Osteoarthritis Center Optimizes Diagnosis, Treatment and Research
More than 27 million people in the U.S. are affected by osteoarthritis, a disease that is ten times more common than rheumatoid arthritis and that has been estimated to cost the health care system $185 billion per year.
“Despite the high prevalence of osteoarthritis in older individuals, a basic understanding of its cause is lacking,” said Antonios Aliprantis, MD, PhD, of the Division of Rheumatology.
On Oct. 6, BWH’s Division of Rheumatology and the Department of Orthopedics opened the Osteoarthritis Center, a multidisciplinary clinical, educational and research effort that aims to optimize the diagnosis and medical and surgical care of patients with osteoarthritis.
Directed by Aliprantis, the center will cultivate a collaborative relationship among clinicians and researchers from numerous disciplines, including Rheumatology, Orthopedics and Radiology. Bill Docken, MD, of the Division of Rheumatology, and Andreas Gomoll, MD, of the Department of Orthopedics, serve as clinical co-directors.
The center is located throughout the BWH system, with participating physicians at BWH, 850 Boylston St. in Chestnut Hill, Faulkner Hospital and the outpatient care center in Foxborough.
“With osteoarthritis, treatment plans can be ambiguous: Which physicians should follow the patients, and what kind of care they should receive along the continuum of their disease, is not well defined,” said Aliprantis. “The Osteoarthritis Center will help maximize a patient’s interactions with either a rheumatologist, orthopedist or
physical therapist—or all three.”
Patients who call the center are connected to an on-site administrative assistant where a series of triage questions helps determine whether the patient should be seen first by an orthopedist or a rheumatologist.
“For example, a joint replacement patient will be referred directly to an orthopedist,” said Aliprantis. “A patient with a few months of knee pain from osteoarthritis, however, might first be sent to a rheumatologist to confirm the diagnosis and for management. Then, the rheumatologist would determine the extent of arthritis and if the patient needs to be seen by an orthopedic surgeon soon or followed by rheumatology. On the other hand, an orthopedist who is questioning the diagnosis of osteoarthritis or believes the patients medical management is not optimal, would refer that patient to rheumatology.”
Aliprantis notes that the Osteoarthritis Center will be instrumental in attracting talented faculty who are interested in studying osteoarthritis and bone biology. “Recruitment is already underway for scientists who are interested in osteoarthritis and the cells that might drive this disease,” he said. “We hope to build a continuum from basic science to translational research to clinical practice.”
The center will also organize a series of periodic conferences and retreats to help galvanize the osteoarthritis community at BWH.
“It’s estimated that by 2030, 25 percent of the adult population may have osteoarthritis,” said Aliprantis. “BWH’s Osteoarthritis Center has an opportunity to be a big piece of the puzzle.”
Research among members of the Osteoarthritis Center will encompass bench and clinical science approaches to understand mechanisms of disease and improvements in the quality of care for patients with osteoarthritis. Many of these projects are ongoing.
Antonios Aliprantis’ basic science group evaluates the molecular pathways that cause osteoarthritis in animal models with the goal of securing new drug targets. His group is also identifying osteoarthritis biomarkers, a project facilitated by a biorepository, co-managed by Aliprantis, containing hundreds of clinical samples from osteoarthritis patients.
Jeffrey Katz, MD, of Rheumatology and Orthopedics, is conducting a multi-center trial to evaluate the efficacy of surgery to trim a torn meniscus versus non-operative management in patients with concomitant osteoarthritis.
John Wright, MD, of Orthopedics, is leading the way to develop strategies to optimize a patient’s experience throughout the knee replacement process, from pre-operative evaluation to post-operative care.
Elena Losina, MD, of Orthopedics, is principal investigator of the Osteoarthritis Policy Model, a computer simulation model that she has used to project the costs and quality of life associated with osteoarthritis, concomitant obesity, anterior cruciate ligament tear and other clinical scenarios.