BioTrib-AVN: The effect of avascular necrosis of the hip on articular function in natural and artificial joints

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The Postdoctoral Fellowship provides the opportunity for the applicant to undertake research and research training in one of Europe's foremost medical engineering research groups at the University of Leeds. The fellowship seeks to enhance the modelling approaches already developed by the applicant in bone remodelling with the advanced cartilage models being generated in Leeds to provide a key tool to mitigate the rising incidence of avascular necrosis (AVN) in Asia. AVN is a destructive disease, mainly found in the younger population, arising due to the disruption of blood supply to the femur head. It is the most common diagnosis (40%) for patients undergoing total hip replacement (THR) in Asia. Some patients may have the risk of collapse of the femoral head, depending upon the size of the lesion. Studies have observed a reduction in strength and stiffness in the pre-collapse stage of the AVN, which reduces the structural competence of the bone as well as the adjacent articular cartilage that covers the femoral head. Any disruption of the articular cartilage that arises from abnormal loading due to damage in the underlying bone has severe consequences for the overall joint function and ultimately pain and disability. The proposed research will investigate the link between AVN induced bone deterioration and joint function - biotribology - using a dynamic computational model that incorporates the evolution of the AVN from a bone function perspective. In the first instance, this will be an examination of the relationship between the cartilage function and bone properties in early stage AVN there are more conservative treatments. Such interventions are in urgent need of scientific underpinning; an aim that this model could achieve in the medium term. The second project, which will be delivered whilst on placement, will focus on late stage interventions for AVN, that is surface replacement where the design will be considered in terms of bone remodelling.