Bauer, Knothe, Midura, Muschler
Osteoporosis, often considered a national epidemic,
and other bone deficiencies are costly
in human and monetary terms. The Cleveland
Clinic considers this area among its highest
research priorities.
Severe osteoporosis strikes 15 percent of women and 8 percent of men during their lifetimes, causing painful fractures and deformities that dramatically decrease the quality of life.
More than 500,000 patients nationwide need bone grafts each year to treat fractures, to achieve effective spinal fusions or to heal disabling skeletal defects. For half of these patients, bone must be “harvested” from their pelvis to serve as a graft, which may result in additional scarring, blood loss, and chronic pain.
The Center’s leadership role in the application of minimally invasive cell-therapy strategies is enhancing the efficacy of bone grafting procedures and reducing their complications. But researchers are not resting on their laurels. Our bone biology investigators are developing fully implantable devices that use the process of "distraction osteogenesis" to regenerate bone segments. This process grows new bone across a gap caused by removal of a tumor, for instance. It may also be used to correct orthopaedic birth defects without cumbersome and painful external frames.
Our biomechanics group is examining the causes of falls in the elderly population and the risk factors for fracture from falls. They are investigating changes in the structures of the foot that lead to tissue breakdown in diabetic patients, as well as ways to minimize lower extremity deconditioning from disuse or "microgravity."
While bone is often considered to be relatively impermeable, our investigators have shown that bone has an entire microanatomy that allows chemical and electrical signals, along with nutrients, to be transported through it. This has tremendous promise for improving bone-healing, for developing innovative drug-delivery systems, and for preventing osteoporosis.
Improved screening for osteoporosis is a necessity, and physicians have implemented an innovative screening system at The Cleveland Clinic. Anyone with a hip fracture undergoes a comprehensive,multidisciplinary screening and an intervention program to treat osteoporosis or any other underlying bone disease and to reduce the significant risk for additional fractures.
Normal skeletal growth in children requires precise programming of the cells in the growth plate cartilages that provide the templates for bone formation. Skeletal growth anomalies and deformities occur when the programming is impaired. Pioneering Center investigators are identifying the factors responsible for this programming and their mechanisms of action.
