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Current Concepts Review   |    
Molecular Biology in Orthopaedics: The Advent of Molecular Orthopaedics
Christopher H. Evans, PhD, DSc1; Randy N. Rosier, MD, PhD2
1 Center for Molecular Orthopaedics, Harvard Medical School, 221 Long-wood Avenue, BLI-152, Boston, MA 02115. E-mail address: cevans@rics.bwh.harvard.edu
2 Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642
The Journal of Bone & Joint Surgery.  2005; 87:2550-2564  doi:10.2106/JBJS.E.00019
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Abstract

Molecular biology is the study, at the molecular level, of how genetic information is stored, inherited, and expressed and how it influences the structure and function of cells.

Although molecular biology approaches have been used for decades in orthopaedic research, they are only now beginning to influence clinical practice.

A variety of sophisticated techniques permit rapid and affordable DNA sequencing, gene expression profiling, gene cloning, gene manipulation, gene transfer, recombinant protein production, and other technologies of enormous biomedical importance.

Success in genomics has spawned additional ambitious endeavors, including proteomics, pharmacogenetics, and bioinformatics.

These techniques are providing new diagnostic, staging, prognostic, and therapeutic opportunities in all areas of medicine, including orthopaedics.

With the use of molecular criteria, treatment of the orthopaedic patient may become more individualized, and greater emphasis will be placed on preventative strategies based on the patient's genetic makeup. Both surgical and nonsurgical decisions will increasingly accommodate molecular criteria.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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    Iñaki Otermin
    Posted on November 18, 2005
    The Use of Molecular Diagnostic Methods to Manage Infected Total Knee Prostheses
    Servicio Navarro de Salud

    To The Editor:

    In their excellent review article(1), Evans and Rosier did not mention that during the past few years, clinical microbiology laboratories have begun to use genetic fingerprinting methods in epidemiological studies for the diagnosis of infectious diseases(2). Currently these methods are being used in the diagnosis and management of infectious diseases in traumatology and orthopedic(2). The laboratories have been using both phenotypic and genotypic methods.

    References:

    1. Molecular Biology in Orthopaedics:The Advent of Molecular Orthopaedics.Christopher H. Evans,Randy N. Rosier.J Bone J Surg.Vol 87- ANumber 11.Nov 2005.pp:2550-2564.

    2. Métodos moleculares de tipificación epidemiológica en bacteriología.Ed:Emilia Cercenado y Rafael Cantón.Sociedad Española de Microbiología y Enfermedades Infecciosas(www.seimc.org).Downloaded in November 2005.

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