In his presidential address, Orthopaedic Research Society (ORS) President Joshua J. Jacobs, MD, outlined a potential new course for the ORS, focused on a growing trend in healthcare research—translating and applying knowledge gained in basic research to the clinical setting.

“The public and policy makers expect that the investment in biomedical research will improve health status and quality of life,” he said. “We are being asked how the public’s investment in research is being translated into improving public health.”

This call for accountability and translational research presents both challenges and opportunities. Among the challenges are escalating healthcare costs and disparities in treatment outcomes. But a rapidly evolving scientific landscape is fostering the development of advanced technologies and encouraging increased collaboration.

The NIH roadmap

To realize a vision of translating research findings into improvements in public health and quality of life, the NIH has developed a roadmap that includes the following:

• provides investment for emerging and needed areas of research such as biologic pathways and networks
• supports individual creativity and collaborative team efforts through interdisciplinary research and public-private partnerships
• assists clinical research by harmonizing regulatory policies
• supports multidisciplinary training, as well as the development of new networking and diagnostic tools and the establishment of academic homes for clinical and translational research.

“One manifestation of the roadmap is the development of new grant mechanisms at the NIH,” noted Dr. Jacobs. “The Clinical and Translational Science Award is intended to ‘provide integrated intellectual and physical resources for the conduct of original clinical and translational science.’” The Centers of Research Translation (CORT) Award is another novel grant mechanism, unique to the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS).

“This mechanism emphasizes disease-specific research translation with a scientific advisory group to include interested lay members and industry representatives. It calls for a minimum of three disease-linked projects, at least one of which is clinical and one of which is basic. The scientific advisory group provides oversight of any supplemental pilot projects,” said Dr. Jacobs.

Because the CORT concept embraces both the translation of new scientific information to clinical application, and the application of clinical findings to new research, Dr. Jacobs called on the orthopaedic research community to respond, “so that our science and our scientists can access these resources and keep pace with translational research in other disciplines.

“The most useful definition [of translational research] is one that is broad, inclusive and not proscriptive,” said Dr. Jacobs, who suggested that it be defined as “research that brings discovery directly from the bench to practical applications in patients.”

The role of the ORS

Dr. Jacobs then proposed an ORS translational roadmap, organized around five themes: the formation of interdisciplinary teams, a focus on specific musculoskeletal diseases, cross-disciplinary education, translational career pathways, and a “translational interface.

“In my view, the ORS is uniquely suited to be a catalyst for research translation,” he said. “By its very structure, the ORS has emphasized the interdisciplinary nature of orthopaedic research. Its three constituencies—the clinician, the biologist, and the engineer—promote unity of purpose and serve as a platform for assembly into interdisciplinary teams that include the life sciences, the physical and quantitative sciences, and the translational sciences.”

He also recognized the critical role that industrial scientists play in translating research. “In many ways, industry scientists are agents of translation—their professional activity involves the practical applications of the scientific advances in our field,” said Dr. Jacobs. “Our industry scientists are an underused resource that we hope to tap through new initiatives, such as the establishment of our Corporate Affairs Committee.”

Pointing to the historically strong focus on musculoskeletal disease, Dr. Jacobs called for “the establishment of disease-specific clusters or special interests groups organized around the refractory chronic musculoskeletal diseases that plague our society including osteoarthritis, osteoporosis, intervertebral disk degeneration, degenerative tendonopathy, and periprosthetic osteolysis.

Dr. Jacobs called on the ORS to play a major role in developing the basic science language of the clinician, as well as in educating nonclinical scientists in the language of the clinician. He also proposed that the ORS develop specific career development programs for the emerging translational researcher.

A unique position

“The ORS is an organization that is uniquely poised to help its members respond to the demands for research translation,” he concluded. “The roadmap I have outlined around these five themes is intended to make our organization even more relevant in our professional lives, and to transform the ORS into an organization that is a true catalyst for improving the musculoskeletal health of the public.”