Development of bioactive graphene based scaffolds for tissue repair

关节炎是一种衰老性疾病，导致疼痛，关节运动缺乏，特别是髋关节和膝关节，生活质量差。2019年全球疾病负担研究报告称，自1990年以来，患有骨关节炎的人增加了一倍多，由于“肥胖症的流行”，这一趋势将继续下去。膝关节骨性关节炎占病例的61%。在英国，45岁以上的人中约有33%曾寻求骨关节炎治疗。膝关节骨关节炎的人数为500万，预计到2030年将进一步增加30%。据估计，2017年英国治疗关节炎的直接医疗费用为102亿英镑。年轻（35-55岁）高活动度患者仍在工作期间，对骨关节炎治疗的需求迅速增加，因此社会成本包括生产力损失（英国每年损失3600万个工作日）、一般和心理健康以及直接治疗成本。骨科科学协会和外科医生普遍认为，保守治疗使许多此类患者失败，但目前的关节置换技术虽然在老年患者中非常成功，但并不适用或有效。因此，需要一种新的方法来解决这个问题，让这些人回到他们选择的生活方式。目前的膝关节置换植入物是由塑料，金属和陶瓷制成的，不能像我们的自然身体一样自我修复。最后它们会磨损。更换它们的手术，即膝关节翻修手术，比初次手术更困难，更容易出现问题。因此，不磨损的膝关节置换是期望的。为了使这成为可能，我们将开发一种结构，使组织用于替代骨关节炎受损的区域。我们已经制造出了足够坚固的支撑结构，可以植入并支持细胞生长。该项目将进一步开发这些材料以再生复杂组织。这将消除使用金属，塑料或陶瓷来修复膝关节的需要。这将有其他好处，例如提供更好的运动，因为它与正常的膝盖相同，并通过减少生物膜形成的风险来减少手术后严重感染的机会。它将保留当前的膝关节手术方法，使患者能够从过去30年来膝关节手术的进步中受益，这些进步显著改善了功能结局。

Arthritis is a disease of aging leading to pain, lack of joint movement, particularly in hips and knees, and poor quality of life. The Global Burden of Disease Study 2019 reported those living with osteoarthritis had more than doubled since 1990 and this trend will continue due to "the epidemic of obesity". Knee osteoarthritis accounted for 61% of cases. In the UK, around 33% of those over 45 have sought treatment for osteoarthritis. The number with knee osteoarthritis is \>5million and estimated to increase a further 30% by 2030\. Estimated UK direct healthcare costs for treating arthritis in 2017 were £10.2billion. There is a rapidly increasing demand for treatment of osteoarthritis in young (35-55 years old) high activity patients who are still within their working life, so costs to society include the loss of productivity (36 million lost working days in the UK per year), general and psychological health, as well as costs of direct treatment. It is widely accepted by orthopaedic scientific societies and surgeons that conservative treatment fails many of these patients but that current joint replacement technologies, although very successful in older patients, are not suitable or efficient. Therefore, a new approach is needed to tackle this problem and return these individuals to their chosen lifestyle.Current knee replacement implants are made of plastic, metal and ceramics and cannot, like our natural bodies, repair themselves. Eventually they wear out. The operation to replace them, revision knee surgery, is more difficult and more likely to have problems than the initial surgery. Therefore, a knee replacement that does not wear out is desirable. To make this possible, we will develop constructs that make tissues to be used to replace areas damaged by osteoarthritis. We have already made supporting structures that are strong enough to be implanted and support cells to grow. This project will further develop these materials to regenerate complex tissues. This will remove the need to use metal, plastic, or ceramic to mend the knee joint. This will have other benefits, such as giving better movement as it is the same as a normal knee and reducing the chances of serious infections after operations by reducing the risk of biofilm formation. It will preserve the current approach to knee surgery so also allowing patients to benefit from the advances that have been made in knee surgery over the last 30 years which have significantly improved functional outcomes.