Patient Oriented Research and Mentoring Program in Orthopedics

描述（由申请方提供）：肌肉骨骼（MSK）疾病，特别是骨关节炎（OA）是所有年龄组疼痛、功能障碍和生活质量恶化的主要来源。全膝关节置换术（TKR）是治疗膝关节OA的一种昂贵且频繁的干预措施。它的成功通常是基于植入物寿命和疼痛缓解来衡量的。然而，有令人信服的证据表明，适度的体力活动可以提高整体健康水平，这表明，如果TKR接受者在手术康复后从事足够水平的体力活动，TKR的价值可能会大幅增加。MSK中的证据库， 矫形外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科学家对MSK和骨科问题进行严格的研究。在这份竞争性的续约申请中，我要求五年的资金来扩大和加强指导和研究项目。目标一：为了进一步加强我的研究培训计划，重点是准备年轻的研究人员对MSK和骨科疾病进行严格的以患者为导向的研究。目的二：进一步发展一个全面的以病人为导向的研究计划，在MSK和骨科疾病。我在本提案中强调了两项研究：研究1：描述全膝关节置换术（TKR）接受者5年以上的体力活动（PA）。目标1.1：随访一个已建立的TKR接受者队列超过5年，以记录参与PA的长期轨迹。目的1.2：确定全膝关节置换术后5年内PA参与度低或下降的风险因素。研究2：提高对膝关节OA的认识，并愿意采取行为改变以降低膝关节OA的风险。目标2.1。开发一个基于网络的个性化膝关节OA风险计算器，该计算器结合人口统计学和临床因素，预测症状性膝关节OA的5、10、15、20、25、30年和终身风险。目标2.2。进行一项概念验证随机试验，以确定使用膝关节OA风险计算器是否能更好地准备改变行为以降低膝关节OA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.