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UPMC Department of Orthopaedic Surgery Research Year in Review

November 21, 2020

The Department of Orthopaedic Surgery is committed to delivering the highest quality of diagnostic and therapeutic patient care for a diverse spectrum of orthopaedic disorders. Read about the research advances the Department has made over the last year.

Effects of Prosthesis Design and Placement on Shoulder Kinematics and Strength After Reverse Total Shoulder Arthroplasty

Albert Lin, MD, and William J. Anderst, PhD, were awarded an R03 grant from the NIH totaling more than $150,000 over the two-year project period. The research aims to determine the in vivo effect of prosthesis placement and design on shoulder kinematics and strength after reverse shoulder arthroplasty, and to identify the shoulder kinematics and strength parameters that are associated with improved clinical outcomes.

Learn more here

STABILITY II: ACL Reconstruction +/- Lateral Tenodesis with Patellar vs. Quad Tendon

Volker Musahl, MD, and James J. Irrgang, PhD, PT, ATC, have been awarded a $3.2 million grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) to conduct a prospective randomized international multicenter clinical trial to determine if the use of the quadriceps tendon versus patellar tendon, either with or without a lateral extra-articular tenodesis, reduces the risk of re-injury of the ACL, results in less symptoms and better function and quality of life and an improved ability to return to sports. The University of Pittsburgh is working in collaboration with Western Ontario University for this study. 

Learn more here.

STaR Trial: Multiple Ligament Knee Injuries

Volker Musahl, MD, and James J. Irrgang, PhD, PT, ATC, are serving as co-PIs for STaR (Surgical Timing and Rehabilitation for Multiligament Knee Injuries), a multicenter, randomized clinical trial. This $4.4 million grant from the Department of Defense will support two parallel, multicenter, randomized clinical trials to investigate the effects of timing of surgery (early versus delayed) and timing of postoperative rehabilitation (early versus delayed) for the treatment of multiple-ligament knee injuries.

Learn more here.

Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes Mechanistic Research Center (LB3P MRC) 

Gwendolyn Sowa, MD, PhD, chair of the Department of Physical Medicine and Rehabilitation, and Nam Vo, PhD, associate professor of orthopaedic surgery, were awarded more than $16 million to establish the LB3P MRC, a multidisciplinary research center dedicated to categorizing patients into subgroups of chronic low back pain with the goal of targeting treatments specific to individual patients’ pain and reducing the use of opioids.

Learn more here.

Multisite Randomized Controlled Trial of Targeted Multidomain (T-MD) Interventions in Military Personnel with mTBI

Anthony Kontos, PhD, Michael Collins, PhD, and David Okonkwo, MD, PhD, have been awarded a $3.1 million grant from U.S. Army Medical Research Acquisition Activity (USAMRAA) over a three-year period. The objective of the three-year multisite randomized controlled trial (RCT) is to determine the effectiveness of a targeted multidomain intervention (T-MD) (anxiety/mood, autonomic, cognitive, migraine, ocular, vestibular, sleep) compared to usual care (behavioral management) in military-aged civilians with complex mild traumatic brain injuries (mTBI). The proposed T-MD RCT will involve identifying complex mTBI domains or clinical profiles using specific symptoms, impairments, and functional limitations and prescribing targeted interventions to address each patient’s profile. 

Tissue Chip Modeling of Acute and Chronic Pain in Osteoarthritis

Hang Lin, PhD, was awarded a $1.3 million grant from U.S. Army Medical Research Acquisition Activity (USAMRAA) over a three-year project period. The study aims to develop a new chip, innervated and mechanical stimuli-enabled tissue chip (iMecChip), that not only contains neural cells, but also allows the application of mechanical loading to the tissues. The project will adapt the tissue chip to the study of osteoarthritis pain, in particular the mechanisms of underlying pain as it transitions from the acute to chronic state. 

Targeting Nitrate-Nitrite-NO pathway for Ameliorating Muscle and Bone Comorbidities in Duchenne Muscular Dystrophy

Hongshuai Li, MD, PhD, was awarded a R01 grant from the NIH totaling more than $1.7 million over a five-year project period. The purpose of the project is to evaluate the efficacy and study the mechanisms of its actions of oral nitrite administration as a novel therapeutic approach to replenish nitric oxide (NO) in dystrophic muscle by targeting the nitrate-nitrite-NO pathway, which is significantly disturbed in Duchenne Muscular Dystrophy (DMD). Learn more here.

Improving Physical Function and Patient-Reported Outcomes Through a Quantitatively Informed Socket Design Process

William Anderst, PhD, received a $1.4 million grant from the Department of Defense over a four-year project period. The project’s goal is improving the lives of people with above-knee limb loss and focuses in two areas: objective support tools to enable providers to assess function and performance throughout treatment and predict long-term outcomes, and optimization of warfighter performance following limb trauma or loss. The ultimate application of this research will be a quantitative socket optimization process that can improve the current iterative, trial and error process for optimizing fit and function in prosthetic sockets. Clinicians will use readily available measurement tools to help guide the optimization process, leading to reduced time and expense to develop a comfortable and functional socket for each amputee.

Antibiotic Treatment of Total-Knee Prosthetic Joint Infection

Kenneth Urish, MD, PhD, was awarded a grant from Peptilogics, Inc., for $376,384 over a three-year project period. The research focuses on treating infection related to total knee arthroplasty (TKA). TKA infection, termed periprosthetic joint infection (PJI), is a serious diagnosis and treatment options are few -- all requiring repeat surgical intervention with a long-term antibiotic regimen. Poor outcomes with infected surgical implants are a result of the high antibiotic tolerance of the biofilm established on the implant, prompting research to improve these outcomes. 

This study continues Dr. Urish’s work with antimicrobial peptides, specifically the synthetically engineered cationic amphipathic peptide (eCAP) CAP, WLBU2. WLBU2 shows promise as a novel therapeutic in the treatment of S. aureus infections in the challenging setting of surgical implants such as PJI. Previous results have demonstrated the efficacy of WLBU2 in vitro and in small animal models, and the current proposal will establish the efficacy of WLBU2 in a larger animal model.