Research Musculoskeletal Research | Lerner Research Institute

Research Programs

Inflammatory Arthritis

The Inflammatory Arthritis research program focuses on biomarker discovery and novel imaging platforms to 1) establish early disease of immune mediated inflammatory arthritis, 2) improve stratification of patients with regard to disease burden and prognosis, and 3) improve upon therapeutic options to personalize treatment over the existing trial and error approach. To this end, we have built several disease specific biorepositories which contains over 15,000 samples to date. This biobank provides a valuable, ample resource for the investigation of mechanisms of disease, targeted therapeutics and identifying comorbidities associated with these conditions as well as discovery and validation of candidate biomarkers. Furthermore, we are refining imaging techniques in this patient population to allow for early detection of inflammatory changes as well as detecting active disease. Point-of-care novel imaging will enable future research on earlier diagnostic methods, identifying associated comorbidities, and improved treatment algorithms for immune mediated chronic inflammatory arthritis.

Research Program Faculty:

Elaine Husni, MD, MPH
Georgeanne Botek, DPM
Unni Chandrasekharan, PhD
Soumya Chatterjee, MD,FRCP
Jianguo Cheng, MD, PhD
Ceylan Colak, MD
Jason Genin, DO
Xiaojuan Li, PhD
Brian Mandell, MD, PhD
Sirada Panupattanapong, MD
Dominic Pelle, MD
Angela Robinson, MD
Carl Winalski, MD
Andrew Zeft, MD

Post-traumatic Osteoarthritis

The Post-traumatic Osteoarthritis research program focuses on identifying novel 'biomarkers' (risk factors) that provide reliable early diagnosis and prognosis of post-traumatic osteoarthritis (PTOA) development after joint injuries. Our multidisciplinary team investigates cohorts of human subjects as well as laboratory models of PTOA, using clinical and patient-reported outcomes, clinical and advanced quantitative imaging, gait analysis and biomechanical modeling. Conventional multivariate analysis as well as machine learning techniques are used to build models that predict long-term outcomes after injury and non-surgical or surgical interventions. By identifying modifiable predictors of PTOA development after joint injuries or surgery, our goals are to provide guidance for future development of novel interventions to reduce and prevent PTOA, help clinicians stratify subjects with regard to their individual risk of developing PTOA and improve clinical care in a directed and evidence-based way for this young and active population.

Research Program Faculty:

Xiaojuan Li, PhD
Suneel Apte, DPhil
Elise Baron, DEng
Gerald Beck, PhD
Jill Beveridge, PhD
Jianguo Cheng, MD, PhD
Ceylan Colak, MD
Robb Colbrunn, DEng
John Elias, PhD
Ahmet Erdemir, PhD
Lutul Farrow, MD
Jason Genin, DO
Peter Imrey, PhD
Atul Kamath, MD
George Muschler, MD
Nancy Obuchowski, PhD
Tammy Owings, DEng
Richard Parker, MD
Dominic Pelle, MD
Joshua Polster, MD
Kurt Spindler, MD
Naveen Subhas, MD
Carl Winalski, MD

Degenerative (Primary) Osteoarthritis

The Degenerative (Primary) Osteoarthritis research program focuses on understanding primary osteoarthritis at a basic level. Many features of osteoarthritis are similar in all patients. However, individual patients vary widely in the severity and underlying cause of joint degeneration. This personalize approach guides our work in developing novel approaches for diagnosis, patient assessment and treatment. We integrate several disciplines to prevent or delay the progression of the disease, and work on options for both surgical and non-surgical treatments. Our aim is to find treatments that prevent arthritis and restore joint function. Our team integrates basic science, translational and clinical research. This begins with novel tools for measurement of stem cells and progenitors, non-invasive structural and functional imaging, and molecular tools that illuminate the physiopathology and biomechanical factors that control joint development, healthy joint function and the onset and progression of disease.

Research Program Faculty:

George Muschler, MD
Suneel Apte, DPhil
Jill Beveridge, PhD
Gary Calabrese, DPT
Jianguo Cheng, MD, PhD
Ceylan Colak, MD
Robb Colbrunn, DEng
Mitali Das, PhD
John Elias, PhD
Ahmet Erdemir, PhD
Jason Genin, DO
Kush Goyal, MD
Jason Ho, MD
Atul Kamath, MD
Michael Kattan, PhD
Dominic King, DO
Xiaojuan Li, PhD
Anthony Miniaci, MD
Nancy Obuchowski, PhD
Richard Parker, MD
Dominic Pelle, MD
Nicolas Piuzzi, MD
Carl Winalski, MD

Arthroplasty

The Arthroplasty research program focuses on identifying the demographic, disease-related, and surgical factors associated with short- and longer-term clinical outcomes following joint arthroplasty of the hip, knee, and shoulder, including potentially modifiable factors.Our approach utilizes both retrospective and prospective arthroplasty cohorts at our institution to allow for investigation of both short and longer-term clinical outcomes in primary and revision arthroplasty surgery. Our aim is to advance clinical outcomes and implant survivorship in total joint arthroplasty, by improving clinical decision-making, patient selection, proactive management of social and disease-related variables, and by optimizing surgical methods and processes. We have developed and utilize unique research tools to achieve this aim, including synovial fluid biomarker analysis in the setting of periprosthetic joint infection and post-operative three-dimensional CT imaging analysis of implant position over time. Our research program involves collaboration of faculty across orthopaedic surgery, biomedical engineering, radiology, pathology, and biostatistics.

Research Program Faculty:

Eric Ricchetti, MD
Jarrod Dalton, PhD
Kathleen Derwin, PhD
Vahid Entezari, MD
Ahmet Erdemir, PhD
Carlos Higuera, MD
Joseph Iannotti, MD, PhD
Peter Imrey, PhD
Bong-Jae Jun, PhD
Jason Ho, MD
Atul Kamath, MD
Michael Kattan, PhD
George Muschler, MD
Luke Nystrom, MD
Leonardo Oliveira, MD
Richard Parker, MD
Nicolas Piuzzi, MD
Sambit Sahoo, MD, PhD
Jonathan Schaffer, MD, MBA
William Seitz, MD
Naveen Subhas, MD

Fracture Repair

The Fracture Repair program focuses on identifying the effects of metabolic disease, chronic unloading and weightlessness, and the systemic and local biologic factors that influence the rate and extent of bone healing. It seeks to better understand and optimize new biologics and non-invasive biophysical treatments to promote better bone quality and augment fracture healing. The major tools used to assess bone healing in animal models are in vivo micro-CT and micro-MRI imaging, bone histomorphometry to assess bone cell populations and their functional activities, biomechanical testing to assess mechanical strength and healing extent, and correlation of all these outcome measures with one another to evaluate functional relationships. We utilize primary cultures of bone- or fracture callus-derived cells for culture experimentation to assess cellular and molecular mechanisms, and bone marrow derived connective tissue progenitors (CTPs) to assess osteochondral capabilities.

Research Program Faculty:

Damien Billow, MD
Robb Colbrunn, DEng
John Elias, PhD
Atul Kamath, MD
George Muschler, MD
William Seitz, MD

Osteoporosis

The Osteoporosis research program focuses on the loss of bone structure and function due to metabolic dysregulation of bone remodeling. Basic research focuses on developing new therapies to stop this loss of bone structure and function. Clinical care in the Center for Osteoporosis and Metabolic Bone Diseases reviews more than 12,000 bone densities every year to identify patients with low bone mass that might require treatment. Bone density results have been integrated into the electronic medical record to identify at risk patients for fracture. The Center has been involved in national and international clinical trials of drugs including anabolic agents, antiresorptive agents, and combination therapies. The Center participated in trials assessing bisphosphonate holidays, and costs and utilities related to osteoporotic fractures. Quality improvement projects are ongoing to better evaluate and treat osteoporosis patients. The Center has an ongoing interest in identifying patients with hypophosphatasia, a genetic condition with bone and musculoskeletal manifestations.

Research Program Faculty:

Chad Deal, MD
Abby Abelson, MD, FACR
Damien Billow, MD
Kush Goyal, MD
Michael Kattan, PhD
Sarah Keller, MD
Xiaojuan Li, PhD
George Muschler, MD
Leonardo Oliveira, MD
Ellen Rome, MD, MPH

Musculoskeletal Imaging

The Program for Advanced Musculoskeletal Imaging (PAMI) is built upon Cleveland Clinic's nationally-ranked clinical care and research programs in orthopaedics, rheumatology and imaging. Our mission is to advance musculoskeletal imaging for improved orthopaedic and rheumatologic healthcare through technical development, clinical translation, and education. Novel imaging and image processing techniques are being developed and validated for improved structural, biochemical, and functional assessment of musculoskeletal tissues (cartilage, bone, tendon, ligament, muscle, fat, etc.). PAMI also strives for rapid clinical translation of state-of-the-art imaging techniques into routine clinical use to improve early diagnosis and prognosis for patients with significant musculoskeletal diseases. In addition to technical development, PAMI has a particular emphasis combining quantitative imaging, advanced data analysis methodologies (including big data analysis) and machine learning techniques. PAMI embraces all imaging modalities including MR (3T and 7T), CT, nuclear medicine and ultrasound.

Research Program Faculty:

Xiaojuan Li, PhD
Carl Winalski, MD
Faysal Altahawi, MD
Charlie Androjna, DEng
Elise Baron, DEng
Jill Beveridge, PhD
Ceylan Colak, MD
Frank DiFilippo, PhD
Vahid Entezari, MD
Jason Genin, DO
Michael Forney, MD
Hakan Ilaslan, MD
Bong Jae Jun, PhD
Stephen Hatem, MD
Atul Kamath, MD
Vladimir Kepe, PhD
Venkata Mantripragada, PhD
Kunio Nakamura, PhD
Joshua Polster, MD
Sambit Sahoo, MD,PhD
Jean Schils, MD
Wanyong Shin, PhD
Naveen Subhas, MD
Mingrui Yang, PhD

Neuromuscular Disease

The Neuromuscular Disease research program focuses on disorders, degeneration and injury of the nervous system and the musculoskeletal system, and how deficits in one impact operation of the other. Our group explores relationships between the nervous system, muscles, and bones, including sensorimotor control, movement patterns, coordination, dexterity, and pain. Through better understanding of these relationships, we seek to develop interventions and improve diagnosis in a variety of conditions such as Parkinson's disease, multiple sclerosis, concussion, limb loss, diabetes, and cartilage and ligament injuries. We analyze healthy and impaired populations using motion analysis, ultrasound imaging, magnetic resonance imaging, electromyography, electroencephalography, and psychophysical techniques to understand how various conditions affect movement, control, and sensory feedback. Computational modeling helps characterize pathology as well as the influence of surgical and rehabilitation interventions. In addition, we incorporate technologies, such as robotic devices and deep brain stimulation, into treatments and quantify resulting benefits to patient health and quality of life.

Research Program Faculty:

Paul Marasco, PhD
Jay Alberts, PhD
Jill Beveridge, PhD
John Elias, PhD
Ghaith Habboub, MD
Dominic Pelle, MD

Spine Health

The Cleveland Clinic Center for Spine Health, a major center for spine-related treatment and research, is on the forefront of developing new technologies and collaborative approaches for effectively managing back and neck disorders. In addition to participating in several clinical trials, research at our center is focused on understanding patient-reported outcomes to learn how spine diseases and treatments are affecting patients' quality of life and using large databases to study the characteristics of spine patients as well as global trends in the delivery of spine care. Another large part of our research is aimed at employing different aspects of artificial intelligence to provide improve patient care and minimize cost for several health conditions, including spinal disorders.

Research Program Faculty:

Thomas Mroz, MD
Kush Goyal, MD
Ghaith Habboub, MD
Dominic Pelle, MD
Michael Steinmetz, MD

Neoplastic Orthopaedic Pathology

Orthopedic oncologic pathology involves collaboration among surgeons, radiologists, radiation oncologists, and medical oncologists. We actively seek to investigate and define both the clinicopathologic features of existing neoplasms (and variants) and entirely new entities, within the musculoskeletal system and skin/subcutaneous tissues. Our group have been instrumental in describing and further clarifying a variety of novel and recently dilenated neoplasms, including atypical sclerosing osteoblastic tumor, malignant chondroblastoma, YAP1-TFE3 hemangioendothelioma, superficial ALK-rearranged myxoid neoplasm, and EWSR1-SMAD3 fibroblastic tumor. Investigation of immunohistochemistry and molecular characteristics, including novel gene rearrangements, is ongoing.

Research Program Faculty:

Brian Rubin, MD
Steven Billings, MD
Karen Fritchie, MD
John Goldblum, MD
Scott Kilpatrick, MD
Nate Mesko, MD
Luke Nystrom, MD
John Reith, MD

Non-neoplastic Orthopaedic Pathology

In orthopedic pathology, especially recently, investigation of non-neoplastic diseases and their respective specimens have been often neglected by the pathology community. Our focus has been twofold: 1) re-evaluating the demographic, clinical, radiologic, and pathologic characteristics of a range non-neoplastic orthopedic diseases and specimens. 2) re-assessing the importance of histologic examination of routine orthopedic specimens on patient care and quality assurance. Over the past couple of decades, based largely on older studies, pathologic examination of joint resections has been decreasing at many institutions due to the perception of limited costeffectiveness relative to clinical information gained. Data from more recent studies, including our own, involving larger numbers of patients where pathologic examination remains routinely and meticulously performed, have challenged this concept, showing benefits to patient care and quality assurance/safety perspectives. Establishing an accurate and reliable diagnosis of avascular necrosis and calcium pyrophosphate dihydrate disease (pseudogout) requires pathologic examination, as predisposing clinical features are frequently absent and radiographs often misleading. Our current investigation into pathologic examination and diseases uncovered in arthroplasties continues, and we have expanded our research efforts into the pathologic evaluation of revision arthroplasties. Multidisciplinary studies with cardiology, orthopedics, and pathology have and currently are evaluating the incidence and significance of amyloid detection in a variety of routine, seemingly insignificant, orthopedic specimens obtained from surgeries related to carpal tunnel, trigger finger, and spinal ligamentum flavum.

Research Program Faculty:

Scott Kilpatrick, MD
Peter Evans, MD, PhD
Steven Maschke, MD
John Reith, MD
William Seitz Jr., MD
David Shapiro, MD

Regenerative Therapies

The Regenerative Therapies research program is focused on advancing patient care through development of new strategies for preservation, repair, regeneration, augmentation, or replacement of musculoskeletal tissues. Our ongoing health requires continuous renewal of the cells and tissues that we lose to degeneration, injury or disease. Regenerative Therapies integrate cells, scaffolds, environmental signals, nutritional support and/or mechanical stimuli into effective biologic therapies. All new strategies require detailed critical evaluation in the laboratory, as well as rigorous, honest, objective and critical assessment in patients, before they can be confirmed as safe, effective, and useful in improving our patient's health and lives. To accomplish this goal we have founded the Cleveland Clinic Joint Preservation Center (JPC). The JPC integrates clinical expertise in the emerging field of cellular and other biological therapies, in an environment of careful measurement, partnering with our patients to advance the future of musculoskeletal care.

Research Program Faculty:

George Muschler, MD
Mitali Das, PhD
Srinivasan Dasarathy, MD
Jason Genin, DO
Kush Goyal, MD
Carlos Higuera, MD
Elaine Husni, MD, MPH
Atul Kamath, MD
Dominic King, DO
Venkata Mantripragada, PhD
Leonardo Oliveira, MD
Nicolas Piuzzi, MD
Sambit Sahoo, MD, PhD
Carl Winalski, MD
Massarat Zutshi, MD

Rotator Cuff Disease and Repair

The Rotator Cuff Disease and Repair research program focuses on identifying the demographic, disease, and surgical factors, as well as local biologic factors such as stem and progenitor cell characteristics and inflammatory biomarkers, which influence healing and clinical outcomes following rotator cuff repair. Our aim is modification of key factors, either pre-operatively or through surgical treatment, leading to better clinical decision making, patient selection and improved outcomes. We also investigate extracellular matrix (ECM) scaffold technologies as a surgical treatment strategy for enhancing healing following rotator cuff repair. We utilize traditional MRI together with novel CT based imaging of radiopaque markers to measure tendon retraction and understand the relationship between structural healing of the tendon and clinical outcomes following rotator cuff repair. Further, we are currently developing imaging biomarkers to quantify local bone marrow 'quality' and guide decision-making about tissue healing potential and the need for cell-based therapies.

Research Program Faculty:

Kathleen Derwin, PhD
Ceylan Colak, MD
Vahid Entezari, MD
Ahmet Erdemir, PhD
Lutul Farrow, MD
Jason Genin, DO
Joseph Iannotti, MD, PhD
Peter Imrey, PhD
Bong-Jae Jun, PhD
Jason Ho, MD
Xiaojuan Li, PhD
Jinjin Ma, PhD
George Muschler, MD
Leonardo Oliveira, MD
Nicolas Piuzzi, MD
Joshua Polster, MD
Eric Ricchetti, MD
Sambit Sahoo, MD, PhD
Mark Schickendantz, MD
Alfred Serna, MD
Carl Winalski, MD

Clinical Trials

NIH (NIAMS) --- R01AR077452
Li, Xiaojuan
"Multi-Vendor Multi-Site Novel Accelerated MRI Relaxometry"

NIH (NIAMS) --- R01AR068342
Derwin, Kathleen / Iannotti, Joseph
"Failure with Continuity and its Relation to Rotator Cuff Repair Clinical Outcomes"

NIH (NIAMS) --- R01AR053684
Spindler, Kurt
"Prognosis and Predictors of ACL Reconstruction: A Multicenter Cohort Study"

NIH (NINDS) --- R01NS073717
Alberts, Jay
"CYClical Lower Extremity exercise for Parkinsons trial (CYCLE Trial)"

NIH (NIAMS) --- R01AR074131
Spindler, Kurt
"BEAR-MOON: A Two Arm Noninferiority Blinded Randomized Clinical Trial Comparing ACL Repair with BEAR Device vs. Standard of Care Autograft Patellar Tendon ACL Reconstruction"

NIH (NIAMS) --- U01AR071658 (sub-award)
Jones, Morgan
"Treatment of Meniscal Problems in Osteoarthritis (TeMPO)"

DOD (CDMRP) --- PR191214 (sub-award)
Li, Xiaojuan
"Altering Posttraumatic Osteoarthritis After Patellar Dislocation: Blood Flow Restriction Training, Aspiration, and Intraarticular Normal Saline"

NIH (NINDS) --- U01NS113851 (sub-award)
Alberts, Jay
"Study in Parkinson Disease of Exercise Phase 3 Clinical Trial: SPARX3"

Grants

Federal Grants

IH (NIBIB) --- R01EB025212
Erdemir, Ahmet
"Software for Practical Annotation and Exchange of Virtual Anatomy"

NIH (NIDCR) --- R01DE029634
Muschler, George
"Understanding and Using Variation in Source Materials for MSC Fabrication"

NIH (NIAMS) --- R01AR077452
Li, Xiaojuan
"Multi-Vendor Multi-Site Novel Accelerated MRI Relaxometry"

NIH (NIAMS) --- R01AR075422
Li, Xiaojuan
"Imaging post-traumatic osteoarthritis 10-years after ACL reconstruction: a multicenter cohort study with quantitative MRI"

NIH (NIBIB) --- R01EB024573
Erdemir, Ahmet
"Reproducibility in Simulation-based Prediction of Natural Knee Mechanics"

NIH (NIAMS) --- R01AR068342
Derwin, Kathleen / Iannotti, Joseph
"Failure with Continuity and its Relation to Rotator Cuff Repair Clinical Outcomes"

NIH (NIAMS) --- R01AR053684
Spindler, Kurt
"Prognosis and Predictors of ACL Reconstruction: A Multicenter Cohort Study"

NIH (NINDS) --- R01NS073717
Alberts, Jay
"CYClical Lower Extremity exercise for Parkinsons trial (CYCLE Trial)"

DOD (USAMRMC) --- W81XWH-20-1-0040
Elias, John
"Improving Treatment for Patellar Instability to Reduce Recurrence and Cartilage Degradation"

NIH (NIGMS) --- R44GM133291 (sub-award)
Muschler, George
"Automation and Performance-Based Selection to Improve the Reproducibility of MSCs"

NIH (NIAMS) --- R00AR069094
Beveridge, Jillian
"The Effects of Reduced ACL Stiffness on Dynamic In Vivo Joint Function"

NIH (NIAMS) --- R01AR073512
Subhas, Naveen
"MRI Predictors of Outcome after Arthroscopic Partial Meniscectomy"

NIH (NIAMS) --- R01AR075286
Ricchetti, Eric
"Identifying the Patient, Disease, Surgical, and Implant Positional Shift Factors that Predict Outcomes Following Total Shoulder Arthroplasty"

NIH (NIAMS) --- U01AR071658 (sub-award)
Jones, Morgan
"Treatment of Meniscal Problems in Osteoarthritis (TeMPO)"

NIH (NHLBI) U01EB023829 (sub-award)
Li, Xiaojuan
"Enhanced MR for morphological characterization of ligaments, tendons and bone"

NIH (NHLBI) R56HL141744 (sub-award)
Dasarathy, Srinivasan
"Nutritional modulation to minimize resistance exercise induced metabolic deregulations and improve training responsiveness in Chronic Obstructive Pulmonary Disease"

NIH (NIAMS) --- R13AR076258
Spindler, Kurt
"Clinician Scholar Career Development Program (CSCDP)"

NIH (NIAMS) --- R34AR077361 (sub-award)
Spindler, Kurt
"Preventing Incident Knee Osteoarthritis: The Osteoarthritis Prevention Study (TOPS)"

NIH (NIAMS) R01AR076159 (sub-award)
Li, Xiaojuan
"Determining the Biological Mechanisms of Pathological Cortical Porosity"

NIH (NIAMS) R34AR073505 (sub-award)
Muschler, George
"Cell-Based Autogenous Grafting for the Treatment of Femoral Head Osteonecrosis"

VA --- I01RX001833
Marasco, Paul
"Advanced Materials to Improve Moisture Management for Prosthetic Socket Liners"

DOD (USAMRMC) --- W81XWH-19-1-0516 (sub-award)
Beveridge, Jillian
"Intra-Articular Injection of Alpha-2-Macroglobulin Prevents Post-Traumatic Osteoarthritis"

NIH (NCCIH) --- R61AT010806 (sub-award)
Alberts, Jay
"Enhancing Exercise and Psychotherapy to Treat Comorbid Addiction and Pain for ImprovingAdherence to Medication Assisted Treatment in Opioid Use Disorders"

NIH (NINDS) --- U01NS113851 (sub-award)
Alberts, Jay
"Study in Parkinson Disease of Exercise Phase 3 Clinical Trial: SPARX3"

Innovations

US PATENTS

Muschler GF, Monnich JK, Kwee EJ, Powell KA, Herderick EE, Boehm CA, Adams TR, Germanoski R, Krakosh III F, Dunn J, Bantz D: "Systems and methods for detection, analysis, isolation and/or harvesting of biological objects". US Patent No: 10,564,172; granted Feb 2020.

Schindler DD, Alberts JL, Hirsch JR: "Systems and Methods to Assess Balance and Stability". US Patent No: 10,588,546; granted Mar 2020.

Iannotti JP, Barsoum WK, Bryan JA, O'Neill PD: "System and Method for Association of a Guiding Aid with a Patient Tissue". US Patent No: 10,624,655; granted Apr 2020.

Assell R, Freeman A, Muschler GF: "Bone Fragment and Tissue Harvesting System". US Patent No: 10,610,242; granted Apr 2020.

Alberts JL, Bermel R, Rao S, Schlinder DD: "Assessment of Low Contrast Visual Sensitivity". US Patent No: 10,667,682; granted Jun 2020.

Alberts JL, McIntyre C: "System and Method for Motor and Cognitive Analysis". US Patent No: 10,741,287; granted Aug 2020.

Derwin K, Aurora A, Iannotti JP, McCarron, JA: "Reinforced Tissue Graft". US Patent No: 10,758,644; granted Sep 2020.

Cheng J: "Devices and Methods for Treating Medical Conditions Associated with Sacroiliac Joint Abnormalities". US Patent No: 10,849,708; granted Dec 2020.

Alberts JL, Schindler DD: "Object Recognition by Touch Screen". US Patent No: 10,206,609; granted Feb 2019.

Iannotti JP, Barsoum WK, Bryan JA: "System and Method for Assisting with Attachment of a Stock Implant to a Patient Tissue". US Patent No: 10,258,352; granted Apr 2019.

Iannotti JP, Barsoum WK, Bryan JA: "Apparatus and Method for Providing a Reference Indication to a Patient Tissue". US Patent No: 10,307,174; granted Jun 2019.

Assell R, Freeman A, Muschler G: "Bone Fragment and Tissue Processing System". US Patent No: 10,342,552; granted Jul 2019.

Derwin KA, Iannotti JP, Milks RA: "Devices and Methods for Tissue Graft Delivery". US Patent No: 10,383,657; granted Aug 2019.

Alberts JL, Schindler DD, Rhodes J, Gabel W, Best J: "Apparatus and Related Method to Facilitate Testing Via a Computing Device". US Patent No: 10,420,497; granted Sep 2019.

Iannotti JP, Barsoum WK, Bryan JA, O'Neill P: "Alignment of Manipulable Sensor Assembly". US Patent No: 10,456,062; granted Oct 2019.

Assell R, Freeman A, Muschler G: "Bone Void Filler Preparation System". US Patent No: 10,456,502; granted Oct 2019.

Alberts JL, Rudick RA, Schindler DD, Hirsch J, Rao SM, Bethoux F, Linder S, Miller D: "Performance Test for Evaluation of Neurological Function". US Patent No: 10,470,679; granted Nov 2019.

Iannotti JP, Barsoum WK, Bryan JA: "System and Method for Assisting with Arrangement of a Stock Instrument with Respect to a Patient Tissue". US Patent No: 10,512,496; granted Dec 2019.

Alberts JL, Bermel R, Rao S, Schindler DD: "Assessment of Low Contrast Visual Sensitivity". US Patent No: 10,028,653; granted Jul 2018.

Derwin KA, Calabro A: "Biocompatible Tissue Graft". US Patent No: 10,004,586; granted Jun 2018.

Evans PJ, Trickett J: "Multipurpose Membranes, Methods for Forming, and Applications Thereof". US Patent No: 10,086,110; granted Oct 2018.

Iannotti JP, Barsoum WK, Bryan JA: "System and Method for Assisting with Attachment of a Stock Implant to a Patient Tissue". US Patent No: 9,877,735; granted Jan 2018.

Machado AG, Alberts JL, McIntyre C, Schindler DD: "Evaluation of Movement Disorders". US Patent No: 10,028,695; granted Jul 2018.

Alberts JL: "System and Method to Facilitate Analysis of Brain Injuries and Disorders". US Patent No: 9,610,029; granted Apr 2017.

Alberts JL, McIntyre CC: "Reversing Cognitive-Motor Impairments in Patients Having a Neuro-Degenerative Disease Using a Computational Modeling Approach to Deep Brain Stimulation Programming". US Patent No: 9,776,003; granted Oct 2017.

Alberts JL, McIntyre CC: "System and Method for Motor and Cognitive Analysis". US Patent No: 9,653,002; granted May 2017.

Alberts JL, Schindler DD: "Object Recognition by Touch Screen". US Patent No: 9,737,242; granted Aug 2017.

Iannotti JP: "Prosthetic Articulation Surface Mounting". US Patent No: 9,572,670; granted Feb 2017.

Iannotti JP, Barsoum WK, Bryan JA, O'Neill PD: "System of Preoperative Planning and Provision of Patient-Specific Surgical Aids". US Patent No: 9,741,263; granted Aug 2017.

Iannotti JP, Barsoum WK, Bryan JA, O'Neill PD: "System of Preoperative Planning and Provision of Patient-Specific Surgical Aids". US Patent No: 9,717,508; granted Aug 2017.

Iannotti JP, Barsoum WK, Bryan JA, O'Neill PD: "System and Method for Association of a Guiding Aid with a Patient Tissue". US Patent No: 9,615,840; granted Apr 2017.

Polster JM, Hoffman G: "Tissue Sampling Device". US Patent No: 9,622,727; granted Apr 2017.

Derwin KA, Iannotti JP, Milks RA: "Devices and Methods for Tissue Graft Delivery". US Patent No: 9,265,524; granted Feb 2016.

Iannotti JP: "Humeral Joint Replacement Component". US Patent No: 9,512,445; granted Dec 2016.

Iannotti JP: "Prosthetic Articulation Surface Mounting". US Patent No: 9,241,804; granted Jan 2016.

Iannotti JP, Barsoum WK, Bryan JA: "Apparatus and Method for Providing a Reference Indication to a Patient Tissue". US Patent No: 9,326,781; granted May 2016.

Iannotti JP, Barsoum WK, Bryan JA: "System and Method for Assisting with Arrangement of a Stock Instrument with Respect to a Patient Tissue". US Patent No: 9,254,155; granted Feb 2016.

Iannotti JP, Bonutti PM: "Methods and Devices for Bone Preparation". US Patent No: 9,439,704; granted Sep 2016.

Iannotti JP, Williams G, Koka D, Hollis MC: "Glenoid Vault Fixation". US Patent No: 9,439,768; granted Sep 2016.

Iannotti J, Williams G, Koka D, Hollis MC: "Shoulder Arthroplasty". US Patent No: 9,414,927; granted Aug 2016.

Miniaci A, Fening SD, Hartzell BE: "Apparatus and Method for Sequentially Anchoring Multiple Graft Ligaments in a Bone Tunnel". US Patent No: 9,339,370; granted May 2016.

Polster J: "Percutaneous Needle Guide and Method". US Patent No: 9,381,035; granted Jul 2016.

Polster JM: "Method and Apparatus for Tissue Sampling". US Patent No: 9,326,754; granted May 2016.

Alberts JL: "Systems and Methods for Improving Motor Function with Assisted Exercise". US Patent No: 9,067,098; granted Jun 2015.

Fening SD, Miniaci A: "Apparatus and Method for Sequentially Anchoring Multiple Graft Ligaments in a Bone Tunnel". US Patent No: 9,011,536; granted Apr 2015.

Iannotti JP, Barsoum WK, Bryan JA: "Apparatus and Method for Dictating at Least One of a Desired Location and a Desired Trajectory for Association of a Landmark with a Patient Tissue". US Patent No: 9,198,732; granted Dec 2015.

Iannotti JP, Barsoum WK, Bryan JA: "Directed Structure Placement Guide". US Patent No: 9,033,990; granted May 2015.

Iannotti JP, Barsoum WK, Bryan JA: "Positioning Apparatus and Method for a Prosthetic Implant". US Patent No: 9,011,452; granted Apr 2015.

Iannotti JP, Barsoum WK, Bryan JA: "Apparatus and Method for Providing a Reference Indication to a Patient Tissue". US Patent No: 8,992,539; granted Mar 2015.

Iannotti JP, Barsoum WK, Bryan JA: "Apparatus and Method for Transferring Predetermined Spatial Positioning Information to an Adjustable Tool". US Patent No: 8,926,627; granted Jan 2015.

Iannotti JP, Bonutti PM: "Methods and Devices for Bone Preparation". US Patent No: 9,216,046; granted Dec 2015.

Machado A, Alberts JL, McIntyre C, Schindler D: "Evaluation of Movement Disorders". US Patent No: 9,186,095; granted Nov 2015.

Muschler G, Caralla T, Hascall V, Midura R: "Enrichment of Tissue-Derived Adult Stem Cells Based on Retained Extracellular Matrix Material". US Patent No: 9,045,735; granted Jun 2015.

Polster JM: "Augmented Reconstruction for Computed Tomography". US Patent No: 9,153,045; granted Oct 2015.

Pilot Project Programs

The Musculoskeletal Research Center's Pilot Project Program for Cleveland Clinic investigators is available to support currently unfunded, novel, particularly innovative, disease-oriented projects that are in need of the early data that would make them competitive for extramural funding. Funding will be available to support projects along the entire continuum of biomedical investigation, including discovery, translation and direct patient-involved research.

Two types of awards of up to $25,000 each are available: (1) MSRC General awards are for musculoskeletal research projects on any topic related to musculoskeletal research, and (2) MSRC MSK Imaging awards are for musculoskeletal imaging research projects. There are two annual funding cycles; deadlines for applications are March 15 and September 15 of each year.

InfoReady Review is used to manage Pilot Project submissions. Each competition will be launched on the InfoReady Review home page one month prior to the deadline. If you have any issues submitting an application, please contact us.

General Funded Projects

Unnikrishnan Chandrasekharan, PhD: "Protein arginine methyltransferase 5 (PRMT5), a novel drug target of inflammatory arthritis and cardiovascular comorbidity." (March 2021)
Jillian Beveridge, PhD: "Computational Modeling of In Vivo ACL Function" (September 2020)
Suneel Apte, MBBS, DPhil: "Proteome-wide analysis of cartilage degradation in knee OA" (March 2020)
Carlos Higuera-Rueda, MD: "Efficacy of MagDAA gel on disruption of established bacterial biofilm in a rabbit model of periprosthetic joint infection (PJI)" (March 2019)

MSK Imaging Funded Projects

Ceylan Colak, MD and Richard Lartey, PhD: "Optimizing Non-Contrast Magnetic Resonance Imaging (MRI) Sequences for Knee Synovitis" (Junior Investigator, September 2020)
Maryam Zokaeinikoo, PhD: "Automated knee radiograph analysis using deep-learning techniques" (Junior Investigator, September 2020)
Brendan Eck, PhD: "Characterization of sarcopenia by magnetic resonance fingerprinting and phosphorous magnetic resonance spectroscopic imaging" (Junior Investigator, September 2019)
Jinjin Ma, PhD: "Investigating MR Biomarkers of Bone Marrow Quality in Musculoskeletal Disease" (Junior Investigator, September 2018)
Mingrui Yang, PhD: "Automated Arthroscopic Partial Meniscectomy Patient Outcome Prediction using Deep Learning" (Junior Investigator, September 2018)
Nicholas Piuzzi, MD: "A Comparative and Correlative Evaluation of Early to Late Stage Osteoarthritis in Human Knee Cartilage utilizing Clinical and Preclinical MRI Imaging (3T & 7T) with Histopathology and Immunohistochemistry as the Standard" (Junior Investigator, March 2018)
John Elias, PhD: "Optimizing Surgical Stabilization for Patellar Instability to Reduce the Risk of Arthritis" (Established Investigator, March 2018)

Resources

Amy and David Krohn Family Orthopaedic Outcomes Center (OOC)

The Amy and David Krohn Family Orthopaedic Outcomes Center (OOC) is an arm of the Cleveland Clinic Musculoskeletal Research Center (MSRC) focusing primarily on the clinical outcomes of orthopaedic surgery and related treatments. Bringing together the expertise of orthopaedic clinicians, researchers, data scientists, and statisticians, the OOC endeavors to:

Develop and implement the technical and logistical infrastructure to systematically collect, analyze, and publish data related to clinical and patient-reported outcome measures (PROMs) with a focus on joint replacement, sports injuries, and shoulder and upper extremity surgery
Guide the development and implementation of grants and research projects related to orthopaedic outcomes
Secure commercial contracts related to outcomes data collection and reporting
Support departmental quality initiatives and outcomes publishing on the Cleveland Clinic Outcomes website

Amy & David Krohn Family Orthopaedic Outcomes Center

Amy & David Krohn Family Orthopaedic Outcomes Center (OOC)

Develop and implement the technical and logistical infrastructure to systematically collect, analyze, and publish data related to clinical and patient-reported outcome measures (PROMs) with a focus on joint replacement, sports injuries, and shoulder and upper extremity surgery
Guide the development and implementation of grants and research projects related to orthopaedic outcomes
Secure commercial contracts related to outcomes data collection and reporting
Support departmental quality initiatives and outcomes publishing on the Cleveland Clinic Outcomes website

About Us

Members

Kurt Spindler, MD: OOC Director
Elizabeth Sosic, BS: OME Program Manager
Greg Strnad, MS: Lead Database Designer
Sage O’Bryant, BS: System Analyst
Brittany Stojsavljevic, BA: Editorial Assistant
Aretha Siggers, BS: Research Assistant
Sonja Ealy, BS: Research Assistant
LaTashua Manning, BS: Research Assistant
Charlotte Gapas, MBA: Research Assistant

Outcomes Management and Evaluation

Overview

The OOC’s flagship service is the Outcomes Management and Evaluation (OME) system, which is used across the institution to systematically collect patient-reported outcome measures (PROMs) in a highly structured and consistent manner. OME is a cost-effective, scientifically valid, scalable electronic system for collecting PROMs and clinical information surrounding an episode of care:

Cost-effective: makes use of commodity hardware, built into existing workflow
Scientifically valid: 95%+ baseline enrollment and 70%+ 1-year follow-up helps prevent bias, and usage of validated PROMs ensures results can be consistent with the scientific literature
Scalable: ability to handle high patient volumes across a wide range of interventions, and operate seamlessly within Cleveland Clinic locations regardless of geographic dispersion as well as with outside institutions for multicenter collaboration

Initially launched in 2015 an “Episode of Care” supplement to the OOC’s former OrthoMiDaS system, OME has since supplanted OrthoMiDaS to establish itself as the de-facto data collection mechanism for orthopaedic surgery. The data collected through this system feeds the OME Cohort, a powerful prospective cohort that supports standard of care, quality initiatives, and three primary points of research focus:

Determine patient and clinical factors that predict patient-reported pain and function prior to orthopaedic surgery
Determine predictors of patient-reported and clinical outcomes one year after orthopaedic surgery
Compare 1- and 2-year patient-reported outcomes of orthopaedic surgery

Current Enrollment

As of August 2019, OME is active at 16 Cleveland Clinic hospitals and ASCs and covers over 95% of elective orthopaedic surgery cases performed on the knee, hip, and shoulder, ranging from arthroscopy to arthroplasty. OME is also used in select spine, hand, wrist, foot, and ankle surgeries, as well as for patients receiving non-surgical orthobiologic treatment and patients undergoing MRI scans for sports injuries. Over 45,000 episodes of care representing over 40,000 patients have been collected to date with average baseline PROM completion rates of over 95% and 1-year follow-up PROM completion rates of over 70%. Additional orthopaedic and non-orthopaedic procedures are being added to the OME portfolio regularly.

Publications

Validity and efficiency of a smartphone-based electronic data collection tool for operative data in rotator cuff repair. Sambit Sahoo MD PhD, Jill Mohr BS, Gregory J. Strnad MS, José Vega MA, Morgan Jones MD MPH, Mark S. Schickendantz MD, Lutul Farrow MD, Kurt P. Spindler MD, Joseph P. Iannotti MD PhD, Eric T. Ricchetti MD, Kathleen A. Derwin PhD. Journal of Shoulder and Elbow Surgery, July 2019.
Predicting the Need for Surgical Intervention Prior to First Encounter for Individuals With Knee Complaints: A Novel Approach. José F. Vega MA, Gregory J. Strnad MS, James Bena MS, Kurt P. Spindler MD. Orthopaedic Journal of Sports Medicine, July, 2019.
Arthroplasty studies with greater than 1000 participants: analysis of follow-up methods. Muhammad B. Tariq BS, José F. Vega MA, Robert Westermann MD, Morgan Jones MD MPH, Kurt P. Spindler MD. Arthroplasty Today, June 2019.
A smart decision: smartphone use for operative data collection in arthroscopic shoulder instability surgery. Jill Mohr, Gregory J Strnad, Lutul Farrow, Kate Heinlein, Carolyn M Hettrich, Morgan H Jones, Anthony Miniaci, Eric Ricchetti, James Rosneck, Mark Schickendantz, Paul Saluan, José F Vega, Kurt P Spindler. Journal of the American Medical Informatics Association, June 2019.
The Main Predictors of Length of Stay After Total Knee Arthroplasty: Patient-Related or Procedure-Related Risk Factors. Nicolas Piuzzi, Gregory Strnad, Wael Ali Sakr Esa, Wael Barsoum, Michael Bloomfield, Peter Brooks, Carlos Higuera-Rueda, Michael Joyce, Michael Kattan, Alison Klika, Viktor Krebs, Nathan Mesko, Michael Mont, Trevor Murray, George Muschler, Robert Nickodem, Preetesh Patel, Jonathan Schaffer, Kurt Spindler, Kim Stearns, Juan Suarez, Alexander Zajichek, Robert Molloy. The Journal of Bone & Joint Surgery, June 2019.
Predictors of Pain and Function Before Knee Arthroscopy. Cleveland Clinic Sports Knee Group, Matthew C Bessette MD, Robert W. Westermann MD, Alan Davis MD, Lutul Farrow MD, Mia S. Hagen MD, Anthony Miniaci MD, Robert Nickodem MD, Richard Parker MD, James Rosneck MD, Paul Saluan MD, Kurt P. Spindler MD, Kim Stearns MD, Morgan H. Jones MD MPH. Orthopaedic Journal of Sports Medicine, May, 2019.
Prospective Evaluation of the Patient Acceptable Symptom State to Identify Clinically Successful Anterior Cruciate Ligament Reconstruction. Vega JF, Jacobs CA, Strnad GJ, Farrow L, Jones MH, Miniaci A, Parker RD, Rosneck J, Saluan P, Williams JS, Spindler KP. American Journal of Sports Medicine, April 2019.
Does Patient Experience After a Total Knee Arthroplasty Predict Readmission? Nipun Sodhi MD, Michael A. Mont MD, Cleveland Clinic Orthopaedic Arthroplasty. The Journal of Arthroplasty, April, 2019.
Implementing a Scientifically Valid, Cost-Effective, and Scalable Data Collection System at Point of Care: The Cleveland Clinic OME Cohort. Nicolas Piuzzi, Greg Strnad, Peter Brooks, Carolyn Hettrich, Carlos Higuera-Rueda, Joseph Iannotti, Michael Kattan, Robert Molloy, T. Lynch, Alex Milinovich, Eric Ricchetti, James Rosneck, Mark Schickendantz, Kurt Spindler. The Journal of Bone and Joint Surgery, March 2019.
Comparison of Standard and Right/Left International Knee Documentation Committee Subjective Knee Form Scores. Justin A. Magnuson BA, Greg Strnad MS, Clair Smith MS, Morgan H. Jones MPH MD, Paul Saluan MD, James J. Irrgang PT PhD ATC FAPTA, Kurt P. Spindler MD. The American Journal of Sports Medicine, March 2019.
Tear characteristics and surgeon influence repair technique and suture anchor use in repair of superior-posterior rotator cuff tendon tears. Kathleen A. Derwin PhD, Sambit Sahoo MD PhD, Alexander Zajichek MS, Gregory Strnad MS, Kurt P. Spindler MD, Joseph P. Iannotti MD PhD, Eric T. Ricchetti MD. Journal of Shoulder and Elbow Surgery, February 2019.
Validation of a Novel Surgical Data Capturing System After Hip Arthroscopy. Brown MC, Westermann RW, Hagen MS, Strnad GJ, Rosneck JT, Spindler KP, Lynch TS. Journal of the American Academy of Orthopaedic Surgeons, February 2019.
A National Collegiate Athletic Association Division I Athlete's Return to Play After Traumatic Knee Dislocation With Vascular and Nerve Injury. Michael Kolosky DO, Kurt Spindler MD. JAAOS Global Research & Reviews, November, 2018.
Validation of a Novel Surgical Data Capturing System Following Total Hip Arthroplasty. Gannon L. Curtis MD, Muhammad B. Tariq MD, David P. Brigati MD, Mhamad Faour MD, Carlos A. Higuera MD, Cleveland Clinic Orthopaedic Arthroplasty Group. The Journal of Arthroplasty, November, 2018.
Birmingham hip resurfacing versus cementless total hip arthroplasty in patients 55 years or younger: A minimum five-year follow-up. Mohamad J. Halawi, Sameer R. Oak, David Brigati, Aretha Siggers, William Messner, Peter J. Brooks. Journal of Clinical Orthopaedics and Trauma, October, 2018.
No Difference in Outcomes 12 and 24 Months After Lower Extremity Total Joint Arthroplasty: A Systematic Review and Meta-Analysis. Prem N. Ramkumar MD MBA, Sergio M. Navarro BS, Heather S. Haeberle BS, Mitchell Ng BS, Nicolas S. Piuzzi MD, Kurt P. Spindler MD. The Journal of Arthroplasty, July, 2018.
The Association Between Readmission and Patient Experience in a Total Hip Arthroplasty Population. Cleveland Clinic Orthopaedic Arthroplasty: Jay M. Levin, BA, Anton Khlopas, MD, Nipun Sodhi, BA, Assem A. Sultan, MD, Morad Chughtai, MD, Wael K. Barsoum, MD, Damien Billow, MD, Michael R. Bloomfield, MD, Daniel Bokar, Peter J. Brooks, MD, Peter J. Evans, MD, Gregory J. Gilot, MD, Carlos A. Higuera, MD, Joseph P. Iannotti, MD, Michael J. Joyce, MD, Michael Kattan, Carmen Kestranek, Viktor E. Krebs, MD, Nathan W. Mesko, MD, John McLaughlin, DO, Anthony Miniaci, MD, Robert M. Molloy, MD, Trevor G. Murray, MD, George F. Muschler, MD, Robert Nickodem, MD, Lukas M. Nystrom, MD, Preetesh D. Patel, MD, Nicolas S. Piuzzi, MD, Kevin Phipps, Eric T. Ricchetti, MD, Susannah Rose, PhD, James Rosneck, MD, Jonathan L. Schaffer, MD, William H. Seitz Jr., MD, Elizabeth Sosic, Kurt P. Spindler, MD, Kim L. Stearns, MD, Greg Strnad, MS, Juan C. Suarez, MD, Michael A. Mont, MD. The Journal of Arthroplasty, June, 2018.
Validation of a New Web-Based System for Point-of-Care Implant Documentation in Total Knee Arthroplasty. Deepak Ramanathan MD, Bishoy V. Gad MD, Matthew R. Luckett MD, Alison K. Klika MS, Kurt P. Spindler MD, Carlos A. Higuera MD. The Journal of Knee Surgery. December, 2017.
Predictors of Hip Pain and Function in Femoroacetabular Impingement: A Prospective Cohort Analysis. Robert W. Westermann MD, T. Sean Lynch MD, Morgan H. Jones MD MPH, Kurt P. Spindler MD, William Messner PhD, Greg Strnad MS, and James Rosneck MD. Orthopaedic Journal of Sports Medicine, September, 2017.
Responsiveness Comparison of the EQ-5D, PROMIS Global Health, and VR-12 Questionnaires in Knee Arthroscopy. Sameer R. Oak MD, Gregory J. Strnad MS, James Bena MS, Lutul D. Farrow MD, Richard D. Parker MD, Morgan H. Jones MD, and Kurt P. Spindler MD. Orthopaedic Journal of Sports Medicine, December 17, 2016.

Publication Tracker (FINER Form)

Grants

BEAR-MOON
Multicenter FDA trial funded by NIH/NIAMS comparing the BEAR® scaffold for ACL repair to standard of care ACL reconstruction
https://bearmoon.org

Members

To become a member of the MSRC, please send an email to owingst@ccf.org.

MSRC Governance Board

Thomas A. Hamilton, PhD,
Director, Strategic Growth, Chief Research & Academic Office
Brendan Patterson, MD,
Chair, Department of Orthopaedic Surgery
Stephen E. Jones, MD, PhD,
Vice Chair Research, Imaging Institute
Serpil C. Erzurum, MD,
Chief Research & Academic Officer, Cleveland Clinic; Chair, Lerner Research Institute (ex officio)
Thomas Mroz, MD,
Chair, Orthopaedic and Rheumatologic Institute (ex officio)
Gregory P. Borkowski, MD,
Chair, Imaging Institute (ex officio)