There is substantial interest in using biologics to reduce body and joint pain and to accelerate healing from orthopaedic injuries and surgery1,2. Musculoskeletal problems attributed to injuries and aging are the leading cause of disability in the United States3. In recent years, there has been an exponential rise in the use of biologics to treat orthopaedic problems. This rise is primarily due to widespread use of ?minimally manipulated? autologous therapies such as platelet rich plasma (PRP), that are not required to undergo pre-market approval/clearance from the Food and Drug Administration1. Consequently, clinical use of these treatments has greatly outpaced evidence based research. Concerns over misinformation and patient safety have led to recent calls to action, including one from the American Association for the Advancement of Science5. The orthopaedic professional societies and research communities share these concerns. To address these concerns, Optimizing Clinical Use of Biologics in Orthopaedic Surgery Research Symposium will be a collaborative and interactive meeting to develop a collective impact agenda to promote informed regulation and funding of new pathways for the clinical evaluation of biologics. Specifically, the symposium aims to determine candidate biologic targets for common orthopaedic conditions and injuries, identify a process to determine what is known about the composition and biologic activity of biologics using PRP as a model, determine the feasibility of establishing a clinical registry to collect data on the use of biologics, and identify regulatory pathways to facilitate their use. Symposium faculty and participants will consider clinical trial designs to include use of adaptive clinical trials to test the efficacy of PRP. A combination of didactic talks presented by subject matter experts followed by small group discussions modeled after the NIH/NIAMS Roundtable format will be used to achieve the aims. Symposium participants will be comprised of orthopaedic physicians, the scientific community including NIH and FDA, and young investigators whose research focuses on biologics. The general sessions of the symposium will be open to registrants. The resultant consensus documents, including draft guidance on clinical assessment of biologics that can impact regulatory pathways, are of critical importance to implementing a framework for responsible and evidence based translation of new biologic treatments into clinical use to treat orthopaedic problems. These outcomes serve the public interest and have high potential to positively impact patient care and public health.
There is substantial interest in using biologics to reduce body and joint pain and to accelerate healing from orthopaedic injuries and surgery. While clinics across the country advertise these treatments for orthopaedic problems, there is not enough evidence to show what treatments are likely to benefit which patients. The goal of the AAOS Optimizing Clinical Use of Biologics in Orthopaedic Surgery Research Symposium is to bring clinical leaders, and scientists from academia and government together to develop a collective impact agenda for clinical evaluation of efficacy, indications, and optimization of biologic treatments for common orthopaedic problems.
| Williams, A A; Titchenal, M R; Andriacchi, T P et al. (2018) MRI UTE-T2* profile characteristics correlate to walking mechanics and patient reported outcomes 2 years after ACL reconstruction. Osteoarthritis Cartilage 26:569-579 |
