Solving the Puzzle of Post-Traumatic OA
Don Anderson, PhD, brings his expertise in osteoarthritis research to the PIKASO trial.
April 24, 2025
Don Anderson, PhD, plays an important role in PIKASO (Preventing Injured Knees from Osteoarthritis: Severity Outcomes), the first Arthritis Foundation-directed clinical trial aimed at preventing post-traumatic osteoarthritis (PTOA). The trial brings together top scientists from nine institutions across the country to examine the use of the drug metformin in people with knee injury who are at a high risk of developing PTOA in the knee after anterior cruciate ligament (ACL) reconstruction. Dr. Anderson is the Richard and Jan Johnston Chair in Orthopedic Biomechanics and Professor and Vice Chair of Research, Orthopedics and Rehabilitation at the University of Iowa.
Tell us about your background.
I grew up in Cedar Rapids, Iowa, a family of 5 boys, no girls. This led to many visits to the emergency room for my parents. But you really had to be hurt for that. Lots of other scrapes, bruises, sprains and strains were just part of the deal. Lots of sports participation, but I didn’t excel sufficiently to compete at the varsity level. I was also a music guy, playing the French horn, so that is what got me on the football field (at halftime). I preferred basketball, and since I grew tall early relative to my peers, I had an advantage for a while.
I showed aptitude in math and science early, and I loved biology. In my family, there were two college choices: University of Iowa or Iowa State University. I chose the former because they had a program that melded biology and engineering — biomedical engineering (BME). Unexpectedly, three and a half years into college, I found myself wanting more, so I stayed on for a PhD. My graduate research was all conducted within the Department of Orthopaedic Surgery, which, much to my surprise, was considered world-class.
Would you recommend biomechanical engineering and orthopedic research to young scientists and researchers?
I unreservedly recommend BME and orthopedic research to young folks. I think the field of inquiry is broad and its impact unparalleled in many respects. Plus, it’s just fun and exciting.
What drew you to science and research, and arthritis research in particular?
I like solving puzzles, and I also like the idea of helping other people. These loves brought me to science and research. The lab I did my graduate research in was focused on articular joint mechanics and how they changed after injury. This led me to a career focused on post-traumatic OA. All I’ve ever hoped for professionally is to impact how injured or diseased patients are treated to improve their lives.
What is the most challenging puzzle you have solved?
We developed a computational 3D puzzle solver that produced an idealized reconstruction template to restore the original bony anatomy, working solely from standard CT scans.
Could you describe what you do with PIKASO?
I work closely with our clinical team to conduct the PIKASO clinical trial. For the most part I guide administrative issues and coordinate between different elements of our team, whether it be biomechanics, imaging or direct clinical care.
What is the most important professional skill that you use to being a good “hub” within your team?
Communication skills are paramount to building a team that can largely function on its own. Communicate openly, clearly, concisely and often.
Do you expect PIKASO to affect patients directly or indirectly?
I am a huge believer in the potential to prevent post-traumatic osteoarthritis (OA), and I think we as a field are getting close. So, I do expect PIKASO to affect patients, directly by helping reduce their risk for OA. I also think that the OA Clinical Trial Network that has been assembled will build on PIKASO, regardless of the outcome. So there’s also indirect benefit going forward.
Patients are generally focused on recovering from the injury more than about future PTOA. Why should people care about a future risk?
One only has to see someone highly disabled years later by PTOA to appreciate what is hanging in the balance. And it’s eye-opening to see how frequently published literature has shown it happens.
What are you excited about in OA and what should patients be excited about?
We understand better than ever what leads to OA after a joint injury, and multiple avenues are being pursued to reduce the risk. I think this is exciting and should be of great interest to patients who have experienced a joint injury.
You also have an award through the Arthritis Foundation and the American Orthopaedic Foot & Ankle Society. What is exciting about that project?
I love starting a new line of research from the ground up, and our group has wanted to broaden the scope of our research to include a larger swath of ankle osteoarthritis patients. It is also exciting building new collaborative networks across multiple sites.
What else would you like to share about your involvement with arthritis research?
I love working with a diverse group of scientists and clinicians who are all rowing in the same direction. We may sometimes have different opinions, but we are all aiming for the same outcome.
Don Anderson, PhD, plays an important role in PIKASO (Preventing Injured Knees from Osteoarthritis: Severity Outcomes), the first Arthritis Foundation-directed clinical trial aimed at preventing post-traumatic osteoarthritis (PTOA). The trial brings together top scientists from nine institutions across the country to examine the use of the drug metformin in people with knee injury who are at a high risk of developing PTOA in the knee after anterior cruciate ligament (ACL) reconstruction. Dr. Anderson is the Richard and Jan Johnston Chair in Orthopedic Biomechanics and Professor and Vice Chair of Research, Orthopedics and Rehabilitation at the University of Iowa.Tell us about your background.
I grew up in Cedar Rapids, Iowa, a family of 5 boys, no girls. This led to many visits to the emergency room for my parents. But you really had to be hurt for that. Lots of other scrapes, bruises, sprains and strains were just part of the deal. Lots of sports participation, but I didn’t excel sufficiently to compete at the varsity level. I was also a music guy, playing the French horn, so that is what got me on the football field (at halftime). I preferred basketball, and since I grew tall early relative to my peers, I had an advantage for a while.
I showed aptitude in math and science early, and I loved biology. In my family, there were two college choices: University of Iowa or Iowa State University. I chose the former because they had a program that melded biology and engineering — biomedical engineering (BME). Unexpectedly, three and a half years into college, I found myself wanting more, so I stayed on for a PhD. My graduate research was all conducted within the Department of Orthopaedic Surgery, which, much to my surprise, was considered world-class.
Would you recommend biomechanical engineering and orthopedic research to young scientists and researchers?
I unreservedly recommend BME and orthopedic research to young folks. I think the field of inquiry is broad and its impact unparalleled in many respects. Plus, it’s just fun and exciting.
What drew you to science and research, and arthritis research in particular?
I like solving puzzles, and I also like the idea of helping other people. These loves brought me to science and research. The lab I did my graduate research in was focused on articular joint mechanics and how they changed after injury. This led me to a career focused on post-traumatic OA. All I’ve ever hoped for professionally is to impact how injured or diseased patients are treated to improve their lives.
What is the most challenging puzzle you have solved?
We developed a computational 3D puzzle solver that produced an idealized reconstruction template to restore the original bony anatomy, working solely from standard CT scans.
Could you describe what you do with PIKASO?
I work closely with our clinical team to conduct the PIKASO clinical trial. For the most part I guide administrative issues and coordinate between different elements of our team, whether it be biomechanics, imaging or direct clinical care.
What is the most important professional skill that you use to being a good “hub” within your team?
Communication skills are paramount to building a team that can largely function on its own. Communicate openly, clearly, concisely and often.
Do you expect PIKASO to affect patients directly or indirectly?
I am a huge believer in the potential to prevent post-traumatic osteoarthritis (OA), and I think we as a field are getting close. So, I do expect PIKASO to affect patients, directly by helping reduce their risk for OA. I also think that the OA Clinical Trial Network that has been assembled will build on PIKASO, regardless of the outcome. So there’s also indirect benefit going forward.
Patients are generally focused on recovering from the injury more than about future PTOA. Why should people care about a future risk?
One only has to see someone highly disabled years later by PTOA to appreciate what is hanging in the balance. And it’s eye-opening to see how frequently published literature has shown it happens.
What are you excited about in OA and what should patients be excited about?
We understand better than ever what leads to OA after a joint injury, and multiple avenues are being pursued to reduce the risk. I think this is exciting and should be of great interest to patients who have experienced a joint injury.
You also have an award through the Arthritis Foundation and the American Orthopaedic Foot & Ankle Society. What is exciting about that project?
I love starting a new line of research from the ground up, and our group has wanted to broaden the scope of our research to include a larger swath of ankle osteoarthritis patients. It is also exciting building new collaborative networks across multiple sites.
What else would you like to share about your involvement with arthritis research?
I love working with a diverse group of scientists and clinicians who are all rowing in the same direction. We may sometimes have different opinions, but we are all aiming for the same outcome.
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