[slideshow_deploy id=’425′]
Spinal Stenosis – “Getting (the) Back On Track”
Symptomatic lumbar spinal stenosis is a highly disabling condition. It is the most common reason for spinal surgery in patients over 65 years of age. In the RESTORE study (Neuromuscular REhabilitation potential after Spinal STenosis OpeRation in the Elderly), we want to contribute to the understanding of this disease – and notably the surgical intervention by evaluating the pre- and postoperative muscular condition. Assessing the regeneration of muscle function will enable us to establish new objective outcome-parameters of postoperative results. We therefore hope to improve treatment strategies for patients with spinal stenosis by identifying patient subgroups with the greatest benefit from surgery. On the other hand, this study will help us to identify the right moment for the operation. Another, probably even more important improvement could affect the conservative treatment in terms of developments of new concepts in prevention of deterioration or even occurrence of symptomatic degenerative lumbar spinal stenosis.
Osteochondral Lesions – “Mind the Gap”
Focal damage to cartilage and underlying bone, so-called osteochondral lesions, are frequently found in knee and ankle joints – especially in young sports-active patients. When not properly treated, these injuries represent a major risk factor for developing osteoarthritis.
In order to prevent osteoarthritis development, accurate and early diagnosis of osteochondral lesions is of crucial importance. Thereafter, well-established and effective surgical techniques such as knee-to-ankle mosaicplasty and iliac crest plug transplantation are routinely applied for treatment.
In collaboration with the Department of Radiology, the Osteoarthritis Research Center pursues innovative non-invasive diagnostic imaging (MRI, SPECT-CT) of osteochondral lesions. Additionally, we investigate pathologic processes on a cellular and molecular level. Through prospective documentation of patients, we continuously evaluate and try to improve treatment methods. Through a combination of high quality research, innovation and expertise, we strive for excellence in patient care.
Basel Study on Early Osteoarthritis (BaSE-OA) – “Treat Before It´s Too Late”
From a treatment perspective, the early phase of osteoarthritis is the most important one. Since only minor structural damage has occurred at this stage, this represents a window of opportunity for preventive treatment. For this, a thorough understanding of the pathological processes in early osteoarthritis is needed.
Prospective studies of patients with early osteoarthritis help to identify risk factors for disease progression. Recently, it has become clear that the prevalence of inflammation is increased in the early stage of disease. Characterizing inflammation in the different joint tissues is expected to contribute to a improved detection and treatment of osteoarthritis.
The Osteoarthritis Research Center premieres with the establishment of a specialized Early OA Clinic, as a joint effort of the Departments of Orthopaedics and Rheumatology. Through cellular, molecular and metabolomic analyses of synovial fluid and tissue we aim to decipher the risk factors for progression of osteoarthritis.
Musculoskeletal Outcome Assessment Group – “Let’s Get Systematic”
Musculoskeletal diseases are among the most important reasons for pain and impairment in present day, industrialized societies. As such the importance of treatment options for such diseases cannot be overestimated, and the availability of evidence based treatment algorithms and cost-effectiveness assessments is crucially important for physicians, economists, and health policy makers. Unfortunately, research on musculoskeletal diseases is highly heterogeneous in quality or simply nonexistent. The objective of this group is to combine specialized knowledge from different field to establish evidence-based outcome assessments and cost-effectiveness assessment to guide clinical decision-making and health policy in Switzerland. The founding members of the musculoskeletal outcome assessment group under the lead of Dr. Patrick Vavken have postgraduate training and experience in orthopedic surgery, internal medicine, rheumatology, public health and epidemiology, biostatistics, basic science. We plan to join these skills to tackle pertinent questions in musculoskeletal health.
Diagnostic Imaging – “What You See Is What You Get”
Computertomography (CT) enables excellent assessment of the complex and distorted bone morphology of an osteoarthritic joint. Apart from assessing morphological changes, monitoring pathological metabolic activity of bone is of great value for diagnosis. At the Osteoarthritis Research Center, we focus on the development, application an innovation of imaging techniques for joint diseases.
Scintigiraphic imaging of bone-specific radionuclides using single photon emission (SPECT) CT is routinely applied for identifying areas of bone remodeling, as a result of increased osteoblast activity. Cartilage thickness can also be assessed using CT, while magnetic resonance imaging (dGEMRIC) enables highly detailed analysis of cartilage structure and function. The latter is applied for monitoring cartilage after a repair treatment.
Currently, our innovative research focuses on novel contrast enhanced CT (CECT) imaging techniques. In vitro experiments showed CECT to be an excellent tool for quantification of proteoglycan content of cartilage. Together, this well-filled toolbox of imaging technologies is essential to early and accurate diagnosis of – and measuring treatment effectiveness for osteoarthritis.