Musculoskeletal diseases and musculoskeletal trauma affect hundreds of millions of people around the world. Research at the Department of Orthopedic Surgery aims at new or advanced treatments to alleviate suffering from musculoskeletal disorders. Problems identified in the clinic are taken to the laboratory bench for study, and the results are then retranslated into clinical practice.
The challenges we face are to improve the clinical outcome for our patients and to develop treatments that are safe, effective and economical. We strive for treatments that require a minimum of surgical interventions and preferably to restore the living tissues. This brings us into the field of regenerative medicine: innovative medical therapies that will enable the body to repair or regenerate damaged or diseased cells, tissues and organs.
To achieve this, researchers and clinicians in our department cooperate with many other researchers within and outside our institution. Clinicians, engineers, biochemists, biologists, and physicists collaborate in the research foundation Skeletal Tissue Engineering Group Amsterdam (STEGA). Our research is embedded in the Research Institute MOVE .
Our facilities include:
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Treatment of Osteosarcoma Lung Metastases
Osteosarcoma (OS) is the most common primary bone tumour in children and adolescents. It has an incidence of 4/million/year, with a peak incidence at the age of 15-19 years. The tumour generally arises at sites of rapid bone growth, most commonly in the distal femur or proximal tibia. It has a high tendency to systemic spread with >80% of metastasis arising in the lungs. Despite an aggressive treatment regimen, the 5 year survival rate for patients with metastatic disease is 20%. There is a need for new or additional treatment modalities to enhance the current treatment strategy. |
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Repair of the herniated intervertebral disc Lumbar discectomy is a well-established surgical procedure to decompress neural structures in patients suffering from a symptomatic herniated lumbar intervertebral disc (IVD). There are, however, serious adverse effects of disc herniation and surgical evacuation on spinal biomechanics. Disc space narrowing may result in discogenic pain or cause overloading in other structures including facet joints, ligaments and muscles by altered motion. The long-term sequelae after discectomy significantly affects the quality of life of the relatively young and employed patient population and therefore has serious socio-economic consequences. In the current project novel treatment strategies, dealing with the damaged IVD are evaluated. The overall goal of the study is to design and evaluate scaffolds intended for functional replacement of the nucleus pulposus of the IVD. The scaffolds should finally be implanted in a one step surgical procedure in combination with a discectomy and allow invasion by native cells from surrounding tissues. The research includes basic material characterisation (rheology), studying cell-matrix interactions and in vivo evaluation in a goat model. The experiments are performed together with the department of oral cell biology and the FOM Institute for Atomic and Molecular Physics (AMOLF). |
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Physical framework in the early development of the vertebral column Funded by: Research Institute MOVE In collaboration with: Prof. Mooney lab , Harvard University, Cambridge MA, USA
Regeneration of skeletal tissues is an important focus of the tissue engineering research field. Since we could gain great insight from nature's own process of bone and cartilage formation, valuable information can be attained from embryonic development. My research focuses on the early development of the vertebral column, its patterned structure of alternating bone and cartilage forming an interesting model system. The embryonic development of the vertebral column starts with the formation of a linear pattern of mesenchymal stem cell condensations along the cranial-caudal body axis. While the cell condensations will eventually become the intervertebral discs (cartilage), the non-condensed regions will become the vertebrae (bone). We wonder what initially triggers the mesenchymal stem cells to form clusters, and in particular why these clusters form a regular linear pattern. And subsequently, why do the cells in the condensations differentiate towards cartilage and the non-condensed towards bone? |
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Op basaal wetenschappelijk gebied vindt onderzoek plaats naar de pathologie en regeneratie van de discusdegeneratie. Daarnaast worden vernieuwende technologieën zoals biomaterialen, stamcellen etc. ingezet die een bijdrage kunnen leveren aan het herstel of fusie van de tussenwervelschijf. De afgelopen jaren is de afdeling orthopedie op het onderzoeksgebied van de wervelkolom in grote nationale en internationale kennisnetwerken geïntroduceerd (DPTE, BMM, DutchFoRM en het EU-REGENERATE). Het onderzoek wordt voornamelijk gesubsidieerd vanuit de eerste en tweede geldstroom en voor een klein deel uit de vierde geldstroom. Op (pre-)klinisch wetenschappelijk gebied vinden dierexperimentele studies plaats naar resorbeerbare cages voor de fusie van wervelkolomsegmenten. Tevens wordt een multicenter klinisch onderzoek verricht naar de resultaten van een resorbeerbare cage voor fusie van de cervicale en lumbale wervelkolom. Daarnaast vindt klinisch onderzoek plaats naar het effect van een lumbale osteotomie op de sagittale balans en blikveld.
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Below you find the PubMed-links to the recent publications of our medical and research staff.
Research institute MOVE is a collaboration between researchers of the Faculty of Human Movement Sciences, VU University Medical Center and ACTA. The goal of MOVE is to understand human movement by conducting excellent scientific research. The underlying goal is to optimize movement of several groups of patients (i.e. patients with osteoporosis, arthrosis, cerebral palsy or a stroke) and of healthy persons (i.e. children, elderly, sportsmen/women and workers). The goals of MOVE are related to healthcare, with the focus on prevention and recovery of injury and disorders of the musculoskeletal system and on optimal recovery of tissue and function. Furthermore, MOVE wants to apply results of research, which are related to prevent injury and other health problems, as well as improve performance, in ergonomics and sports.