Organizers: Josh Roth, PhD, University of Wisconsin-Madison and Cheryl Liu, PhD, Stryker
There is a growing wealth of clinical data available because of increasing numbers of advanced surgical technologies (e.g., robotics), novel implants, and patient monitoring sensors (e.g., wearables) on the market. However, to realize the full potential of these data and complementary technologies to improve patient outcomes, there is a need for novel data-driven approaches leveraging advances in machine learning (ML) and artificial intelligence (AI) technologies. Thus, the orthopedic community (researchers, clinicians, and industry representatives) will benefit from an improved understanding of how to best translate ML/AI technologies into the clinic to improve diagnostics, treatment planning and execution, and medical device design. In this workshop, attendees will gain insights into translating ML/AI technologies from academic, industry, clinical, and regulatory perspectives. Additionally, attendees will also have opportunities for small-group discussion and informal networking with each other, invited speakers, and implant section leadership. Our goal is to establish a collaborative community within the ORS to share and learn how to ensure that impactful ML/AI technologies are successfully translated into clinical practice.
Clare Fitzpatrick, PhD, Boise State University An academic and small-business perspective on translating ML/AI technologies
Nathan Natravali, PhD, Smith+Nephew An industry perspective on translating ML/AI technologies
Prem N Ramkumar, MD MBA, Long Beach Lakewood Orthopedic Institute A clinical and small-business perspective on translating ML/AI technologies
Sheldon Davis, MS, US Food and Drug Administration Keynote: A regulatory perspective on translating ML/AI technologies
Martin Stoddart, PhD, AO Foundation, Geoff Richards, PhD, AO Foundation
Regeneration of damaged degenerated tissue is likely to require a multidisciplinary response. Furthermore, due to the heavy involvement of mechanoregulation, commonly used simple static in vitro culture models are unlikely to predict in vivo outcomes. This session brings together experts in cell biology, engineering, material sciences and clinicians to highlight new developments in the regeneration of multiple tissues, including intervertebral disc, cartilage, tendon, and bone. The role of mechanics in tissue response will be highlighted. New 3D printing techniques will also be discussed. The end users for new technologies are surgeons, therefore a surgeon will also provide insight into issues relevant for clinical translation.
A Brief History of Swiss Orthopaedics
Geoff Richards, AO Foundation
The Mechanics of Tendon Degeneration
Jess Snedeker, PhD, University Hospital Balgrist, ETH Zurich
Complex in vitro/ ex vivo Models for Cartilage and Disc
Sibylle Grad, PhD, AO Research Institute
Marcy Zenobi-Wang, PhD, ETH Zurich
Biomechanical Principles on Fracture Healing
Bryan Van de Wall, MD, Luzerner Kantonsspital
When “off-the-shelf” Implants do not fit – 3D Printed Custom-made Acetabular Implants in Salvage Cases
Martin Clauss, MD, University Hospital Basel
Organizers: Isabel Menendez, DVM, PhD, Washington University in St Louis, Feliks Kogan, PhD, Stanford University
Despite the advancements made in cross-sectional imaging and MR imaging, there remains a gap in our understanding of the metabolic changes that occur in osteoarthritis (OA) and rheumatoid arthritis (RA). While radiography and magnetic resonance imaging (MRI) have provided valuable insights into the morphologic and compositional changes that occur in joint tissues, there is a lack of information on the metabolic changes that may contribute to the progression of these conditions. In addition to articular cartilage, subchondral bone and synovium have been identified as significant contributors in joint crosstalk and play a key role in the early stages of the disease, and the ability to visualize and quantify metabolic changes in these areas would provide valuable information for diagnosis and treatment. This gap in knowledge highlights the need for the development and implementation of new imaging technologies that can provide this supplemental metabolic information. Hybrid PET imaging, particularly PET/MR and PET/CT imaging, offer the potential to fill this gap by allowing for the simultaneous visualization and quantification of both morphologic and metabolic changes in different joint tissues. Overall, the aim of this workshop is to provide an overview of the role of MRI and hybrid PET imaging in the assessment of metabolic changes in human and preclinical models of OA and RA. By highlighting the potential of these imaging techniques, this workshop aims to promote further research in crosstalk imaging and ultimately improve our understanding of the underlying mechanisms of these conditions.
Preclinical Whole-Body Assessment of Inflammation in Arthritis Using PET/CT Isabel Menendez, DVM, PhD, Washington University School of Medicine in St Louis
Whole-Joint MRI Assessment Using Machine Learning Valentina Pedoia, PhD, University of California San Francisco
MRI Assessment of Knee Function in OA Louis DeFrate, PhD, Duke University
Combining Function and Structure with PET/MRI Imaging in OA Feliks Kogan, PhD, Stanford University
Imaging Evaluation in Disease Modifying Interventions for OA Ali Guermazi, MD, PhD, Boston University
Organizers: Uma Sankar, PhD, Indiana University, Jill Fehrenbacher, PhD, Indiana University
Musculoskeletal diseases are a major cause of pain and disability around the world. Current methods of pharmacological and non-pharmacological methods of musculoskeletal pain management remain inadequate and represent a significant clinical problem, as unmanaged chronic pain often results in opioid use and addiction. The recent HEAL initiative by the NIH is a result of lack of adequate interventions for pain control and restrict opioid dependence among patients. Adequate understanding of musculoskeletal pain mechanisms is crucial for the development of novel therapies to combat pain. Research using pre-clinical models has shed light on potential pro-inflammatory and sensory neuronal mechanisms that contribute to chronic pain. Still, much needs to be learned. For example, the mechanisms involved in driving peripheral versus central pain remains to be elucidated. In addition, the assessment of pain levels remains a challenge for pre-clinical researchers and clinicians alike. Difficulties with pain assessments has likely led to unsatisfactory translation of pain-relieving treatments from the bench to the clinic. In order to improve the translation, we must have a thorough understanding of orthopaedic pain mechanisms and advanced monitoring of pain behaviors in pre–clinical models and these animal behaviors must be predictive of a clinical patient effect. The purpose of this “bench-to-bedside” session is to gain a thorough understanding of pain mechanisms and bring tangible examples of historic and novel pain measurements in pre-clinical models that can be applied to clinical trials and ultimately to the clinic. We will discuss challenges stemming from clinical trials involving nerve growth factor (NGF) inhibitors. Gaps in knowledge regarding pain mechanisms, tools for adequately assessing pain, and therapeutic options that are available to treat musculoskeletal pain will be discussed.
Chronic Musculoskeletal Pain – Lessons from Osteoarthritis Anne-Marie Malfait, MD, PhD, Rush University
The Role of Inflammation in Musculoskeletal Pain Mechanisms – From Rodent to Human Mary Barbe, PhD, Temple University
Mechanisms Underlying Low Back Pain in Animal Models and Human Patients Lisbet Haglund, PhD, McGill University
Osteoarthritis Pain Measurements in Human Patients: Mechanisms, Monitoring and Treatment Nancy Lane, MD, University of California at Davis
Organizers: Andreas Seitz, PhD, Ulm University Medical Center, Romain Seil, MD, University of Saarland
Meniscus injury is a significant clinical burden worldwide. Despite the ongoing innovations in the pre-clinical meniscus research landscape, the successful translation of these scientific efforts into products or clinically feasible approaches, that clinicians can actually use to improve current treatment paradigms, is rare. This is because there exists a fundamental disconnect between preclinical innovations (developed through basic science research) and the practical clinical feasibility of said technologies/approaches. This interdisciplinary workshop aims to shed light on this long-existing problem, bringing it into the forefront of discussions between clinician scientists and basic scientists. Further, it will introduce unmet needs in clinical feasibility and discuss how innovative basic research approaches can be adapted to meet them. Overall, this workshop will address clinical problems in meniscus repair and replacement to find a common language for future interdisciplinary projects. After the invited talks there will be a round table discussion, where all the attendees are invited to ask questions.
The ESSKA Consensus on Degenerative and Traumatic Meniscus Lesions Caroline Mouton, PhD, Centre Hospitalier de Luxembourg
Surgical Centralization of the Meniscus to Prevent the Articular Cartilage From Early OA Changes Hideyuki Koga, MD, PhD, Tokyo Medical and Dental University
The Future of Meniscus Replacements – An Alternative to Preservation? Graciosa Teixeira, PhD, Ulm University Medical Center
Functionalized 3D-printing and Bioglue Technology to Enhance Meniscus Repair Chang Lee, PhD, Columbia University
Combining Biological and Surgical Strategies to Improve Healing Rates of Meniscus Tears Aaron Krych, MD, Mayo Clinic
Organizers: Jenny Robinson, PhD University of Washington, Paula Hernandez, PhD, University of Texas Southwestern, Brianne Connizzo, PhD, Boston University
This symposium will provide a current perspective on sex differences in orthopedic tissues with a focus on our understanding of the role of sex hormones in extracellular matrix remodeling and homeostasis after injury. The invited speakers will cover sex differences in joint health from a multiscale view, starting from the whole joint/clinical level to tissue to cell/molecular level in both soft and hard joint tissues. Three invited short talks from key players in the field will provide a historical perspective of current knowledge and gaps for future study. Panel discussion will follow, focusing on what is currently needed to develop clinically relevant and adequate model systems to more clearly understand the role of sex hormones on tissue remodeling, homeostasis and functional mechanics.
Osteoarthritis Risk Between Males and Females Constance Chu, MD, Stanford University
Hormonal Modulation of Crosslinking to Modify Injury and Performance Keith Baar, PhD, University of California Davis
Coupling Experimental and Computational Methods for Insight into Estrogen’s Role in Skeletal Muscle Regeneration Megan Haase, BS, University of Virginia
Sex Differences in the Mechanism of Estrogen Action Barbara Boyan, PhD, Virginia Commonwealth University
(In collaboration with the Pediatric Orthopaedic Society of North America – POSNA)
Monday, February 5 1:30 pm – 3:00 pm
Organizers: Matthew Halanski, MD, Phoenix Children’s Hospital and Harry Kim, MD, Texas Rite Scottish Hospital
Animal models of degenerative diseases are found throughout MSK research. Using broad expertise and a plethora of innovative techniques, these models have allowed advances in the understanding and treatment of these disease processes. Pediatric orthopedic conditions, however, have unique features that make many degenerative models less useful. As such, unique animal models have been developed to further study these pediatric conditions. Without exposure to these pediatric diseases and models, the application of the full breadth and depth of MSK research community to these conditions is limited, diminishing the potential of significant scientific breakthrough.
Development and Use of Preclinical Models to Evaluate the Effect of Age on the ACL Injury Response Martha Murray, MD, Boston Children’s
Osteogenesis Imperfecta and its Animal Models- A Different Source of Fragility Fractures Michelle Caird, MD, University of Michigan
Modeling a Neonatal Nerve Injury-studying Brachial Plexus Injury Roger Cornwall, MD, Cincinnati Children’s Hospital
Modeling Injuries and Treatments for Physeal Cartilage, similarities and Differences from Articular Cartilage Degeneration Nancy Hadley-Miller, MD, Colorado Children’s
Thoracic Insufficiency Syndrome- Clinically Relevant Lessons Learned From a Rabbit Model Brian Snyder, MD, PhD, Boston’s Children’s Hospital/Harvard
Juvenile Femoral Head Osteonecrosis and the Piglet Model Harry Kim, MD, Texas Rite Scottish Hospital
Tendon Transfer Prior to Ossification and Non-Surgically Induced Large Animal Spinal Deformity Model-Two Unique Orthopedic Models in Swine Matthew Halanski, MD, Phoenix Children’s Hospital
Organizers: Nick Willett, PhD, University of Oregon, Robert Guldberg, PhD, University of Oregon
The musculoskeletal system plays a vital role in regulating human performance and function. The proper functioning of the musculoskeletal system is essential for performing everyday tasks, such as walking, running, and lifting, as well as for more complex activities, such as playing sports or performing in the arts. However, dysregulation or injury of musculoskeletal tissues can lead to impaired performance and function and can result in long-term pain and disability. An individual’s peak performance, injury risk, and recovery after injury are governed by both intrinsic factors (such as genetics, age, and sex) and extrinsic factors (such as nutrition, exercise, and sleep). New large-data techniques and analyses are now enabling analyses that explore the complex underlying relationships between these many factors. These relationships have the potential to create integrated and comprehensive personalized medicine approaches and predictive models of health. The proposed symposium will cover new discoveries and technologies in musculoskeletal performance, injury prevention, and recovery after injury. The session will consist of three talks from experts in the field, each covering a different aspect of musculoskeletal health as it relates to human performance. The first talk, by Satchin Panda, PhD, will focus on the molecular regulation of the circadian rhythm of musculoskeletal tissues. His talk will cover the integration of molecular, cellular, and tissue datasets and models that define new principles of musculoskeletal performance. Dr. Panda will discuss new experimental biological measurements of the molecules and gene expression that occur during performance, training, and recovery and how these molecular changes are fine-tuned by an individual’s intrinsic factors and extrinsic factors. The second talk, by Kathryn Ackerman, MD, will focus on female-specific translational research to answer fundamental physiological and sports performance questions important to improving the health and performance of girls and women. Dr. Ackerman will discuss the unique factors for female athletes, including energy availability and hormonal states, differences in tissue structure and function, and increased risk of certain injuries such as bone stress fractures. Dr. Ackerman will also discuss strategies for injury prevention and recovery after injury specific to female athletes. The third talk, by Nick Willett, PhD, will cover regenerative rehabilitation to restore performance after musculoskeletal injury. Dr. Willett will discuss new treatment paradigms that synergize regenerative therapies and rehabilitation protocols to slow or reverse pre-injury degeneration, accelerate post-injury regeneration and functional restoration, and prolong peak performance in aging athletes. Dr. Willett will also discuss how these strategies can be applied to the wider population, where musculoskeletal injury and degeneration are common.
Molecular Regulation of Circadian Rhythm of Musculoskeletal Tissues Satchidananda Panda, PhD, Salk Institute
Female Athlete Performance and Recovery After Injury Kate Ackerman, MD, MPH, Boston Children’s Hospital
Regenerative Rehabilitation to Restore Performance After Musculoskeletal Injury Nick Willett, PhD, University of Oregon
Organizers: Anne Gingery, PhD, Mayo Clinic, Neal Millar, MD, PhD, University of Glasgow
Metabolic dysfunction is multifactorial and encompasses many conditions including insulin resistance, diabetes, obesity, and low-grade sterile inflammation, which results in a continuous anabolic state that drives tissue remodeling and systemic metabolic pathology. Musculoskeletal responses to these conditions are important clinical concerns when promoting patient health, activity and treatment of musculoskeletal damage and disease. Additionally, intratissue adipose accumulation/infiltration not only drives systemic disease, but also tissue level disease advancing neuronal damage, tissue aging, and impaired tissue remodeling and regeneration. This symposium will discuss key aspects of metabolic disorders and tendon dysfunction and mechanistic discoveries regarding how metabolic dysfunction plays an important role in tendon pathogenesis. This symposium will provide a venue to debate how these findings and define the current unmet needs that can drive evidenced-based tendon therapeutics and health.
Chronic Hyperglycemia, Hypercholesterolemia, and Metabolic Syndrome are Associated with Risk of Tendon Injury Christian Couppé, PhD, University of Copenhagen
Serum Advanced Glycation End-Products as Potential Mediators of Tendon Complications with Diabetes Chad Carroll, PhD, Purdue University
Biologic Mechanism and Targets in Metabolic Disorders Anne Nichols, PhD, University of Rochester
Metabolic Syndrome in Treating Musculoskeletal Injury Impacts on Physical Activity, Altered Tissue Composition, Structure, and Mechanical Behavior Jennifer Zellers, DPT, PhD, Washington University School of Medicine
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