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There’s a lot that we don’t know about this debilitating disease. But Gerald Harris, Ph.D., and other experts are working to fill in the blanks.
Harris is a biomedical engineering professor and director of the Orthopaedic & Rehabilitation Engineering Center, a joint effort of Marquette University and the Medical College of Wisconsin’s Department of Orthopaedic Surgery. The OREC team is using nanotechnology and advanced modeling techniques to predict — and ultimately reduce — bone fractures in children with osteogenesis imperfecta.
The OI study is one of several research projects that OREC is conducting with funding support from the National Institute for Disability and Rehabilitation Research. Key collaborators are Zaifeng Fan, Ph.D., research assistant professor of biomedical engineering, and Peter Smith, M.D., an orthopaedic surgeon at Shriners Hospitals for Children in Chicago and one of the leading OI experts in the country.
To predict fracture, the team develops computer models of the femur or tibia and fibula specific to each child. A child is then tested in the gait laboratory at Shriners in Chicago, and as he walks, 14 cameras record body movements while twin plates under his feet record ground reaction forces. Using mathematical analysis, researchers can create fracture prediction models and identify the points of high stress in the child’s bones.
The research is revealing new information about OI gait patterns, which is quite unique, Harris says.
The team is also the first to analyze the biomechanical properties of OI bone. They remove small chips of bone while the children undergo routine corrective surgery to repair fractures. Under the direction of Fan, researchers test tiny pieces of bone to determine the mechanical properties. Because OI patients break bones so frequently, in some cases the team will be able to evaluate the load conditions of a bone before it breaks. By understanding more about OI bone structure and points of stress, researchers could help patients modify risky activities Research could predict and — ultimately reduce — bone fractures in children with OI.
“The amount of information that we’re able to discover could be substantial,” Harris says. “We’re actually putting together a very complete database that looks not only at the specific engineering characteristics of the bones of these children during ambulation, but also looks at the quality of life issues, the day-to-day pain that they experience, fracture occurrence records, ability to integrate in their community and just a plethora of standardized testing.” Researchers hope that this could lead to more comprehensive and effective systems for evaluation and follow-up care.
The OI research won’t be limited to the children’s legs. Thanks to prior research by the OREC and Shriners team on children with cerebral palsy, they have developed and standardized computer models to analyze upper extremity forces. That’s useful because kids with OI often use walkers or crutches.
“We might be able to come up with some better designs for assistive devices for those kids, just as we did with cerebral palsy,” Harris says.
OREC continues to study walker-assisted gait in children with cerebral palsy, treatment methods for children with clubfoot, and the use and design of pedorthics in the management of foot pathology. Together, the OREC and Shriners motion analysis labs evaluate more than 500 patients a year.
“I predict that within two or three years,” Harris says, “we’ll be evaluating more adults and children than anyone in the country.”