Osteoarthritis (OA) is estimated to affect 630 million people worldwide – 15% of all the people on the globe. And the need for new and ever more effective osteoarthritis treatments will continue to expand as populations age.
That’s why Hospital for Special Surgery launched the HSS Osteoarthritis Initiative. The Osteoarthritis Initiative will coordinate all OA research studies and clinical trials at the hospital and with other important academic research institutions. In order to help as many people as possible, the OA Initiative will investigate new therapeutic possibilities at every stage of the disease:
- Before OA symptoms appear – Indentifying the risk factors indicating who is most likely to develop OA can help increase earlier detection among the susceptible population. Finding new ways to modify – or even eliminate – these risk factors could help reduce the severity of OA before it begins.
- At onset – Developing novel therapies to help prevent or reduce cartilage degradation and inflammation when OA symptoms first appear could help keep joint damage from developing further.
- As OA progresses – Finding new treatments and medical interventions to slow cartilage loss and joint inflammation can help ease pain, reduce joint damage, maintain active mobility, and enhance quality of life.
- When surgery becomes necessary – Continually advancing new techniques, procedures, repairs, and surgical solutions can increase greater mobility for a wider spectrum of patients, including younger people as well as the most advanced cases.
Collaboration for Innovation
Hospital for Special Surgery brings two unique advantages to discovering new ways to help people suffering from osteoarthritis:
- The hospital’s uniquely collaborative approach: At HSS, teams of doctors and scientists work together as equal partners, with no separation of bench and bedside. Experts from across HSS's specialties also collaborate in interdisciplinary investigations, bringing a broader and deeper range of knowledge to focus on the issues.
- The hospital’s uniquely large and complex patient volume: Because HSS is a world-leading specialty hospital dedicated exclusively to musculoskeletal medicine, the sheer volume and diversity of cases treated at the hospital allow rapid translation of scientific findings into effective clinical practice.
Hospital for Special Surgery’s pace-setting musculoskeletal research is organized into five main programs. And every program contributes essential knowledge to OA research:
- Arthritis and Tissue Degeneration Program: HSS investigations of the intricate cellular and molecular mechanisms of tissue destruction in all musculoskeletal conditions help reveal the cellular processes of cartilage loss in osteoarthritis. When a new important step of cellular interaction is discovered, it becomes a potential target for therapies that could prevent, slow, or even stop cartilage degeneration in OA.
- Autoimmunity and Inflammation Program: In-depth knowledge from HSS studies of how cells communicate and interact in inflammatory reactions in autoimmune diseases can be integrated with cellular studies of how inflammation is triggered – and then continues to impact – the joints in OA.
- Department of Biomechanics: The mechanics of the body’s movement, function, and ability to carry weight are affected by every stage of osteoarthritis. Biomechanical research uses principles of engineering, materials science, physical and computer modeling, and advanced statistical analysis to study how OA impacts the body’s function and gait. The department also continually researches innovations in the design and materials of joint replacements, surgical instrumentation, and orthopedic devices.
- Musculoskeletal Integrity Program: Using advanced technology not often available at one research center, HSS scientists unlock the understanding of the cellular nature of living bone: how it thrives, how it degenerates, how it interacts with soft tissue like cartilage and tendons, as well as orthopedic devices like implants.
- Tissue Engineering, Regeneration, and Repair Program: Cartilage does not heal itself. Yet, when injured, other soft tissues – like tendons and ligaments – can. HSS’s ongoing studies of the cellular mechanisms of soft tissue degradation and regeneration can help uncover ways to slow and prevent cartilage loss. Understanding the cellular nature of soft tissues also informs the science of tissue engineering. Interdisciplinary studies at HSS are developing new biologic and synthetic tissues that can help damaged joints regain function and mobility.
More Patients, More Knowledge
Presently, over 95% of all joint replacement surgeries are performed on patients with osteoarthritis. Since HSS performs more hip surgeries and more knee replacements than any other hospital in America, the hospital is in a unique position to evaluate current surgical outcomes while pioneering future surgical innovations.
Patient Registries: Information Can Heal
One of the most significant impacts of the Information Age on medical research is the ability to run complex, advanced analyses comparing and contrasting aspects of actual case histories from an enormous numbers of patients. The key is gathering the information.
All patients at HSS are offered the opportunity to contribute their data - anonymously, of course - to medical research. The hospital maintains extensive and highly successful patient registries helping researchers uncover patterns and assess treatment outcomes in musculoskeletal conditions. Some conditions are a direct results of OA, like joint replacement, or can later develop into earlier OA onset, like ACL injury.
Imaging - Seeing Osteoarthritis Inside the Body
As world leaders of musculoskeletal diagnostic imaging, HSS has pioneered pivotal advances in new ways to use both MRI and ultrasound to reveal the impact of OA on the body.
Innovative techniques developed by HSS radiologists can reveal changes in soft tissue indicating the earliest signs of osteoarthrits. HSS radiologists have even developed pulse sequencing protocols that can create clear MRI’s of joint replacements, despite the implant metal.
Ongoing collaborative studies using HSS imaging techniques are assessing and measuring the onset and progression of OA in specific populations, including patients who have been injured and/or had surgical repairs.
Motion Analysis Laboratory
At the Leon Root MD Motion Analysis Laboratory, high tech sensors attached to the body measure precise aspects of movements like walking, reaching, bending, and running. These measurements can be compared to data on normal function, thus showing how the structural realignment and joint damage of OA affect the body. Further measurements can help determine what therapies and training can best improve function.
In other studies, childhood obesity, fitness, and engagement in sports, such as running, are being looked at as possible factors that may accelerate or delay the onset of OA.
The scientists and doctors at Hospital for Special Surgery keep you informed on HSS.edu about their specific and ongoing studies on all musculoskeletal conditions, treatments, and issues. Besides each Division’s research overview (linked below) the biography page of each HSS doctor and scientist links to their research, as well as their articles in noted professional journals.
You can also sign-up for the free HSS eNewsletter that brings a convenient monthly update on the latest news at the hospital right to your email inbox.