International Centre of Excellence in the Treatment of Pathological Fractures

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The International Centre-to-Centre collaboration focuses on a significant area of research activity at the three Universities: Pathological Fractures. Fracture rates are expected to surge as the population ages and therefore constitute an urgent, unmet clinical need. Recent co-creation and engagement activities, by the principal investigator, with clinicians and patients, has noted the need for optimised, patient-specific minimally invasive approaches, fracture prevention and the use of localised delivery of therapeutic agents to reduce infection, disease burden and improve bone quality/fixation.The aim of the Centre-to-Centre is to respond to this clinical need and develop an International Centre of Excellence in Research of Pathological Fractures building on the substantial synergies that exist at the three institutions. These include:University of Leeds (UoL): Advanced assessment of medical devices, substantial investments in research for spinal fracturesarising from bone metastases (EPSRC Programme Grant: Oncological Engineering) and peri-prosthetic fractures (Zimmer-Biomet).Uppsala University: Additive Manufacturing for the Life Sciences (VINNOVA funded Competence Centre) and Soft Bone (EIT Health funded) a new generation of low modulus materials designed to fix and prevent fractures in the vertebrae as well as augmentation of the disc.ETH Zurich: Advanced imaging and modelling for pathological fractures (FHT Singapore) and fracture modelling in metastatic disease (EU funded METASTRA).We have further support from 4 industrial partners and UoL.We will bring these attributes together into a more holistic, multidisciplinary collaboration that would significantly enhance the scope for generating novel underpinning engineering science together with appropriate impact through our industrial and healthcare partners.The objectives, building on and enhancing the activities outlined above, are:(1) An integrated, multiscale, Fracture Prediction Modelling Framework to identify bones that are at risk of fracture in given pathologies so as.a. to aid prophylactic interventions to reduce this fracture risk and enable pathology-specific approaches,b. utilise modelling to improve the design of patient-specific/custom made implants.Developed from research at ETHZ and UoL.(2) Develop a Framework for Prophylactically Amenable, Pathology-Specific, Minimally-Invasive interventions to support the load-bearing bone and prevent fracture so to a. significantly inhibit instability, bone pain and, in the vertebra, the potential for spinal cord injury, with the aid of the modelling developed in objective 1b. develop tools and interventions for hip peri-prosthetic fracture.Developed from the research at Uppsala in the Additive Manufacturing for Life Competence Centre and SoftBone and the UoL.(3) A new generation of innovative coatings specific to treatment requirements including reduction in infection & disease burden, promotion of bone growth and enhanced fixation.a. to take advantage of the material and cement technologies outlined in objectives 1 and 2 to provide better functional outcomes.Based on the research at Uppsala and UoL.The proposal is underpinned by a set of cross-cutting themes which are:(1) Responsible Innovation is central to this activity and includes the appropriate (a) ethical principles ensuring that theresearch benefits a wider set of stakeholders including patients, (b) patient and clinical co-creation and meaningfulinteractions so as to enhance the overall design process and (c) appropriate mechanisms that enhance impact includingdissemination, continued patient engagement and exploitation.(2) Workforce development, to ensure that both researchers and investigators have the appropriate knowledge forthe successful execution of the research and wider career aspirations.(3) Equality, Diversity and Inclusion, of both the researchers and the patients involved.