The primary therapeutic goal in female pelvic medicine is to restore normal pelvic floor function. Despite this, the current standard treatments are 5 compensatory, as they do not directly target sphincteric and supportive muscle dysfunction and do not reverse the existing injury or halt functional deterioration. Surgical treatments, such as muscle transplantation and transposition techniques, have had some success; however, there still exists a need for alternative therapies. Tissue engineering approaches offer potential new solutions; however, current options offer incomplete regeneration. Many naturally derived as well as synthetic materials have been explored as scaffolds for skeletal tissue engineering, but none offer a complex mimic of the native skeletal extracellular matrix, which possesses important cues for cell survival, differentiation, and migration. The extracellular matrix consists of a complex tissue-specific network of proteins and polysaccharides, which help regulate cell growth, survival and differentiation.Despite the complex nature of native ECM, in vitro cell studies traditionally assess cell behavior on single ECM component coatings, thus posing limitations on translating findings from in vitro cell studies to the in vivo setting. Overcoming this limitation is important for cell-mediated therapies, which rely on cultured and expanded cells retaining native cell behavior over time.Skeletal muscles are composed of bundles of highly oriented and dense muscle fibers, each a multinucleated cell derived from myoblasts. The muscle fibers in native skeletal muscle are closely packed together in an extracellular three dimensional matrix to form an organized tissue with high cell density and cellular orientation to generate longitudinal contraction. Skeletal muscle can become dysfunctional due to a variety of different factors including trauma, atrophy or degeneration.The reconstruction of skeletal muscle, which is lost by injury, tumor resection, or various myopathies, is limited by the lack of functional substitutes.  

Sarcopenia  is defined as an age associated decline in or loss of lean skeletal muscle mass. The pathophysiology can be multifactorial and the change in body composition may be difficult to detect due to obesity, changes in fat mass, or edema. Changes in weight, limb or waist circumference are not reliable indicators of muscle mass changes. Sarcopenia may also cause reduced strength, functional decline and increased risk of falling. Sarcopenia is otherwise asymptomatic and is often unrecognized.  

Hemophilic arthropathy is a frequent and debilitating comorbidity. Point-of-care musculoskeletal ultrasound (MSKUS) with Power Doppler capacity has become critical during the past several years to evaluate progression of joint disease longitudinally, as well as to detect the presence or absence of joint bleeding associated with joint pains in a timely fashion. With the advent of emerging new treatment modalities the hemophilia population is aging, bringing hemophilic arthropathy rapidly into focus. Based on the increasing need to develop and validate a joint ultrasound imaging protocol that could easily be used in clinical practice as well as a research outcome tool UC San Diego Clinician-Investigators and Collaborators, specialized in Hemophilia, Ultrasound, Musculoskeletal Medicine and Radiology (Drs. Annette von Drygalski, Eric Chang and Randy Moore, as well as Lena Volland, DPT ) developed and validated a unique MSKUS protocol, specifically adept to assess the extent of hemophilic arthropathy in the acute and chronic setting.  This protocol is named JADE protocol (Joint Tissue Assessment and Damage Exam), as described below. The protocol is taught “hands on” during the CME accredited course “Musculoskeletal Ultrasound in Hemophilia”, and is also accessible through online modules. https://cme.ucsd.edu/muh/

Bone-mimetic mineral-polymer composite materials have several applications ranging from artificial bone grafts to scaffolds for bone tissue engineering. Current bone graft materials include ceramic powders, combinations of proteins and minerals, autologous bone grafts, allografts and xenografts. The greatest limitation with autografts is donor site morbidity while ceramic powders fail to provide structural support while poorly mimicking the composite structure of bone.