Orthopaedics and Biomechanics
In medicine, the bones, muscles, joints, tendons, and ligaments are referred to collectively as the musculoskeletal system. Ailments of this system are some of the most common medical problems that people face. Musculoskeletal problems can arise from trauma, injury, and disease, and affect people from all walks of life. The American Academy of Orthopaedic Surgeons estimates that one in seven Americans suffer from an orthopaedic injury or disease each year, resulting in $215 billion in healthcare costs.
Researchers in the field of orthopaedics and biomechanics study the musculoskeletal system and its problems. At MMRF, this work is conducted in the Orthopaedic Biomechanics Research Laboratory under the direction of Joan Bechtold, PhD. The mission of the lab is to develop improved treatments and orthopaedic devices that are practical and can have an immediate impact on patients’ lives.
The lab develops and tests specialized materials and devices for improved fracture care and joint replacement. Many new and improved surgical devices and technologies have been developed, tested, and optimized for clinical use through their research efforts. These include new devices and procedures for spinal injuries and hip and knee replacements, new devices to treat fractures, and best practices for managing orthopaedic infections.
Back and spine injuries are the most common orthopaedic impairment. The lab is evaluating methods for treating spinal injuries, including procedures that fuse the spine and procedures that restore motion to the spine. Using real-time 3-D cameras, they examine the motions of the spine under varying treatment scenarios. Armed with this information, they hope to determine which procedures produce favorable conditions in patients.
Joint replacement has become a routine procedure as medical technology has improved the performance of artificial joints. However, significant improvement in joint replacement is needed to reduce the number of revisions (replacements of artificial joints) that need to be performed. Dr. Bechtold is collaborating with researchers from Aarhus University in Denmark to examine novel bone/implant interfaces that may improve outcomes for revision joint replacement. They are looking at different materials and surface micro-textures that could improve bone’s adhesion to the implanted device, which should help reduce the need for revisions.
The lab is looking at ways to improve the way bone itself grows around a device. When bone grows onto an implanted joint, it often forms a tough shell around the device which results in a weak bone/device bond. One way to improve bone/device bonding is to perforate the tough shell, allowing blood to reach the developing bone cells below. This results in stronger bone development and adhesion to the device. There are different ways to perforate the bone, and the lab is investigating which result in the best bonding.
To treat bone fractures, surgeons often implant a plate and screw it on to the bone to increase stability and promote healing. Varying the location of the screw/bone interface can impact how quickly the fracture heals. The lab is looking at which locations result in the fastest healing. They are also examining the impact that special screws, called locking screws, have on fracture healing, and seek to optimize their number and location. Using locking screws near the fracture appears to increase stability and may thereby promote healing, however, their cost is higher and they may cause unwanted difficulties during removal.
The lab is researching how growth factors and antibiotics can speed the healing process for orthopaedic injuries. Results are promising and show that using growth factors and antibiotics can reduce healing time and allow physicians to remove implanted devices sooner.
Looking forward, Dr. Bechtold and her lab are committed to developing practical solutions to the challenges of orthopaedic medicine.