Skip to main content

Orthopaedic Research in the Year 2020

  • Chapter
  • First Online:
Sports Injuries

Abstract

By the year 2020, it is anticipated that telemedicine will become widely available so that special medical and surgical expertise can be made available worldwide. Also, novel imaging technologies will further increase our diagnostic capabilities dramatically. These and other new technologies will no doubt enhance the diagnostic aspect of medicine. However, effective treatment of diseases will continue to be lacking as it is much slower and more challenging to develop. In other words, there will be huge opportunities for scientific and clinical investigators to reduce the gap between diagnosis and treatment. In this chapter, we will review the history of the practice of orthopaedic surgery and how fundamental research had helped surgeons and rehabilitation technologists, especially those involved in the practice of sports medicine. We will then give examples of current advances made on healing of tendons and ligaments especially those by functional tissue engineering and how it has played a major role in translating the laboratory findings to the clinics. Finally, as scientific research is becoming more sophisticated as well as multidisciplinary, we identify key areas of research that would deserve our focus and suggest how the specialty laboratories should be organized to conduct collaborative work effectively.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Abramowitch, S.D., Papageorgiou, C.D., Withrow, J.D., Gilbert, T.W., Woo, S.L.: The effect of initial graft tension on the biomechanical properties of a healing ACL replacement graft: a study in goats. J. Orthop. Res. 21(4), 708–715 (2003)

    Article  PubMed  Google Scholar 

  2. Birk, D.E.: Type V collagen: heterotypic type I/V collagen interactions in the regulation of fibril assembly. Micron 32(3), 223–237 (2001)

    Article  PubMed  CAS  Google Scholar 

  3. Caplan, A.I.: Mesenchymal stem cells: cell-based reconstructive therapy in orthopedics. Tissue Eng. 11(7–8), 1198–1211 (2005)

    Article  PubMed  CAS  Google Scholar 

  4. Caplan, A.I., Bruder, S.P.: Mesenchymal stem cells: building blocks for molecular medicine in the 21st century. Trends Mol. Med. 7(6), 259–264 (2001)

    Article  PubMed  CAS  Google Scholar 

  5. Caplan, A.I., Haynesworth, S.E.: Method for enhancing the implantation and differentiation of marrow-derived mesenchymal cells. Patent No. 5,197,985, 30 Mar 1993

    Google Scholar 

  6. Caplan, A.I., Koutroupas, S.: The control of muscle and cartilage development in the chick limb: the role of differential vascularization. J. Embryol. Exp. Morphol. 29(3), 571–583 (1973)

    PubMed  CAS  Google Scholar 

  7. Daniel, D.M., Stone, M.L., Dobson, B.E., Fithian, D.C., Rossman, D.J., Kaufman, K.R.: Fate of the ACL-injured patient – a prospective outcome study. Am. J. Sports Med. 22(5), 632–644 (1994)

    Article  PubMed  CAS  Google Scholar 

  8. Drogset, J.O., Grontvedt, T., Robak, O.R., Molster, A., Viset, A.T., Engebretsen, L.: A sixteen-year follow-up of three operative techniques for the treatment of acute ruptures of the anterior cruciate ligament. J. Bone Joint Surg. Am. 88A(5), 944–952 (2006)

    Article  Google Scholar 

  9. Erickson, R.R.: Holographic medical imaging: the laser as a visual scalpel – issues and observations on 3-D display. IEEE J. Sel. Top. Quantum Electron. 2(4), 976–983 (1996)

    Article  CAS  Google Scholar 

  10. Evans, C.H., Ghivizzani, S.C., Robbins, P.D.: Orthopedic gene therapy in 2008. Mol. Ther. 17(2), 231–244 (2009)

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Evans, C.H., Mankin, H.J., Ferguson, A.B., Robbins, P.D., Ghivizzani, S.C., Herndon, J.H., Kang, R., Tomaino, M.M., Wright, T.M.: Clinical trial to assess the safety, feasibility, and efficacy of transferring a potentially anti-arthritic cytokine gene to human joints with rheumatoid arthritis. Hum. Gene Ther. 7(10), 1261–1280 (1996)

    Article  PubMed  CAS  Google Scholar 

  12. Fithian, D.C., Paxton, E.W., Stone, M.L., Luetzow, W.F., Csintalan, R.P., Phelan, D., Daniel, D.M.: Prospective trial of a treatment algorithm for the management of the anterior cruciate ligament-injured knee. Am. J. Sports Med. 33(3), 335–346 (2005)

    Article  PubMed  Google Scholar 

  13. Franklin Jr., M.E., Gonzalez Jr., J.J., Glass, J.L.: Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2-year follow-up. Hernia 8(3), 186–189 (2004)

    Article  PubMed  Google Scholar 

  14. Friedmann, T.: A brief-history of gene-therapy. Nat. Genet. 2(2), 93–98 (1992)

    Article  PubMed  CAS  Google Scholar 

  15. Fujie, H., Livesay, G.A., Woo, S.L., Kashiwaguchi, S., Blomstrom, G.: The use of a universal force-moment sensor to determine in-situ forces in ligaments: a new methodology. J. Biomech. Eng. 117(1), 1–7 (1995)

    Article  PubMed  CAS  Google Scholar 

  16. Hodde, J.P., Record, R.D., Liang, H.A., Badylak, S.F.: Vascular endothelial growth factor in porcine-derived extracellular matrix. Endothelium 8(1), 11–24 (2001)

    PubMed  CAS  Google Scholar 

  17. Hodde, J., Record, R., Tullius, R., Badylak, S.: Fibronectin peptides mediate HMEC adhesion to porcine-derived extracellular matrix. Biomaterials 23(8), 1841–1848 (2002)

    Article  PubMed  CAS  Google Scholar 

  18. Kaiser, J.: Clinical research: death prompts a review of gene therapy vector. Science 317(5838), 580 (2007)

    Article  PubMed  CAS  Google Scholar 

  19. Karaoglu, S., Fisher, M.B., Woo, S.L.-Y., Fu, Y.C., Liang, R., Abramowitch, S.D.: Use of a bioscaffold to improve healing of a patellar tendon defect after graft harvest for ACL reconstruction: a study in rabbits. J. Orthop. Res. 26(2), 255–263 (2008)

    Article  PubMed  Google Scholar 

  20. Knoll, L.D.: Use of porcine small intestinal submucosal graft in the surgical management of tunical deficiencies with penile prosthetic surgery. Urology 59(5), 758–761 (2002)

    Article  PubMed  Google Scholar 

  21. Koschwanez, H.E., Reichert, W.M.: In vitro, in vivo and post explantation testing of glucose-detecting biosensors: current methods and recommendations. Biomaterials 28(25), 3687–3703 (2007)

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  22. Liang, R., Abramowitch, S., Moon, D. K., and Woo, S. L. Y.: A bioscaffold can enhance the healing of medial collateral ligament: a multidisciplinary functional tissue engineering study, Achilles Orthopaedic Sports Medicine Research Award paper in ISAKOS 5th Biennial CongressHollywood, 2005

    Google Scholar 

  23. Liang, R., Woo, S.L., Nguyen, T.D., Liu, P.C., Almarza, A.: Effects of a bioscaffold on collagen fibrillogenesis in healing medial collateral ligament in rabbits. J. Orthop. Res. 26(8), 1098–1104 (2008)

    Article  PubMed  CAS  Google Scholar 

  24. Marescaux, J., Leroy, J., Gagner, M., Rubino, F., Mutter, D., Vix, M., Butner, S.E., Smith, M.K.: Transatlantic robot-assisted telesurgery. Nature 413(6854), 379–380 (2001)

    Article  PubMed  CAS  Google Scholar 

  25. Mazzu, M., Scalvini, S., Giordano, A., Frumento, E., Wells, H., Lokhorst, K., Glisenti, F.: Wireless-accessible sensor populations for monitoring biological variables. J. Telemed. Telecare 14(3), 135–137 (2008)

    Article  PubMed  Google Scholar 

  26. Miller, A.D.: Human gene-therapy comes of age. Nature 357(6378), 455–460 (1992)

    Article  PubMed  CAS  Google Scholar 

  27. Mostofi, S.B. (ed.): Who’s Who in Orthopedics. Springer, London (2005)

    Google Scholar 

  28. Murray, M.M., Palmer, M., Abreu, E., Spindler, K.P., Zurakowski, D., Fleming, B.C.: Platelet-rich plasma alone is not sufficient to enhance suture repair of the ACL in skeletally immature animals: an in vivo study. J. Orthop. Res. 27(5), 639–645 (2009)

    Article  PubMed  PubMed Central  Google Scholar 

  29. Murray, M.M., Spindler, K.P., Abreu, E., Muller, J.A., Nedder, A., Kelly, M., Frino, J., Zurakowski, D., Valenza, M., Snyder, B.D., Connolly, S.A.: Collagen-platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament. J. Orthop. Res. 25(1), 81–91 (2007)

    Article  PubMed  Google Scholar 

  30. Murray, M.M., Spindler, K.P., Ballard, P., Welch, T.P., Zurakowski, D., Nanney, L.B.: Enhanced histologic repair in a central wound in the anterior cruciate ligament with a collagen-platelet-rich plasma scaffold. J. Orthop. Res. 25(8), 1007–1017 (2007)

    Article  PubMed  CAS  Google Scholar 

  31. Musahl, V., Abramowitch, S.D., Gilbert, T.W., Tsuda, E., Wang, J.H., Badylak, S.F., Woo, S.L.: The use of porcine small intestinal submucosa to enhance the healing of the medial collateral ligament–a functional tissue engineering study in rabbits. J. Orthop. Res. 22(1), 214–220 (2004)

    Article  PubMed  Google Scholar 

  32. O’Connor, R.C., Harding III, J.N., Steinberg, G.D.: Novel modification of partial nephrectomy technique using porcine small intestine submucosa. Urology 60(5), 906–909 (2002)

    Article  PubMed  Google Scholar 

  33. Ohlsson, A., Kubo, S.H., Steinhaus, D., Connelly, D.T., Adler, S., Bitkover, C., Nordlander, R., Ryden, L., Bennett, T.: Continuous ambulatory monitoring of absolute right ventricular pressure and mixed venous oxygen saturation in patients with heart failure using an implantable haemodynamic monitor – results of a 1 year multicentre feasibility study. Eur. Heart J. 22(11), 942–954 (2001)

    Article  PubMed  CAS  Google Scholar 

  34. Owen, M., Friedenstein, A.J.: Stromal stem cells: marrow-derived osteogenic precursors. Ciba Found. Symp. 136, 42–60 (1988)

    PubMed  CAS  Google Scholar 

  35. Papageorgiou, C.D., Ma, C.B., Abramowitch, S.D., Clineff, T.D., Woo, S.L.: A multidisciplinary study of the healing of an intraarticular anterior cruciate ligament graft in a goat model. Am. J. Sports Med. 29(5), 620–626 (2001)

    PubMed  CAS  Google Scholar 

  36. Pearse, R.V., Esshaki, D., Tabin, C.J., Murray, M.M.: Genome-wide expression analysis of intra- and extraarticular connective tissue. J. Orthop. Res. 27(4), 427–434 (2009)

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  37. Rashvand, H.F., Salcedo, V.T., Sanchez, E.M., Iliescu, D.: Ubiquitous wireless telemedicine. IET Commun. 2(2), 237–254 (2008)

    Article  Google Scholar 

  38. Schultz, D.J., Brasel, K.J., Spinelli, K.S., Rasmussen, J., Weigelt, J.A.: Porcine small intestine submucosa as a treatment for enterocutaneous fistulas. J. Am. Coll. Surg. 194(4), 541–543 (2002)

    Article  PubMed  Google Scholar 

  39. Selmi, T.A.S., Fithian, D., Neyret, P.: The evolution of osteoarthritis in 103 patients with ACL reconstruction at 17 years follow-up. Knee 13(5), 353–358 (2006)

    Article  Google Scholar 

  40. September, A.V., Schwellnus, M.P., Collins, M.: Tendon and ligament injuries: the genetic component. Br. J. Sports Med. 41(4), 241–246 (2007)

    Article  PubMed  PubMed Central  Google Scholar 

  41. Steadman, J.R., Cameron-Donaldson, M.L., Briggs, K.K., Rodkey, W.G.: A minimally invasive technique (“healing response”) to treat proximal ACL injuries in skeletally immature athletes. J. Knee Surg. 19(1), 8–13 (2006)

    PubMed  Google Scholar 

  42. Voytik-Harbin, S.L., Brightman, A.O., Kraine, M.R., Waisner, B., Badylak, S.F.: Identification of extractable growth factors from small intestinal submucosa. J. Cell. Biochem. 67(4), 478–491 (1997)

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Savio L.-Y. Woo .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Woo, S.LY., Kim, K.E. (2012). Orthopaedic Research in the Year 2020. In: Doral, M. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15630-4_160

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-15630-4_160

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-15629-8

  • Online ISBN: 978-3-642-15630-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics