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Our People – Orthopedics and Osteoarthritis

Summary

Major focus is the epidemiology of chronic and disabling conditions, using arthritis and musculoskeletal disorders as models for issues relating to quality of life, aging, and access to health care. This research includes: major population surveys for estimating the prevalence of bone and joint disorders and planning community services for people with disabling conditions; estimating the impact of musculoskeletal disorders and disability through the analysis of large scale data sets; and applied research directed towards the provision and evaluation of services for people with arthritis. Current research focuses population-based and clinical studies to better understand the characteristics and impact of musculoskeletal disorders, particularly osteoarthritis.

Keywords

Osteoarthritis; epidemiology; health services research; quality of life; musculoskeletal

Profiles

Keywords

Health services research; outcomes; value-based care

Summary

Expertise in hip biomechanics and the design and development of both primary and revision total hip implants. Special interest in femoral offsets and femoral neck design. Previous implant design and development have included:

  1. Smith & Nephew High Offset Spectron Cemented Femoral Stem.
  2. Biomet Lateralized Mallory Head Cementless Femoral Stem.
  3. Biomet Cemented Generation 4 Cemented Femoral Stem.
  4. Zimmer Cementless ML Taper Femoral Stem.
  5. Zimmer Biomet Arcos Modular revision Femoral Stem.
  6. Zimmer Biomet Arcos One Piece Revision Femoral Stem.

Team Members

  • Dr. Michael Sellan, Clinical Fellow
  • Dr. Jonathan Lex, Orthopedic Resident

Keywords

Hip; knee; revision; biomechanics; implants

Profiles

Summary

As a physiotherapist trained in clinical epidemiology, my research focuses on understanding predictors of outcome in people with musculoskeletal conditions, mainly osteoarthritis (OA), with the goal of bridging the gap between research, implementation of interventions and processes of care to achieve improved patient outcomes. I also develop and evaluate patient-reported outcome measures.

Team Members

  • Rosalind Wong, Research Associate II
  • Krista Steinhart, Research Analyst II

Keywords

Osteoarthritis; health services research; outcome evaluation; patient-reported outcomes; rehabilitation

Profiles

Summary

Understanding the role of systemic inflammation, obesity and osteoarthritis. The guiding hypothesis for this work is that OA is not a single disease entity. My work is focused on identifying important subgroups of individuals, whether biochemical, inflammatory and/or genetic, complemented with patient-reported measures. Identification of these subgroups may suggest different disease etiologies, and responses to medical and surgical treatment.

Advancing the understanding of the pain and functional outcomes and patient satisfaction following knee replacement surgery. Approximately 15% to 30% of people report little to no improvement in pain and function following knee replacement surgery. The present goal of this work is to understand the role of a patient’s individual biology as a predictor and as a therapeutic target for improving knee replacement outcomes.

Team Members

  • Mohit Kapoor, Senior Scientist
  • Sowmya Vishwanathan, Scientist
  • Kevin Robb, PhD Candidate
  • Helal Andisha, PhD Candidate

Keywords

Orthopaedic surgeon; osteoarthritis; inflammation; hip replacement; knee replacement

Profiles

Summary

The group focuses on computational biology and medicine, and specifically on creating explainable models for chronic diseases. We develop and apply integrative computational biology tools across major high-throughput data in multigenic diseases in order to identify prognostic/predictive signatures, find clinically relevant combination therapies, and develop accurate models of disease-altered networks and pathways, and drug mechanism of action.

Team Members

  • C. Pastrello, Research Associate
  • C. A. Cumbaa, Research Associate
  • M. Kotlyar, Research Associate
  • Y. Niu, Research Associate
  • M. Abovsky, Research Program
  • R. Minkstimas, Research Program
  • D. B Waddell, Research Program
  • E. Kadriu, Curator
  • T. Krilov, Co-op Student
  • Rosanne McQuaid, PhD Student
  • Zachary Horvath, MSc Student
  • Sara Rahmati, PDF

Keywords

Integrative computational biology; data mining; machine learning

Research Lab

Jurisica Lab: Data Science Discovery Centre for Chronic Diseases

Profiles

Summary

The Keating Lab has focused a longtime study of the biology of bone marrow derived mesenchymal stromal cells (MSCs) towards treating osteoarthritis (OA). We have identified a molecular signature of potency for MSCs with high anti-inflammatory activity for testing in animal models of OA. We are further investigating engineered, safe, non-immunogenic iPSC-derived, molecular signature-defined MSCs to develop more effective, unlimited therapeutic cells. We will translate these studies to early phase OA cell therapy clinical trials. We are also investigating the microRNA signatures of MSC differentiation to chondrogenic and osteogenic cells to identify specific pathways that promote regeneration of OA damaged tissue. We are also investigating stromal cells present in "bone marrow lesions" as a means to reduce OA pain.

Team Members

  • Xing Hua Wang, MD, Lab Manager
  • Jahan Abdi, PhD, PDF/Research Associate
  • Jenny Warrington, MSc, Senior Technologist
  • Amr Saleh, BSc, Medical Student (Research)
  • Iran Rashedi, MD PhD, Visiting Scientist
  • Marieke de Korte, MSc, Graduate Student

Keywords

Mesenchymal stromal cells; cell therapy; clinical translation research; hematopoiesis; immune modulation

Profiles

Keywords

Orthopedic surgery; spine surgery

Profiles

Summary

Health systems research focusing on development, delivery and evaluation of value-based care.

Keywords

Health systems research;outcomes; value-based care

Profiles

Summary

A clinical trial was used to test the hypotheses that a single intra-articular (ia) injection of autologous BM-MSC (suspended in autologous serum) would be safe and effective in managing knee OA; and that the needed dose-escalation clinical trial will identify an optimal MSC dosage to treat knee OA.

Keywords

Cartilage; arthroscopy; sports; ligaments; arthritis

Research Lab

University of Toronto Orthopaedic Sports Medicine (UTOSM) Program

Profiles

Keywords

Orthopedics


Summary

Suggesting that osteoarthritis (OA) is not a single disease entity, I am working to identify distinct OA subgroups within clinical and population-based OA samples, with particular focus on inflammation and differences by sex. Distinct subgroups may have different causes, disease trajectories, and/or responses to medical/surgical treatment. Consequently, there would be a need for a more refined epidemiological profiling of OA, possible changes to OA prevention and management/treatment strategies, and a need to carefully consider subgroups in designing clinical trials. Work is underway investigating.

  1. Sex-specific associations between inflammation and pain in OA.
  2. Overall and sex-specific differences in patient-reported response to surgery for OA
  3. Pathways linking OA and social participation at a population level.
  4. Heart disease risk profile for those with OA and OA-like symptoms by sex.

Team Members

  • Jessica Wilfong, MPH, Research Associate
  • Calvin Yip, MPH, PhD Trainee
  • Shatabdy Zahid, MPH, Research Analyst

Keywords

Epidemiology; osteoarthritis; patient-reported outcomes

Profiles

Keywords

Spine; orthopedic surgery; spine surgery; clinical outcomes

Profiles

Keywords

Orthopedic surgery; arthritis; health informatics; clinician workflow

Profiles

Summary

Leveraging my industry and clinical trial experience, I have created a translational lab focused on developing cellular therapies for osteoarthritis.

My research program has dual focii:

  1. Understanding inflammation and immune cell interactions in osteoarthritis (OA).
  2. Using advanced engineering/manufacturing solutions to develop more potent and stable anti-inflammatory cellular therapies.

Under this platform, the role of monocytes/macrophages in joint inflammation and degradation are being investigated to identify molecular and cellular metabolic regulators of monocyte/macrophage dysregulation.

Mesenchymal stromal cells (MSCs) with anti-inflammatory and immunomodulatory properties are promising therapeutic for OA as demonstrated in our first-in-Canada MSC trial in knee OA. I am using manufacturing solutions to enhance MSC properties to develop next generation potent MSC products for OA.

Team Members

  • Razieh Rabani, PDF
  • Kevin Robb, PhD student
  • Wing Yan (Mable) Chan, PhD student
  • Amelie Chaboureau, GMP Technician II (on maternity leave)
  • Smitha Mathews, GMP Technician II (until July 2020)
  • Lucy Luo, Masters student
  • Kelly Jesalva, Summer student
  • Atoosa Ziyaeyan, Research Volunteer

Keywords

Mesenchymal stromal cells (MSCs); monocyte/macrophage; cell therapy; clinical trials; cell manufacturing

Profiles

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