Will Regenerative Medicine Make Orthopaedic Implants Obsolete in Our Time?

Tuesday, March 21, 2017
4:45 PM – 5:45 PM

The ORS Program Committee invites you to participate in our first Annual Meeting Debate. ORS Past President Brian Johnstone will propose the motion that advances in tissue engineering are on the horizon to replace our dependence on artificial implants in orthopaedic clinical care. AAOS and ORS Past President Joshua Jacobs will argue that dependence on prosthetic implants will remain for the foreseeable future. ORS Past President Linda Sandell will manage proceedings, and the session will involve strong audience participation, including questions from the floor and key audience votes before and after the debater’s have each made their case. Come along and get involved in the ORS Great Debate!

Linda Sandell, PhD
Washington School of Medicine,
Department of Orthopaedics

johnstoneb_for_webArguing For the Motion:
Brian Johnstone, PhD
Oregon Health & Science University

Why did I accept the challenge of arguing for the proposition? It’s quite simple. Amara’s law states that we tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run. A perfect example of this is the Human Genome Project. In the short run, we overestimated what it was going to accomplish – we would read the code and solve the challenges of complex diseases quickly – that didn’t happen. However, we are now underestimating its long-term effect – the control of, and even creation of stem cells, the design of effective gene therapy, and the amazing development of CRISPR gene editing are all happening because we gained the ability to read, write and edit the genetic code. I make the same case for regenerative medicine – we have been busy overestimating the field in the short run, with claims made that we have not been able to fulfill. The effect of the overestimation is to convince those comfortable with the status quo that they have nothing to worry about. The reality is that orthopaedic surgeons, and the orthopaedic industry, had better become smarter biologists soon, because we are underestimating the myriad of things that regenerative medicine will do in the long run.

jacobs_joshuaArguing Against the Motion:
Joshua J. Jacobs, MD
Rush University Medical Center

Advancements in developmental biology have raised hopes that orthopaedic implants, specifically joint replacement components, fabricated from engineering materials will be added to the heap of discarded and anachronistic medical devices. Yet despite over 20 years of research and development, a viable long-term solution to simple isolated cartilage defects, much less end-stage osteoarthritis, has yet to emerge. Our understanding of the complex ontogeny of musculoskeletal tissues is incomplete and our tools for manipulation of this multifaceted ontogeny are in their infancy. Metal, polymer and ceramic solutions for musculoskeletal diseases are here to stay — at least for our lifetimes.