Faculty at Rush have a long history of being pioneers in adult reconstruction, having transformed many components of the subspecialty over the years. Clinical and basic sections are both extraordinarily active and prolific. Basic research benefits from rich sources of NIH and private funding and a number of distinct research laboratories around campus. Over the years, Rush has made tremendous contributions to adult reconstruction in the areas of biomaterials, bone biology, biomechanics, and tribology. Rush researchers have been international leaders in the understanding of metal ion disease, polyethylene wear, and osseointegration. But clinical research efforts have been equally meaningful for the field of adult reconstruction. With a long history of providing level-1 evidence to surgeons worldwide, adult reconstruction faculty initiate and complete many randomized trials each year. Rush faculty have played a large role in defining the currently accepted algorithm for both diagnosis and management of acute and chronic periprosthetic joint infection. Recent and current projects have focused on the use of tranexamic acid to reduce blood loss, minimizing the risk for pulmonary embolism, prevention and treatment of infection following surgery, and optimization of anesthetic technique. With an expanding adult reconstruction faculty with a deep commitment to continuing to improve the outcomes of hip and knee replacement, Rush will undoubtedly continue to provide an ideal environment for resident research.
The Sports Medicine Division has an active research arm with many opportunities for resident involvement. Research spans all topics in sports medicine, including but not limited to joint preservation, cartilage restoration, hip arthroscopy, knee ligamentous injuries and reconstruction, shoulder instability, rotator cuff injuries, shoulder arthroplasty, and elbow injuries. Clinical research ranges from prospective studies and randomized trials to retrospective analyses, and everything in between. Basic, biomechanical, and translational research projects are also available, including cadaveric biomechanical studies, animal models, and motion analyses. There are also many opportunities for additional work in the area of review articles and book chapters.
The spine section has extremely active research efforts in both the clinical and basic science areas. Clinical research efforts focus on improving the delivery of care and the outcomes of spinal surgery. Prospective studies abound, and retrospective reviews are facilitated by prospective collection of baseline, comorbidity, and outcome data. Recent projects have focused on local intraoperative application of steroids during spinal fusion, the prevention and mitigation of postoperative complications, optimal provision of analgesia, and radiographic outcomes of complex, multi-level procedures, as just a few examples. Residents have a great track record of applying for and obtaining funding for their efforts. Basic research efforts focus on the biomechanics of degenerative spinal pathology, pain modulation, biomechanics of spinal fusion, molecular biology of disc repair, biomechanics of total disc replacement, and much more. Residents are involved in all components of spine research at Rush and have been extremely successful.
The hand surgery division is currently conducting a prospective randomized controlled trial on outcomes of early versus delayed surgical intervention for peroneal nerve injuries. The division is also conducting both retrospective and prospective comparison studies of one-incision versus two-incision distal biceps tendon repair using anatomic and non-anatomic insertion sites.
The foot and ankle section is actively involved in clinical and basic science research as well as publishing interesting case reports and technique tips. Through collaborations with clinical faculty as well as scientists within the medical school and graduate school, we have undertaken projects that involve the basic science and histology effects of non-steroidal anti-inflammatory medications on the Achilles tendon utilizing a murine model and, furthermore, are enrolling patients with Achilles tendon ruptures to investigate their response time while driving and braking. In addition, anatomical studies are ongoing to better identify the amount of saline needed to appropriately load an ankle joint in the setting of a possible traumatic arthrotomy. Epidemiological and database studies that are ongoing include the effect of surgeon volume on the total cost and complication rate involved with total ankle replacement as well as the lifespan of certain ankle arthroplasty implants that were revised at our institution. With regards to other reports, we have completed a technique manuscript on the role of ultrasound to identify foreign material within the foot and have published reports on cases of interest to the general orthopaedic surgeon and the foot and ankle specialist. We have also completed reports that have focused on educating the primary care provider on the many pathologies involving the foot and ankle that they may encounter in practice.
Research opportunities in pediatric orthopaedics are available within the pediatrics division at Rush, as well as at the Shriner’s Hospital for Children and at the Ann & Robert H. Lurie Children’s Hospital of Chicago. The varied patient population at these sites allows for a wide gamut of clinical research studies in pediatrics. Recent projects in pediatric orthopaedics have focused on outcomes of common pediatric procedures, as well as reviews of congenital orthopaedic disorders present at birth. Finally, there are opportunities to collaborate with the spine section for research studies focusing on children’s and adolescent spinal pathology.