Musculoskeletal disorders, affecting as many as 1.3 billion people worldwide, are the leading cause of disability and impose a substantial health and socioeconomic burden. Despite the high prevalence of these conditions, translational research in this field is far from optimal, highlighting the need for stronger collaboration between basic and clinical scientists. This paper, authored by members of the basic and clinical action groups of the European Calcified Tissue Society (ECTS) and endorsed by the Board of the ECTS, examines the key barriers to effective translational research in musculoskeletal diseases, including clinician workload, differences in professional language and culture, physical distance between research sites, and insufficient interdisciplinary funding. Through interviews with eight institutional managers across five European countries, we observed that in some institutions, the collaboration between basic scientists and clinicians was regarded as no concern (but with room for improvement), and in most institutions it was recognised as a serious issue. We found consensus on the importance of collaboration yet identified discrepancies in the provision of structural and financial support. Based on these findings, we propose strategic initiatives to bridge the gap between basic and clinical research. Suggested measures include dedicated translational funding, integrated research facilities, collaborative scientific forums, strategic collaborations, establishment of physician-scientists, and, finally, bringing basic and clinical researchers together in the same building or even in a combined department. Notable successes, such as the development of the anti-osteoporotic drugs, romosozumab and denosumab, underscore the value of a coordinated approach and exemplify how shared insights between laboratory research and clinical practice can lead to impactful therapeutic advances. Moving forward, we advocate for institutional commitments to foster a robust translational research environment, as well as tailored funding initiatives to support such efforts. This paper serves as a call for discussion and action to enhance interdisciplinary cooperation to advance musculoskeletal medicine and improve outcomes for patients with debilitating musculoskeletal diseases.

1st Department of Propaedeutic and Internal Medicine Endocrinology Unit LAIKO University Hospital National and Kapodistrian University of Athens Athens Greece

Department of Endocrinology 424 Military General Hospital Thessaloniki Greece

Department of Pathology Odense University Hospital Odense Denmark

Department of Rheumatology Amsterdam UMC Amsterdam The Netherlands

Department of Trauma and Orthopaedic Surgery Division of Orthopaedics University Medical Center Hamburg Eppendorf Hamburg Germany

Institute of Comparative Molecular Endocrinology Ulm University Ulm Germany

Laboratory of Molecular Physiology of Bone Institute of Physiology of the Czech Academy of Sciences Prague 4 Czech Republic

MABlab ULR 4490 Rheumatology Department University of Lille CHU Lille F 59000 Lille France

Pathology Research Unit Department of Clinical Research University of Southern Denmark Campusvej 55 5230 Odense M Denmark

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