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The Orthopaedic Forum   |    
Beyond the Decade: Strategic Priorities to Reduce the Burden of Musculoskeletal Disease
Joshua J. Jacobs, MD1; Toby R.W. King, CAE2; John H. Klippel, MD3; Sigurd H. Berven, MD4; David B. Burr, PhD5; Paul M. Caskey, MD6; Ann L. Elderkin, PA7; Paul W. Esposito, MD8; Eric P. Gall, MD9; Steven R. Goldring, MD10; Andrew N. Pollak, MD11; Christy I. Sandborg, MD12; Kimberly J. Templeton, MD13
1 Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Suite 300, Chicago, IL 60612
2 U.S. Bone and Joint Initiative, 6300 North River Road, Rosemont, IL 60018
3 Arthritis Foundation, 1330 West Peachtree Street, Suite 100, Atlanta, GA 30309
4 Department of Orthopaedic Surgery, University of California San Francisco, 500 Parnassus Avenue MU-320W, San Francisco, CA 94143-0728
5 Department of Anatomy and Cell Biology, Indiana University School of Medicine, MS 5035, 635 Barnhill Drive, Indianapolis, IN 46202
6 Shriners Hospitals for Children Spokane, 911 West 5th Ave, Spokane, WA 99204-2901
7 American Society for Bone and Mineral Research, 2025 M Street N.W., Suite 800, Washington, DC 20036-3309
8 Children’s Hospital & Medical Center, 8200 Dodge Street–Pavilion 4th Floor, Omaha, NE 68114
9 Arizona Arthritis Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724
10 Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
11 Orthopaedic Surgery–Shock Trauma Center, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201-1595
12 Pediatric Rheumatology, Stanford University School of Medicine, Lucile Salter Packard Children’s Hospital, 300 Pasteur Drive, A085 A MC 5208, Stanford, CA 94305
13 Musculoskeletal Oncology, University of Kansas Medical Center, 3901 Rainbow Boulevard, SM 3017, Kansas City, KS 66160
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Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, one or more of the authors has had another relationship, or has engaged in another activity, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Sep 04;95(17):e125 1-6. doi: 10.2106/JBJS.L.01370
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In the U.S., direct expenditures involving health-care costs and indirect expenditures involving lost wages of persons with musculoskeletal diseases have been estimated to total $950 billion, or 7.4% percent of the U.S. gross national product, in 2004-20061. Despite this enormous financial burden, in addition to the personal and societal impact, musculoskeletal research represents less than 2% of the National Institutes of Health (NIH) budget2. This disparity between the burden of these diseases and the investment in research to develop improved preventive and treatment strategies for them is noted in every region of the world and has been a major impetus for the global Bone and Joint Decade movement. After ten years, it is important to undertake a retrospective analysis of what has been accomplished and what remains to be done with this program.
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