Q: The new building is co-owned by the medical center and the practice. What is the significance of that?
Joshua Jacobs, MD: Midwest Orthopaedics financed the building in partnership with the medical center. Rather than being employed physicians who are part of a faculty practice plan, we physicians are in a private practice that is aligned with the medical center. This allows us to have more autonomy in tailoring our facilities to meet the needs of patients.
Q: How does the new building improve orthopedics at Rush?
JJ: For the first time, we will have administration, research, education and patient care at Rush under one roof. Patients can go to one place in the medical center for all their outpatient orthopedic needs, including imaging and rehabilitation.
The close proximity of all parts of the orthopedic enterprise will improve interactions among staff, and this will make us more efficient. Just as important, it will enhance our translational research efforts — translating research into clinical practice.
Q: What sort of research activities are Rush orthopedic surgeons involved in?
JJ: Where do I start? Rush orthopedic researchers have been doing studies on bone remodeling, cartilage restoration, spine and joint biomechanics, fixation of total hip and total knee prostheses, the biology of implant loosening and analysis of retrieved orthopedic implants.
For example, we are trying to build better artificial joints by analyzing how different materials wear and corrode in the body. We also have a human motion analysis lab, which provides specific data on the forces and motions in joints during a variety of activities.
Rush researchers are engaged in tissue engineering, bone biology, cartilage biochemistry, growth factor research, inflammatory arthritis research, intervertebral disc biology and clinical outcome studies, to name some more key areas. We have multiple NIH grants to study several of these topics.
When we know how materials put in the body wear and corrode, we can design a better implant. We also use molecular biological methods to investigate how cells respond to debris generated from hip and knee replacements. One of our goals is to develop treatments other than surgery, such as medications or local injections, to prevent bone loss around hip and knee implants.
Q: You are director of the Section of Biomaterials in the Orthopaedics Department. Can you talk about your work there?
JJ: I spend about half of my time doing research. For many years, I’ve been studying the degradative processes of implant materials, such as wear and corrosion. We do much of this research on implants retrieved postmortem, often after decades of excellent clinical function. Rush has a large autopsy retrieval program to help predict the long-term success of joint replacements.
One of my interests is the effect that an orthopedic implant has on the surrounding body tissues and distant organs. Based on this work, we now can take blood from the patient and determine the level of metal in the serum. This may help us pinpoint a problem with the artificial joint without having to do exploratory surgery.
Q: You have an engineering degree. How has that helped you with your work?
JJ: I have an undergraduate degree in material science & engineering. I got an in-depth knowledge of the properties of metal, ceramics and polymeric materials, which has helped me understand many of the clinical problems of patients with implants made from these materials. In many ways, my work is at the interface of medicine and materials science & engineering.
Q: Do you want to predict future developments in orthopedics?
JJ: Orthopedic tissue-engineering is a growing area of research. It uses engineering principles to regenerate tissues that are components of the musculoskeletal system, such as cartilage, bone, tendons and ligaments. In addition, in this age of dramatic advancement in biotechnology, genetic tests may eventually be able to predict a patient’s likelihood of developing an orthopedic disorder, including an adverse reaction to an orthopedic implant.
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