Our research aims to reduce the burden of musculoskeletal diseases for individuals and society. We approach this broad scientific goal through a range of research designs and traditions.
The Osteoarthritis Policy Model (PI Dr. Losina) is our state-transition computer simulation model of the natural history of knee osteoarthritis (OA) and the economic and symptomatic impacts of various preventive measures and treatments. Our current funding cycle focuses primarily on concomitant co-morbid conditions in relation to knee OA. Analyses in this cycle of work will incorporate pain phenotypes, weight management strategies (surgical and non-surgical) and physical activity programs. The OAPol model has enabled us to perform innovative research that informs policymaking. Our analyses have covered such diverse topics as: the cost effectiveness of OA prevention and treatment strategies including obesity management, injury prevention, and total knee replacement; the potential cost effectiveness of disease modifying OA drugs (DMOADs); and the total economic and quality of life burden of knee OA in the US. You can learn more about our ongoing analyses here and our previously published analyses here.
Two of our ongoing Investigator-Initiated and coordinated clinical studies concern treatment of meniscal tear, a common injury in knee OA patients. TeMPO (Treatment of Meniscal Problems in Osteoarthritis; PI Dr. Katz) is a 4-arm randomized controlled trial (RCT) that examines the outcomes associated with various physical therapy (PT) regimens in patients with OA and meniscal tear. The trial aims to answer several key questions regarding the efficacy of PT, including how much of a PT regimen’s efficacy can be attributed to the psychological effects of working closely with a therapist, to the physiologic effects of exercise, or to spontaneous improvement. The study is currently recruiting across four academic medical centers across the United States.
The MeTeOR Trial (Meniscal Tear in Osteoarthritis Research; PI Dr. Katz) is a seven-center NIH-funded RCT that randomized subjects with OA and meniscal tear to undergo arthroscopic partial meniscectomy (APM) or receive structured. PT. Over 350 participants were randomized into the MeTeOR trial between 2008 and 2011. We followed these subjects through five years post-randomization. Publications using the data gathered through these first five years of follow-up have informed current guidelines for treatment of patients with meniscal tear and OA. Our current funding will allow us to re-contact the original MeTeOR cohort to collect one final set of knee images (MRI and x-rays) and to assess current health states and knee-related symptoms. We anticipate that the 12-year follow-up of the MeTeOR cohort will provide greater clarity about the long-term symptomatic and structural outcomes of APM vs. PT and elucidate any possible link between short-term OA progression and long-term pain and function.
With support from Biosplice, a private biopharmaceutical company studying OA, we are also conducting the ORBIT study (Osteoarthritis Registry of Biomarkers and Imaging Trajectories; PI Dr. Katz, Medical Director, Dr. MacFarlane). The goal of this study is to guide new therapies with a better understanding of how knee OA evolves over time and affects both the knee joint structures as well as the wellbeing of those with knee OA. The registry is following a cohort of 100 participants with symptomatic and radiographic knee OA to gather data from MRIs, x-rays, a musculoskeletal exam, bio-sample collection, and questionnaires about their knee symptoms.
Mentorship and methodologic rigor are fundamental tenets of the OrACORe ethos. Dr. Losina leads the Methodology Core of an NIH P30 Center Grant VERITY (Value and Evidence in Rheumatology using bioinformaTics and advanced analYtics). The core’s primary mission is to ensure methodological rigor in the design and implementation of MSK-related research studies and to develop and advance methods that optimize the design and conduct of clinical trials. The COMET (Clinical and Orthopaedic Musculoskeletal Education and Training) Program, co-directed by Drs. Katz and Losina strives to train clinical researchers to address the growing national and global burden of musculoskeletal (MSK) disorders by conducting rigorous clinical research that seeks to better understand, prevent, and treat these disorders. COMET is a NIAMS-sponsored T-32 program that currently supports 2 pre-doctoral and 3 post-doctoral trainees each year.
We coordinate the PRIDE program in the Department of Orthopedic Surgery at Brigham and Women’s Hospital (Program for Research Incubation and Development). This program enables faculty in the Orthopedics Department to collaborate with OrACORe personnel to advance their clinical research ideas forward. OrACORe faculty and staff typically provide expertise in study design, data management, data analysis, and the interpretation of study findings involving PRIDE projects.
This is just a preview of the research in which we are involved. For a complete list of our ongoing projects, some of which have not been mentioned above, visit our directory. We invite you to explore our myriad studies and programs at OrACORe!