J Orthop Sci (2002) 7:431–432
Editorial The 17th Annual Research Meeting of the Japanese Orthopaedic Association Seiko Harata, M.D. President, Aomori Prefectural Central Hospital, 2-1-1 Higashitsukurimichi, Aomori 030-8553, Japan
Key words Bridge between basic and clinical research · Translational research · OPLL
We have chosen “A Bridge Between Basic and Clinical Research” as the theme of the 17th Annual Orthopaedic Research Meeting of the Japanese Orthopaedic Association. The work done on a clinical basis in the Japanese orthopedic field, which deals mainly with bones, is well recognized. In basic research, there is a long history of exploration of areas such as bone tissues, including connective tissue, pathology, and bone metabolism. However, it cannot be denied that in regard to basic research in areas such as cancer of the alimentary canal, which is a soft tissue, Japan has lagged behind. This is attributable, in part, to the difficulties in manufacturing tissue samples due to the characteristics of bone tissue, and to difficulties involved in investigative molecular biology methods for bone and cartilage cells. On the other hand, however, much pioneering work has been done in the analysis of, for instance, biomechanics and motor function in the living body. Twenty or more years ago, in comparison with that of the United States and other countries, it was said that basic orthopedic research in Japan was about 30 years behind. Of course, we were dependent on the research being done in the orthopedic departments of major universities, meaning that clinical doctors gained most of their research experience while studying overseas. Thanks to the efforts of our predecessors, in recent years impressive progress has been made in basic orthopedic research in Japan, not only in bone and cartilage but also in connective tissue, genetics, and molecular biology. The quality of the research has greatly improved to the point that in some areas Japanese researchers are now leading the field worldwide. This situation has been influenced by the elimination of many of the separations between the basic and clini-
cal departments in medical schools, and the greater attention shown by basic researchers to bone and soft tissue. Recent governmental measures emphasize the necessity of developing efficient academic research systems that will result in practical application. Accordingly, cooperative translational research, especially between basic and clinical medical school departments, is receiving ever-greater focus. This calls for more streamlined systems in which the provision of bone and cartilage tissues by clinical departments to basic researchers will stimulate greater interest among those researchers, spurring more investigation in these areas. On the international scene, we are gratified to see that, under the auspices of the World Health Organization, which has designated the first 10 years of the twenty-first century as the Bone and Joint Decade, both clinical and basic research has begun. This has been brought about through the greater awareness that the aging of societies all over the world will be accompanied by the need to deal with greater numbers of patients with bone and joint diseases. For the current meeting, we have planned 16 symposia. We have asked the chairmen to select appropriate experts for each of the symposium topics, in addition to choosing participants from among those who submitted abstracts for the regular sessions. Concerning the subjects to be covered, not only can we look forward to hearing about the genetic analysis of bone and cartilage, but there will also be discussions on molecular biology, in addition to collaborative studies in which clinical doctors have provided a range of information and materials such as the epidemiology, symptoms, tissue and other living body materials while, of course, giving due consideration to the ethical aspects. Genetic analysis and the further development of genetic analysis methods will serve to elucidate the causes of disease and open avenues to genetic treatment. The use of robotics is expected to enable safe and standard
surgical techniques leading to great progress in the treatment of bone and cartilage diseases. The accurate application of spinal instrumentation will bring great benefits to patients with vertebral and spinal cord diseases. The clarification of bone resorption and ossification will help us to understand the causes of osteoporosis and other bone metabolism diseases. The selection of the theme of this meeting also grew out the desire to discuss the current situation after the 20-odd years of research by the Japanese Ministry of Public Health and Welfare Investigation Committee on OPLL. In other words, although ossification of ligaments, which forms new bone, and osteoporosis are intimately related, until now there has been no comprehensive investigation of these two phenomena. Joint cartilage has been studied for many years, but recent progress in molecular biology has elucidated the causes of changes in joint cartilage. This development already has provided ideas for the repair and prevention of such changes, and we expect more progress in this area. Many effects of mechanical stress on the living body can be commonly seen, but basic research into the effect on patients with bone and joint diseases has not yet been undertaken. It has been shown that mechanical stress clearly causes changes on the cellular level, sometimes promoting bone formation. Currently, it is thought that mechanical stress is closely related to the development of ossification of spinal ligaments, and research in this area will be essential in clarifying the causes of other diseases as well. The mechanism of bone metastasis of cancer is not yet known. Research on cancer including treatment and prevention is being performed on the governmental
S. Harata: 17th Annual Research Meeting of JOA
level, and the idea that cancer is an uncurable disease is now lessening. As survival periods of cancer patients lengthen, problems of decreased quality of life caused by bone metastasis become more prevalent. Elucidation of the mechanism of bone metastasis and methods for its prevention will greatly improve the outlook for cancer patients. Spinal cord symptoms caused by chronic spinal cord compression syndrome do not always correspond to the degree of deformity of the compressed spinal cord. Studies on remolding of the spinal cord will make it possible to forecast postoperative recovery of spinal cord function. Evidence will be gained for vertebral and spinal cord diseases, ossification of the spinal ligaments, and spondylosis, leading to the establishment of treatments in conformity with the requirements of evidencebased medicine and greater trust among the public. I have touched upon just a few of the many important topics that will be dealt with in the symposia of the current meeting. In addition, many interesting papers will be presented. The previous barriers between the clinical and basic research departments of medical schools are coming down, and many institutions are now sharing information and knowledge, making farreaching interdisciplinary investigations possible. To the extent that bridges are built between large numbers of medical institutions, research facilities, and the basic research field, we will see more efficient research and good results. The data obtained will be put to practical application in the clinic, resulting in clinical doctors having more trust in basic researchers. It will also be important for these research methods to be passed down to our younger colleagues.