Keith Knurr, DPT, PhD, assistant professor, Department of Orthopedics and Rehabilitation, and Corinne Henak, PhD, assistant professor, Departments of Mechanical Engineering / Orthopedics and Rehabilitation / Biomedical Engineering, were recently awarded the UW Institute for Clinical and Translational Research (ICTR) Advancing Translational Research and Science (ATRS) project planning grant.

Their project, “A Step Towards Precision Medicine: Collaborative Team Building to Leverage Quantitative MRI for the Clinical Management of Knee Osteoarthritis,” aims to develop a pipeline for creating patient-specific knee models that can provide estimates of the loads experienced by the cartilage across various tasks, such as walking, running, and jumping. These models may provide better insight into an individual’s risk of osteoarthritis onset and progression.

To make these models patient-specific, Drs. Knurr and Henak will use an individual’s knee shape acquired from standard knee MRIs, cartilage mechanical properties from advanced quantitative MRIs of the cartilage, and movement biomechanics from three-dimensional motion capture analyses within Badger Athletic Performance.

This project will also leverage data from a separate study, partially funded by a Department of Orthopedics and Rehabilitation Freedom of Movement Fund Award, investigating factors associated with early signs of knee osteoarthritis in former collegiate athletes with a history of anterior cruciate ligament reconstruction. The team chose to apply these patient-specific knee models to individuals following anterior cruciate ligament reconstruction because they are at a high risk of developing osteoarthritis.

May 30, 2023 – Scott Crawford, PhD, an assistant professor in the University of Wisconsin Departments of Kinesiology at the School of Education and Orthopedics and Rehabilitation at the School of Medicine and Public Health, was recently awarded a KL2 Scholar Program grant; he will officially begin the program in July 2023. Funded by the NIH through the UW Institute for Clinical and Translational Research (ICTR), the KL2 Scholar Program supports “junior faculty at UW Madison pursuing and actively engaged in translational research and who are committed to developing an independent research program.” Crawford’s KL2 grant will provide him with two years of protected time for research and career development training – allowing him to delve into novel ideas and emerge as a leader in the field.

His current research project, “Neuroplasticity in Muscle Mechanics Following Hamstring Injury: A Combined fMRI and Ultrasound Study,” will investigate the neural changes that occur after hamstring injuries. Crawford says that, while we have gotten good at diagnosing and identifying the progression of hamstring injuries and returning athletes to their sport, “re-injury rates are still very high.” Most studies show as high as 1 in 3 will go on to re-injure – though some show re-injuries as high as 60% or more.

By examining muscle tissue mechanics using ultrasound and brain activity using fMRI, Crawford hopes to uncover if altered brain activity following a recent hamstring strain injury may be related to why re-injury rates for hamstring strains remain high, despite advancements in rehabilitation protocols. The study is still in the piloting stage, where Dr. Crawford and his team are refining their methodology before enrolling participants.

Before coming to UW, Dr. Crawford earned his Bachelor of Science in Mechanical Engineering from Cedarville University in Ohio and his Master’s and PhD in Biomedical Engineering from The Ohio State University. He joined the UW as an NIH-funded TL1 Post-Doctoral Trainee under Dr. Bryan Heiderscheit in January 2019 – later transitioning to a faculty position in the Kinesiology Department with a joint appointment in the Department of Orthopedics and Rehabilitation in August 2022.

Dr. Crawford’s educational background in biomedical engineering and biomechanics and his work in the Badger Athletics Performance Lab shaped his interdisciplinary approach to studying sport-related muscle injury. Further, as Dr. Crawford pursues the focused study afforded by his KL2 grant, he says that the symbiotic relationship between research investigators across different academic departments, clinicians, and surgeons at UW allows him to “collaborate with people like Dr. Heiderscheit, [the Badger Athletics Performance Program], and other orthopedic faculty members” and find “common ground” that will ultimately translate research findings into impactful treatments for patients.
 

UW researchers are recruiting participants for a clinical trial exploring an innovative non-opioid therapy to treat painful diabetic peripheral neuropathy (PDPN). Nalini Sehgal, MD, Professor and Chair of the Division of Rehabilitation Medicine and the Director of the UW Interventional Pain Medicine Program and Pain Medicine Fellowship, is the study’s principal investigator (PI); Ali Zandieh, MD, and Collin Kreple, MD, of the UW Department of Neurology are the trial’s sub-PIs.

PDPN affects up to 30% of patients with diabetes, significantly decreasing the quality of life for those who experience the condition – causing numbness, tingling, and intense pain in the hands, feet, and lower limbs. Worse, current treatments provide little pain reduction and are frequently not well-tolerated for most PDPN patients.

A novel substance called NRD could hold the key to finding relief for these patients. NRD was discovered in a medicinal tea used in a village in Siberia to treat various illnesses and was identified as the substance in the tea most likely to result in pain reduction. Improved by researchers through chemical alterations and put into pill form, NRD was shown to be safe and well-tolerated in three Phase 1 trials. It was then tested for a Phase 2a trial, resulting in reduced pain.

To further test the safety and efficacy of NRD, the National Institutes of Health (NIH) is funding a multi-center initiative to conduct a phase 2, placebo-controlled clinical trial. Based at Massachusetts General Hospital, the study has 16 research sites nationwide – the UW School of Medicine and Public Health is the Wisconsin site. Investigators aim to recruit 122 participants from around the United States. To participate, individuals must meet the following criteria:

• Are at least 18 years old and have had Type II diabetes with PDPN for at least six months;
• Can stop other pain medications for 12 weeks, other than acetaminophen (Tylenol), as needed;
• Don’t have a history of heart attacks, heart disease, or stroke.

Study volunteers must come in for eight to nine visits over 13 weeks and will receive up to $850 for their participation. For more information or to determine if you can participate, please contact Janelle Suriaga, Clinical Research Coordinator at (608) 265-2413 or by email.

This research is a part of the NIH-funded Early Phase Pain Investigation Clinical Network (EPPIC-Net), whose mission is to “enhance pain treatment and reduce reliance on opioids with early phase clinical trials of non-addictive pain therapeutics.”

Uncovering the reason behind Type 1 Diabetes-related bone loss

Department of Orthopedics and Rehabilitation associate professor and researcher, Wan-ju Li, MS, PhD was recently awarded a $50,000 one-year Translational Basic & Clinical Pilot Grant from the UW Institute for Clinical and Translational Research (ICTR) for a proposal titled “GATA6 in Regulation of Type 1 Diabetes Mellitus-related Bone Loss.”  Dawn Davis, MD, PhD of the Department of Medicine is co-principal investigator for the project.

Why are Type 1 diabetes patients prone to bone loss?

Drs Li and Davis believe that the molecule GATA6 dysregulated in skeleton-forming stem cells in type 1 diabetes patients is a key player that connects the two diseases. Through their study, Li and Davis expect to “determine the role of GATA6 in regulating the pathological mechanism of type 1 diabetes-associated bone loss and provide insight into developing potential pharmacological treatments for the disease.”

A Minimally-Invasive Approach to Correcting Leg Length Discrepancy in Children

Yet another dynamic collaboration receiving a one-year, $50,000 ICTR Pilot Grant was UW Orthopedics and Rehabilitation faculty member, Kenneth Noonan, MD and his co-PI, Christopher Brace, PhD of the UW Radiology and Biomedical Engineering departments. Funding from this grant will support their project, “Microwave Ablation to Correct Leg Length Discrepancy in Children.”

Drs. Noonan and Brace aim to develop a safe, less invasive treatment for children with limb length discrepancy (LLD) greater than three centimeters by adapting an alternative to the condition’s standard treatment – a surgical procedure that mechanically disrupts growth plates using drills. Microwave ablation, a “well-tolerated method to destroy tissue through highly localized heating,” is a tried and true technique that “has been used widely in other contexts such as liver cancer treatment.”

Their goal is to determine the effectiveness of using targeted microwave heating to ablate the growth plate (curtailing bone growth) in growing pigs, paving the way toward using this method in human subjects.

The ICTR Pilot Awards Program funds projects that focus on cross-disciplinary research, emphasizing “innovative research methods, team science, health equity, and impact.”
 

October 20, 2022

Congratulations to Dr. Brian Grogan, Dr. Eric Cotter of the University of Wisconsin Department of Orthopedics and Rehabilitation, and their team of researchers on winning the “2022 American Shoulder and Elbow Surgeons’ Candidate Research Grant.”  This ASES $10,000 grant award will help support their research exploring the clinical effectiveness of adding blue light therapy to current prophylactic strategies in reducing postoperative infections caused by cutibacterium acnes.

Co-Investigators are:

Lisa Cotter, MD  (Investigator) – University of Wisconsin, Dermatology
Jonah Dixon, BS (Investigator) – University of Wisconsin, Infectious Disease
Nasia Safdar, MD, PhD (Investigator) – University of Wisconsin, Infectious Disease
David Gold, PhD (Investigator) – University of Wisconsin, Physics
Aniekanabasi Ime Ufot, BS (Data Collection) – University of Wisconsin, Orthopedics
Nicholas VanDerwerker, BS (Data Collection) – University of Wisconsin, Orthopedics

“Our multidisciplinary team is excited for the investment by ASES in our work defining the optimal dosing of blue light to eradicate C acnes,” stated Co-Principal Investigator, Dr. Eric Cotter.