*Information subject to change.
Organizers:
Xinping Zhang, PhD and Edward Brown, PhD
In vivo imaging is essential due to the fact that the dynamic behavior of cells is influenced by a complex in vivo microenvironment that consists of diverse cellular components, biological factors, cytokines and growth factor gradients. In vitro or ex vivo settings cannot fully replicate what happens in vivo. Multiphoton microscopy as a superior in vivo imaging modality has been underutilized in orthopaedic research. Through this workshop, we expect to raise the interests and awareness of this technology and further promote its use in orthopaedic research. Through this workshop we expect to achieve the following learning objectives: 1. Acquire a better understanding of the technology by which stem/progenitor cells and their surrounding microenvironment can be visualized and analyzed under both physiological and pathological conditions. 2. Acquire an understanding of experimental models for study of skeletal tissue during homeostasis and regeneration. 3. Learn about the available advanced optical techniques as a means to stimulate new research avenues and develop new collaborative studies.
Speakers:
Overview of Multiphoton Excited Fluorescence, Second Harmonic Generation, and Lifetime Methods
Edward Brown, PhD
University of Rochester
Imaging Bone Tissue Vascularization and Bone Healing Microenvironment via Multiphoton Microscopy
Xinping Zhang, PhD
University of Rochester
In Vivo Imaging, Sensing, and Micromanipulation of Bone Tissue
Charles Lin, PhD
Harvard University
Organizers:
Scott Rodeo, MD and Suzanne Maher, PhD
Our workshop will review multidisciplinary advances in in vitro, in silico, cadaveric and clinical studies, which are being used to identify mechanobiological factors related to OA development, with a specific focus on how the joint changes after meniscal surgery.
Speakers:
Biological Aspects of the Pathogenesis of OA
Robert Brophy, MD
Washington University
Imaging Joint Changes
Matthew Koff, PhD
Hospital for Special Surgery
Statistically Augmented Computational Models
Amy Lerner, PhD
University of Rochester
Mechanical Aspects of the Pathogenesis of OA
Suzanne Maher, PhD
Hospital for Special Surgery
Surgical/Anatomical Considerations, Innovations and Dilemmas – How We Are Leveraging This Data
Scott Rodeo, MD
Hospital for Special Surgery
ORS International Section for Fracture Repair
Organizers:
Melanie Haffner-Luntzer, PhD and, Katherine Hixon, PhD
Bone fracture healing is a tightly regulated process involving many cell types, mediators, and signaling pathways and is still not well understood. For successful bone regeneration, biological but also biomechanical factors play an important role. Because of this complexity, bone healing was mainly studied in animal models for decades. However, there is a strong ethical need to implement the 3R principles (replacement, reduction, refinement) into animal experiments. Therefore, this workshop will focus on existing ex vivo and in silico models to study bone regeneration. Further, strategies to refine in vivo animal models will be discussed.
Speakers:
Ex Vivo Chorioallantoic Membrane Assay and the Ex Vivo Organotypic Culture for Bone Regeneration
Richard Oreffo, DPhil DSc
University of Southampton
In Silico Models for Outcome Assessment in Bone Healing Research
Hannah Dailey, PhD
Lehigh University
Refining Animal Experiments: Pain Assessment and Management in Mouse Femoral Fracture Models
Annemarie Lang, DVM, PhD
University of Pennsylvania
Organizers:
Ata Kiapour, PhD and Braden Fleming, PhD
Quantitative magnetic resonance imaging (qMRI) has shown promises in direct non-invasive assessment of surgically treated ACL structural properties. However, there is significant knowledge gap in technical challenges and clinical benefits of incorporating qMRI as part of postoperative management of patients with ACL injury. The current workshop will discuss the current state of the art in qMRI assessment of healing ACL/graft structure as well as promises and challenges in using qMRI as a return-to-sports criteria. We hope to stimulate multidisciplinary discussion and brainstorming focused on establishing a roadmap to translate qMRI into clinic to assist with postoperative management of patients with ACL injuries.
Speakers:
qMRI Evaluation of Healing ACL: Promises and Challenges
Ata Kiapour, PhD
Boston Children’s Hospital and Harvard Medical School
qMRI as a Clinical Tool to Track ACL Healing After Surgery
Kurt Spindler, MD
Cleveland Clinic
qMRI Application in ACL Injury Risk Prediction and Return to Sports Clearance
Sandra Shultz, PhD, ATC
North Carolina Greensboro
Organizers:
Anne Gingery, PhD and Neal Millar, MD, PhD
The immune system, both systemic and locally, has been increasingly found to play an important role in tendon disorders. However there remains much debate in the musculoskeletal community of the relevant hierarchy of the immune system in tendon pathogenesis. The workshop aims to bridge the current knowledge gaps in the MSK and tendon communities and highlight the key molecular/immunological techniques that have been used over the past decade to dissect a key role of the immune system in tendon diseases that is currently being translated into novel immune mediated therapeutics in tendon pathologies.
Speakers:
Immune Environment in Normal Tendon
Sarah Snelling, DPhil
University of Oxford
The Role of Inflammatory Mediators in Tendon Healing
Stephanie Dakin, PhD
University of Oxford
The Immunology of Tendon Repair
Alayna Loiselle, PhD
University of Rochester Medical Center
The Immunobiology of Tendinopathy and Lessons From the Enthesis
Moeed Akbar, PhD
University of Glasgow
Organizers:
Fergal O’Brien, PhD and Laoise McNamara, PhD
Mechanical stimuli play critical roles in directing skeletal tissue development, are fundamental to skeletal health and can play a role in the aetiology of disease. Physical exercise can have a powerful regenerative effect on skeletal tissues through stimulation of anabolic mechanosensitive cell signalling pathways. However, mechanical loading can also be injurious, and in degenerative conditions such as osteoarthritis, can propagate cell dysfunction and inflammation. Advances in understanding of the roles of specific mechanosensory machinery in response to loading, have highlighted molecular processes that can be targeted to promote regeneration. Improved understanding of the impact of mechanobiology on skeletal tissue development and regulation may enable identification of therapeutic targets, development of precision therapeutics and mechanically regulated biomaterials that promote regeneration, and enable restoration of healthy mechanical environments in disease.
Speakers:
Overview and Introduction
Fergal O’Brien, PhD
Royal College of Surgeons in Ireland
Scaffold-Based Delivery of Nucleic Acid Therapeutics for Enhanced Bone & Joint Repair
Tom Hodgkinson, PhD
Royal College of Surgeons in Ireland
Mechanobiologically Mimetic Model Systems for Studies of Bone Disease
Laoise McNamara, PhD
National University of Ireland Galway
Multi-Scale Mechanobiology of Skeletal Development
Niamh Nowlan, PhD
University College Dublin
Bone-Cartilage Crosstalk; Subchondral Damage and Joint Disease
Oran Kennedy, PhD
Royal College of Surgeons in Ireland
Organizer:
Cesar de Cesar Netto, MD, PhD and William Ledoux, PhD
It is commonly understood that the ankle infrequently develops primary osteoarthritis (OA), especially when compared to the hip and the knee. While this is true, the consequences of end-stage ankle OA can nonetheless be extremely debilitating, with associated impairment comparable to that associated with end-stage kidney disease or congestive heart failure. Ankle OA generally develops following trauma. Recent evidence suggests that ankle OA can develop more often than previously appreciated after “simple” rotational ankle fractures and chronic instability associated with recurrent ankle sprains. The mechanisms whereby post-traumatic ankle OA develops are not entirely understood, but mechanical factors are implicated. A better understanding of the prevalence and mechanical etiology of ankle OA will lead to better prevention and mitigation of post-traumatic ankle OA. New technologies, including weight bearing CT, dual video fluoroscopy and needle arthroscopy offer fresh opportunities to better understand the relationships between trauma, residual ankle instability, OA development and foot/ankle function. New conservative and surgical interventions, including custom carbon fiber bracing, improved fracture fixation, and ligamentous repair, hold promise for improving treatment that may prevent residual ankle instability and the development of post-traumatic ankle OA, but studies are needed to fill in key knowledge gaps here related to etiology so that the interventions can target key factors. (ORS Foot and Ankle RIG & American Orthopedic Foot and Ankle Society (AOFAS) & International Weight Bearing CT Society (IWBCTS).
Speakers:
Enabling Technologies for Measuring Deformity to Inform New Interventions to Treat Ankle OA
Amy Lenz, PhD
University of Utah
A Role for Custom Carbon Fiber Bracing in the Prevention of Post-Traumatic Ankle OA
Jason Wilken, PT, PhD
University of Iowa
Operatively Treating Ankle Instability to Prevent Post-Traumatic OA
Mark Easley, MD
Duke University
Organizer:
Yen-Sheng Lin, PhD and Nitin Jain, MD
Excessive myosteatosis accumulation leads to altered muscle fiber orientation and is associated with muscle inflammation, reduced muscle strength, and physical performance. The type I (slow twitch) and type II (fast twitch) muscle fibers contain oxidative and glycolytic capacity, respectively. The lipid composition and distribution express tissue-specific signatures to offer stability and protection against oxidative stress conditions to lipid membranes. The mechanisms that directly impair the force generation and fatigue followed by the irreversible loss of muscle quantity (sarcopenia) or reversible muscle type shift during myosteatosis is still unknown. Lipid species and rotator cuff myofiber type-specific composition will provide insights into the post-injury cuff muscle oxidative or glycolytic capacity that impacts the muscle function, healing, and fatigability.
Speakers:
3D Ultrasonic Shearwave Elastography in Muscle
Kathryn Nightingale, PhD
Duke University
Quantitative Assessment of Muscle Properties and Function Using Ultrasound Shear Wave Eelastography Imaging
Hugo Giambini, PhD
University of Texas San Antonio
Biomechanical Effects of Total Hip Arthroplasty on the Hip Muscles
Tsung-Yuan Tsai, PhD
Shanghai Jiao Tong University
Assessment of Myosteatosis and Integration of Skeletal Muscle Quality Exam at the Bedside
Yen-Sheng Lin, PhD
University of Texas Southwestern Medical Center
Targeted Lipidomics and Metabolomics Approaches Reveal Potential New Biomarkers of Musculoskeletal Quality and Performance
Marco Brotto, PhD
University of Texas at Arlington
Organizer:
Gabriela Graziani, PhD
In the treatment of spine conditions, many challenges remain unmet. In particular, from an educational point of view, there is a need to bridge the gap between clinicians, material scientists and researchers, to fully understand the clinical needs and how to address them, as well as the potentiality and range of application of newly developed materials and technologies.
Speakers:
New Technologies in the Regeneration of the Intervertebral Disk: A Clinical Perspective
Gianluca Vadala, MD, PhD
University of Rome
Biomaterial Carriers for Intradiscal Cell Delivery – Evaluation In Vitro and in Organ Models
Sibylle Grad, PhD
AO Research Institute
Spine Fusion by Biomaterials… A Still Open Challenge
Giovanni Brodano, MD
Rizzoli Orthopaedic Institute
Functionalisation of Custom-Made Spinal Implants by Antibacterial, Anti-Tumor Metal-Based Coatings
Gabriela Graziani, PhD
Rizzoli Orthopaedic Institute
New Solutions for Surgical Site Infection in the Spine: Known Complications, Present Concerns and Industrial Perspectives
Zak Kemp, PhD
Arthrex
Organizers:
Yasin Dhaher, PhD and Paula Hernandez, PhD
Joint injury rates differ substantially between males and females, with females more likely to experience poorer post-injury outcomes than males participating in similar sports. These injuries can cause short- and long-term morbidity and increase the probability of the development of degenerative joint pathologies, such as post-traumatic osteoarthritis. Thus, sexual dimorphism in cartilage structure, mechanics, and biological response to load may contribute to sex disparities in cartilage pathologies. In this symposium, we will seek to present the most recent development exploring sex-specific differences in the mechano-transduction of the cartilage cellular constituency, the composition of cartilage tissue, the aggregate mechanical characteristics, and stress-induced inflammatory responses. We seek to present studies explored at the different scales of synthesis – cellular to human-centric examinations.
Speakers:
Identifying Temporal Features of Stress-Induced Joint Inflammation in Humans: Sex and Endocrine-Specific Signatures
Conner Hutcherson, PhD Candidate
UT Southwestern Medical Center
Cartilage Dimorphism Before Menopause: From Tissue to Cell
Paula Hernandez, PhD
UT Southwestern Medical Center
Sex and Piezo1 Post-ACL: Details of Chondrocyte Mechanotransduction in Female and Male Mice
Whasil Lee, PhD
University of Rochester Medical Center
Organizers:
Chad Carroll, PhD and Kathleen Derwin, PhD
Tendinopathy describes a complex multifaceted pathology of the tendon, characterized by pain, decline in function and reduced exercise tolerance. The most common overuse tendinopathies involve the rotator cuff tendon, medial and lateral elbow epicondyles, patellar tendon, gluteal tendons and the Achilles tendon. The prominent histological and molecular features of tendinopathy include disorganization of collagen fibers, an increase in the microvasculature and sensory nerve innervation, dysregulated extracellular matrix homeostasis, increased immune cells and inflammatory mediators, and enhanced cellular apoptosis. Management consists of different exercise and loading programs, therapeutic modalities and surgical interventions; however, their effectiveness remains ambiguous. This symposium brings together three key clinical experts to discuss the short-comings and opportunities of current and emerging approaches to the treatment of tendinopathies.
Speakers:
Conservative Treatment: Is It All About Loading?
Karin Silbernagel, PT, ATC, PhD
University of Delaware
Orthobiologic Treatments
Scott Rodeo, MD
Hospital for Special Surgery
Novel Therapies
Neal Millar, MD, PhD
University of Glasgow
Organizers:
Tristan Maerz, PhD and Jillian Beveridge, PhD
The concept of crosstalk between tissues within the joint grew from the realization that diarthrodial joints function as an organ, with the health of the organ being dependent on its component tissues. Advances in our scientific knowledge of joint health and disease now acknowledges that the health of tissues are co-dependent: a failure in one tissue leads to failure in another. Thus, the crosstalk between joint tissues plays a central role in modulating joint health and response to trauma. Today, emerging evidence suggests that crosstalk should be considered even more broadly across scales and larger body systems, including cellular communication via systemic routes. The complexity of these multi-tissue, multi-joint and multi-system interactions necessitates new collaborations amongst investigators with once seemingly disparate interests to make meaningful progress towards improving joint health.
The purpose of this symposium is to highlight scientific programs of early-stage investigators that target crosstalk themes from different joints, scales, and systems, followed by an interactive panel discussion of new avenues of collaborative crosstalk research that should be pursued. We will split the program into two parts: First, two presentations will focus on crosstalk within the joint; then, three presentations will cover diverse crosstalk themes between a joint and distant/systemic organ systems. The studies encompass highly original investigations involving cutting edge methodology and diverse animal models of disease. One or two discussion sessions, led by our expert moderators (Karl Lewis, PhD, Cornell University and Tamara Alliston, PhD, University of California San Francisco), will promote an exchange between the audience and our panelists.
Speakers:
Pathogenic Stromal – Immune Crosstalk in Synovium
Tristan Maerz, PhD
University of Michigan
Mechanobiology Crosstalk in the Knee
Jillian Beveridge, PhD
The Cleveland Clinic
Muscle-fat Crosstalk: The Intersection of Adipose Phenotype and Disease
Gretchen Meyer, PhD
Washington University
Calming the Inflammatory Noise Following Joint Instability to Reduce Pain and Restore Function
Jarred Kaiser, PhD
Emory University
Intervertebral Disc and Facet Joint Crosstalk During Spinal Degeneration
Sarah Gullbrand, PhD
University of Pennsylvania
Organizers:
Michael Hast, PhD and Markus Wimmer, PhD
Orthopaedic implants are currently undergoing a transformation from permanent, life-long devices, towards transient, biodegradable tools that are engineered to disappear over time. Applications of biodegradable implants are diverse, ranging from cartilage and soft tissue repair to bone substitution and fracture reconstruction. Over the last 30 years, the development and implementation of biodegradable implants has led to an influx of in vitro experiments, animal models, and clinical trials. Resorbable implants have shown their capacity to avoid some pitfalls that afflict permanent devices (e.g. eventual failure due to fatigue; need for removal in pediatric applications); however, they also introduce a host of new issues. Temporal parameters regarding degradation, biocompatibility, cytotoxicity, and biomechanical strength for a given application must be carefully addressed as part of the design cycle. The breadth and depth of these questions becomes apparent when one considers the different types of implants, the large number of viable materials, and the spectrum of manufacturing techniques that may be used for fabrication. In the end, biodegradable implants are still not a standard in orthopaedics, especially when it comes to commonly performed procedures, such as joint replacements. So where are we with this technology, and will it ever become ubiquitous? The purpose of this symposium is threefold: 1) to provide an update on state-of-the-art biodegradable implants, 2) to identify the shortcomings of current technologies, and 3) to predict the short- and long-term future for implants in this realm. This symposium will consist of three speakers that all have extensive research expertise in the area of biodegradable implant design and application. They will each speak for 20 minutes about their work. This will allow for 30 minutes of robust conversation/Q&A with the audience.
Speakers:
Increasing the Resolution Limits of 3D Printing for Complex, Biodegradable Implants
Paul Dalton, PhD
University of Oregon
Scaffoldless Tissue Engineering Strategies for Rotator Cuff Repair in an Ovine Model
Lisa Larkin, PhD
University of Michigan
Regenerative Engineering and Rehabilitation of the Musculoskeletal Niche
Karina Nakayama, PhD
Oregon Health and Science University
