SUMMARY
The research of Rafael J. Sierra, M.D., involves clinical trials in hip and knee arthroplasty, prospective and retrospective clinical research in hip preservation surgery, and the diagnosis and management of femoral head osteonecrosis.
Dr. Sierra also focuses on prevention of complications associated with primary and revision hip arthroplasty. He investigates the biomechanics of periprosthetic fractures, the improvement of function with soft tissue procedures of the abductor mechanism and failure modes of dual mobility implants.
Dr. Sierra has multicenter trials investigating how to improve the perioperative management of people with knee arthroplasty and the treatment of periprosthetic infection.
Focus areas
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Hip dysplasia. Dr. Sierra leads a multidisciplinary team of clinical researchers from Mayo Clinic that focuses on redefining the natural history of osteoarthritis in patients with hip dysplasia and impingement.
Dr. Sierra's publications document that surgical treatment of femoroacetabular impingement can result in decreased hip pain and improved hip function. This surgical treatment also prevents progression of osteoarthritis or conversion to hip replacement in mid- and long-term follow-up.
- Avascular necrosis and bone regeneration. Dr. Sierra and collaborators research the pathophysiology, diagnosis and treatment of osteonecrosis of the femoral head in young patients. Dr. Sierra has a grant to study the use of exosomes for bone regeneration. Basic science research has been completed by Dr. Atta Behfar, M.D., Ph.D., and staff at Mayo Clinic.
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Complication prevention after total hip replacement. Dr. Sierra and his colleagues in the Department of Orthopedic Surgery investigate the use of cementless and cemented total hip arthroplasty in older people at risk of periprosthetic fracture.
He performs translational science research with industry-sponsored studies that evaluate different implant systems for primary hip arthroplasty in the biomechanics laboratory.
- Preventing and treating complications associated with revision total hip arthroplasty. Dr. Sierra leads clinical and basic science research in the treatment of abductor insufficiency and on use of dual mobility implants in revision total hip arthroplasty. He focuses on implant innovation and prevention of complications of its use.
Significance to patient care
Hip dysplasia is a leading cause of total hip arthroplasty in patients less than 50 years of age. The goal of Dr. Sierra's research is to provide quantitative measures of success after periacetabular osteotomy to prevent total hip arthroplasty in this population. His research shows that periacetabular osteotomy can prevent total hip arthroplasty in half of the patients undergoing surgical management.
Osteonecrosis continues to be one of the unsolved problems in modern orthopedic surgery. Dr. Sierra's basic science and translational research contribute to the surgical management of this condition in early- and midterm stages with excellent results.
Prevention of periprosthetic fracture, one of the most common and devastating complications after hip arthroplasty, is a major goal of Dr. Sierra's research. His studies highlight the importance of implant selection as a way to prevent these fractures in the elderly population. The goal of this research is to enhance care by improving implant design and surgical care.
Professional highlights
- Central program chair, American Academy of Orthopaedic Surgeons, 2023-present.
- Vice president, Association Research Circulation Osseous, 2022-present.
- Secretary, American Association of Hip and Knee Surgeons, 2021-present.
- Chair, board of directors, Maurice E. Mueller Foundation of North America, 2019-present.
- Member, Executive Committee, Academic Network of Conservational Hip Outcomes Research, 2018-present.
- Frank Stinchfield Award, American Academy of Orthopaedic Surgeons, 2023.
- Lawrence Dorr Award, American Association of Hip and Knee surgeons, 2022.
- Achievement Award, American Academy of Orthopedic Surgery, 2017.
- John Charnley Award, American Academy of Orthopaedic Surgeons.
- Chitranjan Ranawat Award, Knee Society, 2015.
- Emerging Leader Award, American Association of Hip and Knee Surgeons, 2014.
- Honorary Knighthood, Caballero Honorario, Colombian Orthopedic Society, 2013.
- Leaders in Joint Replacement, Generation Next, 2013.