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Rush Department of Orthopedic Surgery National Acclaim · #4: Current ranking in U.S. News & World Report · 8,000+: The number of times Rush sports medicine surgeons are cited in scientific publications each year · #9: Orthopedic surgery residency program, as ranked by Doximity · #1: Inpatient leader in the Chicago area for orthopedic surgery Harnessing the Power of Bone Marrow-Derived Stem Cells The development of minimally invasive surgical techniques and better rehabilitation protocols has changed the way sports medicine orthopedic surgeons treat many of the most common orthopedic injuries. Nevertheless, tears to the knee’s anterior cruciate ligament, or ACL, and meniscus, as well as injuries to the shoulder’s rotator cuff, remain characterized by lengthy recovery periods and, occasionally, suboptimal outcomes. A disconcerting percentage of patients in the U.S. who undergo surgery for full-thickness rotator cuff tears require subsequent surgery; ACL and meniscus tears appear to accelerate the development of osteoarthritis in the knee. Leading physician-scientists at Rush — including Brian Cole, MD, MBA (pictured to the right); Nikhil Verma, MD; Adam Yanke, MD, PhD; and Brian Forsythe, MD — are advancing studies utilizing bone marrowderived stem cells that they hope will fundamentally improve the way surgeons treat these pervasive injuries. In randomized controlled studies — experiments accepted as the strongest scientific evidence of a new treatment’s effectiveness — the physicians are looking to determine if these stem cells can help minimize inflammation, accelerate healing, reduce pain and improve the quality of the surgical repair. While the patient is undergoing surgery, the physician extracts a small amount of bone marrow from the patient’s hip and uses a special centrifuge to separate out mesenchymal stem cells, or MSCs, from the rest of the bone marrow. The MSCs are then delivered back into the patient at the surgical site. With several patients now one year postsurgery, the researchers are entering an important phase of the study. They have begun collecting MRI evidence and biomarker assessments from subjects to begin determining the effect that these stem cells have on healing and long-term outcomes. These MRIs and study protocols are not covered by Medicare or insurance; philanthropy makes this data collection and analysis possible. Brian Cole, MD, MBA, is leading studies utilizing bone marrow-derived stem cells that could alter the standard of care for many orthopedic conditions. Leading the Pursuit for Better Solutions to Chronic Back Pain About half of the 215 million opioid prescriptions filled in the U.S. in 2016 were for chronic back pain, the most common reason for health care visits among musculoskeletal disorders and the leading cause of disability worldwide. While opioids may alleviate pain for some patients — if only temporarily — this relief comes at a significant cost: Current drug formulas are highly addictive and have contributed to a national opioid epidemic. Put simply, the need for better pain treatments has never been greater, and researchers led by Howard An, MD, the Morton International Chair of Orthopedic Surgery, are advancing discoveries to develop a safer way to manage chronic back pain. Dr. An’s team believes that medicines utilizing peripherally restricted kappa receptor agonists, or PRKRAs, would be a more effective therapy for back pain. Unlike conventional opioid drugs which target receptors that enter the brain and central nervous system (making them highly addictive), the PRKRAs may relieve pain without crossing the blood-brain barrier, and recent studies have proven them to effectively reduce pain for women after hysterectomy surgeries. The researchers also hypothesize that with sufficient pain relief from the safer PRKRA drugs, patients could tolerate physical exercise to further reduce their symptoms. Generous donor support has enabled Dr. An’s team to begin its study of PRKRA in a unique rodent model in the lab (a very common precursor to research in patients). The results of these studies will help lay the groundwork for human trials of nonaddictive, PRKRA therapy as a viable treatment for chronic back pain. Continuing a Legacy of Excellence in Joint Replacement Research Well over 1 million knee and hip replacement procedures are performed each year in the U.S. — a number that will more than double by the year 2030. Faced with this growing need, surgeons from around the country look to the reconstructive experts at Rush to help this rising number of patients reclaim lost mobility and eliminate pain. Guided by a rich legacy of pioneering research in the area of joint replacement, physicianscientists at Rush actively oversee dozens of study protocols that aim to prevent problems before they happen, preserve natural joints as long as possible, and — when no
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