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Findings in Post-Injury Arthritis Garner Top Honor in Orthopedics Research

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DURHAM, N.C. – A team of Duke Medicine researchers has earned the highest honor for research in orthopedic surgery after more than a decade of investigation into arthritis caused by traumatic injury. Post-traumatic osteoarthritis accounts for about 12 percent of all cases, affecting about 6 million people in the U.S. each year.

The team of Steven Olson, M.D., Farshid Guilak, Ph.D., Virginia Kraus, M.D., Ph.D., Bridgette Furman, B.S., and Janet Huebner, M.S., will receive the Kappa Delta Award from the American Academy of Orthopaedic Surgeons and the Orthopaedic Research Society at a ceremony March 26 in Las Vegas.

Among their accomplishments, the researchers developed the first closed-joint experimental model of a knee fracture in mice to study post-traumatic inflammation and the onset of osteoarthritis.

They found that injecting a rheumatoid arthritis drug called anakinra immediately after the fracture actually lessened the severity of the inflammation and arthritis. This is the first successful intervention to limit the development of arthritis after the fracture of a weight-bearing joint.

The team also established that infusing a joint fracture with stem cells increased bone volume while the fracture was healing, but found anakinra to be a more effective treatment to lessen the severity of osteoarthritis in the joint.

The team’s body of work is based on a uniquely holistic view of injury in the knee joint, said Olson, an orthopedic surgeon at Duke and the principal investigator for the research.

“The traditional approach is to take a complicated problem like a knee fracture, and dissect it and look at each element – the load that goes across the joint, the force that’s transmitted to the bone and cartilage, the blood and inflammation,” Olson said. “While these pieces are interesting, all of these things are happening at once. It’s hard to make sense of these pieces in isolation. We needed to look at the joint as a whole. The big step was creating the model.”

The development of the knee fracture model in 2003 was followed by years of research in animal models and examination of their joints microscopic slice by microscopic slice, for more than 10 years. This exacting process helped the scientists better understand the fracture, inflammation, and genetic and environmental variables that allowed some animals to recover quickly while others had much more inflammation and more severe arthritis.

At this time, there is not much surgeons can do to prevent arthritis in their human patients after a joint fracture but to align the joint as precisely as possible, Olson said.  

With the knowledge gained from the Duke team’s pre-clinical work, Olson said he anticipates further research in larger animals and eventually humans.

“Right now, the only thing we can offer many people is surgery,” Olson said. “But with this much better understanding of why arthritis develops, in the future we may be able to offer additional treatment to actually prevent its onset.”

The researchers received funding from the Arthritis Foundation, the National Institutes of Health (NIH P01 AR050245), the U.S. Department of Defense (OR090702, OR110100) and Synthes USA.

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