USBJI March 2021 Newsletter

USBJI Welcomes New Executive Director

After a thorough search in the Fall, the Board of Directors selected Stephanie Taylor as the next Executive Director. Stephanie has an extensive non-profit management background and has spent the past 10 years working with a prominent radiology society where she oversaw the operations for three academic radiology societies and the Research and Education Foundation. She joined the organization in January.

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“I am excited to join the USBJI team and continue the important mission of this incredible organization. I look forward to meeting everyone in the near future.”

Memorial: Toby King

It is with gr

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eat sadness that we inform you of the passing of Toby King on Tuesday, December 29, 2020. Toby lost a battle with cancer that he had stoically fought for many years.

Toby served as the founding Executive Director of the USBJI (formerly USBJD) since 2002 and made invaluable contributions to advancing the organization’s mission. Toby was an expert connector and collaborator. He recognized the value of working together and had the patience and diplomatic skills to achieve success on many multi-disciplinary initiatives in advocacy, public education and the creation of the Young Investigator program.

Toby was a true leader and mentor for the Bone and Joint community. We will continue the vision Toby had for MSK research and follow the example of commitment and leadership set by him. His positive energy and tireless ability to drive new initiatives, coupled with his dry sense of humor will be greatly missed. We extend our deepest sympathies to Toby’s wife Judy and his entire family.

The King family has requested that donations be made to the USBJI Toby King Memorial fund.

Creating Opportunities for Arthritis Control @ Home (COACH)

From 2013-15, at least 54.4 million adults in the United States were told by their doctors that they had some form of arthritis. Today, that number is far higher. Ideally, patients are able to receive specialized treatment and ongoing care from a team specializing in rheumatology but access to specialized treatment and to evidence-based community programs that teach self-management skills is limited. There simply aren’t enough specialists and community programs to meet the need.

One way to bridge this gap is to support many more healthcare providers with training and tools to encourage self-management among their patients with arthritis. Creating Opportunities for Arthritis Control @ Home (COACH) is an Experts in Arthritis training module with a compendium of tools and techniques to help a wider circle of providers become self-management coaches for their patients with arthritis.

You don’t have to be a rheumatologist to help your patients with arthritis achieve a better quality of life. COACH modules are not intended to replace specialized care from rheumatologists; they are designed to provide tools and techniques to healthcare providers who interact regularly with people who have been diagnosed with arthritis and can support them in specific ways — alongside and complementary to the care they receive from rheumatologists.

The intended audiences for the COACH modules are nurses, nurse practitioners, physician assistants, physical therapists, occupational therapists, social workers, primary care providers, pharmacists, orthopedists, podiatrists, and pain management specialists, among others. All of these providers have the potential to extend the specialized rheumatology workforce by reaching patients with arthritis and reinforcing the information patients receive from specialists.

COACH tools are designed for providers who may see patients with arthritis regularly but have not necessarily been trained to meet their specific needs. Like other self-management tools and techniques, the COACH approaches are relevant to chronic diseases in general, not just arthritis.

The COACH tools are organized into six modules:
An overview of the different types of arthritis

Patient perceptions and misperceptions
The roles of providers in helping patients manage their arthritis
Overview of behavior change approaches
Arthritis-specific content for using behavior change tools
Additional resources (with links and downloads) for providers and patients

For some providers, the self-management techniques and tools presented through COACH will be familiar from their discipline-specific training; for them, these tools will be a refresher and reminder to use them with patients with arthritis and other chronic diseases. For others, these may be new approaches — or ones that require more practice and thought. In either case, as a refresher, or as new knowledge, we hope this content will encourage a wide variety of providers to incorporate self-management guidance into their interactions with patients who have been diagnosed with arthritis, as well as other chronic diseases.

The materials are all available on the USBJI website and include a 1-hour webinar with role plays of interactions between providers and patients, downloadable handouts customized for discussions about arthritis, a workbook, and links to additional resources. Please check out the materials and help spread the word about this new training resource!

Public Education Programs on Arthritis, and on Fracture Prevention Upgraded & Available in Spanish

The USBJI released the upgraded editions of its public/patient education programs Experts in Arthritis on how to manage your arthritis, and Fit to a T, on fracture prevention, bone health and osteoporosis last year.

The Presentation Guide, and Slide Set for both Fit to a T and Experts in Arthritis have been translated into Spanish. We would like to thank Katiuska Peppard, BSN, RN, CMSRN for translating our programs.

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Experts in Arthritis, which provides guidance to people with arthritis and those who care about them, has a new look and feel, with enhanced content on managing pain and fatigue. Designed to encourage discussion between expert presenters and participants, there is greater focus on addressing the most common concerns of people with arthritis and maximizing retention of the educational messages. Experts in Arthritis has always primarily been designed for presentation at live community gatherings. Due to COVID-19 Experts in Arthritis is offered with video conference presentations, led by a local expert on arthritis, so community centers, senior centers and other organizations can continue to offer this important education activity to their members while at home. Some of the messages are particularly relevant at this time, as people are confined and unable to exercise and move around as freely as they would be normally.

Experts in Arthritis and accompanying materials are provided at no cost, and come with a ready-made slide set, Presentation Guide, handouts, and logistical support.

The recorded presentation is offered at www.ControlArthritis.org, presented by Dr. Linda Ehrlich-Jones.

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Fit to a T, a public/patient education program, presents the necessary steps to understanding why bones break suddenly and apparently without warning, and how to prevent such events which can cause people, particularly older people, to lose their independence.

The incidence of these fractures in the US was declining, but in recent years this improvement has reversed. Covering bone health throughout the lifespan, the new version of Fit to a T focuses especially on those at highest risk of a fracture, and how to prevent these from occurring. The presentation covers the basics of bone health and how bone quality can deteriorate as people age, or at any age due to other health factors. It covers racial and ethnic differences. It covers the prevention, early detection, diagnosis, and treatment of osteoporosis, and fall prevention, a leading cause of fractures.

Designed to encourage greater discussion between healthcare professional presenters and participants, there is greater focus on addressing the major concerns of participants and maximizing retention of the educational messages. Fit to a T also was primarily designed for presentation at live community gatherings, but due to COVID-19 Fit to a T is also being offered via video conference, led by a local expert on bone health, so those who are effected can still benefit from this important educational program. Some of the messages are particularly relevant at this time, as people are confined and unable to exercise and move around as freely as they would be normally.

Fit to a T and accompanying materials are provided at no cost, and comes with a ready-made slide set, Presentation Guide, handouts, and logistical support.

A recorded presentation is offered at www.fit2t.org, presented by Catherine Sweeney, PA-C, CCD.

Pathogenesis and Treatment of Orthopedic Diseases Afflicting Children & Adolescents

Ferenc Toth, DVM, PhD, DACVS-LA, Assistant Professor at University of Minnesota, a participant in the USBJI Young Investigator Initiative

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I am a board-certified large animal surgeon with a PhD in comparative and experimental medicine. I currently hold a tenure-track assistant professor position in comparative orthopaedic research at the University of Minnesota. My primary research interest is to study the pathogenesis and treatment of orthopedic diseases afflicting children and adolescents by developing and utilizing clinically-relevant animal models. The long-term goals of these investigations are to identify novel diagnostic, treatment and preventative approaches to decrease the disease burden of pediatric orthopaedic disorders and concomitant early onset osteoarthritis.

I was introduced to orthopedic research during my large animal surgery residency at the University of Tennessee, where I developed a strong interest in orthopaedic diseases affecting young animals and obtained the surgical skills necessary to treat these conditions. After the residency, I moved to Minnesota where I joined the lab of Cathy S. Carlson. In her lab, as a NIH T32 postdoctoral fellow, I applied my surgical skills and developed expertise in medical imaging and histology to conduct translational studies investigating developmental joint disorders affecting children. In particular, my research was concentrated on osteochondrosis/osteochondritis dissecans (OC/OCD) of the knee, a condition affecting children and adolescents that results in disabling cartilage defects. During the last year of my postdoctoral fellowship, I was fortunate to obtain an NIH K01 award which also enabled my transition into a faculty position as an assistant professor. During this NIH K01 award period, OC/OCD remained the focus of my research, but I also launched new lines of investigations into other developmental orthopaedic disorders of vascular origin, such as Legg-Calvé-Perthes disease. My research findings from these studies were instrumental in refining the understanding of the pathogenesis of these pediatric orthopaedic diseases through demonstrating similarities between naturally occurring OC/OCD in animals and in human patients. We were also successful in developing surgically induced animal models of OC, and with the help of these models, we have evaluated and identified multiple novel MRI sequences that allow their diagnosis in the early stage, when conservative treatment approaches are more likely to succeed.

Reaching the end of my K01 award period I am in the midst of establishing myself as an independently funded investigator. As I work towards this goal, I am heavily reliant on the information and experience I gained at USBJI/YII workshop in Chicago and the guidance I receive from the mentors in this program. Although my most recent R01 grant proposal has not been reviewed yet, I firmly believe that the critique I received from my USBJI/YII mentors on this submission makes the proposal more competitive. I found particularly useful their comments that came from the perspective of scientists not intimately involved in researching OC/OCD, which also happens to hold true for the overwhelming majority of NIH study section members, that helped me identify areas in the grant that required further explanation.

Looking back at my career progression from a clinician to a full-time researcher, I am glad that I chose this path. I greatly enjoy the everyday challenge of research, and on those days when I do not get the result I expected I try to find solace in the wisdom of one my early mentors who never failed to point out: “It is called research for a reason: First you search for something, and when you do not get it, you go back and ‘research’ for it again”…

For the Love of Learning – Integrating Machine Learning & Musculoskeletal Biomechanics

Jennifer Nichols, PhD, Assistant Professor at University of Florida, a participant in the USBJI Young Investigator Initiative

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Dr. Jennifer A. Nichols is an Assistant Professor in the J. Crayton Pruitt Family Department of Biomedical Engineering at the University of Florida with Affiliate Faculty Appointments in the Department of Mechanical & Aerospace Engineering and the Department of Orthopaedics & Rehabilitation. She is an alumna of the USBJI Young Investigator Initiative. The guiding vision of her Musculoskeletal Biomechanics Lab is to create predictive simulations that cross disciplinary boundaries and improve the functional ability and quality of life for individuals with musculoskeletal disorders.

Learning Musculoskeletal Biomechanics
The goal of research is to learn. As researchers, we learn to become experts in our fields and then we keep learning as we strive to discover new knowledge and work to positively impact human lives. In my lab, both the researchers and the musculoskeletal models we develop are learning hand biomechanics.

The hand is one of the most complicated multi-body, multi-joint systems in the human body. Seemingly simple tasks, such as grasping a cup, require the coordinated interaction of twenty-nine bones, twenty-one joints (excluding individual carpal joints in the wrist), and over thirty muscles. Given this complexity, restoring hand function remains an elusive goal for many clinical conditions, such as osteoarthritis and traumatic injury. One of our ongoing projects aims to build patient-specific hand models that will someday inform personalized treatments. For this work, we are integrating musculoskeletal models with machine learning models. Musculoskeletal models can be thought of as anatomical libraries that describe how muscles, bones, and joints affect movement. Current hand models represent the average adult, but fail to capture all of the features that make each of us unique. In contrast, machine learning models can be trained to identify and characterize unique features. By integrating musculoskeletal and machine learning models, we will be able to collect basic patient-specific data, such as age, biological sex, pinch strength, and hand size, and rapidly generate a patient-specific musculoskeletal model. With these models, we will learn how patient-specific characteristics influence hand function and be one step closer to using models to inform personalized clinical care. This work is funded by Trailblazer R21 Award from the NIH National Institute of Biomedical Imaging and Bioengineering.

Learning from the Research Team
The most important lesson that I learned as an early career scientist is the importance of a research team. The USBJI Young Investigator Initiative provided practical tips and empowered me to build an interdisciplinary research team. My trainees and I now work with collaborators across the fields of orthopaedic surgery, translational pain research, physical therapy, and artificial intelligence. Through cross-disciplinary conversations and spirited debate, we are continuously learning new research methods and gaining new perspectives. Our projects span the musculoskeletal system, including work on the wrist/hand, foot/ankle, and shoulder. I credit my research team with ensuring that we are pursuing interesting questions and for pushing me to become a stronger researcher each and every day.

For more information, please e-mail Dr. Nichols at jnichols@bme.ufl.edu

American Bone Health’s grassroots coalition is making a difference in the Tampa Bay area

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The Tampa Bay, FL area has the highest rate of osteoporotic fractures of any comparable U.S. metro area. Women 65 and older in the Tampa Bay area sustain more than 16,000 fractures each year, and current data suggests too many of these women aren’t being identified and treated to prevent more broken bones. American Bone Health saw an opportunity to address this local public health crisis and to create a model for outreach within the community. The result is Healthy Bones Tampa Bay, a nonpartisan, grassroots community coalition dedicated to fostering bone health and fracture prevention.

Led by a diverse group of stakeholders from business, education, health care and nonprofit organizations, Healthy Bones Tampa Bay set a goal of reducing osteoporotic fractures by 25% by 2025 in the Tampa Bay region. Amgen provided support for starting the initiative.

Ongoing activities include:

Virtual presentations of American Bone Health’s evidence-based signature programs in partnership with Tampa General Hospital, Florida Medical Center, and other health and wellness institutions.
Collaborating with AARP on a series of virtual educational events.
Engagement with clinical professionals to outline a patient care pathway and identify tools needed to close gaps in care;
Social marketing program, in collaboration with the University of Tampa, to drive awareness of screening and diagnostic solutions.

In the works are programs to reach underserved populations, including Black and Latinx residents and people living with HIV.

The Health Bones Tampa Bay coalition also hosted a virtual policy briefing for public officials and organized an effort by state lawmakers to issue a proclamation declaring May as Osteoporosis Awareness Month in Florida.

“The success of Healthy Bones Tampa Bay shows what can be possible when many segments of a community mobilize to address the crisis of bone health,” says Cheryl Hostinak, Executive Director of American Bone Health. “As more individuals and organizations join this initiative, we find new opportunities to make a difference. Those include reaching out to the HIV community and communities of color who historically have not had equal access to bone health treatment. We look forward to taking what we have learned in Tampa Bay to other metro areas and using it as a model for building grassroots engagement around bone health.”

https://americanbonehealth.org/hbtb/

American Orthopaedic Foot & Ankle Society Announces 2021 Research Grant Recipients

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Congratulations to the American Orthopaedic Foot & Ankle Society (AOFAS) 2021 Research Grant Recipients! The AOFAS Research Grants Program, funded by the Orthopaedic Foot & Ankle Foundation, awarded three Small Project Grants (up to $20,000 each), and two Established Project Grants (up to $50,000) to promising foot and ankle research projects. Since 1997, the AOFAS Research Grants Program has provided more than $1.7 million in funding to discover new treatments and advance patient care.

Established Project Grants

Evaluation of frHMGB1 Treatment for Nonunion Fracture Healing in a Diabetic Rat Model
Jarrett D. Cain, MSc, DPM; Feng Li, MD, PhD; Jianying Zhang, PhD; Alan Y. Yan, MD; MaCalus V. Hogan, MD, MBA, FAAOS, FAOA

Creating Machine Learning Algorithms to Assess the Risk of Developing Venous Thromboembolism and Bleeding Adverse Events in Patients with Ankle Fractures
Daniel Guss, MD, MBA; Bart Lubberts, MD, PhD; Gregory R. Waryasz, MD; Christopher W. DiGiovanni, MD; Rohan Bhimani, MD, MBA; Soheil Ashkani-Esfahani, MD; Reza Yazdi, MSc; Takahisa Ogawa, MD, MPH; Haggai Schermann, MD, MPH

Small Project Grants

Identification of Differentially Expressed Genes in Synovial Tissue of the Arthritic Ankle
Kenneth J. Hunt, MD; Michael Zuscik, PhD; Cheryl Ackert-Bicknell, PhD; Mary C. Hamati

Does the Synovial Fluid Fracture Hematoma after Intra-articular Ankle Fracture Cause Cartilage Damage?
Samuel B. Adams Jr., MD

Effect of Preoperative Mobility Device Training on Postoperative Fall Incidence in Foot and Ankle Surgery
Ashish Shah, MD; Nicholas Andrews, BS

American Orthopaedic Association - Own the Bone - 2021 Virtual Own the Bone Symposium

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Join Own the Bone for its virtual symposium on bone health and fragility fractures. Target audience includes orthopaedic surgeons, multidisciplinary physicians, nurses, nurse practitioners, physician assistants, physical and occupational therapists and other allied health professionals who care for orthopaedic patients in both acute care and outpatient settings.

Learning objectives include:

Discuss the fragility fracture epidemic and how secondary fracture prevention efforts help solve the problem.
Analyze multidisciplinary implementation considerations for a Fracture Liaison Service (FLS) model of care for secondary fracture prevention.
Investigate and practice completing a patient work-up for osteoporosis.
Discuss current and potential pharmacologic management strategies for the patient with or at risk for osteoporosis.
Investigate multidisciplinary post-fracture management and prevention strategies related to bone health through case studies.

When (access virtually - live or on-demand recordings):

Pre-Event: March 23^rd from 7:00 – 8:15pm ET
Session #1: May 14^th from 10:00am – 12:00pm ET
Session #2: May 21^st from 10:00am – 12:00pm ET
Session #3: May 27^th from 5:00 – 7:00pm ET
Session #4: June 3^rd from 5:00 – 7:00pm ET

Earn Recognition:

Earn approximately 9.25 hours of AMA PRA Category 1 Credits™ for all five events
Or earn approximately 9.25 hours of Category A nursing contact hours for all five events
Participants will receive a Bone Health Training Certificate of Completion upon finishing the course

To register and learn more, please visit our website.

Arthritis Foundation - Focusing on OA in 2021 and Beyond

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Focusing on OA in 2021 and Beyond
While there are over 100 forms of arthritis, nearly 33 million people — that’s more than 60 percent of all arthritis cases — live with osteoarthritis (OA). The disease can affect any joint and is almost always accompanied by constant chronic pain, progressive, irreversible structural damage and gradual loss of function.

Despite this, OA has not been a focus of novel research. Because of its slow presentation, researchers find it challenging to measure and track disease progression, and with no consensus on how to measure success, scientists find it difficult to make progress toward OA-specific treatments. The Arthritis Foundation is working to accererate the study of OA and find lasting treatments and even a cure for the disease. Along with calling on Congress to fund the CDC at $10 billion, which could fully fund the arthritis program, we’re also focused on OA initiatives to tackle this most common form of arthritis.

FastOA Initiative
To speed the research process and gather data to bring us closer to a cure for post-traumatic osteoarthritis, the Arthritis Foundation launched the FastOA Initiative. Since people with lower extremity injuries are among the highest risk group for developing OA, the FastOA Initiative is designed to identify risk factors for patients who will rapidly progress (<5Y) toward OA. This data may be used to study and develop the most effective treatments for those at greatest risk. Future clinical trials and studies supported by the Foundation will target this high-risk patient population to research new cures for OA, with hopes that conquering the disease can be fast tracked.

FDA-Arthritis Foundation Workshop on OA Endpoints for DMOADs
Developing a disease-modifying osteoarthritis drug (DMOAD) eludes researchers — not due to lack of interest, but due to a lack of agreed-upon clinical endpoints that demonstrate the benefit of these drugs. To date, no medication that inhibits the structural progression of OA has been approved. The biggest challenge is the lack of agreement on measurements of success, as the FDA has yet to codify what type of endpoint data it will accept to approve a DMOAD. On June 22, the Arthritis Foundation will partner with the FDA via a public workshop to work toward guidance on appropriate surrogate endpoints for the development of DMOADs. Together, we will convene the scientific community to bring consensus to the types of data to accept and allow manufacturers to effectively develop drugs.

OACS Program
Each year, the Arthritis Foundation hosts the Osteoarthritis Clinical Studies (OACS) forum series, which features top experts discussing the needs and progress being made to develop new OA therapies. This series of online meetings allows scientists from around the world to learn more about advances in OA from the top scientists in rheumatology, orthopedic surgery, physical therapy, sports medicine and imaging. In 2021, the program will focus on the challenges of behavior modification and exercise therapy, the role obesity plays in OA treatments, OA-specific joint pain and medication options, and what role nutraceuticals play in treating the disease.

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Highlights and Upcoming Opportunities from the American Society of Bone and Mineral Research

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ASBMR Releases Joint Guidance on COVID-19 Vaccination and Osteoporosis Management
In response to the release of several COVID-19 vaccines, the American Society for Bone and Mineral Research (ASBMR), American Association of Clinical Endocrinology (AACE), Endocrine Society, European Calcified Tissue Society (ECTS), the International Osteoporosis Foundation (IOF), and the National Osteoporosis Foundation (NOF) released guidance to assist clinicians in managing patients with osteoporosis who will receive vaccination against COVID-19. The coalition acknowledges the paucity of data to provide clear guidance. Thus, the recommendations are based primarily on expert opinion. Read the entire joint guidance statement here.

ASBMR to Host First Virtual Capitol Hill Day in April
US-based investigators in the bone and mineral research field are invited to participate in the ASBMR Virtual Capitol Hill Day is a two day event on Tuesday, April 13-Wednesday, April 14, 2021. This is a great opportunity to speak with your elected members of Congress and their staff to discuss musculoskeletal research priorities and the importance of sustained and predictable federal funding for biomedical research. Please visit the ASBMR website for more information and to register.

Limb Lengthening and Reconstruction Society - Update on New Pubications

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Techniques in Orthopedics devoted its entire Fall issue to one of the latest innovations in the field of Limb Deformity: the motorized internal lengthening nail. Experts from around the world came together to share their experience with this family of implants providing the public with many operative pearls. Dedicated to the education, the authors ensured open access to all of the articles. The issue starts with a commentary by the surgeon-inventor of the magnetic internal lengthening nail who shares a lifetime of perspective on Limb Lengthening. The articles then tackle best practices for tibia, femur, humerus lengthening and deformity correction. Special consideration is given to surgery in children including the use of an intramedullary device outside of the femur for extramedullary lengthening. Lengthening of amputated limbs, compression of nonunions, and all-internal bone transport are explored in great detail. Clinical outcomes are reviewed as well as cost considerations for this operation with comparison to other available treatment options. Through this publication, the editors at Techniques in Orthopedics have shown interest in the field of Limb Deformity and have provided a mainstream platform for LLRS members to share their work with colleagues and students. The issue is a must read for anyone that treats children, foot and ankle injuries, and skeletal trauma. The following link will bring you to the articles: https://journals.lww.com/techortho/toc/2020/09000

A recent publication on the estimation of skeletal maturity was released in JBJS this year emphasizing this oftentimes critical component of planning in the correction of pediatric limb deformity. Historically, this is done with the technique of Greulich and Pyle, which is limited by the requirement of an additional radiograph of the hand, the complexity of the Greulich and Pyle atlas, and the need for additional corrective factors when bone age and chronological age are discordant. Using the same Bolton Brush historical data set used to create the Greulich and Pyle atlas, Benedick and colleagues optimized the Roche-Wainer-Thissen knee skeletal maturity system. They were able to isolate seven straightforward parameters of the knee which outperformed Greulich and Pyle and designed the system to easily incorporate chronological age. Although modern validation is still necessary, this system offers the potential for user friendly and highly accurate skeletal maturity determination in limb deformity patients.

Benedick A, Knapik DM, Duren DL, Sanders JO, Cooperman DR, Lin FC, Liu RW. Systematic Isolation of Key Parameters for Estimating Skeletal Maturity on Knee Radiographs. J Bone Joint Surg Am. 2021 Jan 28. doi: 10.2106/JBJS.20.00404. Epub ahead of print. PMID: 33512968.

National Association of Orthopaedic Nurses (NAON) - Celebrate at its Upcoming 41st Annual Virtual Congress!

Help NAON Celebrate at its Upcoming 41st Annual Virtual Congress!

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As a result of the ongoing conversations between NAON leadership, the Palm Springs Convention Center and our hotel partners, and to ensure the safety of our members, we are excited to share that the NAON 41st Annual Congress will transform into the NAON 41st Virtual Annual Congress and will be hosted completely online.

Taking place May 22-25, this brand new virtual format will allow you to:

Experience the conference and gain access to unparalleled educational opportunities without the risk or cost of travel;
Access the education from all offered sessions, both live and on-demand, rather than needing to choose among those happening concurrently;
Earn up to 42.5 CNE credits - more than NAON has ever been able to offer;
Network virtually with fellow orthopaedic nurses, including through an online community as well as visiting virtual exhibitor booths;
Hear from speakers and panelists who will share their thought leadership and best practices;
Experience virtual product demos and vendor sponsored sessions from leading sponsors and exhibitors and hear timely updates and information about products, services and approaches.

We encourage you to register and make plans to join us this May for the best in orthopaedic education, presented by leaders and experts within orthopaedic nursing. Register by the extended early registration deadline of March 19 to take advantage of the best rates.

For more information and to register for either event, please visit: http://www.orthonurse.org/congress

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NAON Announces New Podcast Series: No Bones About It
NAON is excited to announce the launch of our new No Bones About It Podcast Series! The No Bones About It Podcast Series provides a deep-dive into hot topics and trending research within the field of orthopaedics. Featuring interviews with industry experts and current NAON members, each episode aims to address best practices in an easy, on-the-go format. The NAON Podcast Series will release on a bi-monthly schedule.

Subscribe to the podcast by searching "No Bones About It" wherever you get your podcasts.

In Remembrance of Toby King NAON was deeply saddened to learn of the loss of Toby King. Toby was a dear friend and honorary member to the NAON community. On behalf of the NAON executive board, membership and staff we share in this time of grief, but also share in the love and memories Toby brought to each one of us.

Recent National Spine Health Foundation Research Using Artificial Intelligence

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The National Spine Health Foundation is dedicated to research that improves the quality of care available to spine patients. In one of our most recent research projects, we have partnered with the Virginia Spine Institute and Raylitc (developer of the only fully automated platform for medical image analysis and clinical data extraction) to determine if artificial intelligence (AI) can be trained to measure spinopelvic parameters on spine x-rays accurately when compared to measurements made by expert spine surgeons. These measurements give information on spinal alignment and are made using geometry which can be time consuming, but critical in diagnosing and treating spine disorders. This becomes particularly crucial during surgical planning.
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In additio

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n, in this NSHF AI study, spinopelvic parameters were measured on 150 x-rays of the low back, which allowed for AI training as well as measuring the accuracy of the AI measurements. This groundbreaking technology is the first of its kind to develop an algorithm that allows spine surgeons to simply upload x-rays. Subsequently, the software automatically makes these measurements in a fast, accurate, and reproducible manner. The results of this study will propel this software throhttp://usbji.org/sites/default/files/styles/program_logo/public/NSHF_Pas... the development channels until it becomes available for use. This tool is expected to free up the spine surgeon’s time which can be spent with their patients, to improve the accuracy of the measurements, and having this information accessible during surgical planning can be used to design how to best approach re-alignment, which is known to improve patient outcomes.

The use of artificial Intelligence technology is widespread and growing in many other fields as well. In general, the benefits of artificial intelligence include replicating human intelligence in machines through a training process called ‘machine learning.’ In many cases, algorithms are used to train computers to think like humans. AI enhances speed, precision, and effectiveness of human efforts. In addition, computers do not get tired, do not have bias, and are not affected by emotions. The implications of the NSHF AI research project for spine surgery are profound. Patients can benefit from better surgical outcomes due to enhanced accuracy.

A Multicenter Study of Intramedullary Rodding in Osteogenesis Imperfecta

A multicenter study of intramedullary rodding in Osteogenesis Imperfecta (OI) supported by the Brittle Bone Disease Consortium (BBDC) was recently released. The BBDC is funded through the Osteogenesis Imperfecta (OI) Foundation and the Office of Rare Diseases Research (ORDR) of the NCATS, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute of Child Health and Human Development (NICHD), and the National Institute of Dental and Craniofacial Research (NIDCR).

Osteogenesis imperfecta (OI), a heritable connective tissue disorder with wide clinical variability, predisposes to recurrent fractures and bone deformity. Management requires a multidisciplinary approach in which intramedullary rodding plays an important role, especially for moderate and severe forms. The study investigated the patterns of surgical procedures in OI in order to establish the benefits of rodding. The main hypothesis that guided the study was that rodded participants with moderate and severe OI would have lower fracture rates and better mobility.

With data from the Linked Clinical Research Centers, the study analyzed rodding status in 558 individuals. Mobility and fracture data in OI Types III and IV were compared between rodded and non-rodded groups. Univariate regression analyses were used to test the association of mobility outcomes with various covariates pertinent to rodding.

Of the individuals with OI, 42.1% had undergone rodding (10.7% of those with Type I, 66.4% with Type III, and 67.3% with Type IV). Rodding was performed more frequently and at a younger age in femora compared with tibiae. Expanding intramedullary rods were used more frequently in femora. In Type III, the rate of fractures per year was significantly lower for rodded bones. In Type III, the mean scores on the Gillette Functional Assessment Questionnaire (GFAQ) and Brief Assessment of Motor Function (BAMF) were higher in the rodded group. However, Type-IV non-rodded subjects had higher mean scores in nearly all mobility outcomes. OI type, the use of expanding rods in tibiae, and anthropometric measurements were associated with mobility outcomes scores.

In conclusion, current practice in 5 orthopaedic centers with extensive experience treating OI demonstrated that most individuals with moderate and severe types of OI undergo rodding procedures. Individuals with severe OI had improved mobility outcomes and lower fracture rates compared with their non-rodded peers, which suggested that early bilateral rodding benefits in OI Type III. The study also showed a change in practice patterns. In the final years of the study in the severe forms, earlier and more simultaneous rodding procedures were performed.

For a full report of the study please refer to JBJS Open Access – 2020:e20.00031 http://dx.doi.org/10.2106/JBJS.OA.20.00031

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USBJI March 2021 Newsletter

In This Issue

Calendar of Events