“If you don’t conduct research, things will stay the same, and if you don’t educate people, it’s the end of your world,” said Henry J. Mankin, MD, a senior research consultant for the Orthopaedic Oncology Service at Massachusetts General Hospital, who has received several Educational Grants from OREF.

AAOS Now

Published 3/1/2008
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William P. Cooney III, MD

The “E” in OREF

Education grants equip orthopaedic surgeons to excel

Orthopaedic research has resulted in advancements such as total joint arthroplasty, innovative procedures for correcting cartilage injuries, and better bone grafting. Had the research stopped at the lab, however, the practice of orthopaedics would have remained stagnant. That’s why, for more than 50 years, the Orthopaedic Research and Education Foundation (OREF) has recognized the importance of funding both education and research activities.

Henry J. Mankin, MD

A database of knowledge
With his OREF Educational Grants, Dr. Mankin is creating a searchable database so that orthopaedic surgeons can view disease pathology slides and determine the best course of treatment for their patients.

“If you treat only the symptoms of a disease, you can make a lot of mistakes,” explained Dr. Mankin. “But if you understand the pathology of a disease, you can treat it very effectively. It really is necessary to understand the nature and character of a disease, as well as the problems that can arise from it.”

Dr. Mankin’s database will include his personal collection of about 7,000 slides and the computer program he developed to track various diseases, as well as cases willed to him by Henry L. Jaffe, MD, which includes cases collected by Jakob Erdheim, MD, and slides willed to Dr. Mankin by Crawford W. Campbell, MD.

“The full collection contains bone, cartilage, and soft-tissue pathology slides,” said Dr. Mankin—about 25,000 slides in all, covering about 5,000 cases and including diseases ranging from osteosarcoma to giant cell tumor. “I want to build a logical, sensible database for people to use for education and research. And I’m doing it in part with generous funding from OREF.”

The database would be searchable so surgeons could type in a search term and find pictures and patient summaries for the disease. “We are digitizing the Jaffe and Erdheim images, and still have a way to go,” said Dr. Mankin. “Ms. Carol Trahan, laboratory supervisor, Cartilage Biology in Orthopaedic Oncology Laboratories, is working diligently and with great skill at this activity. She manages to digitize about 25 or so cases a week, which is about 300 images, including X-rays, gross photographs, histologic pictures, letters, and reports from Dr. Jaffe to the referring physician.”

Once completed, the database will enable anyone to pull up and download a specific set of images. “This is a crucial part of our current plans because we need to enter the data into a Web site that will be accessible to appropriate users,” Dr. Mankin said.

“If you don’t conduct research, things will stay the same, and if you don’t educate people, it’s the end of your world,” said Henry J. Mankin, MD, a senior research consultant for the Orthopaedic Oncology Service at Massachusetts General Hospital, who has received several Educational Grants from OREF.
Two examples from Dr. Mankin’s collection of more than 25,000 bone, cartilage, and soft-tissue pathology slides. Shown here (top to bottom): Giant cell tumor and myeloma.

While the project is not yet complete, Dr. Mankin has already compared Dr. Jaffe’s cases to his own cases and was surprised to find that the survival rates for patients with Paget’s sarcoma were about the same in his cases as they were in Dr. Jaffe’s time. This prompted the Musculoskeletal Tumor Society to fund a current study of patient cases contributed by its members.

The disturbing results will be published in an upcoming issue of Sarcoma.

Dr. Mankin approached OREF with the project because he wasn’t sure how to cover the cost of digitizing the slides.

“I thought it would be wonderful to obtain funding through orthopaedic organizations. The one that made the most sense, by definition, was OREF. It sponsors, supports, and encourages research and education, and that’s my whole life—that’s what I believe in,” he said.

A brief discussion of Dr. Jaffe’s collection and his contribution to orthopaedics was the first chapter of Dr. Mankin’s book, Pathophysiology of Orthopaedic Diseases, which AAOS published in 2006.

Said Dr. Mankin, “Needless to say, we are very grateful for the Educational Grants we have received from OREF, which are enabling this work!”

Teaching new generations
Through the years, OREF Educational Grants have supported activities such as clinical consensus conferences, workshops and symposia, and the research and development of educational electronic media, such as the AAOS Web site Orthopaedic Knowledge Online. Other OREF-funded educational programs range from lectures on careers in orthopaedic surgery to topical issues such as gene therapy in rheumatology to grant writing workshops and research symposia.

As vice chair of development for OREF, I invite you to support OREF’s educational programs, as I do, by contributing to the annual campaign at www.oreg.org/donate.

William P. Cooney III, MD, is chair-elect and vice chair, development, for OREF.

Since 1955, OREF has funded more than $3 million in education grants and awards. This includes more than $600,000 in Educational Grants given to the AAOS and approximately $500,000 presented to the American Orthopaedic Association. OREF has also provided $172,500 in educational funding to National Institutes of Health (NIH) programs. Every year OREF funds approximately 15 Educational Grants of up to $25,000 each. Since establishing the first Educational Grant in 1963, OREF has provided funding for more than 175 such grants.