Impactful orthopedic research honored with Kappa Delta, OREF Clinical Research Awards
Key takeaways:
- The American Academy of Orthopaedic Surgeons announced the recipients of the Kappa Delta and Orthopaedic Research Foundation Clinical Research Awards.
- Four research teams were chosen from 24 submissions.
Each year, the American Academy of Orthopaedic Surgeons presents the Kappa Delta Awards and the Orthopaedic Research Education Foundation Clinical Research Award for outstanding clinical research on musculoskeletal disease or injury.
This year, four research teams were chosen from 24 submissions, each of which underwent an intensive review process, according to Brian D. Snyder, MD, PhD, FAAOS, co-chair of the research awards committee of the AAOS.
“We are looking for research that is impactful, that is going to change the way we practice orthopedic medicine or think about orthopedic musculoskeletal science,” Snyder, the Maurice Muller Professor of Orthopedic Surgery at Harvard Medical School and attending physician at Boston Children’s Hospital, told Healio. “Most of the work represents decades of work with multiple papers that have been published in prestigious medical journals. It is an opus of work performed over a significant amount of time with multiple team members participating.”
Ann Doner Vaughn Award
The Kappa Delta Ann Doner Vaughn Award was presented to Matthew T. Provencher, MD, MBA, CAPT MC USNR (Ret.), and colleagues for research on understanding and treating anterior shoulder instability among U.S. military members, according to a press release from the AAOS.
“This was truly a team effort in which we collaborated over 25 years through multiple military hospitals and military services, and we were able to bring together and collate and integrate all of our outcome measures on patients,” Provencher, professor of orthopedics and orthopedic surgeon at the Steadman Clinic, told Healio. “We started the journey trying to understand this problem of shoulder instability better and tried to take a scientific-based approach to the entire issue at hand, being recurrent shoulder instability, lost days of work, lost days of duty, early discharges from the military and things that we knew we could do better and get our patients back to function at the highest level.”
According to Col. John M. “J.T.” Tokish, MD, MC, USAR, co-author and professor of orthopedic surgery at the Mayo Clinic, Arizona, much of this research stemmed from “the importance of keeping a warrior ready for the battlefield.”
“The injuries that are keeping all those soldiers from deploying are sports injuries. They are shoulder instabilities, they are ACLs, and this was a great realization for many of us that were caring for these athletes to see if you have a shoulder instability episode, you are still lost to the fight for a year,” Tokish told Healio.
Through a combination of “bench-to-bedside research,” Provencher said the group was able to identify how to assess the pathology of shoulder dislocations, including extensive labral tears, cartilage injuries, glenoid bone loss, Hill-Sachs lesions of the humerus, humeral bone loss, capsular injuries and capsular tears.
“Our goal was always to restore the anatomy, and I think that is a significant portion of the legacy of this research is how we truly understand the patient’s history, their physical exam, interpreting multimodal imaging findings and then putting it together to optimize an individual’s overall treatment for shoulder instability,” Provencher said.
Although the research team has made “great strides” in how glenoid bone loss impacts shoulder instability, Tokish said there are still issues regarding resorption. He also said more work needs to be done on the humeral side of the shoulder, especially when large Hill-Sachs lesions are involved.
“We have techniques that are out there to address [Hill-Sachs lesions]. The remplissage has been seminal, but the remplissage does not work in all cases. There are lesions that are too big for that,” Tokish said. “We have techniques that graft it or replace it or address it, but I do not think any of us would say that we have solved that puzzle yet.”
Hardware is another challenge to be solved, according to Tokish. With surgeons moving away from using screws due to hardware complications, Tokish said more research is needed on soft tissues and buttons.
“Shoulder instability is an incredibly humbling diagnosis to follow the path on because you answer one question, and it raises a few others,” Tokish said. “We are still not perfect there, but we are greatly improved, and we have a roadmap.”
Elizabeth Winston Lanier Award
The Kappa Delta Elizabeth Winston Lanier Award was presented to Brian T. Feeley, MD, FAAOS, and colleagues for research in fatty infiltration and muscle degeneration in rotator cuff injuries and impact of these factors on repair outcomes, according to a press release from the AAOS.
The release noted that Feeley and colleagues identified a link between the Akt/mTOR molecular pathway and fatty infiltration, which was inhibited with daily administration of 1.5 mg/kg of rapamycin, in a mouse model.
“Once we had good animal models that allowed us to look at what cells were responsible for turning into fat, we eventually identified, first in mice and then in humans, that there is a cell population that is called a fibro-adipogenic progenitor, or FAP, and had been described by a group out of Japan in other disease conditions to turn into fat,” Feeley, professor of orthopedic surgery, sports medicine and shoulder surgery at the University of California, San Francisco, told Healio.
However, FAPs may also be able to provide regenerative and pathologic responses to muscle injury by delivering extracellular vesicle-associated markers to promote muscle regeneration, according to the release.
“[FAPs] put in different microRNAs that send a signal to satellite cells and other muscle progenitors to become more active and to proliferate and make more muscle,” Feeley said. “It also allows the mitochondria within these cells to be transferred into other cells. It fundamentally takes the mitochondria from a resting state into a more active state when its delivered.”
Not only is this research helpful for treatment of rotator cuff tears but may also be translated for use anywhere muscle degeneration occurs, Feeley said.
“We think the ability to promote muscle regeneration, especially in our aging population, will have ideally broad implications to make people feel better and function at a higher level,” he said.
Young Investigator Award for Research
The Kappa Delta Young Investigator Award was presented to Nicolas S. Piuzzi, MD, and colleagues for optimizing outcomes and satisfaction after total hip and knee arthroplasty through advanced analytics with personalized outcome prediction tools.
“We want to try to create pathways so that we can counsel patients and guide them through this stressful and complicated process of surgery the safest that we can with the most predictable outcome,” Piuzzi, director of the Cleveland Clinic Adult Joint Reconstruction Research program, told Healio. “In that journey, we looked at how can we work on the shared decision-making in the preoperative, intraoperative and after care, integrating the best available data that we then create into models that can help us predict how the patient will do.”
Piuzzi said he hopes this research will help empower patients of all ages undergoing joint replacement and make the procedure safer.
“We hope that this provides a path where we can continue to expand on these and we can also raise awareness on the need that we have for increased funding for research and innovation in the field of musculoskeletal issues,” Piuzzi said. “That is important because if we look at musculoskeletal conditions, they are the number one burden of disability in our nation, which is tremendous, and the amount of health care spending in this is number one.”
In the future, Piuzzi said the goal is to expand this research to create prediction models for other orthopedic injuries and procedures, including osteoarthritis.
“At our center of excellence in osteoarthritis at the Cleveland Clinic, we are trying to, with a similar approach, understand why osteoarthritis happens and trying to develop new treatments so that hopefully we can start even earlier with interventions and we can save patients, hypothetically, from even having a joint replacement,” Piuzzi said. “The research pathway we are defining for that is working on creating and developing a true data analytic core center that we can incorporate all the machine learning, artificial intelligence and advanced analytics so that we can do that in a high throughput environment both for research and clinical practice.”
OREF Clinical Research Award
The Orthopaedic Research and Education Foundation (OREF) Clinical Research Award was presented to Brian J. Cole, MD, MBA, FAAOS, and colleagues for the advancement of osteochondral allograft transplantation to treat cartilage and bone defects in the knee, according to a release from the AAOS.
“We are honored given the past recipients of this award,” Cole, director of the Rush Cartilage Restoration Center and professor and acting chair in the department of orthopedics at Rush University Medical Center, told Healio. “It embodies more than 25 years of basic science and translational research as it relates to osteochondral allograft transplantation (OCA) for the treatment of articular cartilage disease of the knee.”
According to Cole, “an osteochondral allograft lends itself to several opportunities to perform translational research,” as there are many steps to be analyzed, from the time of acquisition to the time of implantation and even postoperatively as it relates to accelerated rehabilitation and return to sport.
“This summary of our work contains more than 100 papers, contributed to by more than100 investigators who are to be credited for doing the hard work to identify several key steps along the way that can be improved upon that we now implement today in the operating room and clinic,” Cole said.
While much of the research has focused on the fitness of the osteochondral allograft cartilage, Cole said future research will focus on qualitative, basic science or biochemical aspects of the subchondral bone and whether the interface between the host and donor site may lead to failure.
“Our next iteration of research is going to focus on the bone load-sharing principles, in addition to the cartilage, to identify where we can further impact patient outcomes for patients undergoing OCA,” Cole said.
References:
- AAOS names 2025 Kappa Delta Ann Doner Vaughn Award winner for 25-year anterior shoulder instability research. https://www.aaos.org/aaos-home/newsroom/press-releases/2025-kappa-delta-ann-doner-vaughn-award. Published Feb. 7, 2025. Accessed Feb. 19, 2025.
- Kappa Delta Elizabeth Winston Lanier Award recognized Brian T. Feeley, MD, FAAOS, for groundbreaking research on rotator cuff repair. https://www.aaos.org/aaos-home/newsroom/press-releases/2025-kappa-delta-elizabeth-winston-lanier-award. Published Feb. 7, 2025. Accessed Feb. 19, 2025.
- Nicolas S. Piuzzi, MD, presented Kappa Delta Young Investigator Award for research on employing data analytics to improve patient outcomes. https://www.aaos.org/aaos-home/newsroom/press-releases/2025-kappa-delta-young-investigator-award. Published Feb. 7, 2025. Accessed Feb. 19, 2025.
- OREF Clinical Research Award presented to Brian J. Cole, MD, MBA, FAAOS, for 25 years of basic science, clinical research leading to optimized patient outcomes follow osteochondral allograft transplantation. https://www.aaos.org/aaos-home/newsroom/press-releases/2025-oref-clinical-research-award. Published Feb. 7, 2025. Accessed Feb. 19, 2025
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