Eliminating Pain. Restoring Mobility. Improving Bone and Joint Care — Everywhere. Your impact on RUSH and the future of orthopedic medicine 2023 Report to Donors
Message From the Chairperson Joshua J. Jacobs, MD Chairperson, Department of Orthopedic Surgery The William A. Hark, MD – Susanne G. Swift Professor of Orthopedic Surgery
Dear Donor Partner, Every year, more individuals from around the Midwest with musculoskeletal conditions turn to the talented orthopedic specialists at RUSH for their care. For the 11th-straight year, RUSH’s orthopedic program ranked among the nation’s Top 10 in the U.S. News & World Report specialty rankings. Just recently, 15 of my outstanding colleagues were named “Top Docs” in Chicago magazine — the highest number of RUSH orthopedic specialists since the inception of this popular list. RUSH’s leadership in orthopedics isn’t by chance. It’s because of you, our donor community. Thank you. Our donors fuel research to generate new knowledge that makes orthopedic care better — not just for our patients, but for millions of patients around the world. Whether they know it or not, providers everywhere are influenced by RUSH’s bone and joint research any time they select a hip implant device for a patient, affix a screw during spine surgery or use an arthroscopic approach to repair a torn rotator cuff. RUSH teams, in the exam room and the laboratory, lead studies that improve upon these and countless other treatment approaches that restore mobility and eliminate pain. Philanthropic support enables our experts to create the evidence that guides evidence-based care. Donor funding strengthens research that helps our teams make incremental progress, but it is especially critical in propelling new discoveries. Our researchers frequently make novel observations that have never been explored before. Pilot funding from donors allows them to pursue these types of high-risk, high-reward studies that frequently lead to breakthroughs. Finally, because of you, RUSH is able to carry this tradition of excellence in orthopedic care and research forward to the next generation of experts. Your support for our academic endeavors enables us to educate dozens of resident physicians, fellows, medical students, PhD students and other trainees who are embedded in our work today and are the thought leaders of tomorrow. From all of us involved in RUSH’s bone and joint programs, thank you for your continued investment in our team and the future of orthopedic medicine. With gratitude,
Reconstruction Research Reverberates Advancing the Science of Joint Replacement Thanks in large part to the trailblazing work of RUSH physicians and scientists, joint replacement practice today is overwhelmingly successful. More than 1.2 million knee and hip replacements are performed each year in the U.S. — a number expected to double by the end of the decade. This means even low complication rates affect tens of thousands of people and cost the U.S. healthcare system billions. At the same time, joint replacements for the shoulder, elbow, wrist, hand and ankle continue to increase in popularity. RUSH leads one of the country’s preeminent programs for joint replacement research, with donor support fueling grants from the National Institutes of Health that make joint reconstruction procedures even more successful.
Seeds Planted by Donors Blossom into Federal Grants Frustratingly, federal funding for arthritis and joint reconstruction research from the National Institutes of Health, or NIH, has stagnated over the past decade: It receives a disproportionately low amount of funding compared to rarer conditions. Donor support gives RUSH investigators an advantage in this competitive landscape for federal grants. Philanthropy allows researchers to gather preliminary data in pilot studies, maintain world-class research laboratories and support postdoctoral scientists who are essential in shaping high-quality grant submissions to the NIH.
“Without philanthropic funding, I would not have been able to support the students and fellows in the way we needed to move our research forward, nor would I have been able to acquire the software that is essential to our laboratory’s work,” said Hannah Lundberg, PhD, associate professor of orthopedic surgery and director of computational biomaterials. Dr. Lundberg currently leads an NIH-funded study related to corrosion-induced hip implant failure and is working to obtain funding for research focused on the wear behavior of total knee implants.
Ten Years, $10.6 Million in NIH-Funded Research A recent analysis published in the Journal of Bone and Joint Surgery found that RUSH was second in the nation for NIH funding for hip and knee replacement research between 2010 and 2020, behind only the Mayo Clinic. Grants from the NIH are viewed as the gold standard in medical research funding. Applications undergo a peer review process and are rigorously evaluated for their scientific and technical merit. In 2019, the most recent year with available data, just 17% of applications to the National Institute of Arthritis and Musculoskeletal and Skin Diseases were awarded. Source for table: Silvestre J, Martinez R, Thompson TL, Wilson RH, Nelson CL. Impact of Orthopaedic Surgeons on National Institutes of Health Funding for Hip and Knee Arthroplasty Research. Journal of Bone and Joint Surgery. 2022 Dec 7; 104(23): e100.
A New Grant to Study Partial Joint Replacement RUSH’s Tribology Laboratory is focused on understanding the friction, lubrication, and wear of natural and artificial joints. The technology and techniques used in the lab aim to simulate how artificial joint materials behave in the body and how they affect cartilage and other tissues. The lab’s leadingedge findings guide improvements to implant materials. In 2023, Markus Wimmer, PhD, the Grainger Director of the RUSH Arthritis & Orthopedics Institute, was awarded an NIH grant to study hemiarthroplasty, an alternative to total joint replacement that preserves healthy portions of the joint. A barrier to advancing this approach is that not enough is known about the many potential implant materials that rub against cartilage. Dr. Wimmer and his collaborators are now studying several metal-bearing surfaces that could be used during hemiarthroplasty procedures and evaluating how healthy cartilage responds to various implant materials.
Seeking to Understand How Acute Pain Becomes Chronic in a Massive, Multicenter Study Why does a subset of people who receive a knee replacement go on to experience chronic pain after surgery? And can we predict it? These are the questions a consortium of the nation’s leading research institutions is trying to answer, with RUSH leading the way. A large portion of the 2,800 people to be enrolled in the national Acute to Chronic Pain Signatures consortium are patients who have received or will receive a total knee replacement at RUSH. Joshua Jacobs, MD, is a principal investigator on this first-of-its-kind study, which also includes collaborators at RUSH from psychiatry and anesthesiology. Participants in the study agree to provide blood samples for various “omic” analyses (such as genomics, proteomics, transcriptomics, etc.) and undergo quantitative sensory testing, psychosocial
Markus Wimmer, PhD, directs RUSH’s tribology lab and has launched a study to advance hemiarthroplasty, a potential alternative to total joint replacement that preserves healthy portions of the joint. profiling and functional MRI imaging of the brain. Funded by a multimillion-dollar NIH grant, the study’s data and resulting discoveries will be made available to scientists everywhere.
Putting Their Best Foot Forward for a Study of Total Ankle Replacements Total ankle replacement is an option for people with advanced arthritis, and the number of these procedures performed in the U.S. has more than doubled over the past decade. But it isn’t as well-studied as hip and knee replacements, something Daniel Bohl, MD, MPH, is working to change. Dr. Bohl and his colleagues are leading a study that involves gathering blood samples from people who have undergone total ankle replacement. The team is studying how metal from implant devices gets released into surrounding tissue or the bloodstream. Learning how metal release from implants affects patient satisfaction, ankle stability and complications is an important step forward for the field.
Keeping Athletes — and Everyone — Active Spotlight on Sports Medicine Faculty Research RUSH sports medicine specialists are internationally regarded experts and the trusted team physicians for the Chicago Bulls and White Sox. While they provide leading-edge care for shoulder, knee, elbow and related injuries to elite athletes, the vast majority of patients they treat are everyday people looking to reclaim their mobility or live without pain. Research findings and treatment innovations from RUSH sports medicine experts have a far-reaching impact on the field. A Seven-Year Study Comes to a Close: Publishing Findings on Biologic Augmentation After Rotator Cuff Repair For people with severe shoulder injuries — a torn rotator cuff — surgery is usually required to reattach the tendon to the upper arm bone. Unfortunately, a significant percentage of people do not heal as hoped and experience a retear to the rotator cuff after surgery.
Brian J. Cole, MD, MBA The Dr. Ralph and Marian C. Falk Professor of Biochemistry
From 2015-2022, Dr. Cole led a prospective, randomized clinical trial of people who underwent rotator cuff repair to determine if a biologic treatment at the time of surgery called bone marrow aspirate concentrate, or BMAC, can improve outcomes. Derived from the patient’s bone marrow, BMAC contains growth factors and antiinflammatory proteins thought to promote bone and soft tissue healing. In American Journal of Sports Medicine, Dr. Cole and his partners published the results from 91 patients: On MRI scans taken one year after surgery, evidence of rotator cuff retear was observed in 18% of people who received the BMAC, compared with 57% of people who were in the control group. It is generally accepted that patients with an intact rotator cuff after a repair are more satisfied with better pain relief and restoration of function.
Using 3D Printing to Make Cartilage Transplantation Procedures More Precise Sports medicine surgeons may recommend an osteochondral allograft transplantation for people with a debilitating cartilage injury to their knee or other joints. This procedure removes the damaged cartilage and replaces it with healthy cartilage from a tissue donor. For the procedure to be successful, the donor cartilage must be placed with a high degree of precision so that the transplanted tissue mimics the contours of the patient’s native cartilage.
Adam B. Yanke, MD, PhD Associate Professor, Department of Orthopedic Surgery
Dr. Yanke, partnering with colleague Alejandro A. Espinoza Orías, PhD, is using CT and MRI data from patients undergoing this procedure to create 3D-printed surgical guides that help with the precise placement of transplanted cartilage. These patient-specific “jigs” minimize the potential for surgeon error and support optimal treatment outcomes.
Giving Surgeons New Options for Hip Labrum Reconstruction Procedures When people experience a particularly severe tear to the hip’s labrum — the ring of cartilage on the socket part of the hip joint — a relatively new procedure called labral reconstruction may be recommended. To rebuild the labrum, doctors use tissue grafts safely harvested from another part of the body. Dr. Chahla’s team, working with Elizabeth Shewman, MS, in the biomechanics lab, has been investigating if and how tissue from a nearby tendon in the hip could fit the bill.
Jorge Chahla, MD, PhD Associate Professor, Department of Orthopedic Surgery
The team’s studies and biomechanical testing protocols, using cadavers and advanced imaging, show the indirect head of the rectus femoris tendon could be a “gold-standard graft” for hip labral reconstruction, giving surgeons performing hip arthroscopy a new — and potentially superior — option in the operating room.
Studying Disparities in Hip Surgery Outcomes to Help Eliminate Them Minimally invasive hip arthroscopy procedures — to address damaged tissues, repair tears or reshape bones — help patients reclaim their mobility and can stave off the need for hip replacement surgery. Like many medical procedures, though, there are disparities in patients’ long-term outcomes that seem associated with their socioeconomic status. Dr. Nho and his team are working to understand this better and identify ways to eliminate these disparities.
Shane J. Nho, MD, MS Associate Professor, Department of Orthopedic Surgery
Dr. Nho and his team analyzed thousands of hip surgery patients and grouped them by Social Deprivation Index, or SDI, a composite score that uses a person’s zip code to estimate social determinants of health such as education level and income. Five years after surgery, people with lower SDI scores were much more likely to experience a worse outcome. The researchers are now drilling down to pinpoint factors that influence these disparities the most so they can design interventions.
Advancing Research to Understand a Main Cause of Shoulder Implant Failure As total shoulder replacements become increasingly common (more than 350,000 are expected to be performed annually by 2025), more research is needed to make these implants last even longer and minimize complication rates.
Grant E. Garrigues, MD Professor, Department of Orthopedic Surgery
Dr. Garrigues and his collaborator, Robin Pourzal, PhD, have zeroed in on the issue of aseptic loosening, a leading cause of implant failure that occurs when wear particles from the joint replacement induce an inflammatory response damaging to the bones connected to the implant device. The team is currently studying 270 failed shoulder implants removed during revision procedures, including the devices themselves and surrounding tissues. Through advanced lab techniques including electron microscopy, they are forging new ground in understanding the biologic conditions that lead shoulder implant devices to fail.
Bone and Joint Briefs Notes from Our Labs, Clinics and Communities Pioneering and Pursuing a Promising Therapeutic Approach for Rheumatoid Arthritis Although new therapies for rheumatoid arthritis have emerged in recent years, these drugs tend to suppress the immune system, can have difficult side effects and don’t target the underlying mechanisms causing rheumatoid arthritis. More breakthroughs are needed to meaningfully transform care for this chronic autoimmune joint disease affecting about 1.5 million people in the U.S. The lab of Adrienn Marcovics, MD, PhD, assistant professor in the Department of Orthopedic Surgery, has been a pioneer in studying an enzyme called SHP-1 in the context of autoimmune joint disease. Produced by immune cells, SHP-1 is understood to put the brakes on excessive immune cell activation that leads to the body attacking its own tissues. In rodent studies, Dr. Marcovics’ lab found that mice with genetically enhanced SHP-1 activity were protected from rheumatoid arthritis. Therapies designed to activate SHP-1 activity were also successful in reducing disease severity in two different mouse models of the disease. “Considering recent advancements in medicine and technology, such as the development of mRNA vaccines and the genetic engineering of patient-derived immune cells for cancer therapy, we believe that cell-based approaches like ours represent the future of successful therapeutics for rheumatoid arthritis,” Dr. Marcovics said. She and her colleagues are now working to build on these studies and gather more data in the hopes of moving this research closer to human study.
Frank Phillips, MD, was the first surgeon to use an augmented reality system during a lumbar fusion procedure in 2020. The headset accurately determines the position of surgical tools, in real-time, and a virtual trajectory is then superimposed on the patient's CT data.
Applying Artificial Intelligence to Spine Surgery In 2020, RUSH’s Frank Phillips, MD, made headlines when he became the world’s first surgeon to use augmented reality surgical guidance during minimally invasive spine surgery. Since then, Dr. Phillips, the Ronald L. DeWald, MD, Professor of Spinal Deformities, has advanced his research into augmented reality and artificial intelligence, publishing four articles on the topic last year with colleagues. Their focus now is developing an artificial intelligence platform that will help predict outcomes after spine surgery.
Improving Joint Replacement Outcomes Through Research and Disseminating Findings Reducing postoperative pain, improving sleep and minimizing the need for opioids after reconstructive knee surgery — these are just some of the objectives being spearheaded by Craig Della Valle, MD, the Aaron G. Rosenberg, MD, Professor of Orthopaedic Surgery, and his research team. They are currently enrolling participants into randomized studies to determine how carefully timed interventions before and after surgery,
such as antidepressant medications and nonsteroidal anti-inflammatory drugs (a safer alternative to opioids), address patient outcomes. Dr. Della Valle and his collaborators recently presented on their research findings at the American Association of Hip and Knee Surgeon’s annual meeting in Dallas.
List of the World’s Leading Researchers Includes 19 Orthopedics Faculty from RUSH Nineteen. That’s how many faculty from RUSH’s Department of Orthopedic Surgery were represented in a recent ranking of the world’s top 2% of scientists compiled each year by Stanford University statisticians. This database applies a standardized methodology accounting for how many scientific papers these researchers have published and how often their work is cited by international colleagues in the field. “These rankings speak to the credibility and impact of our bone and joint research,” said Dino Samartzis, DSc, associate professor, who is among those recognized on the list. “Further, it illustrates the productivity of our group, with the papers from these 19 researchers being cited more than 20,000 times in the year 2022 alone.”
The seventh annual Chicago Sports Summit generated $75,000 to support RUSH’s bone and joint research.
Discussing the Latest Topics in Sports and Fueling Orthopedic Research Leaders from pro and college sports organizations, as well as experts in the business of athletics and sports medicine, gathered on Oct. 17, 2023, for the seventh annual Chicago Sports Summit hosted by Midwest Orthopaedics at RUSH. “The challenges we have in high-level sports are the exact same challenges we deal with on a daily basis with our patients who want to remain active and pain-free,” said Brian Cole, MD, MBA. Dr. Cole and his colleagues directed event proceeds to bone and joint research underway at RUSH.
Celebrating a Career Milestone for Steven Gitelis, MD In 2022, RUSH celebrated the 50-year career milestone of internationally recognized orthopedic oncological surgeon Steven Gitelis, MD. Dr. Gitelis pioneered surgical resection and reconstruction methods known as limbsalvage techniques to improve the treatment of sarcomas, making amputation a rare, last resort. He has directed the Section of Orthopedic Oncology at RUSH University Medical Center since 1984. Dozens of former patients, colleagues and friends hosted a gathering in May 2023 at Murphy’s Bleachers, the iconic sports bar across from Wrigley Field, to raise a toast in Dr. Gitelis’ honor. In addition to touching tributes and heartfelt speeches, the event raised awareness about orthopedic oncology research at RUSH, which has benefited significantly from philanthropic support during Dr. Gitelis’ career. “We have watched pediatric patients grow into adulthood and our adult patients’ hair turn gray,” reflected Patty Piasecki, a nurse practitioner who has worked closely with Dr. Gitelis for the past 39 years. “We have attended our patients’ weddings, met the children they thought they’d never be able to have and celebrated career, education and life milestones alongside them.”
Grateful patients and colleagues hosted an event celebrating Dr. Gitelis’ 50 years in medicine in May at Murphy’s Bleachers. An expert in orthopedic oncology, Dr. Gitelis (second from left) was one of the nation’s first surgeons to perform bone transplants and helped establish the region’s first tissue banks for bones used in reconstructive procedures after cancerous bone tissue is removed.
To make a gift, arrange a tour of RUSH’s bone and joint laboratories, or learn more about how you can support research that transforms orthopedic care around the world, contact:
Derek Lambert Executive Director of Development (312) 942-6289 derek_lambert@rush.edu
Your support helps more people lead active lives, free of pain. Make a gift at rushgiving.com/boneandjoint