History of MIBJH

What is now the McCaig Institute for Bone and Joint Health originated as a small research group within the Faculty of Medicine, with one member from what was then the Faculty of Engineering. The Musculoskeletal Research Group (from 1984-1988) became the Joint Injury and Diseases Research Group (1988-1992) and then the Joint Injury and Arthritis Research Group (1992-2004).

At the start, the Musculoskeletal Research Group consisted of five individuals who used space primarily within the Calgary General Hospital and the Medical School. The transition to the JIDRG occurred with some collocation of the members onto the ground floor of the Heritage Medical Research Building in the fall of 1988. With the involvement of basic scientists, rheumatologists, orthopaedic surgeons and community leaders, “Project Motion” became a successful fund-raising campaign to develop the fourth floor of the Heritage Medical Research Building and the McCaig Centre for Bone and Joint Health officially opened in March 1992.

The McCaig Centre was named after one of the Co-Chairs of Project Motion – Mr. J.R. (Bud) McCaig. Mr. McCaig was a strong supporter of bone and joint health research and due to his leadership the research group became one of only a handful of “Institutes” within the Faculty of Medicine.

The McCaig Institute suffered a tremendous loss with the unexpected passing of Mr. McCaig in January of 2005: however, his daughter-in-law, Mrs. Marilyn McCaig has graciously taken on the role of Calgary Institute Community Leader and members of the Institute look forward to continuing the relationship with the entire McCaig Family.

The research group/Institute has had several Chairs/Directors over the years:

• Cy Frank (1988-1993 and 2004-2007);
• David Hart (1993-1995 and 2007-2008);
• Ron Zernicke (1996-1999);
• Robert Bray (1999-2002);
• Nigel Shrive in 2002-2004.

In June 2008, Dr. Shrive took on the role as Interim Director of the McCaig Institute and was officially appointed as Institute Director in November of 2009.

Mr. J.R. (Bud) McCaig

Joint Injury and Arthritis Research Group

A multidisciplinary group of clinicians, clinician-scientists, basic scientists, and engineers interested in the mechanisms of joint injury and repair, and the causes, prevention, and treatment of arthritis. The Centre does not coordinate clinical services; therefore it is unable to accept patient referrals.

The Joint Injury and Arthritis Research Group (JIARG) is a multidisciplinary group of clinicians, clinician-scientists, basic scientists, and engineers interested in the mechanisms of joint injury and repair, and the causes, prevention, and treatment of arthritis.

The research in JIARG takes place both in the laboratory and in clinical settings, reflecting the diverse backgrounds of its members, who come from Orthopaedic Surgery, Rheumatology, Immunology, Engineering, Biochemistry, Pathology, Microbiology, Molecular Biology, Statistics, and Epidemiology. Each member brings a different perspective to the study of arthritis, and the synthesis of these perspectives provides a unique research environment.

The JIARG, formed in the mid 80s, brings together young promising researchers and experienced engineers, scientists, and clinicians and has become a leading group in national initiatives in arthritis research. JIARG works closely with the Arthritis Society of Canada, the Alberta and Northwest Territories Division of the Arthritis Society and the Canadian Arthritis Network (CAN)- a nation-wide team of more than 80 researchers.

Other major sources of support includes the Alberta Heritage Foundation for Medical Research (AHFMR)which has helped establish and support many investigators in the JIARG since inception. Another important source of support is through a group of local citizens and business people who have generated research monies through the Western Orthopaedic and Arthritis Research Foundation (WOARF).

Presently, the centre does not coordinate clinical services; therefore it is unable to accept patient referrals.

Address & Contact Information

Foothills Medical Centre

1403 29 Street NW,

Calgary, Alberta

T2N 2T9


Telephone: 403-220-4554

Fax: 403-283-7742

On the cutting edge of joint research

“When I came around a turn, I hit an icy patch on the hill and lost control. My skis crossed, then I fell. I could hear a tearing sound… the pain was excruciating.”

That’s how 47-year-old Linda Smith* started off the new year. Her skiing accident resulted in complete and partial tears of ligaments in both her knees.

“I came home with braces on my legs, but it wasn’t until I had an MRI and consulted with doctors and physiotherapists that I began to appreciate the severity of what had happened to me. I now realize that my knees will never be the same again.”

Six months after her accident, Linda is making an amazing recovery. She’s back at work and participating in intensive physiotherapy and exercise programs.

“I’m walking well, and I’m much stronger than I was. However, I think about my knees all the time…before my accident I would have laughed at the idea of thinking about my knees all the time. I worry about pivoting and having my knees give out, or about my dogs bumping me in the knees. I’m very cautious on uneven ground because I’m terrified of tripping.

“And then there’s ten or fifteen years down the road. Are my knees going to hurt all the time? Will I get osteoarthritis? When I’m a grandmother,will I be able to kneel down and play with my grandchildren?”

Joint injury a tremendous shock

This story is all too familiar to orthopaedic surgeon and Heritage Scientist Dr. Cy Frank. “Joint injury is a tremendous shock to a person’s life. Many people think of joint injury as an illness-something that they will recover from after a defined period of time. But joint injury is often not like this. Healing takes a long time, and sometimes does not happen at all or happens incompletely. There are often long-term effects, and joint injuries frequently alter what patients can do for the rest of their lives.

“However, the outlook for patients with joint injuries is much better now than it was even five years ago. We now understand a lot more than we did about joints and healing. We can prescribe things scientifically that we couldn’t have years ago-and we’re beginning to understand what’s going on in the cells in these tissues.

“Still, what we offer patients today are only patches. We’re not yet delivering solutions. Our challenge as researchers is to do better. We’re moving to an age of science in the treatment of bones and joints.”

Pioneering research

Dr. Frank, who is a professor at the University of Calgary, is known for his pioneering research into ligament healing and repair. A renowned knee surgeon, he collaborates with a team of researchers at the university’s McCaig Centre for Joint Injury and Arthritis Research-a centre known for its revolutionary research in gene therapy, ligament transplantation, and arthritis treatments.

The McCaig Centre group is on the leading edge of joint research. The multidisciplinary team of 26 engineers and scientists is drawn from the University of Calgary’s faculties of Medicine, Kinesiology, and Engineering. Research projects cover three major areas: biomechanics (the analysis of motion, muscle function, loads at joints, joint function), biomaterials (the architecture of tissues, tissue function, orthopaedic implants) and systems physiology (the interaction of biochemistry and molecular biology, morphology, physiology and mechanics in disease progression and healing processes). Total annual research funding for the group is in excess of $5 million.

“We’ve created an excellent environment for collaboration,” says Dr. Frank. “We have clinicians who are receptive to new knowledge. There are also clinician-scientists who work at the interface of the laboratory and the bedside. And we have researchers who are creators of new knowledge. Our goal is to see that the research we do makes a difference in people’s lives.”

AHFMR’s role

AHFMR has played a critical role in developing this group. Since 1991, ten scientists have been funded by AHFMR for approximately $11.5 million. McCaig Centre students, fellows, and summer students have also been funded by AHFMR for a total of $4.5 million.

One of the key concepts underlying the research done at the McCaig Centre is the idea of the joint as an organ, similar to a heart or a lung. “This is a relatively new concept,” explains Dr. Frank. “Research has gone far enough with reductionism-taking each component and looking at it in detail. We realized that we had to start looking at connections among cartilage, bone, ligaments, synovium, tendons, and muscles. If one part of a joint, such as a ligament, is damaged, other parts of the joint are affected. You can’t simply study the individual parts in isolation.

“This is our strength. Individually we have depth; collectively we have breadth. And we work together to synthesize the findings from individual research programs into a coherent picture of what is going on in joints. Why do some components heal well and others only poorly? What can surgeons do to optimize the recovery of patients with ligament problems? Why does osteoarthritis develop in an injured joint? These are some of the important questions we are attempting to answer.”

Understanding Healing

We need our knees. Unfortunately, many of the things we use them for-like jumping, running, and climbing-can damage certain parts of the knee. Cartilage and the menisci (moon-shaped cushion pads in the knee) can be torn or worn away. Prolonged athletic activity can irritate or roughen the kneecap. Ligaments are fibrous bands that connect the bones of the knee and provide stability to the joint. A torn ligament, especially the anterior cruciate ligament, can be exceedingly disabling.

Ligaments heal by a process that resembles scar formation. But a healed ligament is a mechanically inferior structure and often fails to provide adequate joint stability. This can lead to re-injury, a chronically lax joint, or progression to osteoarthritis.

Architecture in soft tissue

“There’s an incredible architecture in the soft tissues of our joints,” says Dr. Nigel Shrive, current chair of the research group. One of his main research areas is the mechanical and structural behaviour of normal, healing, and transplanted ligaments. “Tissues such as ligaments play key roles in joint motion and joint stability. The cells in the tissues react to a load and produce proteins that assemble themselves to carry these loads. The level of complexity is amazing, but how it all works is still very much a black box to us.”

Dr. Shrive is working with Dr. Frank and another McCaig Centre colleague, Dr. David Hart, a Professor in the Department of Microbiology and Infectious Diseases at the University of Calgary, to understand cell-tissue load interaction. They are particularly interested in how loading affects the cellular activity that drives healing, the range of loads to which a ligament is subject during healing, and how other tissues in the joint may compensate for or begin to fail under the changing stability of the joint.

The team is working on developing ways of improving the healing of damaged or reconstructed ligaments. “If we can get a handle on how gross behaviour of the tissue can be improved by different treatment regimens, perhaps we can do things therapeutically to enhance healing for patients,” says Dr. Shrive.

Development of arthritis

In another area of research, Dr. Shrive is working with Associate Professor Dr. Janet Ronsky from the Department of Mechanical and Manufacturing Engineering, to understand what happens in the joint when ligaments are injured. They are developing techniques to determine the in vivo loading on tissues. Analytical models of joints are used to study contact between joint cartilage layers and investigate the stress distributions in joint structures. “We’re interested in understanding how ligament damage alters loads in other joint tissues,” explains Dr. Shrive. “What is it that causes these injured joints to often develop arthritis?

“These are multifaceted, tricky problems. You can’t just focus in on one thing, thinking that it will be the magic bullet to cure diseases. The basic approach at the McCaig Centre has been to bring together experts in different fields so we can understand how the different areas interact. We’ve managed to achieve a level of communication and interaction that to others appears quite extraordinary.”

Working together

The collaborative, multidisciplinary approach of the McCaig Centre caught Dr. Ron Zernicke’s attention 10 years ago and was an important factor in his decision to move from UCLA to the University of Calgary. Today, Dr. Zernicke is Dean of the Faculty of Kinesiology and has cross-appointments in the faculties of Medicine and Engineering. “My research collaborations-and my colleagues at the McCaig Centre have similar wide-ranging collaborations-demonstrate that we have a research culture that encourages transdisciplinary work. There are no boundaries. It’s a very stimulating environment.”

One of Dr. Zernicke’s main research areas is the functional adaptation of bone, especially in osteoarthritis. “It’s a different approach because most research to date has focused on how a mechanical injury to a ligament puts the cartilage at risk,” he explains. “I’m looking at how the injury affects the bone. For example, we see dramatic changes in blood flow and the structure of bone, especially porosity. We believe these changes in the bone put the cartilage at risk.”

The adaptation of bone

There may be ways to prevent some of these changes. Dr. Zernicke is collaborating with Dr. Hasan Uludag, from the University of Alberta’s Faculty of Engineering, and Dr. Robert Bray in the Department of Surgery at the University of Calgary, in a project investigating the use of certain drugs to protect the bone after injury.

“For more than 20 years, the emphasis has been on the cartilage,” says Dr. Zernicke. “Now we’re looking at the joint as an organ. We understand that if one element is injured or changed, the whole system is going to be affected. This understanding has tremendous implications for therapy.”

Keeping up with the leading-edge research and translating it into useful therapies for patients is a challenge for health professionals. Dr. Zernicke says there is growing recognition that more must be done to ensure that the insights gained from research are used to help patients. One important Alberta initiative is a new graduate education and research program in bone and joint health run by the universities of Alberta and Calgary, in partnership with the Calgary Health Region and the Capital Health Authority. This provincial training program, which begins in September 2002, will train health professionals such as physiotherapists, kinesiologists, physiatrists (physicians who specialize in physical medicine and rehabilitation), rheumatologists, orthopaedic surgeons, nurses, and chiropractors in transdisciplinary research.

“Highly qualified bone and joint health professionals and scientists are desperately needed across North America,” says Dr. Zernicke. “With our aging population, this need will grow rapidly in the next 20 years. One of every ten Canadians currently suffers from osteoarthritis, and within two decades it is estimated that 20% of Canadians will have the disease.”

A better outlook

While Linda Smith’s ligament injuries are serious and debilitating, the outlook for patients like her is improving. “Twenty years ago, knowledge about joint injury was minimal,” says Heritage Senior Scholar Dr. Robert Bray, an orthopaedic surgeon and professor at the University of Calgary. “Many ligament injuries went undiagnosed and a lot of the surgery was not very helpful. We haven’t perfected things yet, but we are certainly moving in that direction.

“People sometimes grumble about the amount of attention given to elite athletes who are injured. But they are the ones who pushed for better treatment of joint injuries, and this led to research that has resulted in improved therapies.”

Blood flow in tissues

A case in point is Dr. Bray’s career. Trained as an orthopaedic surgeon, he became interested in the physiology of ligaments, especially why they do not heal well. “The standard answer is that blood flow isn’t adequate in these tissues,” says Dr. Bray. “I wanted to learn more about this.”

In 1991, Dr. Bray received an establishment grant from AHFMR and began a research program as a Heritage Clinical Investigator at the University of Calgary. “Cardiac researcher and Heritage Scientist Dr. John Tyberg took me under his wing and taught me all about blood flow,” he explains.

Dr. Bray has continued this line of research, which has recently resulted in the development of a non-invasive tool for studying blood flow and its role in tissue repair. It was designed by his Ph.D. student Kevin Forrester, who was co-supervised by University of Alberta engineering professor Dr. John Tulip. Pending approval, the instrument-called a laser speckle perfusion imager-will be used to take measurements of blood flow during certain orthopaedic operations at Calgary’s Peter Lougheed Centre hospital.

“This is largely a trial of the instrument’s application,” notes Dr. Bray. “We’ll collect data and be able to evaluate its usefulness. Beyond this first step, I’m excited by the possibilities. We say the blood supply is a determinant of the health of tissue, and yet we don’t measure it. We need good, accurate measurements that we can link to patient problems and outcomes of treatments such as arthroscopic surgery.

Driven to do better

“I started doing this research 13 years ago, and I finally feel I’m getting somewhere. Sometimes it seems frustrating, but nature is subtle and it takes a long time to figure things out. As a surgeon, I know that I am still reconstructing joints, not restoring them. Many of us are driven to do better. I can now see a day when surgeons will be restoring joints and returning patients to the level of function they had prior to their accident.”

Dr. Cy Frank is a Heritage Scientist and Professor in the Department of Surgery at the University of Calgary. He is the McCaig Professor in Joint Injury and Arthritis Research and was recently named Scientific Director of the Institute for Musculoskeletal Health and Arthritis, one of the Canadian Institutes of Health Research (CIHR).

Dr. Nigel Shrive is a Professor in the Department of Civil Engineering at the University of Calgary and holds a Killam Memorial Research Chair. Research done by Drs. Frank and Shrive is also supported by the Arthritis Society of Canada, the Canadian Institutes of Health Research (CIHR), and the Canadian Arthritis Network.

Dr. Ron Zernicke is Dean of the Faculty of Kinesiology with cross-appointments in the faculties of Medicine and Engineering and is the John and Chris Wood Professor in Joint Injury Research. He is a past recipient of AHFMR funding and his research is currently supported by the Arthritis Society of Canada, the Canadian Orthopaedic Foundation, the Canadian Institutes of Health Research (CIHR), the Canada Foundation for Innovation, the Alberta Children’s Hospital Foundation, NSERC (Natural Sciences and Engineering Research Council of Canada), and the Workers’ Compensation Board.

Dr. Robert Bray is a Heritage Senior Scholar and Professor in the Department of Surgery at the University of Calgary. His research is also supported by the Canadian Institutes of Health Research (CIHR), the Arthritis Society of Canada, the Whitaker Foundation, the Department of National Defence, and the Olympic Oval Foundation.

Selected publication

Lo IK, Ou Y, Rattner JP, Hart DA, Marchuk LL, Frank CB, Rattner JB. The cellular networks of normal ovine medial collateral and anterior cruciate ligaments are not accurately recapitulated in scar tissue. Journal of Anatomy 2002 Mar;200(Pt 3):283-96.

Thornton GM, Frank CB, Shrive NG. Ligament creep behaviour can be predicted from stress relaxation by incorporating fiber recruitment. Journal of Rheology 2001 Mar/Apr;45(2), 493-507.

Majima T, Marchuk LL, Sciore P, Shrive NG, Frank CB, Hart DA. Compressive compared with tensile loading of medial collateral ligament scar in vitro uniquely influences mRNA levels for aggrecan, collagen type II, and collagenase. Journal of Orthopaedic Research 2000 Jul;18(4):524-31.

Boyd SK, Müller R, Zernicke RF. Mechanical and architectural bone adaptation in early stage experimental osteoarthritis. Journal of Bone and Mineral Research 2002 Apr;17(4):687-94.

Bray RC, Leonard CA, Salo PT. Vascular physiology and long-term healing of partial ligament tears. Journal of Orthopaedic Research. In press.

• The name has been changed.

History of WOARF

WOARF was established in 1989.

The Western Orthopaedic and Arthritis Research Foundation (WOARF) is a non-profit organization that consists of 17 individuals including businessmen, orthopaedic surgeons, rheumatologists, and basic researchers. Initially, WOARF raised the funds necessary to construct and furnish the McCaig Centre for Joint Injury and Arthritis Research, which is a 30,000 square foot research Centre housed on the entire 4th floor of the Heritage Medical Research Building in the Faculty of Medicine at the University of Calgary. At present, the WOARF members meet quarterly to administer funds for future growth of the McCaig Centre and for innovative projects in Joint Injury and Arthritis research or development.

Board of Directors of the Western Orthopaedic and Arthritis Research Foundation:

• Mr. J. R. McCaig — Trimac Ltd
• Mr. R. Melchin — Three Sisters Resorts
• Mr. I. Robinson — Ernst & Young
• Mr. R. Tingle — Tingle & Associates
• Dr. C. Frank — Orthopaedic Surgeon
• Dr. G. Hughes — Orthopaedic Surgeon
• Mr. M. Gray — Semi-Retired
• Dr. S. Miller — Orthopaedic Surgeon
• Mr. D. Kitchen — Self-Employed (formerly with the Royal Bank of Canada)
• Mr. A. Dumont — CenAlta Energy Services Inc.
• Mr. R. McDaniel — McDaniel & Associates Consulting Ltd.
• Dr. R. Zernicke — Researcher and Dean of the Faculty of Kinesiology, University of Calgary
• Mr. G. Little — Arthritis Society
• Dr. R. Bray — Orthopaedic Surgeon
• Mr. J. Hayden — Donahue & Partners, Ernst & Young
• Dr. L. Martin — Rheumatologist
• Dr. M. Fritzler — Rheumatologist