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Potential conflicts of interest: Dr Culpepper has served as an advisor to or consultant for Boehringer-Ingelheim, Forest, Janssen, Jazz, H

Future Direction and Call to Action The current evidence gap presents an opportunity for orthopaedic investigators to establish high-quality prospective registries evaluating peptide exposure in real-world musculoskeletal populations

Safe, effective use of peptide therapy requires appropriate dosing, administration, and monitoring as well as sourcing from reputable manufacturers

In 1981, Lubert Stryer (19382024) emphasized that protein molecules are not inflexible crystal-like entities, but are characterized by very rapid motions of selected regions, since nanosecond fluorescence polarization analysis revealed that segmental flexibility, where domains can rotate over an appreciable angular range of times of nanoseconds, is a characteristic feature of multidomain proteins, whereas time-resolved fluorescence polarization studies have demonstrated that internal tryptophan residues can be flexible in the subnanosecond time range (Stryer, 1981)

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