World-renowned health professionals plan

The Bone & Joint Decade

Drs. Walsh and Lidgren

Five health professionals worldwide recently were invited to set goals and strategies at an international musculoskeletal consensus meeting for the Decade of the Bone and Joint, 2000-2010, and one of these leaders was from the Health Science Center. Nicolas E. Walsh, MD, professor and chairman of the department of rehabilitation medicine, and two other steering committee members will go before a United Nations assembly to request endorsement of the decade designation.

Why does the world need a decade dedicated to bone and joint problems? Dr. Walsh explained that musculoskeletal disorders, such as joint diseases, back pain, fractures related to osteoporosis, severe injuries caused by traffic accidents and war, and crippling diseases and deformities are the most common causes of severe, long-term pain and physical disability. For example, according to the Scandinavian University Press:

To improve the quality of life of people with musculoskeletal disorders and address the growing societal and financial burdens of such ailments, the group developed four goals for the decade:

According to Dr. Walsh, increasing numbers of people in both developed and developing countries have musculoskeletal problems, simply because the people are living longer. "We're living longer, and that's well and good. But other things go along with that--our bodies literally wear out," he said.

"Musculoskeletal problems, outside of trauma, begin occurring when you stop growing," Dr. Walsh added. He cited studies done during the Korean War which demonstrated that soldiers, ages 17 to 20, had early degenerative joint disease. "When your bones and joints stop growing, then it's just a case of repetitive trauma to the joint. Joints degenerate over time; they can't replace themselves fast enough," he stated.

Steering Committee

Among the many messages Dr. Walsh and the international group will promote during the Decade of the Bone and Joint are the ways musculoskeletal problems can be prevented. "The whole idea of the decade is that there are many things that can be done in terms of prevention--in terms of how you live, how you walk," added Dr. Walsh. "Walking, taking fluoride and taking calcium can make a lot of difference, if begun at a fairly young age, in preventing osteoporosis.

"Also, back strain often can be prevented. If coins are dropped on the floor, for example, many people will bend over to pick them up, causing stretched ligaments, increased interdiscal pressure and a literal positioning of their backs like a cantilever bridge--not suspended but just hanging out there," explained Dr. Walsh. "We need to educate people to get down on their knees and sweep the coins together. It's simple, but we don't do it."

One of Dr. Walsh's interests is treating amputees. "They are a fairly significant component of the trauma portion of the Decade of the Bone and Joint--their problems result when we fail to prevent damage, when we fail to educate people, or when our best medical treatment fails with diabetics or trauma patients," he stated.

"Then, the challenge is to restore function in as economic, optimal and complete way as possible," he added. "And that challenge is met by our research at the Health Science Center--in terms of computer-assisted design and manufacture of prosthetic devices for use both in the United States and developing countries.

"My interest is especially in treating war injuries in developing countries," said the former member of the U.S. Navy's most elite fighting group in Vietnam, SEAL Team One. "It is rare to see somebody in an agrarian society working in the field on crutches; crutches just don't work. You need to have both legs. The unfortunate fact is that the world is always at war, at least somewhere. We need better ways to deal with resulting trauma and delivering prostheses.

"The prevention side of that is really redesigning land mines," he added. "The United States happens to be on the side of the issue that says we still need them. In some military situations that's very correct. But they can be designed so that they self-destruct or so that they become inert after a set period of time."

Rehabilitation medicine is not alone in contributing to treatment and management of musculoskeletal disease and to the Decade of the Bone and Joint. Dr. Walsh cited the outstanding accomplishments of the Health Science Center's department of orthopaedics in the area of cartilage replacement and fracture repair, and the division of endocrinology (department of medicine) in the area of osteoporosis treatment. "The unique thing about this decade is that all of the people working in this area of medicine deal with musculoskeletal problems across the whole continuum of care," said Dr. Walsh. "I don't see patients after all other treatments are finished. I see them on the prevention side, too, including the visits with orthopaedists, rheumatologists and endocrinologists."

During the decade Dr. Walsh will be presenting education sessions for medical professionals and the public. "Work is being done now so that by 2010, 2015 or 2020 we're positioned to deal with musculoskeletal problems," concluded Dr. Walsh. "Otherwise there is no conceivable way that we're going to be able to deal with them."

This summer Dr. Walsh became chair of the American Board of Physical Medicine and Rehabilitation, the national certifying agency for all physical medicine and rehabilitation specialists.

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