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Published 6/1/2007
Erin L. Ransford

Fracture repair symposium addresses challenges and opportunities

AAOS research symposium examines bone healing at the cellular level

The AAOS-sponsored research symposium on Fracture Repair: Challenges and Opportunities, held April 28-29, offered an invitation-only audience of orthopaedic surgeons, young investigators, researchers, industry representatives, and other medical specialists a look into the future. Organized by principal investigators Thomas A. Einhorn, MD, and Cato T. Laurencin, MD, PhD—both of the AAOS—and Karen Lyons, PhD, of the Orthopaedic Research Society, the symposium aimed to establish the current knowledge of the cellular, molecular, and engineering aspects of bone repair and regeneration.

More than 30 faculty presented the latest basic, translational, and clinical science in bone healing. In four sessions over the two days, investigators addressed the following issues:

  • Tissue response and cellular recruitment after cellular injury
  • Cellular signaling during bone formation and repair, including specific functions of individual bone morphogenetic proteins, the role of the Wnt pathway (Wnts comprise a family of secreted signaling proteins that regulate diverse processes during skeletal development in utero and may be essential in bone regeneration and repair), fibroblast growth factors, and the intrinsic activity of bone to initiate new bone formation
  • Emerging technologies for imaging and enhancing fracture repair
  • Critical issues in translational and clinical research in the studies of bone repair enhancement technologies

Merging science and technology
Several government representatives attended the symposium, including James Panagis, MD, MPH, orthopaedics program director at the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), who emphasized the importance of the symposium as a means to identify key challenges that need to be addressed by NIAMS-supported research.

Roderic Pettigrew, PhD, MD, director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB), discussed the significance of regenerative medicine within his institution and throughout the National Institutes of Health (NIH). He presented an overview of the NIBIB, which frequently partners with the National Institute on Aging and NIAMS, and aims to improve health by merging the physical and biologic sciences to develop new technologies. The institute is interested in supporting new research dealing with fracture healing challenges in three broad subject areas—cells, scaffolds, and emerging technologies.

In his address, Dr. Pettigrew reviewed currently funded research initiatives in nanotechnology, biosensors, cellular and molecular imaging, bioinformatics, and image-guided intervention. He emphasized that regenerative medicine holds great promise to transform health care. “His attendance at the symposium was vital,” said Dr. Laurencin. “Imaging technology and fracture modeling are considerable issues in new technologies that can enhance bone repair.”

Young Investigators
Several young investigators with research interests in skeletal regeneration and repair were awarded the opportunity to attend the symposium under the Young Investigator initiative. “We received several applications from clinician-scientists and researchers,” said Dr. Lyons. “The applicant pool was extremely diverse and included developmental and molecular biologists, trauma surgeons, general orthopaedists, epidemiologists, and even veterinarians. We were extremely impressed by the quality of the applicants, and expect that these Young Investigators will be among the leaders in orthopaedic research in the future.”

The seven selected to attend include Celine Colnot, PhD (University of California, San Francisco); Anthony E. Johnson, MD (McDonald Army Health Center); Phillip Leucht, MD (Stanford University); Saam Morshed, MD, MPH, PhD (University of California, Berkeley); Patrick W. O’Donnell, MD, PhD (University of Minnesota); John Wixted, MD (University of Massachusetts); and Terri A. Zachos, DVM, PhD (Michigan State University).

The future of fracture repair research
Manuscripts detailing the research presented at the symposium will be published in a supplement of the Journal of Bone and Joint Surgery (JBJS) this winter. The future research directions established at the symposium will be published in a simultaneous Current Concepts Review article in JBJS.

“This format will allow the meeting proceedings to be distributed to a wide spectrum of the musculoskeletal community,” Dr. Einhorn explained. “The faculty and symposium participants have developed a strong list of questions and research directions addressing cellular signaling and recruitment, tissue response, clinical and translational research issues, and emerging practices, including the need to establish a fracture registry.”

Erin L. Ransford is a research coordinator in the AAOS department of government affairs. She can be reached at ransford@aaos.org

About the AAOS Research Symposia
Since the 1980s, the AAOS has partnered with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) to produce workshops and research symposia on topics of musculoskeletal relevance. These symposia allow leaders in the industry to discuss and define the state of the art as it pertains to a topical area of orthopaedics and to define future research directions, stimulating the research agenda and providing education to the musculoskeletal community.

In 2006, the AAOS was awarded a NIAMS multi-year R13 conference support grant for symposia scheduled in 2006 through 2010. “Fracture Repair: Challenges and Opportunities” was the second in the series.

Also in 2006, the Young Investigator initiative was incorporated into all AAOS symposia, enabling young physicians and researchers to attend and be exposed to the state-of-the-art research in each symposium topic area.

The fracture research symposium also received grant support from the Orthopaedic Research and Education Foundation, the Orthopaedic Research Society, and NIAMS. Smith & Nephew, DePuy, Kyphon, Medtronic, Stryker, Synthes, and BioMimetic Therapeutics also provided support.

Additional information about AAOS research symposia can be found online at http://www.aaos.org/researchsymposia.