AAOS, Orthopaedic Research and Education Foundation recognize work of Braden C. Fleming, PhD
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The American Academy of Orthopaedic Surgeons announced Braden C. Fleming, PhD, received the Orthopaedic Research and Education Foundation Clinical Research Award for more than 15 years of clinical research conducted with his colleagues into certain mechanical, psychological and biological factors that may lead to the onset and progression of post-traumatic osteoarthritis following ACL reconstruction.
Fleming, the Lucy Lippitt Professor of Orthopaedics at Brown University, and Gary Badger, MS; Paul D. Fadale, MD; Michael J. Hulstyn, MD; Robert M. Shalvoy, MD; and Glenn Tung, MD, analyzed factors that may be under the control of the surgeon at the time of ACL reconstruction, such as graft selection and high or low amounts of graft tension.
They studied these factors in a group of patients whose grafts were fixed in high tension and a group of patients whose grafts were fixed in low tension and compared the long-term results of these groups to a matched control group of patients with intact ACLs.
“Initial tension did not impact outcomes at 7 years postop, but the outcomes were worse than the matched control group and there was evidence of [post-traumatic osteoarthritis] PTOA progression in both groups,” Fleming said at the Orthopaedic Research Society (ORS) Annual Meeting, where he presented the results that were recognized by the AAOS and Orthopaedic Research and Education Foundation Clinical Research Award.
According to the AAOS press release, Fleming and colleagues also concluded that, after studying the patient population through 7 years postoperatively, there were no significant differences in the clinical, functional and patient-reported outcomes for the two graft tensioning conditions of low tensioning, which restores normal laxity, and high tensioning, which makes the knee tighter at the time of surgery.
“Our primary hypotheses were that the high-tension group would have improved outcomes compared to the low-tension group at 7 years postop, and the outcomes for the high-tension group would be equivalent to the matched control group,” Fleming said at the ORS Annual Meeting.
“As a bioengineer, I wanted to explore the mechanical functions of the knee and the way the joint distributes its force or load during activity to determine if joint stability is related to PTOA risk,” Fleming said in the press release.
“While surgical treatment for ACL injuries can be beneficial for patients, many of these patients still present with functional deficits and are now at a higher risk for PTOA,” he said.
Additional findings from the randomized controlled trial, which included 90 patients, were that grafts from both groups stretched to the same extent during the first year of healing and one-leg hop test distances in both groups of operated patients were significantly less than in the control group.
The OREF Clinical Research Award, which was established in 1995, recognizes outstanding clinical research related to musculoskeletal disease or injury. – by Susan M. Rapp
Reference:
https://aaos-annualmeeting-presskit.org/2020/awards/oref_award/
Disclosure: Fleming reports he received study support from the NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases; the Lucy Lippitt Endowment; the RIH Orthopaedic Foundation; and Boston Children’s Hospital Orthopaedic Surgery Foundation.