Research Programs

CLEAR Center Research Mentorship, Support, and Funding

The CLEAR Center supports and mentors early-stage investigators in developing research skills and project portfolios. The CLEAR Center team strives to prepare the next generation of musculoskeletal researchers by providing access to mentorship, datasets, analyst support, and research project funding support.

The CLEAR Center’s Pilot & Feasibility Award Program is meant to foster early-stage investigators interested in musculoskeletal research. Investigators can receive up to $20,000 (direct costs) over one year for faculty/staff effort and/or the purchase of services and supplies. Information on the application process for the Pilot & Feasibility Award Program can be found here.

Current CLEAR Center-Supported Projects and Investigators

Christine Rehwald, MD

Christine Rehwald, MD

CLEAR Center Pilot & Feasibility Awardee 2020
Project Title: Spinal infection: assessing incidence, comorbidities, and costs using local and national databases to inform patient management and resource use strategies
Current Status: In Progress

Project Description

Dr. Christine Rehwald is an acting Assistant Professor in the University of Washington Department of Radiology and one of three recipients of the 2020-2021 CLEAR Center Pilot & Feasibility Awards.

Dr. Rehwald’s project will confirm the effect of comorbidities on spinal infection (SI), singly and in combinations, and the associated inpatient/outpatient costs using patient-level data.

Spinal infection (SI) is associated with significant morbidity and costs to the healthcare system. Annual incidence of SI has been increasing, with proposed links to opioid use disorder within Washington State. Other risk factors for developing SI include diabetes mellitus (DM), chronic kidney disease, endocarditis, chronic liver disease, malnutrition, HIV infection and recent spine surgery.

Dr. Rehwald and her team will assess clinical risk factors and test their impact on SI management costs. They aim to better identify and specify comorbidities; to evaluate inpatient, emergency, and outpatient costs; and to develop predictive cost-related models to guide future patient-management strategies and resource planning for SI patient care.

Mia S. Hagen, MD

Mia S. Hagen, MD

CLEAR Center Pilot & Feasibility Awardee 2020
Project Title: A randomized controlled pilot trial of postoperative hip bracing after arthroscopic osteoplasty and labral repair for femoroacetabular impingement syndrome (FAIS)
Current Status: In Progress

Project Description

Dr. Mia S. Hagen is an Assistant Professor within the University of Washington’s Department of Orthopaedics and Sports Medicine, the Surgical Director of the Sports Medicine Center at Husky Stadium, serves as a team physician for the University of Washington Husky Athletics, and one of the three recipients of the 2020-2021 CLEAR Center Pilot & Feasibility Awards.

Dr. Hagen’s project will test the benefits of postoperative hip bracing on short-term outcomes including patient reported pain scores and physician exam findings of hip flexor tendonitis (IPT).

Hip arthroscopy for treatment of femoroacetabular impingement syndrome (FAIS) involves reshaping of the osseous sources of impingement (“osteoplasty”) and repair of impingement-associated labral tears. The diagnoses of FAIS and the incidence of hip arthroscopy have both increased dramatically in the last 20 years in the US. Despite the increasing incidence of hip arthroscopy in the US, on a recent review Dr. Hagen and her team found few evidence based studies on postoperative care. A particular area of debate is the use of postoperative hip braces, which can be relatively expensive. 

In this study, Dr. Hagen and her team will use a randomized controlled trial to test the cited benefits of postoperative hip bracing on short term patient reported pain scores, validated hip-specific pain scores, and physical exam findings of hip flexor tendonitis.

Michael O'Reilly, MBBCh

Michael O'Reilly, MBBCh

CLEAR Center Senior Fellow
2019-2020
Project Title: Rates of Vertebral Augmentation for the Treatment of Osteoporotic Vertebral Compression Fractures among the Commercially Insured

Description of Work

Dr. Michael O’Reilly is a Senior Neuroradiology Fellow in the University of Washington Department of Radiology. Dr. O’Reilly is training in diagnostic neuroradiology and interventional radiology with a focus on health services research and comparative effectiveness analysis in order to identify the most effective ways to organize, manage, finance, and deliver high quality care while improving patient safety.

Dr. O’Reilly’s study, Rates of Vertebral Augmentation for the Treatment of Osteoporotic Vertebral Compression Fractures among the Commercially Insured is a retrospective cohort analysis of patients with osteoporotic vertebral compression fractures in the IBM MarketScan® Research Database of Americans with employer-provided health insurance. For his study, Dr. O’Reilly analyzed a cohort of patients who had thoracic and lumbar osteoporotic fractures and calculcated the proportions who were treated with vertebroplasty and kyphoplasty, collectively termed vertebral augmentation. This study provided data on a notable knowledge gap regarding vertebral augmentation in younger patients, particularly with regard to kyphoplasty. Interim results of this study indicate that vertebral augmentation is highly utilized in this younger patient cohort, with rates of kyphoplasty in particular increasing in recent years.

Dr. O’Reilly will perform further analyses on this cohort of patients with osteoporotic fractures in the IBM MarketScan® Research Database that will compare healthcare utilization, including opioid use, complication rates, and spine surgeries, and costs among patients who did and did not receive vertebral augmentation.

Other projects of Dr. O’Reilly’s include a study to determine the prevalence of reported findings on lumbar spine imaging examinations performed subsequent to a patient’s index visit to their primary provider during the LIRE study, as well as a project to assess the materials available to create radiographic high-fidelity anthropomorphic phantoms using 3D printing and common and commercially available castable materials.

Jonah Hebert-Davies, MD

Jonah Hebert-Davies, MD

CLEAR Center Pilot & Feasibility Awardee 2019
Project Title: A Randomized Controlled Pilot Study Evaluating the Efficacy of Early Glenohumeral Cortisone Injection in Patients with Shoulder Stiffness Following Proximal Humerus Fractures
Current Status: In Progress

Project Description

Dr. Jonah Hebert-Davies is an Assistant Professor in the University of Washington Department of Orthopaedics and Sports Medicine and one of two recipients of the 2019-2020 CLEAR Center Pilot & Feasibility Awards.

Dr. Hebert-Davies’ Pilot & Feasibility Award project will determine the feasibility of performing a large-scale trial to address post traumatic decreased range of motion in patients with proximal humerus fractures.

Shoulder stiffness is a common complication of proxmial humerus fractures and has the potential to seriously impact daily function. Standard treatment includes physical therapy, home exercise, and “watchful waiting” to see if symptoms improve with time. In this study, Dr. Hebert-Davies and his team will examine whether or not steroid injections are a viable treatment option for this type of injury. This study will conduct pilot work to determine the feasibility of conducting a large scale multi-centered randomized trial to evaluate the viability of steroid injections as a treatment option for shoulder stiffness following proximal humerus fracture.

Patients participating in this study will be randomized to receive an ultrasound-guided intra-articular injection with lidocaine or an ultrasound-guided intra-articular cortisone injection. The team will examine clinical and functional outcomes at multiple timepoints to determine the feasibility of studying this treatment on a larger scale.

Completed Projects

James Andrews, MD

James Andrews, MD

CLEAR Center Pilot & Feasibility Awardee 2018
Project Title: Identifying Aging-related Sarcopenia as a Novel Risk Factor for the Development of Osteoarthritis in Older Adults – a Population-Based Approach
Current Status: Complete

Project Description

Dr. James Andrews is an Assistant Professor in the University of Washington Department of Medicine Division of Rheumatology and was one of two recipients of the inaugural CLEAR Center Pilot & Feasibility Awards.

Dr. Andrews’ Pilot & Feasibility Award project leveraged the NIH/NIA-funded Health, Aging, and Body Composition (Health ABC) dataset to identify novel risk factors for the development of osteoarthritis among older adults, such as sarcopenia (low lean mass and grip strength) and serum biomarkers. Dr. Andrews and his team explored the relationship between sarcopenia and osteoarthritis, as well as examined the potential for sarcopenia to predict development of osteoarthritis in the future. Understanding the relationship between sarcopenia and development of osteoarthritis in older adults will pave the way for identification of patients at greatest risk for osteoarthritis and provide novel data on how osteoarthritis is developed that will ultimately promote interventional studies designed to prevent osteoarthritis and reduce disability for millions of at risk older Americans.

 

Additional Funding Received

  • Sarcopenia as a Predictor of Functional Outcomes of Acute Illness in Older Adults with Dementia
    National Institute on Aging
    1R03AG063168-01
    4/15/2019 – 1/31/2021
  • Sarcopenia as a Predictor of Hospital-Associated Disability in Older Adults
    National Institute on Aging
    5K23AG058756-02
    8/15/2018 – 4/30/2023
Scott Telfer, EngD

Scott Telfer, EngD

CLEAR Center Pilot & Feasibility Awardee 2018
Project Title: Blood Flow Restriction for Anterior Cruciate Ligament (ACL) Rehabilitation
Current Status: Complete

Project Description

Dr. Scott Telfer is a Research Assistant Professor in the University of Washington Department of Orthopaedics and Sports Medicine and was one of two recipients of the inaugural CLEAR Center Pilot & Feasibility Awards.

Dr. Telfer’s project involved a cross-sectional study designed to test the acceptability of blood flow restriction training for those undergoing rehabilitation from ACL reconstruction surgery. It also investigated the biomechanical effects of the blood flow restriction training rehabilitation technique.

Rehabilitation after surgical reconstruction of the ACL aims to re-establish the function of the knee. Effectively building muscle strength requires exercises with high resistance loads, but the joint stress and risk of further injury make these types of activities inappropriate and unsafe for those rehabilitating after ACL reconstruction surgery. Personalized blood flow restriction training is a technique where the blood flow to the muscles being exercised is controlled by a pressure cuff to a predefined level, and has been shown to increase strength while exercising with significantly lower loads. Dr. Telfer’s CLEAR Pilot & Feasibility project compared 2 groups of 20 participants each: one group of individuals underwent rehabilitation after ACL reconstruction, and the second group was an age-, weight-, and sex-matched control group. Both groups completed personalized blood flow restriction training and had their movements and muscle activation monitored. Participants were also asked to complete post-exercise surveys rating the difficulty and discomfort associated with each exercise they performed.

Aaron Bunnell, MD

Aaron Bunnell, MD