Bone Health and Orthopedics studies

We work closely with Kaiser Permanente orthopedic surgeons to examine factors related to injuries in patients of all ages. Studies have focused on prevention and treatment of hip fractures, osteoporosis-related injuries, and outcomes associated with total joint replacements and other reconstructive interventions.

Clinical Biomechanics of Hip Fracture

The aim for this study is to extend biomechanical analyses of CT (BCT) to more completely incorporate all major biomechanical aspects of hip fracture etiology, using available clinical data to optimize the ability of BCT to clinically identify patients at high risk of hip fracture, particularly those who do not have BMD-defined osteoporosis or those who are at more imminent or short-term risk fracture.

Site Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Funding Years:

2020 - 2023

Research Categories:

Fracture, Osteopenia, and CT Utilization Study (FOCUS Study)

The aim of this study is to validate within a population of KPSC patients the ability of a CT-based Biomechanical CT analysis to identify patients with osteopenia who are at high risk for hip fracture.

Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

Merck & Co., Inc.

Funding Years:

2015 - 2017

Research Categories:

Osteoporotic fractures and associated healthcare resource utilization

The primary aim of this cohort study is to assess the downstream effects of fragility fracture, including mortality, recurrent fracture, and health-care resource utilization in the first post-fracture year.

Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

Radius Health, Inc.

Funding Years:

2018 - 2020

Research Categories:

Pooling International Cohort Studies of Long-Term Bisphosphonate Use and Atypical Femur Fractures

The aim of this study is to use individual-level data from three large, population-based cohorts with radiographically adjudicated atypical femur fractures (AFFs) to determine how the risk of AFFs relates to bisphosphonate treatment duration, drug holidays, and treatment re-initiation while accounting for other potential risk factors. This information will be used to develop models to predict individual AFF risk, combining clinical risk factors, patterns of long-term anti-osteoporosis treatment, and periods of drug holiday.

Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Funding Years:

2022 - 2027

Pre-operative Assessment of Fusion-related Bone Failure

The objective of this case-cohort study is to apply biomechanical computed tomography (BCT) analysis and virtual stress testing (VST) to pre-operative CT scans for a cohort of candidates for spine-fusion surgery to predict clinical/surgical outcomes such as pedicle screw failure, endplate subsidence, proximal junctional failure, and overall surgery failure. We will be testing the hypothesis that VST indices can predict surgical failure independent of other known pre-operative risk factors or bone mineral density.

Site Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

National Institutes of Health (NIH)

Funding Years:

2018 - 2019

Research Categories:

Retrospective Cohort Study of Risk of Hip Fractures Associated with High Dose, Long-term Proton Pump Inhibitor (HD-PPI) Use and Cytochrome P450 Pharmacogenomics

The main goals of this study are to conduct two related cohort studies intended to address questions related to the association between PPI and HD-PPI use in a setting of complex medication usage patterns and to conduct a pharmacogenetics study exploring potential modification of the relationship between PPI use and hip fracture risk by CYP2C19 genotype.

Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

Food and Drug Administration (FDA)

Funding Years:

2014 - 2018

Skeletal Outcomes in Primary Hyperparathyroidism

The aim of the study is to retrospectively compare fracture rates and BMD changes in patients with PHPT who have received the following types of treatment: observation, bisphosphonate therapy, surgery, or both surgery and bisphosphonate therapy.

Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

University of California, Los Angeles (UCLA)

Funding Years:

2013 - 2019

Studying the relationship of hyponatremia on bone disease, fractures, and fall risk

A cross sectional and longitudinal study that seeks to establish or determine a relationship between hyponatremia and bone density disorders (osteoporosis); hyponatremia and vertebral fractures; hyponatremia and risk of hip fractures.

Principal Investigator:

John Sim, MD

Funding Source:

Not Applicable

Funding Years:

2015

Research Categories: