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Jeff Green

Researchers at ������Ƶ University want to ease the burden for those living with the most disabling joint disorder in the world.

Osteoarthritis affects 500 million people worldwide.

Newfoundland and Labrador has the highest prevalence in Canada, with more than 31 per cent of people affected.

A team in the Faculty of Medicine is being recognized for its innovative studies aimed at learning more about the disease.

Dr. Guangju Zhai, university research professor, human genetics and genomics, Division of Biomedical Sciences, and Dr. Christie Costello, B.Sc.(Hons.)’17, PhD’23, are included on the ’s Top 10 list of .

 from the University Health Network (UHN) in Ontario is co-author of a publication related to the study, which included other UHN collaborators led by .

The researchers focused on identifying factors associated with the poor outcomes of total joint replacement surgery, one of the most commonly performed surgeries in orthopedics.

“This work has the potential to benefit Canadians by laying the groundwork for more personalized medicine approaches.”— Dr. Christie Costello

In particular, they’re looking at knee osteoarthritis.

They found that the detection of traces of a biochemical process called phosphatidylcholine metabolism in the blood is associated with lingering pain even after joint replacement surgery.

In the future, a blood test may predict who is likely to still have treatment-resistant pain after joint replacement and be used to create patient care plans.

‘Better understanding’

Despite a good outcome for many patients, Dr. Zhai says up to 20 per cent of osteoarthritis patients still suffer joint pain after their total joint replacement surgery.

“This poor outcome of the surgery affects all dimensions of health-related quality of life and is associated with almost three times greater risk for mortality,” Dr. Zhai explained. “I hope that our research can contribute to our better understanding of the causes of osteoarthritis and develop targeted care for patients who are affected by this disease.”

‘Laying the groundwork’

Dr. Costello, who is from St. John’s, is currently in her third year of the Doctor of Medicine Program.

Once completed, she will graduate with an MD-PhD joint degree.

As part of the study, she examined the many factors and their ability to predict outcomes from surgery, including demographic, epidemiological, metabolomic and genetic factors.

“This work has the potential to benefit Canadians by laying the groundwork for more personalized medicine approaches to the management of osteoarthritis,” said Dr. Costello.

The pair say they are “thrilled” by the national recognition.

“I think the recognition really highlights the significance and the impact of our work,” noted Dr. Costello, who hopes to one day practise as a clinician and conduct research in Newfoundland and Labrador. “I have always been interested in health and medicine, but I found this area particularly interesting because my grandmother had several joint replacement surgeries due to her arthritis.”

Developing treatments

This is the second time research from Dr. Zhai’s team has made the Arthritis Society’s Top 10 listing.

“The biggest motivation for me to continue to work in this area is . . . there is still no cure for it.”— Dr. Guangju Zhai

In 2021 Drs. Zhai and Salem Werdyani (PhD’23) were included in the list for a  where they used state-of-the-art technology to examine the metabolomic “fingerprints” in the blood of hundreds of people from this province who have osteoarthritis.

They discovered they could be divided into three groups with distinct blood markers.

Those findings could help to develop targeted treatment strategies for different subgroups of osteoarthritis patients and realize personalized medicine in osteoarthritis management.

“The current work is the continuation of our overall research program with a focus on a specific subgroup of osteoarthritis patients, that is those who still experience joint pain after their total joint replacement surgery,” said Dr. Zhai. “The biggest motivation for me to continue to work in this area is that we still know very little about what causes this disease and there is still no cure for it.”