Using graphene to generate tissues suitable for joint replacement components

关节炎是一种衰老疾病，会导致疼痛、关节（尤其是臀部和膝盖）缺乏活动，以及生活质量下降。2016年全球疾病负担研究将髋关节和膝关节骨关节炎列为全球第12大致残因素。随着人口老龄化和肥胖的增加，英国患有膝骨关节炎的人数超过500万，预计到2030年将进一步增加30%。年轻（35-55岁）高活动量患者对骨关节炎治疗的需求迅速增加。这些患者仍在其工作年限内，因此对社会造成的损失包括生产力、一般健康和心理健康以及直接治疗的损失。人们普遍认为保守治疗对许多此类患者无效，但目前的关节置换技术虽然在老年患者中非常成功，但并不适合或有效。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，有时是陶瓷制成的，因此不能像我们的自然身体那样自我修复，最终会磨损。替代它们的手术，即膝关节翻修手术，比第一次手术更困难，也更容易出现问题。因此，不磨损的膝关节置换术是更可取的。为了使这成为可能，我们将开发制造组织结构的第一阶段，这些组织结构可以用来制造部件，然后取代被骨关节炎损伤的膝盖部分。这将通过为这些组织制造正确的支撑结构来实现，因为它们需要足够强大，才能制成可植入的部件。这将消除使用金属、塑料或陶瓷来修复膝关节的需要。这还有其他的好处，它应该给更好的运动，因为它和正常的膝盖一样，它应该减少手术后严重感染的机会，因为体内没有“外来”物质，如金属、塑料或陶瓷，细菌可以附着在上面。它将保留目前的膝关节手术方法，因此它也将使患者受益于过去20年来膝关节手术的进步，这些进步大大改善了患者的功能结果。

Arthritis is a disease of aging and leads to pain, lack of movement in joints, particularly hips and knees, and poor quality of life. The Global Burden of Disease Study 2016 has hip and knee osteoarthritis ranked as the 12th highest contributor to global disability. With an aging population and increasing obesity the number of people in the UK with knee osteoarthritis is over 5 million and estimated to increase a further 30% by 2030\. There is a rapidly increasing demand for treatment of osteoarthritis in young (35-55 years old) high activity patients. These patients are still within their working life so costs to society include the loss of productivity, general and psychological health, as well as those of direct treatment. It is widely accepted 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 sometimes ceramics and so cannot, like our natural bodies, repair themselves so they eventually wear out. The operation to replace them, revision knee surgery, is more difficult and more likely to have problems than the first one. Therefore, a knee replacement that did not wear out would be more desirable. To make this a possibility, we will develop the first stage in making tissue structures that can be used to make components that could then replace the parts of the knee damaged by osteoarthritis. This will be by making the correct supporting structures needed for these tissues as they need to be strong enough to be made into components that can be implanted. This will remove the need to use metal, plastic or ceramic to mend the knee joint. This will have other benefits, it should give better movement as it is the same as a normal knee, it should reduce the chances of serious infections after operations as there is no "foreign" material such as metal, plastic or ceramic within the body for bacteria to attach to. It will preserve the current approach to knee surgery so it will also allow patients to benefit from the advances that have been made in knee surgery over the last 20 years which have significantly improved functional outcomes for patients.