Research Program

Featured Articles

Ulbrecht JS, Hurley T, Mauger DT, Cavanagh PR.

In a recent publication of Diabetes Care, Department of Orthopaedics and Sports Medicine Faculty member Peter Cavanagh assessed the efficacy of in-shoe orthoses that were designed based on shape and barefoot plantar pressure in reducing the incidence of submetatarsal head plantar ulcers in people with diabetes, peripheral neuropathy, and a history of similar prior ulceration.

In a single-blinded multicenter randomized controlled trial, subjects were randomized to wear shape- and pressure-based orthoses (experimental, n = 66) or standard-of-care A5513 orthoses (control, n = 64). Patients were followed for 15 months, until a study end point (forefoot plantar ulcer or nonulcerative plantar forefoot lesion) or to study termination. Proportional hazards regression was used for analysis.

There was a trend in the composite primary end point (both ulcers and nonulcerative lesions) across the full follow-up period (P = 0.13) in favor of the...


Schmale GA, Kweon C, Larson RV, Bompadre V.
Clin Orthop Relat Res. 2014 Jul;472(7):2168-74. doi: 10.1007/s11999-014-3561-6. Epub 2014 Mar 15.

UW Orthopaedics and Sports Medicine faculty members performed a retrospective review of 29 patients who underwent transphyseal ACL reconstruction using soft tissue grafts passed through open physes and followed to skeletal maturity, and at least 2 years from their index surgery, who were invited and returned for a study interview and examination. Pre- and postinjury activity levels were assessed via the Tegner activity score, satisfaction was determined using a 10-point Likert scale, function was assessed via the Lysholm score and IKDC grade, and an open-ended questionnaire was used for explanations of changes in activity levels. Reoperations were classified as major or minor, determined from a review of the medical records conducted after interview and examination.

At a minimum follow up of 2 years (mean, 4 years; range, 2-8 years), four revision reconstructions and seven minor operations were performed for a reoperation rate of 11 of 29 (38%). Eight of 29...


Gundle KR, Cizik AM, Punt SE, Conrad EU 3rd, Davidson DJ.
Sarcoma. 2014;2014:450902. doi: 10.1155/2014/450902. Epub 2014 Mar 19.

In a recent publication in Sarcoma, UW Orthopaedics faculty, staff, and residents,sought to describe a psychometric evaluation of the SF-6D in a cross-sectional population of lower extremity sarcoma patients.

In 63 pairs of surveys in a lower extremity sarcoma population, the mean preference-weighted SF-6D score was 0.59 (95% CI 0.4-0.81). The distribution of SF-6D scores approximated a normal curve (skewness = 0.11). There was a positive correlation between the SF-6D and TESS (r = 0.75, P < 0.01). Respondents who reported walking aid use had lower SF-6D scores (0.53 versus 0.61, P = 0.03). Five respondents underwent amputation, with lower SF-6D scores that approached significance (0.48 versus 0.6, P = 0.06).

The SF-6D health state utilities measure demonstrated convergent validity without evidence of ceiling or...


Recidoro AM, Roof AC, Schmitt M, Worton LE, Petrie T, Strand N, Ausk BJ, Srinivasan S, Moon RT, Gardiner EM, Kaminsky W, Bain SD, Allan CH, Gross TS, Kwon RY.
J Bone Miner Res. 2014 May 7. doi: 10.1002/jbmr.2274. [Epub ahead of print]

JMBR-Kwon-articleIn a recent article in the Journal of Bone and Mineral Research, researchers from the Orthopaedics Research Lab developed a model of Botulinum toxin (BTx)-induced muscle paralysis in adult zebrafish and examined its effects on intramembranous ossification during tail fin regeneration.

Intramuscular administration of BTx has been associated with impaired osteogenesis in diverse conditions of bone formation (e.g., development, growth, and healing), yet the mechanisms of neuromuscular-bone crosstalk underlying these deficits have yet to be identified. Motivated by the emerging utility of zebrafish (Danio rerio) as a rapid, genetically tractable, and optically transparent...


Kollitz KM, Parsons EM, Weaver MS, Huang JI.
Hand (N Y). 2014 Jun;9(2):217-24. doi: 10.1007/s11552-013-9583-9.

A team of researchers at the Department of Orthopaedics and Sports Medicine—led by faculty member, Jerry Huang, and visiting medical student Katie Kollitz —has evaluated the effect of Platelet-rich plasma (PRP) on healing in a rabbit zone II flexor tendon model.  PRP has previously shown promise in the treatment of tendinopathy, including rotator cuff and lateral epicondylitis.

There were no significant differences in ultimate tensile strength between treatments at 2, 4, or 8 weeks. There was a trend towards lower tensile strength in the PRP group at 2 weeks. There was no statistically significant difference in excursion or range of motion between PRP and control tendons. Cell counts at 4 weeks were statistically significantly reduced in the PRP tendons as compared to controls. No difference in collagen content or maturity was detected.

In contrast to previous studies, PRP did not significantly improve ultimate tensile strength. PRP-...


Kim JE, Lee SM, Kim SH, Tatman P, Gee AO, Kim DH, Lee KE, Jung Y, Kim SJ.
Int J Nanomedicine. 2014 May 7;9 Suppl 1:141-57. doi: 10.2147/IJN.S54114. eCollection 2014.

In a recent article, faculty member Albert Gee and his colleagues from the Department of Orthopaedics and Sports Medicine evaluated the efficacy of mesenchymal stem cells (MSCs) encapsulated in self-assembled peptide (SAP) hydrogels in a rat knee model for the prevention of osteoarthritis (OA) progression.

Concentration of biotinylated SAP at week 1 was not significantly different from those at week 3 and week 6 (P=0.565). Bone mineral density was significantly lower in SAP-MSC groups than controls (P=0.002). Significant differences in terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling staining between the control group and all other groups were observed. Caspase-8, tissue inhibitor of metalloproteinases 1, and matrix metalloproteinase 9 were diffusely stained in controls, whereas localized or minimal staining was observed in other groups. Modified Mankin scores were significantly lower in the SAP and SAP-MSC groups than in...


Bone marrow- or vessel wall-derived osteoprotegerin is sufficient to reduce atherosclerotic lesion size and vascular calcification. Callegari A, Coons ML, Ricks JL, Yang HL, Gross TS, Huber P, Rosenfeld ME, Scatena M. Arterioscler Thromb Vasc Biol. 2013 Nov;33(11):2491-500. doi: 10.1161/ATVBAHA.113.301755. Epub 2013 Aug 29. PMID: 23990207

Vascular calcification refers to the mineralization of ectopic soft tissue in the walls of vessels in the vasculature system.  Of most concern is arterial wall mineralization, which is present in a majority of patients affected by cardiovascular disease. Osteoprotegerin (OPG) is a protein known to be involved in regulating bone homeostasis but has also been shown to play a controversial role in vascular calcification.  Researchers at the UW’s Department of Orthopaedics and Sports Medicine and Department of Bioengineering have found that OPG can strongly inhibit calcium...


Burst fractures of the lumbar spine in frontal crashes

Kaufman RP, Ching RP, Willis MM, Mack CD, Gross JA, Bulger EM. Accid Anal Prev. 2013 Oct;59:153-63. doi: 10.1016/j.aap.2013.05.023. Epub 2013 Jun 3. PMID: 2379261

Researchers at the Harborview Injury Prevention and Research Center examined the types of motor vehicle accidents that can cause major compression lumbar spine (MCLS) fractures.  Compression and burst fractures of the lumbar spine are defined as a > 20% loss in height.  In the US, these types of injuries continue to occur despite improvements in restraint technology.  Researchers examined databases from the National Automative Sampling System (NASS) and Crash Injury Research and Engineering Network (CIREN) to examine biomechanical data and mechanism of injury for patients who have suffered MCLS fractures.  Study investigators found that frontal...


ESET histone
methyltransferase is essential to hypertrophic differentiation of growth plate
chondrocytes and formation of epiphyseal plates

Yang L, Lawson KA, Teteak CJ, Zou J, Hacquebord J, Patterson D, Ghatan AC,
Mei Q, Zielinska-Kwiatkowska A, Bain SD, Fernandes
, Chansky HA. Dev Biol. 2013
May 4. doi:pii: S0012-1606(13)00225-X. 10.1016/j.ydbio.2013.04.031. [Epub ahead
of print] PMID: 23652029

 A team of researchers at the Department of Orthopaedics
and Sports Medicine—led by faculty member, Liu Yang—have discovered that the
protein ESET is fundamentally important in skeletal development.  ESET is a histone methyltransferase that
catalyzes methylation of histones on DNA. 
Their study used knock-out mice that were deficient in the ESET protein.  Comparisons with wild type mice found several
key differences in the knock-out...


Bone Collagen: New
Clues to Its Mineralization Mechanism from Recessive Osteogenesis Imperfecta.

Eyre DR, Weis MA. Calcif Tissue Int. 2013 Mar 19. [Epub ahead of print] PMID:


In this review
article, Dr. David Eyre and Mary Ann Weis (part of the Collagen
Biology and Genetic Disorders Lab
) discuss the mechanism behind bone
collagen mineralization by examining recent findings about the genetic disorder
osteogensis imperfecta.

Osteogenesis Imperfecta (OI) is a congenital bone
disorder that is commonly known as “brittle bone disease.”  OI causes bones to fracture easily; it can
cause loose joints, short stature and severe bone deformation.   It is caused by the inadequate formation of


KK, Sousa T., J Am Acad Orthop Surg. 2013 Jan;21(1):12-22. doi:
10.5435/JAAOS-21-01-12. PMID: 23281467

Orthopaedics and Sports Medicine faculty, Klane White, and resident, Ted Sousa,
published a review article about a rare family of genetic disorders,
mucopolysaccharidoses (MPSs).  There are
seven distinct types of MPS that show similar clinical symptoms but range in
severity.  MPSs are disorders
characterized by the cell’s inability to degrade glycoaminoglycans (GAGs), long
chains of sugar molecules that are the normal byproducts of cells.  This inability is attributed to the lack of
or malfunction of lysosomal enzymes that normally serve to break these
byproducts down.  Since the body is no
longer able to break down GAGs, these accumulate in cells, disrupt normal
cellular function and have a system wide effect on mental development, physical
appearance and organ function. 

to the authors, skeletal abnormalities are early and prominent features of MPS,
and the orthopaedic surgeon is often the first healthcare...