Ellen Brooks/Dr. Marx - Week 5

Due to the 4th of July, this week was shorter and slower paced. I shadowed Dr. Marx in the Operating Room for another round of ACL reconstruction surgeries on Wednesday. One of the operations he performed was part of a study to determine the best possible graft for high risk patients. This is a multi-center project aimed at determining the best option between a bone-tendon-bone (patellar tendon) graft or a quadricep graft. The patient is randomly assigned a graft choice based on patient gender and if the meniscus are intact. The patient is also randomly assigned whether or not to receive an additional lateral extra-articular tenodesis (LET) which further stabilizes the new ACL by looping the IT band around the new graft. As a person that has always operated in wet chemistry, biology, and physics labs it is interesting to see clinical research. Clinical research seems more focused on the outcome alone rather than why the outcome occurs. 

Another interesting thing that I discussed with a fellow observing student was how in an ACL reconstruction, the surgeon must weaken some part of the body to make the new ACL. Essentially, in the overall healing, a lesser injury is induced at the site of the graft. This makes me wonder how we can improve treatments and if we can successfully perform a reconstruction via tissue engineering, regeneration, or another method. The current method that I am aware of that does this is to use a cadaver allograft. However, this treatment is associated with far higher re-rupture rates than taking an autograft. 

On the lab side of things, I am continuing to sort through data and search for other papers where RNAseq has been performed during cartilage compression studies. So far this search has yielded lots of interesting information, but little new data that I can use for comparison. Within the data set I am working with, I believe I have identified 3 genetic pathways that are altered in cartilage compression but not in induced cartilage inflammation. This may give insight into the typical processes occurring when joints are loaded.

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