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

博士后奖学金为申请人提供了在利兹大学欧洲最重要的医学工程研究小组之一进行研究和研究培训的机会。该奖学金旨在加强申请人在骨骼重塑方面已经开发的建模方法，并在利兹产生先进的软骨模型，为减轻亚洲日益上升的缺血性坏死（AVN）发病率提供关键工具。AVN是一种破坏性疾病，主要发生在年轻人群中，由于股骨头血液供应中断而引起。在亚洲接受全髋关节置换术（THR）的患者中，这是最常见的诊断（40%）。一些患者可能有股骨头塌陷的风险，这取决于病变的大小。研究已经观察到AVN塌陷前的强度和刚度降低，这降低了骨头以及覆盖股骨头的相邻关节软骨的结构能力。由于底层骨骼损伤而引起的异常负荷引起的关节软骨的任何破坏都会对整体关节功能造成严重后果，最终导致疼痛和残疾。拟议的研究将研究AVN诱导的骨退化和关节功能之间的联系-生物摩擦学-使用动态计算模型，从骨功能的角度结合AVN的演变。首先，这将是一个检查软骨功能和骨特性之间的关系，在早期AVN有更多的保守治疗。这些干预措施迫切需要科学依据；这种模式可以在中期实现这一目标。第二个项目将在放置时交付，将重点关注AVN的后期干预，即在骨骼重塑方面考虑表面替换设计。

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.