New Constellations 2019 | Page 52

ORTHOPEDICS • CONTINUED FROM PREVIOUS PAGE Research that gels Dr. Payne and her lab are testing a number of factors, alone and in combination, with the potential to repair bony bars. Their most promising projects build mimetic and regenerative factors into two main delivery systems. 1 2 Nancy Hadley-Miller, MD, has spent most of her career researching the molecular genetics of scoliosis. Her breakthrough work in growth plate regeneration came out of a series of happy accidents. Dr. Hadley-Miller. Her 30-year career has been focused on the molecular genetics of scoliosis. She heard about the grant talking to a colleague after a surgery, and she ran it past Dr. Payne, whose office was just a few doors down. As it turned out, Dr. Payne knew someone they could work with at Mines. For her, it represented a new and interesting research direction. For Dr. Hadley- Miller, it was something like a return. “In fellowship I always wanted to do something with growth plate,” she recalls. “But I didn’t find a bone lab to work in, didn’t have the mentorship. That’s how I ended up in scoliosis. I followed another idea. It wasn’t a bad way to go.” Now, though, with funding from both the Gates Grubstake Fund and the National Institutes of Health, their lab is just one of a few in the world doing groundbreaking work in growth plate regeneration, and it’s leading the field. For Dr. Payne, that conversation has fundamentally altered the course of her career. Some of that is coincidence, Dr. Hadley-Miller acknowledges. But more than that, it’s having the pieces in the right place. “Patient care is our bread and butter,” she says. “Here we’re using it to pay for research. But you really have to want to do it. You have to invest in the people and the infrastructure to make those connections happen.” She knocks back the rest of her tea. And with that, she’s off to surgery. ● Working with biopolymer expert Melissa Krebs, PhD, of the Colorado School of Mines (see “Fetalizing the Adult,” p. 57), Dr. Payne’s team is testing microgels made of chitosan, a biomaterial derived from crustacean cells. They’re using them as a delivery mechanism for antibodies that block angiogenesis, as well as factors that attract stem cells from surrounding tissue to encourage cartilage growth. Those studies are seperate for now, but the aim of the NIH grant that funds them is to bring them together. In their collaboration with Dr. Bryant and others at CU Boulder, the team is testing a biomimetic hydrogel delivery system based on polyethylene glycol, a synthetic biomaterial ideal for attaching biofactors. To this one they attach factors that promote cartilage growth and the environment it likes to grow in. “Once we put mesenchymal stem cells into this hydrogel,” says Dr. Payne, “they start producing collagen type 2 and sulfated glycosaminoglycans” — the chemical backbone, so to speak, of cartilage. 0 Surgical site infections in standard spinal fusion patients (2015-2017) 98% ACL reconstruction success after 2 years, with 87.9% of individuals returning to play 3 years post-surgery ONLY 1% Of patients with club foot require major surgery for correction due to our clinical care guidelines 2.41 DAY Median decrease in length of opioid prescriptions at discharge (4/18-10/18) LEADERSHIP: Mark Erickson, MD, MMM Co-Chief, Pediatric Orthopedics, Rose Brown Chair in Pediatric Orthopedics Nancy Hadley-Miller, MD Co-Chief, Pediatric Orthopedics For orthopedic healthcare professional resources, visit childrenscolorado.org/OrthoHCP. 50 NEW CONSTELLATIONS 51