Young Investigator Research Development 2021 Awardees

Drs Graham DeKeyser and Augustine Saiz share the goals and inspirations for their research projects

Dr. Graham DeKeyser is a current Fellow at Harborview Medical Center, Orthopaedic Division.

I plan on studying pelvic malreductions at the sacroiliac joint. I will start by using a cadaveric model to judge what magnitude of malreductions and which planes of malreduction can be detected with current intra-operative technology. I then plan to use this cadaveric model to measure changes in adjacent joint kinematics and pressure. Finally, after making these determinations, I hope to translate this research into a clinical setting to evaluate how good orthopedic surgeons are at judging sacroiliac joint reductions and how slight malreductions at this point affects patients clinically.

This research is important to me because evidence regarding reduction of complete SI disruptions is lacking. My study should help guide understanding of a joint that is poorly understood in the orthopedic trauma literature. I am inspired to do this research due to patients with complete SI joint disruptions that stuck out to me during my training. After listening to these patients’ concerns, I began to question the accuracy and importance of sacroiliac joint reduction in the context of pelvic ring and acetabular injuries. I hope to start this portion of the research at Oregon Health and Science University.

Dr Augustine Saiz is a current Fellow at The University of Texas Health Science Center at Houston.

Using this grant, I plan to build a programmatic, focused research program centered on:

  1. Translational bench research on muscle-bone biochemical interaction and crosstalk in fracture healing
  2. Clinical outcomes and surgical techniques in pelvis/acetabulum fracture care

There is a growing recognition of the critical interactions between skeletal muscle and bone during development, homeostasis, aging, and healing due to traumatic injury. Acetabulum and pelvic treatment algorithms have undergone significant advancement over the last six decades.

Regarding the muscle-bone biochemical crosstalk research, the overarching motivation is to improve open fracture healing by accelerating and increasing muscle regeneration, including through transplantation of mesenchymal stromal cell (MSC) spheroids using engineered biomaterials.

The impact of this proposed research in the field of orthopedic surgery and tissue engineering will be substantial, as this proposal examines the optimization of a biomaterial to augment both bone and muscle healing. This represents a shift in the research of fracture nonunions, which occur in a higher incidence in open fractures compared to closed fractures, as the proposed research focuses on a biomaterial that will regenerate muscle to concomitantly improve bone healing.

Ideally, I hope this proposed research will serve as a foundation for further research into the development of optimal biomaterials for both muscle and bone regeneration. Regarding the pelvis/acetabulum-focused research, the treatment of pelvic/acetabulum fractures is a subspecialized field I thoroughly enjoy and the reason I am inspired to do this research. The goal of both fields of study is to advance the field of orthopedics incrementally through new findings. The studies focused on muscle-bone interactions will hopefully generate new paradigms and surgical solutions to open fractures with severe muscle injury/loss.

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