasing osteoinductive factors. An osteoconductive scaffold is a material that mimics the normal tissue that the bone cells attach to and make bone, upon which bone can grow and osteoinductive factors are molecules that direct stem cells to become bone cells and make bone.

According to Dr. Yaszemski, "The osteoconductive scaffolds and osteoinductive factors are intended to replace bone graft in these procedures. Usually, the bone graft is harvested from the patient's pelvis, and these new techniques might decrease or eliminate the need for an orthopaedic surgeon to obtain the bone graft from this area of the body."

Dupuytren's Contracture and Frozen Shoulder

Helping patients to regain mobility and pain-free motion was the goal of the 2009 OREF Clinical Research Award recipients Lawrence C. Hurst, MD; Marie A. Badalamente, Ph.D.; and Edward D. Wang, MD. This State University of New York at Stony Brook research team and their paper "Injectable Clostridial Collagenase: Striving Toward Nonoperative Treatment Options for Fibroproliferative Disorders" focused on the use of injectible Clostridial collagenase as an alternative to surgery in treating these conditions.

According to the paper, "Fibroproliferative disorders like Dupuytren's contracture and adhesive capsulitis (frozen shoulder) seriously impact quality of life." Dupuytren's contracture is characterized by a progressive accumulation of collagen in the palm of the hand that causes "Dupuytren's cords to form, leading to a progressive flexion of the fingers...the standard of care is surgery." Dr. Hurst and his team injected Clostridial collagenase to the joint and reduced contractures in metacarpophalangeal and proximal interphalangeal joints within zero degrees to five degrees of normal extension after the last injection.

An additional study in humans with frozen shoulder yielded promising results, concluding "this investigational minimally invasive injection therapy shows potential for patients with fibroproliferative disorders affecting the musculoskeletal system."

About OREF and the Kappa Delta Award (http://www.aaos.org/research/committee/research/Kappa/Kappa.asp)

Previous Kappa Delta Award Winners (http://www.aaos.org/research/committee/research/Kappa/kappa_winners.asp)

About AAOS

http://www6.aaos.org/news/Pemr/releases/release_boiler.cfm?category=40&releasenum=735

    For more information, contact:

    Catherine Dolf
    C (847) 894-9112
    O (847) 384-4034
    dolf@aaos.org

    Lauren L. Pearson
    C (224) 374-8610
    O (847) 384-4031
    lpearson@aaos.org


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SOURCE American Academy of Orthopaedic Surgeons
Copyright©2009 PR Newswire.
All rights reserved

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