“It's A Bargain” Thrift Shop - Orthopaedic Hospital

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ogy, Diabetes and Metabolism.
He was the program director of
the General Clinical Research
Center at Cedars-Sinai’s Burns
and Allen Research Institute.
He is a professor of medicine in
residence at the David Geffen
School of Medicine.
Dr. Adams received his
bachelor’s degree from the University
of Kansas and his medical
degree from the University
of Kansas School of Medicine.
He completed his fellowship
in endocrinology and internal
medicine at Massachusetts General Hospital, Harvard
Medical School.
In the following interview, Dr. Adams outlines
his vision for the Orthopædic Hospital
Research Center.
motion: Orthopaedic research seems poised to
achieve breakthroughs in the coming decade,
perhaps even eliminating the need for surgery
in some cases.
Dr. Adams: That’s true. First, you want to try to
prevent illnesses or fractures before they occur.
Second, if you do have to repair something, it
would be a lot better if you could do it in the
cells and matrices instead of performing surgery.
Our view is that the major advances in
medicine over the next 50 to 75 years will
be made by teams of scientists that normally
wouldn’t be positioned to work together.
Consider fractures that occur due to osteoporosis.
Osteoporosis is a major political and
social healthcare problem. It’s expensive. It
causes a tremendous amount of suffering for the
individual who sustains a fracture and for the
family who must deal with this person who can
no longer live independently.
The major cause of morbidity and mortality
in this disease is age. Once you fracture your
hip, you’re never really the same. If you’re a man
over 80, you have about a 50% chance of dying
in the first year after surgery.
These are big medical problems that affect a
huge number of people. Right now, we’re wait-
research
“Our view is that the major
advances in medicine over the
next 50 to 75 years will be
made by teams of scientists that
normally wouldn’t be positioned
to work together.”
— John S. Adams, MD
Vice Chair for Research,
UCLA and Orthopædic
Hospital Department of
Orthopaedic Surgery
ing for the fracture to occur, we’re fixing it and
we’re keeping our fingers crossed that the person
doesn’t fall again and experience another
fracture.
But we are really getting a grasp on how to
best handle these orthopaedic conditions.
In osteoporosis, the major determinant of
bone mass — which is the major determinant
of fractures — is how much bone you start off
with at the end of adolescence. It’s not the way
in which you lose bone but actually where you
are at peak bone mass, which is at 19 to 20
years of age in females and males, respectively.
Everybody loses bone mass after the age of
25. Because women start with about 20% less
bone than men, they get to the fracture threshold
more quickly. Now that men are living
longer, they’re having exactly the same thing
occur to them, except that it’s about 10 years
later because they started off with more bone
to begin with.
motion: Can we do anything to improve peak
bone mass?
Dr. Adams: What’s interesting is that 85% of the
variation in peak bone mass is genetically determined.
85%! So that means whether you will or
will not get osteoporosis is pretty much determined
at the time of conception. We’re making
a big push to find the genes that are responsible.
We want to know how they get turned on during
adolescence and how they are responsible
for the construction of the mature skeleton.