Preclinical models of orthopaedic trauma: Orthopaedic Research Society (ORS) and Orthopaedic Trauma Association (OTA) symposium 2022

Author:

Wise Patrick M.1,Saiz Augustine M.1ORCID,Haller Justin2,Wenke Joseph C.34,Schaer Thomas5,Schneider Prism6,Morshed Saam7,Bahney Chelsea S.78

Affiliation:

1. Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA

2. Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT

3. Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch at Galveston, Galveston, TX

4. Shriners Children's Texas, Galveston, TX

5. Department of Clinical Studies, New Bolton Center University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA

6. Section of Orthopaedic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada

7. Orthopaedic Trauma Institute, University of California, San Francisco (UCSF), San Francisco, CA

8. Center for Regenerative and Personalized Medicine, The Steadman Clinic & Steadman Philippon Research Institute, Vail, CO

Abstract

Abstract Orthopaedic trauma remains a leading cause of patient morbidity, mortality, and global health care burden. Although significant advances have been made in the diagnosis, treatment, and rehabilitation of these injuries, complications such as malunion, nonunion, infection, disuse muscle atrophy and osteopenia, and incomplete return to baseline function still occur. The significant inherent clinical variability in fracture care such as differing patient demographics, injury patterns, and treatment protocols make standardized and replicable study, especially of cellular and molecular based mechanisms, nearly impossible. Hence, the scientists dedicated to improving therapy and treatments for patients with orthopaedic trauma rely on preclinical models. Preclinical models have proven to be invaluable in understanding the timing between implant insertion and bacterial inoculation on the bioburden of infection. Posttraumatic arthritis (PTOA) can take years to develop clinically, but with a porcine pilon fracture model, posttraumatic arthritis can be reliably induced, so different surgical and therapeutic strategies can be tested in prevention. Conversely, the racehorse presents a well-accepted model of naturally occurring PTOA. With preclinical polytrauma models focusing on chest injury, abdominal injury, multiple fractures, and/or head injury, one can study how various injury patterns affect fracture healing can be systemically studied. Finally, these preclinical models serve as a translational bridge to for clinical application in human patients. With selection of the right preclinical model, studies can build a platform to decrease the risk of emerging technologies and provide foundational support for therapeutic clinical trials. In summary, orthopaedic trauma preclinical models allow scientists to simplify a complex clinical challenge, to understand the basic pathways starting with lower vertebrate models. Then, R&D efforts progress to higher vertebrate models to build in more complexity for translation of findings to the clinical practice.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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