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Molecular Biology in Orthopaedics: The Advent of Molecular Orthopaedics

¹ Center for Molecular Orthopaedics, Harvard Medical School, 221 Long-wood Avenue, BLI-152, Boston, MA 02115. E-mail address: cevans{at}rics.bwh.harvard.edu
² Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642

The workshop on which this review article is based was supported, in part, by an R13 award from the National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Institutes of Health conference grant; the American Academy of Orthopaedic Surgeons; the Orthopaedic Research and Educational Foundation; Merck, Inc.; Genetics Institute, Inc.; Immunex Corp.; Millenium Pharmaceuticals; and Pfizer Pharmaceuticals. In addition, C.H. Evans received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. (He is a member of the Scientific Advisory Board of TissueGene, Inc., and Orthogen, AG. He also received research support from TissueGene, Inc; Orthogen, AG; and Osiris, Inc.) No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Although molecular biology approaches have been used for decades in orthopaedic research, they are only now beginning to influence clinical practice.

A variety of sophisticated techniques permit rapid and affordable DNA sequencing, gene expression profiling, gene cloning, gene manipulation, gene transfer, recombinant protein production, and other technologies of enormous biomedical importance.

Success in genomics has spawned additional ambitious endeavors, including proteomics, pharmacogenetics, and bioinformatics.

These techniques are providing new diagnostic, staging, prognostic, and therapeutic opportunities in all areas of medicine, including orthopaedics.

With the use of molecular criteria, treatment of the orthopaedic patient may become more individualized, and greater emphasis will be placed on preventative strategies based on the patient's genetic makeup. Both surgical and nonsurgical decisions will increasingly accommodate molecular criteria.

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