Historically, genetics researchers have not dedicated time to the orthopedic field, instead focusing on oncology, infectious diseases and cardiovascular diseases.
"Orthopedics is usually quite simple; a bone is broken, you splint it and let it heal," explains Michael Swartzon, MD, of Miami Orthopedics & Sports Medicine Institute at Baptist Health South Florida. "I think that's why orthopedics wasn't a bigger player earlier on in using genetics."
This may be changing, however, as sports medicine physicians realize the power of genetics and environmental data in injury prevention.
Dr. Swartzon and colleagues published a review in Strength and Conditioning Journal on precision sports medicine. The review argues how leveraging information from an individual's genetics, environment, lifestyle and epigenetics could help providers "maximize resources by targeting pathology and human performance on the molecular level."
Dr. Swartzon sees promise in using an individual's genetic information to determine various contributors to performance, such as muscle fiber composition. Equipped with genetic information, physicians may be able to predict who is prone to arthritis or who may dehydrate faster.
"There are many areas in which we could use genetics for elite athletes to advance their performance," says Dr. Swartzon. In addition to performance, genetics will play a critical role in athlete safety.
"When you look at what you're trying to do as a physician, preventing people from fatal injuries is the top priority," Dr. Swartzon adds. Although genetic tests are available to determine whether athletes are at greater risk of conditions, like cardiac issues, Dr. Swartzon emphasizes the controversy surrounding such tests. The decision lies in whether young athletes should refrain from playing basketball, for instance, since they test positive for a gene related to cardiac issues.
"Just because you have the gene for something, doesn't mean you actually get it," he says.
Although preventative genetic testing for sports involvement is still under debate, Dr. Swartzon highlights pharmacogenomics as a hot research field. Pharmacogenomics involves leveraging genetic information to predict how a person will respond to a medication. The process could help identify which medication and dose will prove more effective for a particular person.
Further, with orthobiologics gaining steam in the orthopedics field, Dr. Swartzon sees genetics entering the game to determine who should receive treatments.
"That's where the research comes in, and hopefully the question of why and which person will be answered by genetics," he adds.
Genetics will help physicians forgo treatments they know will not work for individual patients, reduce side effects and ultimately, speed recovery.