Research Report 2012 / 2013
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Julius Wolff Institute in collaboration with the Center for Musculoskeletal Surgery Research Report 2012 / 2013 Julius Wolff Institute in collaboration with the Center for Musculoskeletal Surgery Research Report 2012 / 2013 Welcome With enthusiasm, we look back on two and a half years of exciting research at the Julius Wolff Institute. Recent research findings, be it the surprisingly high in vivo friction moments in total hip replacements, the essential role of TEMRA cells as “bad guys” in bone regeneration or the role of biomaterial as guiding structure in tissue regeneration, showed an essential impact on the understanding in musculoskeletal science on a global scale. Examples of the later are the first completed phase I-IIa clinical trial on stem cells for muscle regeneration or the assessment of a specific implant failure with a recent re- launch of that implant after mechano-biological optimization. As institution, we feel obliged to continue working on both the basic re- Univ.-Prof. Dr.-Ing. Prof. Dr.-Ing. search side as well as on clinical research aspects to building bridges Georg N. Duda Georg Bergmann between a basic research understanding and the translational aspects of musculoskeletal sciences (see http://translate-event.charite.de, jointly with the journal Science Translational Medicine). We are very proud that our intention to stabilize the institute and continue with a highly dedicated team of scientists was granted with positive reviews of not only the existing programs of the DFG graduate school BSRT and the translational research center BCRT but also with the funding of two major new initiatives, the BMBF research networks on osteoarthritis (OVERLOAD/ PrevOP) and osteoporosis (OSTEOPATH) as well as our DFG research group on regeneration in aged patients (FG 2165). 4 5 Of particular importance was that two members of our core team in Berlin To improve further these interactions, we founded the OrthoLoadClub, a forum Markus O. Heller and William R. Taylor received calls on professorships dur- of continued discussion on biomechanics and musculoskeletal loading with ing the last years from world-renowned institutions in University of South- most of our commercial partners. The club proved so far to be an extremely ampton and ETH Zurich. We are very happy for both of them, look forward valuable tool of joint or bi-lateral discussions on the importance of in vivo to continued interaction now on an European level and whish them all the forces and their consequences to patients and the global public. This together success they deserve. Further, we are excited that we could complement our with the continued support by the Charité, the German Research Foundation team at Julius Wolff with the start of Prof Frank Witte on the DePuy-Synthes (DFG), the various Federal Ministries and the European Commission make our sponsored professorship on resorbable biomaterials. Profs Britt Wildemann work possible. and Kay Raum have seen very positive evaluations by the faculty and continue their work in our team. We thank everyone who has been involved in our activities for their interest, support and encouragement during the last years and we very much hope that In addition, we are very proud that Prof. Georg Matziolis has been called as the information in this research report will be of interest and of use to you. the youngest W3 in Germany on a chair in orthopedics in Jena and that a num- We look forward to continue this excellent co-operation. ber of Clinical Scientists have “completed” their training by very success- fully reaching their habilitation. We congratulate the most recent PDs Tobias Berlin, July 2014 Winkler, Patrick Strube and Bernd Preininger. Our comprehensive research activities and their structural and technical requirements were also made possible through continued support by our part- ners from industry and from public foundations. We are very proud of having you as partners, often based on long-standing, personal relationships. This interaction is especially important to bring our basic findings into products or solutions for musculoskeletal recovery or regeneration and reach a large Univ.-Prof. Dr.-Ing. Prof. Dr.-Ing. number of patients. Georg N. Duda Georg Bergmann Director Vice Director 6 7 Greetings from the Clinical Advisory Board It is remarkable to note that the field of musculoskeletal research experienced We have learned that a dedicated Clinical Scientist educational program is es- substantial increase in public awareness, both from patient representatives sential to support young clinical fellows early on a path towards an academic as well as from funding agencies. Especially the call of the BMBF to initiate career. Without the structured support of such education, only limited possi- Musculoskeletal Research Networks in Germany has given the field a more re- bilities do exist in nowadays-classical surgical department infrastructures. We markable, national visibility. We are proud that two of our initiatives were suc- are happy that the concept has been taken along into the DFG funded graduate cessful in this call. In addition, we could recently install a clinically motivated school BSRT and now as a concept of Clinical Scientists through the Berlin research group funded by the German Research Foundation. Taken together, Institute of Health across the whole Charité. We welcome that our example is these measures illustrate the general increase in awareness of the need to now discussed in the DFG Senatskommission Klinische Forschung. improve musculoskeletal science and treatment. Kapitelbezeichung JWI-Report Kapitelbezeichung 2011 The backbone of these activities is a personal tight interaction between us The challenges in musculoskeletal health for medical experts and the health at the Center for Musculoskeletal Surgery and our Julius Wolff Institute. With care system are growing enormously due to an aging population, changes in such tight interactions, musculoskeletal sciences have a realistic chance to lifestyles and the demographic changes in industrialised nations. Musculo- solve the unmet clinical needs that derive from the essential health care bur- skeletal disorders are now ranked top among global health threads, specifi- dens we aim to attack. cally if back pain, osteoporosis, arthrosis, sport injuries and traffic injuries are taken together. Disorders of the musculoskeletal system account for nearly Berlin, July 2014 half of all absences from work and sixty percent of permanent work incapacity in Europe. Our aim is to realize effective and application-related research that allows to prevent or regenerate musculoskeletal disorders or to improve cur- rent treatments of degenerative diseases. Over the years we have been able to realize an integrative model of basic and clinical research with joint research efforts at both the Julius Wolff Institute Univ.-Prof. Dr. med. Dr. h.c. Univ.-Prof. Dr. Univ.-Prof. Dr. and the Center for Musculoskeletal Surgery. We have developed modes of tight Norbert P. Haas Carsten Perka Klaus-Dieter Schaser interaction between Clinical Scientists and researchers in Engineering or Biol- Director Vice-Director Vice-Director ogy to thrive musculoskeletal science. of the Center for of the Center for of the Center for Musculoskeletal Surgery Musculoskeletal Surgery Musculoskeletal Surgery of the Charité (CMSC) of the Charité (CMSC) of the Charité (CMSC) 8 9 Table of Contents 4 Welcome 66 Muscle force transfer to a finite element model 114 Biophysical Cues and Tissue Organization 174 Mechanical regulation of bone healing 8 Greetings from the Clinical Advisory Board 67 Lumbar spinal loads and trunk muscle forces 116 Scaffold architecture and BMP timulations 176 Development of Mineralization 14 Synopsis 68 Simulation of lumbar disc nucleus replacements 118 3D tissue growth in-vivo under geometrical constraints 178 Maturation dynamics of the forming mouse femur 15 Developments at the JWI 2012 – mid 2014 70 In vivo / in vitro Measurements 120 Macroporous alginate hydrogels 180 High resolution non-contact full-field strain mapping 22 Julius Wolff Institute Structure 72 Spinal forces during lifting up a weight 122 Control Tissue Formation 182 Nano-particle strains in mechanically loaded dentine 24 News from the Research Network 73 Monitoring the load on a VBR 124 Scaffolds orf creating sharp tissue patterns 27 Clinical Scientists in Musculoskeletal Surgery 74 How does the back shape affects spinal loads? 184 Regeneration and Reconstruction 75 Effects of implant parameters on kinematics 126 Cell Biology 30 Loading and Movement 76 Dynamic assessment of the lumbar spine 186 Impaired Bone Healing & Tendon and 78 Motion and posture analysis at the workplace 128 Stem Cells for Muscular Regeneration Ligament Healing 32 Instrumented Implants 79 Age-related loss of lumbar lordosis and mobility 130 Mesenchymal stem cell for skeletal 188 A new antibiotics/bone graft mixing device 34 Reductions of the EAM cause muscle injuries 190 Gentamicin does not impair bone healing different effects on Fmed 80 Bone Healing 131 Improvement of contraction force in 192 Influence of a statin on implant integration 36 External vs. internal knee joint loading injured skeletal muscle via autologous 193 Hepatic osteodystrophy in Abcb4 deficient mice 38 Hip joint loading during different athletic activities 82 Biology of Bone Healing MSC-transplantation 194 β-TCP coated with Zoledronic Acid 39 Joint loading during whole body vibration training 84 Rewriting the story of the initial 134 Functional comparison