Highlights of the 2003 Orthopaedics Trauma Association (OTA) Annual Meeting

Andrew H. Schmidt, MD; David Templeman, MD

Disclosures

January 15, 2004

In This Article

Introduction

The 19th Annual Meeting of the Orthopaedic Trauma Association (OTA) was held in Salt Lake City, Utah, from October 9-11, 2003. During the 3-day period, 97 scientific papers and 110 posters were presented. Quoting Mark Swiontkowski, MD, the current president of the OTA, "the program is a comprehensive collection of outstanding research findings in musculoskeletal trauma topics from basic science issues to the multiply injured patient."

One of the hallmarks of osteomyelitis is its refractory nature and its propensity for recurrence. The first presentation addressed this difficulty of treating osteomyelitis.

It is known that Staphylococcus aureus can exist within osteoblasts. Using human osteoblast cultures, Ellington and colleagues[1] from Wake Forest University demonstrated that if S aureus organisms exist within the intracellular environment for 12 hours, they become more resistant to bactericidal antibiotics that are capable of penetrating the cell wall. This change in resistance was associated with the appearance of a thick capsule around the S aureus organisms. Further osteomyelitis research should consider this protective mechanism that results in the increased virulence of S aureus.

In another paper, Alt and coworkers[2] from Giessen, Germany, demonstrated that a preparation of bone cement containing nanoparticulate silver was capable of inhibiting the growth of multidrug-resistant strains of S aureus and Staphylococcus epidermidis on bacterial plates. No evidence of cytotoxicity was observed. Clinical trials of a commercial preparation of nanoparticulate bone cement are warranted.

Using a malnourished rat femoral fracture model, researchers at the University of Missouri[3] found that a high-protein diet supplemented with specific amino acids improved fracture healing.

In a study with important implications for augmenting fracture healing, investigators in Hanover, Germany,[4] demonstrated that an adenoviral vector can successfully transfect all cells of primary callus, including chondrocytes, osteoblasts, and osteoclasts. Gene expression continued through all stages of fracture healing. This research suggests that gene transfer of BMP-2 may be feasible, although much more research is needed.

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