We've only just begun to change the playing field

BEFORE HER ACCIDENT, SANDRA REYNOLDS DIDN'T KNOW HOW TO SLOW DOWN. A SINGLE MOTHER, SHE WORKED BY DAY, ATTENDED COLLEGE BY NIGHT, AND USED LUNCH HOURS TO HIT THE GYM. When she fell against a sharp metal edge one morning, she didn’t let that stop her daily routine. But the following morning, she could not get out of bed. The throbbing pain in her lower back was unyielding, despite anti-inflammatory medicines, steroid injections, and months of physical therapy. Referred to Scott Boden, director of the Emory Orthopaedics

and Spine Center, Reynolds told him she could no longer live with the pain, dependence on pills, and inactivity. Boden told her she needed surgery to fuse the vertebrae in her injured back. He also explained that she would need a bone graft, with healthy bone tissue harvested from a second surgical site, to make the repair.
     Harvesting bone tissue for grafting has traditionally been highly invasive, with so much tissue needed from the harvest site that it can become a new source of chronic pain for the patient. Thanks to recent research led by Boden, however, Reynolds could benefit from a procedure that was less painful and more effective than conventional approaches.
     Boden had led clinical trials of a genetically engineered version of a bone morphogenetic protein (BMP) that causes nearby stem cells to turn into new bone (the same protein and process through which broken bones heal normally). He used BMP to augment Reynolds’ own tissue and thus minimize the amount needed from the harvest site. BMP also increased the success and speed of bone healing at the site of injury where the graft was implanted.
     “My life was totally transformed,” recalls Reynolds, back to most of her old activities a year after surgery.
     Reynolds’ story was not unusual. With Food and Drug Administration approval for BMP, Boden is already at work on the next phase. He has discovered another gene for a growth protein that he expects to be more potent and more affordable than the first and able to regenerate other tissues in addition to bone. Until he finds the answer, he won’t slow down either.

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	Team spirit

	A recent move to a new facility for the Emory Orthopaedics and Spine Center meant more than plush space and easier access to the interstate. It was a prime opportunity for a culture change, to integrate all services related to musculoskeletal disorders under one roof and all relevant specialists under one team coach. For example, all Emory spine surgeons, whether their training is in orthopaedics or neurosurgery, are now together in one location, helping ensure a team approach to both care and research. Such coordinated care is a proven model for getting the best results in patient care, whatever the specialty. This game plan is particularly important in orthopaedics, in view of the fact that more people will need to see an orthopaedist in their lifetime than any other kind of specialist.



	Change the playing field:


	> PUT SOME BALANCE IN A CHILD'S LIFE. Walking smoothly is a problem for children with cystic fibrosis, muscular dystrophy, scoliosis, or other diseases affecting mobility. A specially designed gait and balance facility, built on-site in Emory’s Orthopaedics and Spine Center for $750,000, would bring together in one place a team of surgeons, therapists, and other clinicians to help these patients walk unaided.


	> SUPPORT SOME OF RESEARCH'S UNSUNG HEROES AND HEROINES. The MDs and PhDs get most of the credit, but good researchers know that clinical research depends on the coordinators who organize appointments, interview patients, and painstakingly measure and record outcomes. For $1 million, you can endow a clinical research coordinator position to provide continuity and research opportunities for these invaluable members of the research team.


	> LET A BRILLIANT MIND SOAR. Each year, spine surgeons from around the world compete for a limited number of visiting research fellowships at Emory. These highly skilled fellows design and conduct experiments to move research projects to fruition and get invaluable experience in the process. Each fellowship costs $75,000, and orthopaedics would like to recruit two additional fellows a year.


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