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Orthopaedics & Biomechanics
Musculoskeletal (bones, joints, ligaments, tendons, muscles and nerves) disorders cost our country approximately $254 billion annually. In the United States, 28.6 million people experience musculoskeletal injuries each year, and it is the number one reason that people visit their doctors.
Orthopaedic Researchers at the Minneapolis Medical Research Foundation (MMRF) are international leaders in finding ways to improve care for people with musculoskeletal injuries.
Ramon Gustilo, MD, former Chairman of HCMC Orthopaedics, established the Orthopaedic Biomechanics Research Laboratory to study health problems affecting his patients.
The Biomechanics Laboratory, under the direction of Joan Bechtold, PhD, develops and tests specialized materials and devices for improved fracture care and joint replacement. Many new and improved surgical devices and technology have been developed, tested and put into clinical use through the research efforts of the lab. These include: new developments in hip and knee replacements, fracture devices, and specific techniques for infection problems. Currently the recipient of a half million-dollar grant from the National Institutes of Health and a $280,000 grant from the Arthritis Foundation, the lab remains an active, vital member of the international biomechanics research community.
Research Excellence from HCMC's Department of Orthopaedics
- Ramon Gustilo, MD, designed and commercialized one of the earliest total knee replacements (Gustilo knee).
- MMRF researchers designed the first hip replacement (BIAS hip) approved by the United States Food and Drug Administration (FDA) for use without bone cement.
- MMRF researchers designed one of the most successful of today's total knee replacements (Genesis Knee), which moves like a real knee, creating less pain and more mobility.
- MMRF researches are internationally recognized for development of surgical instrumentation, fracture fixation devices and techniques for infection problems.
Current Research
Joint Implants
Most of us know someone who has had a hip or knee replaced. As baby boomers age, these procedures will become even more common, and as we live longer, we will want the implants to last longer too.
To give good function and long life to joint replacements, research has shown that it is critical that the implants remain stably fixed into the patient's bone.
MMRF researchers are studying ways to make the fixation at this interface more secure and durable. Joan Bechtold, PhD, leads a team that is studying bioactive coatings on implants, growth factors, and new surgical tools as some of the promising methods to improve this interface.
"Since we know that long term success of implants requires a stable and durable interface, we focus our studies on improving this interface. We want to prevent loosening altogether, but we also are studying the more difficult case of how to improve fixation of a revision implant, if the first one loosens," said Dr. Bechtold. "We have found promising results with a very simple and practical new surgical instrument, as well as with a hydroxyapatite implant coating, and with the use of a patient's own growth factors combined with bone graft".
Research from this laboratory has become part of clinical studies that ultimately lead to improving the outcome for our patients.
Growth Factors
There are many challenges in orthopaedic surgery. Hardware that is surgically implanted to stabilize a fracture or restore joint function may become unstable due to things such as infection or diseases such as osteoporosis that weaken the bone.
MMRF researchers Richard Kyle, MD, Chairman of HCMC Department of Orthopedics, HCMC orthopaedic surgeon Andy Schmidt, MD, and Senior Scientist Louis Kidder, PhD, have studied the use of growth factors in orthopaedic surgery.
MMRF researchers are using a technique that creates a gel with a patient's own blood in it. The blood contains growth factors that stimulate bone formation. In the lab, according to Dr. Kidder, research has shown that an increase in growth factors can enhance healing. Because the gel is produced from a patient's own blood, they don't have to worry about contamination. The growth factors can also be injected directly into the fracture site to promote faster bone healing and in some cases possibly prevent non union. In addition, Dr. Kidder said that companies can manufacture growth factors, but it is much more expensive than the method being tested.
Dr. Kyle is using the growth factors to stimulate bone formation and permit earlier removal (or incorporation) of the stabilizing hardware. He also thinks it is promising for hip revisions where the hip becomes loose or breaks from the bone.
"Research such as this continues to help us find better ways to treat our patients," said Dr. Kyle. "This is a very promising development for the treatment of orthopaedic injuries."
In addition, Andy Schmidt, MD, is using a similar technique to stimulate bone formation in the repair of fractures of the leg. If the technology to enhance bony fusion and healing is successful, patients may not need additional surgeries or bone grafts.
"I am really seeing some good results with my patients," said Dr. Schmidt. "I think this will be a useful tool for improving the way we take care of leg fractures."
MMRF orthopaedic researchers will continue to study the growth factors in the lab as well as in a clinical setting.
Ramon Gustilo, MD
Richard Kyle, MD
Chair, Department of Orthopaedic Surgery
Andrew Schmidt, MD
Director, Orthopaedic Learning Center
Louis Kidder, PhD
Joan Bechtold, PhD
Director of Biomechanics Laboratory
©2008 Minneapolis Medical Research Foundation
MMRF Webmaster
Last Modified:
June 6, 2008
