Enabling Individualised Surgical Treatment of Osteoarthritis

实现骨关节炎的个体化手术治疗

• 批准号: EP/W003139/1
• 负责人: Ruth Wilcox
• 金额: $ 158.87万
• 依托单位: University of Leeds
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FW003139%2F1
• 关键词: Enabling; Individualised; Surgical; Treatment; Osteoarthritis

Osteoarthritis affects over eight million people in the UK alone, with nearly three quarters of patients reporting some form of constant pain. Treatment for arthritis is estimated to cost the UK healthcare system over £10 billion per year, with significant additional societal costs for lost working hours and welfare payments.Although hip and knee replacement surgeries are considered successful, these treatments are not suitable for all patients and some devices fail early, requiring costly and less successful revision surgery. There are over 15,000 revision surgeries performed in the UK alone each year. Younger and more active patients, as well as rising numbers with obesity, are placing greater demands on these treatments: implants need to last for longer and withstand more extreme loading than ever before. There is evidence that both individual patient biomechanics and surgical choices influence the outcomes of these treatments. Improved outcomes, particularly for more challenging patient groups, can only be achieved by better matching the treatment to the functional requirements of the individual patient.This proposal will bring together complementary research expertise from two of the world's leading research institutes in the field to build the evidence needed to enable treatments for osteoarthritis to be better tailored to individual patient needs. The Institute of Medical and Biological Engineering at the University of Leeds has developed unique capability and expertise to evaluate artificial and natural joints. These include the world's largest academic facility for experimentally testing joint replacements, as well as computational modelling methods to simulate how implants perform in the body. These capabilities enable the mechanical performance of implants to be evaluated under a range of different conditions, for example to study how the implant wears over time or becomes damaged with usage.The Center for Orthopaedic Biomechanics at the University of Denver has developed world-leading capability in measuring patient joint mechanics in vivo, including methods of imaging patient joints as they undertake different activities, and parallel computational methods for deriving biomechanical information. These methods enable the forces and motions on an individual patient's hip or knee joints to be derived and, by collecting data on many patients, examine how these differ from one individual to another. By combining the expertise across both groups, this Centre-to-Centre Research Collaboration will enable relationships to be developed between an individual patient's characteristics (e.g. their anatomy and how they load their joints) and the mechanical performance of the implant. Specifically, in the hip we will combine methodologies developed at the two centres to evaluate how patient and surgical factors affect the risk of early failure in hip replacements due to the device components pushing into each other or the surrounding bone (impingement), or the way the components are aligned. We will also examine how different choices of implant can influence the outcomes. In the knee, we will combine methodologies to identify how patient factors (such as the anatomy of the knee and the way it is loaded during different activities) affect early-stage treatments for knee osteoarthritis. We will also examine the effects of a greater range of activities, such as squatting and stair climbing, on the outcomes of knee replacements. These studies will bring together different methodologies and build new pathways for acquiring and sharing data that can be adopted more widely and applied to other musculoskeletal systems in the future. The work will build the evidence needed to improve hip and knee implant design, inform clinical decision-making, enhance patient quality of life and reduce early complications.

骨关节炎仅在英国就影响了800多万人，近四分之三的患者报告了某种形式的持续疼痛。关节炎的治疗估计每年花费英国医疗保健系统超过100亿英镑，其中包括因工作时间和福利支出而损失的大量额外社会成本。虽然髋关节和膝关节置换手术被认为是成功的，但这些治疗并不适合所有患者，有些设备早期失败，需要昂贵且不太成功的翻修手术。每年仅在英国就有超过15，000例翻修手术。更年轻、更活跃的患者以及越来越多的肥胖患者对这些治疗提出了更高的要求：植入物需要比以往任何时候都更持久，承受更极端的负荷。有证据表明，个体患者的生物力学和手术选择都会影响这些治疗的结果。只有更好地将治疗方案与患者个体的功能需求相匹配，才能改善治疗效果，特别是对于更具挑战性的患者群体。该提案将汇集该领域两个世界领先研究机构的互补研究专业知识，以建立所需的证据，使骨关节炎的治疗更好地适应个体患者的需求。利兹大学医学和生物工程研究所已经开发出独特的能力和专业知识来评估人工和天然关节。其中包括世界上最大的用于实验测试关节置换的学术设施，以及模拟植入物在体内表现的计算建模方法。这些功能使植入物的机械性能能够在一系列不同的条件下进行评估，例如研究植入物如何随着时间的推移而磨损或随着使用而损坏。丹佛大学矫形生物力学中心开发了世界领先的体内测量患者关节力学的能力，包括在患者进行不同活动时成像患者关节的方法，以及用于导出生物力学信息的并行计算方法。这些方法能够导出单个患者髋关节或膝关节上的力和运动，并通过收集许多患者的数据，检查这些个体之间的差异。通过结合两个团队的专业知识，这种中心对中心的研究合作将使个体患者的特征（例如他们的解剖结构和他们如何加载关节）与植入物的机械性能之间的关系得以发展。具体而言，在髋关节中，我们将结合两个中心开发的联合收割机方法，以评价患者和手术因素如何影响髋关节置换术中由于器械组件相互推挤或周围骨（撞击）或组件对齐方式而导致的早期失败风险。我们还将研究植入物的不同选择如何影响结果。在膝关节方面，我们将结合联合收割机方法来确定患者因素（如膝关节的解剖结构及其在不同活动中的负荷方式）如何影响膝关节骨关节炎的早期治疗。我们还将研究更大范围的活动，如蹲下和爬楼梯，对膝关节置换术的结果的影响。这些研究将汇集不同的方法，并建立新的途径来获取和共享数据，这些数据可以在未来更广泛地应用于其他肌肉骨骼系统。这项工作将为改进髋关节和膝关节植入物设计、为临床决策提供信息、提高患者生活质量和减少早期并发症提供所需的证据。

项目成果

A Finite Element Model to Investigate the Stability of Osteochondral Grafts Within a Human Tibiofemoral Joint

• DOI: 10.1007/s10439-024-03464-6
• 发表时间: 2024-03-06
• 期刊: ANNALS OF BIOMEDICAL ENGINEERING
• 影响因子: 3.8
• 作者: Day，Gavin A.;Jones，Alison C.;Wilcox，Ruth K.
• 通讯作者: Wilcox，Ruth K.

Inertial Tracking System for Monitoring Dual Mobility Hip Implants In Vitro.

• DOI: 10.3390/s23020904
• 发表时间: 2023-01-12
• 期刊: Sensors (Basel, Switzerland)

Impingement in total hip arthroplasty: A geometric model.

• DOI: 10.1177/09544119211069472
• 发表时间: 2022-02-11
• 期刊: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine
• 作者: Pryce GM;Sabu B;Al-Hajjar M;Wilcox RK;Thompson J;Isaac GH;Board T;Williams S
• 通讯作者: Williams S

Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients.

步态过程中的动态髋臼杯定向：对快走和慢走全髋关节置换患者的研究。

• DOI: 10.3390/bioengineering11020151
• 发表时间: 2024
• 期刊: Bioengineering (Basel, Switzerland)
• 作者: Vasiljeva K