Patient Oriented Research and Mentoring Program in Orthopedics

描述(申请人提供)：肌肉骨骼(MSK)疾病，特别是骨关节炎(OA)是所有年龄段疼痛、功能障碍和生活质量恶化的主要来源。全膝关节置换术(TKR)是治疗膝骨性关节炎的一种昂贵且频繁的干预措施。它的成功通常是根据植入物的寿命和疼痛缓解来衡量的。然而，令人信服的证据表明，适度的体力活动有助于整体健康，如果TKR接受者在手术后康复后进行足够的体力活动，TKR的价值可能会大幅增加。MSK中的证据基础和 骨科临床科学有很大的差距。在过去的15年里，我一直致力于通过设计严格的以患者为导向的研究研究和指导年轻的临床科学家来满足这些研究需求。通过下一个K24周期，我希望继续培训年轻的科学家对MSK和骨科问题进行严格的研究。在这份竞争性续签申请中，我请求五年的资金，以扩大和加强指导和研究计划。目的一：进一步加强我的研究培训计划，重点是为MSK和骨科疾病的严格面向患者的研究培养年轻的研究人员。目的II：进一步发展以患者为中心的MSK和骨科疾病的综合研究计划。我在这项建议中重点介绍了两项研究：研究1：描述全膝关节置换术(TKR)受者5年内的体力活动情况。目标1.1：跟踪已建立的TKR接受者队列超过5年，以记录在PA中参与的长期轨迹。目标1.2：确定在TKR后5年内PA参与度低或下降的危险因素。研究2：提高对膝骨性关节炎的认识和进行行为改变的意愿，以降低膝骨性关节炎的风险。目标2.1。开发一种个性化的基于网络的膝骨性关节炎风险计算器，结合人口统计学和临床因素来预测症状性膝骨性关节炎的5、10、15、20、25、30年和终生风险。目标2.2。进行一项概念验证随机试验，以确定使用膝骨性关节炎风险计算器是否能更好地为行为改变做好准备，以降低膝骨性关节炎的风险。

DESCRIPTION (provided by applicant): Musculoskeletal (MSK) disorders and particularly osteoarthritis (OA) are a major source of pain, functional impairment, and worsening quality of life across all age groups. Total knee replacement (TKR) is a costly, frequent intervention for knee OA. Its success is generally measured on the basis of implant longevity and pain relief. However, compelling evidence that moderate physical activity enhances overall health indicates that the value of TKR could be increased substantially if TKR recipients engaged in adequate levels of physical activity after rehabilitating from their surgeries. The evidence base in MSK and orthopedic clinical science has substantial gaps. I have devoted the last 15 years to addressing these research needs by designing rigorous patient-oriented research studies and mentoring younger clinical scientists. Through the next K24 cycle, I hope to continue to train young scientists in rigorous studies of MSK and orthopedic problems. In this competitive renewal application, I request five years of funding to enlarge and strengthen the mentoring and research programs. Aim I: To further strengthen my research training program, which focuses on preparing young investigators for rigorous patient-oriented research on MSK and orthopedic disorders. Aim II: To further develop a comprehensive patient-oriented research program in MSK and orthopedic disorders. I highlight two research studies in this proposal: Study 1: Portraying physical activity (PA) over 5 years among recipients of total knee replacement (TKR). Aim 1.1: To follow an established cohort of TKR recipients over 5 years to document long-term trajectories of engagement in PA. Aim 1.2: To determine risk factors for low or declining engagement in PA over 5 years post-TKR. Study 2: Raising awareness of knee OA and willingness to undertake behavioral changes to reduce the risk of knee OA. Aim 2.1. To develop an individualized web-based knee OA risk calculator that incorporates demographic and clinical factors to predict 5, 10, 15, 20, 25, 30-year and life time risk of symptomatic knee OA. Aim 2.2. To conduct a proof of concept randomized trial to establish whether the use of a knee OA risk calculator results in greater readiness for behavioral changes to reduce the risk of knee OA.