Injury & Reconstruction Biomechanics Test Suite

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The resilience of communities and productivity of the nation is compromised by ill health. Musculo-skeletal disorders are one of the biggest expenditures in the annual NHS budget at approximately £5.4 billion, not including the hidden costs associated with loss of independence. This burden will increase with time not only because 1 in 4 citizens in the UK is expected to be over 65 years of age by 2045, but also due to the rising expectations of activity. At the same time, trauma is a leading cause of death and disability. Approximately 5.8 million people die each year as a result of injuries; this accounts for 10% of the world's deaths, 32% more than the number of fatalities that result from malaria, tuberculosis and HIV/AIDS combined. Trauma predominantly affects the young, who require swift return to physical activity and work, and interventions that will last them for life. Innovation in reconstruction of the musculoskeletal system at all stages of life is therefore paramount to ensure healthy, independent ageing. Currently, research into the biomechanics and reconstruction of injury is conducted largely by analysing sensor data (force, displacement, strain, high-speed photography) during the event, and assessing tissue failure after the event through dissection and imaging. What occurs precisely, however, at the vicinity of interest during loading, both prior to and at the time of failure, cannot be characterised truly unless a methodology is developed to 'look inside' while the event occurs. As the events of interest have millisecond durations, the temporal resolution of data acquisition needs to be far higher than what is possible with conventional clinical imaging equipment. We will combine high-speed photography with x-ray imaging in a way that it will enable us to perform radiostereometric analysis (RSA) with unprecedented sampling rates. This will be an internationally unique testing configuration allowing the system to be used with commercial and bespoke organ and tissue testing equipment. The Injury & Reconstruction Biomechanics Test Suite will enable experimental models of musculoskeletal trauma with detailed visualisation and quantification of the location and time of injury initiation and propagation, and so deliver a detailed picture of the mechanism of injury that we want to treat or mitigate. By enabling testing of prostheses and surgical interventions over a range of physiological, dynamic loading regimes, the Suite will allow for the quantification of the precise interaction between prostheses with human tissue and the evaluation of the efficacy of surgical interventions. This will not only promote further innovation in prostheses design and surgical techniques, but also the development of new, more appropriate and accurate qualification criteria for prostheses and surgical interventions. The Suite will enable the quantification of the motion and deformation of protective equipment, such as airbags or specialised clothing, and their precise interaction with the human body in unprecedented detail during the insult. This will inform the development of more biofidelic human surrogates for testing vehicles and protective equipment, provide robust data for the development and validation of computational models of human injury, and facilitate innovation in design of protective equipment for defence, automotive, and sport applications. The Suite will be an internationally unique national facility that has the potential to spawn exciting transformational research in musculoskeletal, orthopaedic and injury biomechanics, injury prevention, and surgical reconstruction, and enable its translation into practice for the improvement of lifelong health.