I want to acknowledge that our session time is done and that there's a shoulder session starting in 10 minutes, but I wanted to ask each of the panelists, because we obviously have so much interest right now, what should come next in terms of research, in terms of how we approach clinical procedures? Dr. Don? I think that continuing long-term follow-up of the studies that we do have is key, and if that could also involve biological analysis, synovial fluid and imaging is key to understand the biological cascade role and add to what we think we understand about the mechanical role. Dr. Gil? I think, just to pick up on that, I think it starts with the time of injury. I think the research to do is there, whether it's interruption of the cytokines, of teloproteases, whatever it is, at the time of the initial, just to go with my topic, ACLs, is there something we can do to prevent the later cascade of arthritis? And then the next part of that is, if you already have some arthritis, then with the new biologics and regenerative medicine, like Johnny was talking about, is there a way, if we can get the pain down and prevent the cartilage disruption, I think it then opens the door for these ligamentous reconstructions, or like what Ben was talking about, or what I was talking about, later and later into life, if we can control the actual cartilage breakdown. You can't discuss one without discussing the other. Johnny? Well, I think, obviously, you know, orthobiologics is what, you know, I've been spending a lot of time on. And, you know, before we were talking about platelet-rich plasma and bone marrow aspirate, but now, you know, we have a lot of drugs, like COSR to block fibrosis. We have senolytic drugs to reduce senescent cells, reduce inflammation. But I would like to stress that, you know, the best way to do the research there is to really do double-blind clinical trials, to really prove to skeptical people that really it works sometimes, or it doesn't work. So I think unless we do this, then this orthobiologics, you know, will be difficult to be accepted in the field. Yeah. Ben? I think I'd wrap up by saying our goal is to cure joint pain. And there are probably three major ways that we can come at this. The first is regenerative medicine. The second is preventative repairs. And the third is curative surgeries. So if we as individual surgeons or we as centers can encompass all three of those approaches and offer all three to our patients and use them in patient-specific indications, we can really cure a lot of joint pain over the next decade. And I just want to add, sorry, one more thing, Alonza, from your presentation that I think is really important is we've been talking about joint pain and joints and cartilage, but your talk, I thought, was spot on. It's just such an amazing picture of your 70-year-old triathlete and the muscle cross-section versus I think the one in the middle, you brought up a slice of my biopsy with that 90% fat and the minus in the middle. But I think whether it's supplements, creatines, whether it's therapeutic and not illegal or whatever use of things like growth hormone or testosterone or whatever it is, if there is a safe way to manage the hormones or other supplements to keep the muscle healthy and keep the muscle strength, which can then unload the joints, I think that'd be a very important area of research as well. Absolutely. And I just have one question, Ben and John, whoever wants to answer. It might be science fiction, but, you know, we're capable of now of measuring biologic clocks that uses big data and AI and genomic sequencing. And there's a company I like called AgeRate. What would happen, Ben, if we added that kind of data to your algorithm to say, okay, physiologically you may be 30, but your biologic age is 61 and vice versa. Is that too science fiction or could we use that across the board? No, I think we can use it. And what we found in the hip specifically is that we don't need to do the same operation on every person. So if, for example, a labral repair is going to work better in a younger person than an older person, but a labral reconstruction can be a really good option in an older person to rejuvenate their hip. Now, if we incorporate a person's biological clock, maybe there's a 60 year old person who is biologically 30 and we should repair that patient. So I think that'd be extraordinarily helpful. Johnny, wrap us up here. Yeah. I think, you know, we have a program on LT aging. So where the goal, we do personalized medicine and we look at your blood, we look at senescent cells, we look at telomere, we look at a lot of different things, biomarkers, and what I'm very excited about it is when we have all this information, my goal will be to be able to predict disease before they hit you. And is there anything we can do today to try to delay a disease that's going to develop tomorrow? Of course, we talk about osteoarthritis here, but the work that we're doing, if we're successful to delay osteoarthritis in your knee by using senescent, senolytic drug to eliminate senescent cells or any other drug we're using, then it is very likely that we can delay neuro degeneration in your brain because aging related disease is all inflammation related. So I think the future is very bright there, but again, I stress that, you know, to use those different drug and medication, you always have to do a personalized medicine because a drug that works for someone may not work as well for someone else. Great. Well, I'm thankful for all the interest today. Thank you for staying and I'm sure you'll be here if people want individual questions. Thank you. Great job.

orthopedics

regenerative medicine

biologics

joint pain cure

personalized medicine