Project Summary/Abstract:
While the structure of the physis, or growth plate, has been well described by histology and radiologic
measures, its physiology remains a mystery. Investigators have probed the physis and defined its makeup of
extracellular matrix, collagen, the presence of certain growth factors, and characterized the histomorphometry
of its cells. Yet how these different entities interact normally and in the face of disease is not known. Currently,
surgeons employ techniques to slow growth and use implants to harness growth to correct deformity; but the
mechanisms behind these interventions are elusive. Basic concepts such as what stimulates growth and how it
can be harnessed is unknown; this remains the holy grail of pediatric orthopaedics. This topic is timely as
surgical intervention is trending toward minimally invasive treatments. By defining the mechanisms by which
the matrix, cells, and growth factors interact, pharmacologic and surgical interventions can be developed. In
addition, a disproportionate share of musculoskeletal physeal diseases are found in obese children. As the
obesity epidemic rages in our pediatric population, more children will suffer the consequences of physeal
diseases. Pediatric patients will benefit from a deeper knowledge of the physis, but there are benefits to the
larger scientific community as well. Understanding the endocrine cascade that works on the physis could give
insights into cartilage disease beyond children, such as osteoarthritis and inflammatory arthritis. In order to
begin to further our understanding of the physis and develop treatments, we have developed a scientific
symposium to allow experts in both basic science and clinical medicine to discuss current knowledge about the
growth plate, the effects of various stimuli on its structure, and to design novel treatments for physeal
disorders. This symposium will include summaries of the current literature, original research presentations, and
open and directed discussions over a two day interactive forum. The content and findings of the symposium
will then be disseminated and available to the public through publication in a relevant orthopaedic journal.
