Bone & Joint Decade Brings Awareness to Musculoskeletal Issues on Nashville Medical News

Bone & Joint Decade Brings Awareness to Musculoskeletal Issues

By: CINDY SANDERS

The United States Bone and Joint Decade (USBJD) – 2002-2011 – is nearing the end of Phase I. Yet, the work of raising awareness and research dollars to better address preventive measures and effective treatment options has really just begun.

A multi-disciplinary global effort, the Bone and Joint Decade was internationally launched in 2000 and adopted in the United States in 2002.

"This was essentially a movement that came out of Sweden," explained Joshua J. Jacobs, MD, president of the USBJD. "There was a general realization by healthcare practitioners of the growing burden of musculoskeletal disease worldwide and the fact that it wasn't appreciated by policymakers and the public."

Raising Awareness

National Rehabilitation Awareness Week: September 20-26, 2009 (www.nraf-rehabnet.org)

National Physical Therapy Month: October 2009 (www.apta.org)

World Arthritis Day: October 12, 2009 (www.worldarthritisday.org)

Bone & Joint National Action Week: October 12-20, 2009 (www.usbjd.org)

World Spine Day: October 16, 2009

World Trauma Day: October 17, 2009

World Osteoporosis Day: October 20, 2009 (www.iofbonehealth.org)

Jacobs, who is a board-certified orthopedic surgeon and chair of the Department of Orthopedic Surgery at Rush University Medical Center in Chicago, noted the concept was modeled after the highly successful "Project on the Decade of the Brain," which resulted in increased awareness and research funding of neurological disorders.

Jacobs and his colleagues around the globe hope to bring more attention to the pervasive issues tied to musculoskeletal health. "Even though the mortality rates don't approach other common diseases like cancer, cardiovascular disease, and stroke, the overall burden on the individual and society rivals those other conditions," he stated.

Although pleased with the progress that is being made, Jacobs said it is clear more needs to be done. "We still think musculoskeletal disease research is under funded. It only gets less than 2 percent of NIH research dollars … yet represents among the most prevalent diseases in our society."

Despite the range of conditions included – from lower back pain and osteoporosis to arthritis, cerebral palsy, and injuries from trauma – the current National Institutes of Health budget of approximately $30 billion includes less than $500 million for musculoskeletal research.

Worldwide, musculoskeletal conditions are the most common cause of long-term pain and physical disability … an issue that is only intensifying as the population ages. Furthermore, according to the USBJD, joint diseases account for half of all chronic conditions in the elderly, and a full 40 percent of women over the age of 50 are expected to suffer a minimum of one osteoporotic fracture in their lifetime. In addition to chronic diseases, musculoskeletal trauma as a result of accidents also represents a major cost. In developing nations, traffic injuries are expected to account for as much as 25 percent of all healthcare expenditures by 2010.

Momentum Gathers for a National Joint Registry

On June 10, 2009, Reps. William Pascrell, Jr. (D-N.J.) and Lloyd Doggett (D-Texas) introduced the "National Knee and Hip Replacement Registry Act," (HR:2813) to establish a national joint registry within the Agency for Healthcare Research and Quality.

The legislation calls for the identification of predictors that lead to poor outcomes in knee and hip replacement to assist providers in decision-making, a reduction in the number of revision surgeries needed as a result of poor outcomes, and detection of poorly performing devices or surgical techniques.

"We are one of the few English-speaking countries in the world that doesn't have this, and we think it is important for the orthopedic surgical community to have a handle on how these devices are performing in large populations of patients," said Joshua J. Jacobs, MD, chair of the Department of Orthopedic Surgery at Rush University Medical Center in Chicago and an active member of the American Academy of Orthopaedic Surgeons (AAOS). A major concern with the proposed legislation in its current format, he continued, is with the provision that the registry be under government control.

"The most successful registries have not been government-controlled and government-run," Jacobs noted. "What we're advocating is for an independent, third party to administer the registry. So while we're supportive of the registry concept, we think the current bill in Congress could be amended and improved."

In a July 2009 cover story for AAOS Now, Daniel J. Berry, MD, AAOS second vice president, also stated the organization's concerns over establishing a government-run entity. "As such, it would analyze only the information pertaining to patients who have had surgeries paid for by the government. This would provide a great deal of data but would exclude a huge number of the patients who have joint replacements every year," he said.

Berry continued, "The AAOS strongly supports the intent of this legislation. We could fully support it if it established an independent joint registry with the same legal protections for orthopedic surgeons that it has proposed for patients and implant manufacturers."

Here in the United States, musculoskeletal conditions account for more than 130 million patient visits to healthcare providers annually and are the number one reason people visit a physician. More than one in four Americans has a musculoskeletal condition that warrants medical attention.

Based on data gathered in 2004, Jacobs said, "Healthcare costs and lost wages for patients with musculoskeletal conditions is estimated to be almost $850 billion on an annual basis, which is 7.7 percent of the gross domestic product."

Despite the frustration over tight research dollars, Jacobs and others involved in the USBJD have expressed excitement over the potential for progress. Scientists are on the verge of several exciting discoveries that could potentially improve treatment options and simplify procedures, while shortening recovery times.

The USBJD has also launched several projects that have had positive outcomes including PB&J, Fit to a T, and the Young Investigators Initiative.

PB&J (Protect Your Bones & Joints) "is targeted toward young individuals to learn what to do to optimize bone and joint health," explained Jacobs. The interactive program helps teens and young adults adopt preventive measures to lessen the chances of arthritis, osteoporosis, sports- and road-related trauma.
Fit to a T "reflects the T-score on a bone density test," said Jacobs. "This is a public program to raise awareness of osteoporosis, which can lead to fragility fractures. This is very important in an aging population."
Young Investigators Initiative "is a program to train early career clinical investigators to write grants to be as competitive as possible for federal funding," Jacobs noted of this program aimed at a professional audience.

Soon, the United States will have the opportunity to showcase the work that has been accomplished so far and to discuss strategies for the future with their counterparts from around the world. On October 21, a cadre of preeminent scientists, surgeons, physicians, policymakers and activists will converge on Washington, DC from around the globe for the Bone and Joint Decade Global Network Conference.

"We have, for the first time in the Bone & Joint Decade movement, a global conference being held in the United States," said Jacobs. "We've chosen Washington, DC as the venue because it is the place to be if you want to affect public policy," he stressed.

During this meeting, Jacobs said a major focus would be on leveraging the successful coalitions formed as part of the Bone & Joint Decade to move forward in the next decade and beyond. He added the need to find effective solutions intensifies here in the United States as baby boomers become senior citizens since the prevalence of musculoskeletal diseases increases with age.

Jacobs concluded, "Obviously we haven't solved all the problems, but we have an excellent start. We want to take advantage of the progress that we've achieved during the first seven years of the Bone & Joint Decade in the United States."

AOSSM Inducts New President

Surgeon James Andrews, MD, Takes the Reins

On July 11, 2009, internationally recognized orthopedic surgeon and sports medicine specialist, James R. Andrews, MD, was installed as the 38^th president of the American Orthopaedic Society for Sports Medicine (AOSSM) during the organization's annual meeting in Keystone, Colo.

Andrews is a founding member of the Andrews Sports Medicine and Orthopaedic Center located at St. Vincent's Hospital in Birmingham, Ala. He is also the founder and chairman of the non-profit American Sports Medicine Institute, which focuses on injury prevention, education and research in orthopedics and sports medicine. He serves as a clinical professor of orthopedic surgery at the University of Alabama School of Medicine; University of Virginia, School of Medicine; University of Kentucky Medical Center; and the University of South Carolina Medical School. Additionally, he is the founder and medical director of the Andrews Institute in Gulf Breeze, Fla.

In his long and distinguished career, Andrews has served on multiple AOSSM committees, mentored nearly 300 sports medicine fellows, authored more than 250 papers tied to his scientific and clinical research in knee, shoulder, and elbow injury prevention and treatment, and presented his findings around the world.

He is actively involved in sports medicine and cares for athletes at Auburn University, the University of Alabama, Troy University, University of West Alabama, Tuskegee University and Grambling University. He is also involved on the professional level as a consultant for the Washington Redskins, medical director for the Tampa Bay Rays and the LPGA, and team physician for the AA Birmingham Barons. Andrews also serves on the Medical and Safety Advisory Committee of USA Baseball and on the board of directors for Little League Baseball, Inc.

Andrews received his undergraduate degree from Louisiana State University and his medical degree from LSU School of Medicine. In 1972, he completed his orthopedic residency at Tulane Medical School and had surgical fellowships in sports medicine at the University of Virginia and the University of Lyon in Lyon, France.