# A Multi-Factorial Therapeutic Delivery System to Attenuate Post-Traumatic Osteoarthritis

> **NIH VA I21** · PHILADELPHIA VA MEDICAL CENTER · 2024 · —

## Abstract

Post-traumatic osteoarthritis (PTOA) is a phenotype of osteoarthritis (OA) that is temporally linked to acute joint
injuries, such as intra-articular ligament rupture or meniscus tear (1). Service members and veterans are
disproportionally affected by extremity injuries that can lead to PTOA due to heavy load carriage, high activity
rates, insufficient recovery time, and combat trauma (10–14). Absent early intervention, acute knee injuries
induce diverse pathogenic cascades including hemarthrosis, inflammation, necrosis, apoptosis, and matrix
degradation (2). Targeting only a single aspect of these pathogenic mechanisms has proven insufficient for joint-
level chondroprotection and attenuation of PTOA. Due to the lack of regenerative capacity of cartilage and the
paucity of early intervention therapeutics, OA and PTOA have remained the leading cause of service member
disability and medical discharge over the past decade (11, 13). Current reliance on non-steroidal anti-
inflammatory drugs, analgesics, and physical therapy highlights an unmet need for novel solutions that attenuate,
delay, or altogether prevent PTOA following an acute knee injury. Without these solutions, the young cohort of
veterans suffering from career-ending and life-altering joint injuries will continue to grow. Therefore, our goal is
to develop an intra-articular therapeutic to control the spatial and temporal release of bioactive factors in an early
intervention setting following an acute joint injury. By establishing an early intervention therapeutic, we hope to
reduce the number of service members who develop PTOA and alleviate the physical, medical, financial, and
psychosocial burden on the veteran population (8, 9). In Aim 1, we will establish a biologic profile of the post-
injury joint microenvironment using human clinical data from veteran patients enrolled at the Corporal Michael J.
Crescenz Veterans Affairs Medical Center (CMCVAMC) with traumatic ACL and/or meniscus tears. Through our
understanding of the pro-inflammatory biomarkers and synovial transcriptome gained from this data, we will
develop a state-of-the-art large animal model of PTOA that resembles the phenotype observed in our veteran
patients. We will extend our existing porcine model of PTOA to combine arthroscopically assisted ACL
transection (ACLT) and destabilization of the medial meniscus (DMM) to recapitulate an acute knee injury for
evaluation of novel, early intervention therapeutics. In Aim 2, we will develop a multi-factorial therapeutic that
addresses the spatial and temporal pathology of PTOA by precisely delivering multiple bioactive factors within
mechanically activated microcapsules (MAMCs) in a hyaluronic acid (HA) carrier. We will employ a 3D model of
PTOA using porcine osteochondral explants exposed to mechanical overload to recapitulate the aberrant
cartilage loading observed in our in vivo ACLT/DMM model. By early delivery of anti-inflammatory, anti-apoptotic,
and antioxidant factors, ...

## Key facts

- **NIH application ID:** 10923534
- **Project number:** 1I21RX005135-01
- **Recipient organization:** PHILADELPHIA VA MEDICAL CENTER
- **Principal Investigator:** Liane Miller
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-08-01 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10923534

## Citation

> US National Institutes of Health, RePORTER application 10923534, A Multi-Factorial Therapeutic Delivery System to Attenuate Post-Traumatic Osteoarthritis (1I21RX005135-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10923534. Licensed CC0.

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