Musculoskeletal (MSK) disorders and particularly osteoarthritis (OA) are a major source of pain, functional impairment, and worsening quality of life across all age groups. Total knee replacement (TKR) is a costly, frequent intervention for knee OA. Its success is generally measured on the basis of implant longevity and pain relief. However, compelling evidence that moderate physical activity enhances overall health indicates that the value of TKR could be increased substantially if TKR recipients engaged in adequate levels of physical activity after rehabilitating from their surgeries. The evidence base in MSK and orthopedic clinical science has substantial gaps. I have devoted the last 15 years to addressing these research needs by designing rigorous patient-oriented research studies and mentoring younger clinical scientists. Through the next K24 cycle, I hope to continue to train young scientists in rigorous studies of MSK and orthopedic problems. In this competitive renewal application, I request five years of funding to enlarge and strengthen the mentoring and research programs.
Aim I : To further strengthen my research training program, which focuses on preparing young investigators for rigorous patient-oriented research on MSK and orthopedic disorders.
Aim II : To further develop a comprehensive patient-oriented research program in MSK and orthopedic disorders. I highlight two research studies in this proposal: Study 1: Portraying physical activity (PA) over 5 years among recipients of total knee replacement (TKR).
Aim 1. 1: To follow an established cohort of TKR recipients over 5 years to document long-term trajectories of engagement in PA.
Aim 1. 2: To determine risk factors for low or declining engagement in PA over 5 years post-TKR. Study 2: Raising awareness of knee OA and willingness to undertake behavioral changes to reduce the risk of knee OA.
Aim 2. 1. To develop an individualized web-based knee OA risk calculator that incorporates demographic and clinical factors to predict 5, 10, 15, 20, 25, 30-year and life time risk of symptomatic knee OA.
Aim 2. 2. To conduct a proof of concept randomized trial to establish whether the use of a knee OA risk calculator results in greater readiness for behavioral changes to reduce the risk of knee OA.

Public Health Relevance

Musculoskeletal and orthopedic problems are extremely common and disabling. Research on ways of preventing and treating these problems is sorely needed. I propose to further develop my patient-oriented research and mentoring programs so that I can continue to train younger investigators to perform cutting edge research on these important problems and so that I can continue to lead my own research, particularly in the areas of enhancing physical activity following total knee replacement and using innovative online tools to prevent osteoarthritis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AR057827-09
Application #
9418505
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Washabaugh, Charles H
Project Start
2010-02-01
Project End
2020-01-31
Budget Start
2018-02-01
Budget End
2019-01-31
Support Year
9
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Rajan, Prashant V; Qudsi, Rameez A; Wolf, Lindsey L et al. (2017) Cost-Effectiveness Analyses in Orthopaedic Surgery: Raising the Bar. J Bone Joint Surg Am 99:e71
Katz, Jeffrey N; Smith, Savannah R; Yang, Heidi Y et al. (2017) Value of History, Physical Examination, and Radiographic Findings in the Diagnosis of Symptomatic Meniscal Tear Among Middle-Aged Subjects With Knee Pain. Arthritis Care Res (Hoboken) 69:484-490
Smith, Savannah R; Katz, Jeffrey N; Collins, Jamie E et al. (2017) Cost-Effectiveness of Tramadol and Oxycodone in the Treatment of Knee Osteoarthritis. Arthritis Care Res (Hoboken) 69:234-242
MacFarlane, L A; Yang, H; Collins, J E et al. (2017) Associations among meniscal damage, meniscal symptoms and knee pain severity. Osteoarthritis Cartilage 25:850-857
Wolf, Lindsey L; Chowdhury, Ritam; Tweed, Jefferson et al. (2017) State-level geographic variation in prompt access to care for children after motor vehicle crashes. J Surg Res 217:75-83.e1
Wolf, Lindsey L; Chowdhury, Ritam; Tweed, Jefferson et al. (2017) Factors Associated with Pediatric Mortality from Motor Vehicle Crashes in the United States: A State-Based Analysis. J Pediatr 187:295-302.e3
Losina, Elena; Michl, Griffin L; Smith, Karen C et al. (2017) Randomized Controlled Trial of an Educational Intervention Using an Online Risk Calculator for Knee Osteoarthritis: Effect on Risk Perception. Arthritis Care Res (Hoboken) 69:1164-1170
Lape, Emma C; Katz, Jeffrey N; Losina, Elena et al. (2017) Participant-Reported Benefits of Involvement in an Adaptive Sports Program: A Qualitative Study. PM R :
Suter, Lisa G; Smith, Savannah R; Katz, Jeffrey N et al. (2017) Projecting Lifetime Risk of Symptomatic Knee Osteoarthritis and Total Knee Replacement in Individuals Sustaining a Complete Anterior Cruciate Ligament Tear in Early Adulthood. Arthritis Care Res (Hoboken) 69:201-208
Gedmintas, L; Wright, E A; Dong, Y et al. (2017) Factors associated with fractures in HIV-infected persons: which factors matter? Osteoporos Int 28:239-244

Showing the most recent 10 out of 119 publications