Orthopedic & Arthritis Center for Outcomes Research, OrACORe (Dr. Jeff Katz & Dr. Elena Losina)

The Orthopedic and Arthritis Center for Outcomes Research (OrACORe) consists of ~ 15 investigators, research staff, pre- and post-doctoral trainees and students. The team is dedicated to rigorous clinical and policy studies of pressing questions in musculoskeletal health with particular focus on osteoarthritis, knee, shoulder and hip problems and orthopedic interventions. The OraCORe team had a productive 2012-13 academic year. Several publications and grant awards are highlighted here:

1. • We reported initial findings from MeTeOR Trial (Meniscal Tear and Osteoarthritis), a seven center randomized controlled trial of arthroscopic partial meniscectomy vs. standardized physical therapy regimen for patients with symptomatic meniscal tear and concomitant symptomatic OA.¹ The efficacy of surgical vs. rehabilitative approaches to meniscal tear in this setting OA had not been examined previously in a multicenter RCT.
2. • We examined the cost effectiveness of disease modifying therapy for osteoarthritis.² As of today, there are no established disease-modifying medications for OA and this study examined the circumstances in which such an agent could be cost effective.
3. • We estimated the burden of knee replacement in the United States.³ This was the first study to estimate the total number of individuals in the US who have received knee replacement across the age spectrum.
4. • We reported results of analyses of the lifetime risk and age at diagnosis of knee OA in the US.⁴ This study underscored the very high risk of OA among the obese.
5. • We reported the cumulative risk of reconstruction for patients with ACL injury seen at a referral center and we evaluated factors associated with the decision to perform surgery in patients with ACL injury.⁵
6. • We reviewed the clinical examination of the shoulder in patients with suspected rotator cuff disorders.⁶

Dr. Elena Losina, OrACORe co-Director, received two NIH grants this year as well. One is a large R01 award to use the Osteoarthritis Policy Model to examine policy relevant questions pertaining to pain management in patients with osteoarthritis. The other is an R21 award to examine the efficacy of using financial incentives and/or behavioral interventions to optimize outcomes of rehabilitation following total knee replacement. Dr. Katz, OrACORe Director, was awarded funding from NIH to follow the MeTeOR cohort for another five years to examine clinical and imaging outcomes in this valuable cohort with meniscal tear and osteoarthritis. Drs. Katz and Losina are Principal Investigators of an NIH funded T32 training program that was approved for another five years of funding.