Untitled Document

Research

Mark D. Markel

D.V.M., University of California at Davis Ph.D., Mayo Graduate School of Medicine
Professor and Chair, Department of Medical Sciences, School of Veterinary Medicine
Associate Dean for Advancement, Veterinary Medicine
markelm@svm.vetmed.wisc.edu
http://www.vetmed.wisc.edu/people/markelm

Enhancing Function and Reducing Pain in Patients Who Have Undergone Total Joint Replacement.

We are interested in the reconstruction of the proximal femur during total hip replacement. One of the most difficult problems in orthopaedics is reconstruction of the proximal femur when a hip replacement must be revised due to loss of bone stock. Although disuse, infection, and fracture can contribute to bone loss, extensive loss of bone often occurs after one or more cemented total hip revisions and after resection of primary and/or metastatic tumors. Despite the successful reconstruction of the proximal femur with an allograft (cadaveric bone) or an allograft combined with a metallic prosthesis, the muscular attachments to the bone remain a significant problem. Patients with such failed attachments often have long term pain, high dislocation rates, and an abnormal gait leading to poor limb function.

The long-term objective of our research is to increase the functional use and long-term outcome of patients with total hip replacement and hip revision. In our current research efforts, we are evaluating the attachment of the gluteal muscles to a proximal femoral reconstruction using an allograft/prosthesis composite. We are interested in the specific time-related changes that occur in functional weight bearing, the density of the bone, the histologic appearance of the bone, and the mechanical characteristics of the reconstruction during incorporation of the allograft tendon and bone following reconstruction of the femur. The results of this research should enhance patients' function and increase their quality of life following total hip replacement.

We are evaluating several methods to replace bony defects that may occur secondary to bone loss from osteoporosis. These methods include replacement of the section of bone with an allograft (cadaveric bone) combined with various bone growth factors to enhance the incorporation of the bone in order to speed healing and return the patient to his or her previous level of activity. This research will allow us to design methods to replace large bony defects that may occur in fractures secondary to osteoporosis.

We are also investigating enhancement of joint stability using laser energy or radio frequency energy to shrink joint capsular tissue to stabilize joints, which will be particularly valuable for the elderly population who have pain secondary to increased joint laxity. This research should lead to a technique that allows for rapid return to the activities of daily living following surgery with minimal morbidity.

Representative Publications
Lopez, M.J., Lewis, B.P., Swaab, M.E., & Markel, M.D. (2008). Relationships among measurements obtained by use of computed tomography and radiography and scores of cartilage microdamage in hip joints with moderate to severe joint laxity in dogs. Am. J. Vet. Res., 69, 362-370.

Sample, S.J., Behan, M., Smith, L., Oldenhoff, W.E., Markel, M.D., Kalscheur, V.L., Hao, Z., Miletic, V., & Muir, P. (2008). Functional adaptation to loading of a single bone is neuronally regulated and involves multiple bones. J. Bone Miner. Res., 23, 1372-1381.

Perrier, M., Lu Y., Nemke, B., Kobayashi, H., Peterson, A., & Markel, M.D. (2008). Acceleration of second and fourth metatarsal fracture healing with recombinant human bone morphogenetic protein-2/calcium phosphate cement in horses. Vet. Surg., 37, 648-655.

Pluhar, G.E., Manley, P.A., Heiner, J.P., Vanderby, R., & Markel, M.D. (2007). Gluteal muscle attachment during proximal femoral reconstruction in a canine model. J. Orthop. Res., 25, 208-220.

Edwards, R.B., Lu, Y., Bogdanske, J.J., Muir, P., & Markel, M.D. (2007). Comparison of mechanical debridement and radiofrequency energy for chondroplasty in an in vivo equine model of partial thickness cartilage injury. Osteoarthritis Cart., 15, 169-178.

Muir, P., Sample, S.J., Barrett, J.G., McCarthy, J., Vanderby, R., Markel, M.D., Prokuski, L.J., & Kalscheur, V.L. (2007). Effect of fatigue loading and associated matrix microdamage on bone blood flow and interstitial fluid flow. Bone, 40(4), 948-956.

Muir, P., McCarthy, J., Radtke, C.L., Markel, M.D., Santschi, E.M., Scollary, M.C., & Kalscheur, V.L. (2006). Role of endochondral ossification of articular cartilage and functional adaptation of the subchondral plate in development of fatigue microcracking of joints. Bone, 38, 342-349.

Lu, Y., Markel, M.D., Swain, C., & Kaplan, L.D. (2006). Development of partial thickness articular cartilage injury in an ovine model. J. Orthop. Res., 24, 1974-1982.

Daubs, B., Markel, M.D., & Manley, P.A. (2006). Histomorphometric analysis of articular cartilage, zone of calcified cartilage, and subchondral bone plate in femoral heads from clinically normal dogs and dogs with moderate or severe osteoarthritis. Am. J. Vet. Res., 67, 1719-1724.

Sicard, G.K., Markel, M.D., & Manley, P.A. (2005). Histomorphometric analysis of the proximal portion of the femur in dogs with moderate osteoarthritis. Am. J. Vet. Res., 66, 150-155.

Lu, Y., Adkisson, D., Bogdanske, J., Kalscheur, V., Maloney, W., Cheung, R., Grodzinsky, A.J., Hruska, K.A., & Markel, M.D. (2005). In vivo transplantation of neonatal ovine neocartilage allografts: Determining the effectiveness of tissue transglutaminase. J. Knee Surg., 18, 31-42.

Meyer, M.L., Lu, Y., & Markel, M.D. (2005). Effects of radiofrequency energy on human chondromalacic cartilage: an assessment of insulation material properties. IEEE Trans. Biomed. Eng., 52, 702-710.

Da Costa-Gomez, T.M., Barrett, J.G., Sample, S.J., Radtke, C.L., Kalscheur, V.L., Lu, Y., Markel, M.D., Santschi, E.M., Scollary, M.C., Muir, P. (2005). Up-regulation of site-specific remodeling without accumulation of microcracking and loss of osteocytes. Bone, 37, 16-24.

Williams, J.M., Virdi, A.S., Pylawka, T.K., Edwards, R.B., III, Markel, M.D., & Cole, B.J. (2005). Prolonged-fresh preservation of intact whole canine femoral condyles for the potential use as osteochondral allografts. J. Orthop. Res., 23, 831-837.

Bergh, M.S., Muir, P., Markel, M.D., & Manley, P.A. (2004). Femoral bone adaptation to stable long-term cemented total hip arthroplasty in dogs. Vet. Surg., 33, 214-220.

Bergh, M.S., Muir, P., Markel, M.D., Manley, P.A. (2004). Femoral bone adaptation to unstable long-term cemented total hip arthroplasty in dogs. Vet. Surg., 33, 238-245.

Colopy, S.A., Benz-Dean, J., Barrett, J.G., Sample, S.J., Lu, Y., Danova, N.A., Kalscheur, V.L., Vanderby, R., Markel, M.D., & Muir, P. (2004). Response of the osteocyte syncitium adjacent to and distant from microcracks during adaptation to cyclic fatigue loading. Bone, 35, 881-891.

Noonan, K.J., Farnum, C.E., Leiferman, E.M., Lampl, M., Markel, M.D., & Wilsman, N.J. (2004). Growing pains: Are they due to increased growth during recumbency as documented in a lamb model? J. Pediatr. Orthop., 24, 726-731.

Edwards, R.B., Lu, Y., Nho, S., Cole, B.J., & Markel, M.D. (2002). Thermal chondroplasty of chondromalacic human cartilage: An ex vivo comparison of bipolar and monopolar radiofrequency devices. Am. J. Sports. Med., 30, 90-97.

Edwards, R.B., Lu, Y., Rodriguez, E., & Markel, M.D. (2002). Thermometric determination of cartilage matrix temperatures during thermal chondroplasty: Comparison of bipolar and monopolar radiofrequency devices. Arthroscopy, 18, 339-346.

Pluhar, G.E., Heiner, J.P., Manley, P.A., Bogdanske, J.J., Vanderby, R., & Markel, M.D. (2002). Comparison of three methods of gluteal muscle attachment to an allograft/endoprosthetic composite in a canine model. J. Orthop. Res., 18, 56-63.

Lu, Y., Edwards, R.B., Kalscheur, V.L., Nho, S., Cole, B.J., & Markel, M.D. (2001). Effect of bipolar radiofrequency energy on human articular cartilage: Comparison of confocal laser microscopy and light microscopy. Arthroscopy, 17, 117-123.

Pluhar, G.E., Manley, P.A., Heiner, J.P, Vanderby, R., Seeherman, H.J., & Markel, M.D. (2001). The effect of recombinant human bone morphogenetic protein-2 on femoral reconstruction with an intercalary allograft in a dog model. J. Orthop. Res., 19, 308-317.

Hayashi, K., & Markel, M.D. (2001). Thermal capsulorraphy treatment of shoulder instability: Basic science. Clin. Orthop., 390, 59-72.

Lu, Y., Hayashi, K., Edwards, R.B., Fanton, G.S., Thabit, G., & Markel, M.D. (2000). The effect of monopolar radiofrequency treatment pattern on joint capsular healing: In vitro and in vivo studies using an ovine model. Am. J. Sports Med., 28, 711-719.

Lu, Y., Hayashi, K., Hecht, P., Fanton, G.S., Thabit, G., Cooley, A.J., Edwards, R.B., & Markel, M.D. (2000). The effect of monopolar radiofrequency energy on partial-thickness defects of articular cartilage. Arthroscopy, 16, 527-536.

Osmond, C., Hecht, P., Hayashi, K., Hansen, S., Fanton, G.S., Thabit, G., & Markel, M.D. (2000). Comparative effects of laser and radiofrequency energy on joint capsule. Clin. Orthop., 375, 286-294.

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