MRC/FNR Returning Safely to high-impact activities after JOINT replacements (SafeJOINTs)

MRC/FNR 在关节置换后安全返回高影响力活动（SafeJOINT）

• 批准号: MR/Y013557/1
• 负责人: Bernard Liew
• 金额: $ 72.75万
• 依托单位: University of Essex
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY013557%2F1
• 关键词: MRC; FNR; Returning; Safely; impact

Hip and knee replacements are very commonly performed surgeries. Joint replacements involve removing the painful portion of bone and replacing it with an implant. More and more patients wish to return to high-impact activities, like running, after a joint replacement. However, high-impact activities are discouraged by surgeons, for fear that they will harm the new joint implant and the surrounding bones - thus, requiring a second surgery. A second surgery is more expensive than the first and riskier for the patient.This project will be the first to quantify the loads experienced by the implants and surrounding bones in high-impact activities after a joint replacement. It is very hard to conduct a 5 to 25-year study following patients over time and precisely measuring how many activities they are doing over these periods. However, computer models can allow us to precisely and efficiently measure the short- and long-term safety of high- and low-impact activities. Our three sub-projects will address this.In our first sub-project, we will recruit individuals with hip and knee replacement who have successfully returned to high-impact activities. All participants will attend a single session of testing. Participants will complete a survey to gather information about their health and activity levels. We will capture motion and force measures and muscle activation patterns, while they will perform short bouts of walking, running, jumping, landing, hopping, and change of direction running. Lastly, participants will wear a small sensor for a week, to measure how much walking and running is done. The objective of this first sub-project is to understand how people move during high- and low-impact activities following a joint replacement. We also want to determine the volume of high- and low-impact activities undertaken by people after a joint replacement in their daily lives. The second sub-project's objective is to determine how different types of activities (high-impact alone, lower-impact alone, or a mixture), different volumes and different movement techniques influence the amount that the new joint implant will wear out. This is crucial to understanding the safety of returning to running, because even though running exerts a higher impact than walking, it is done less frequently, and different running techniques can be used to potentially maximise its long-term safety. We will create computer models of the joints using information from the first sub-project, and create models that mimic many years of performing walking and running, and study the speed and amount of wear on the implants. The objective of the final sub-project is to determine how different types of activities and movement techniques, influence the load experienced by the bone surrounding the new joint implant. By knowing how much load is applied and where it is concentrated, we can determine if these loads can result in bone breaking, or potentially be beneficial to build stronger bones. We will create another set of computer models of the joints to determine if the loads exerted by different activities will exceed the strength of the bone, causing breakage. As joint replacements become more common and people live longer, more patients receiving a joint replacement will wish to return to some form of high-impact activities. High-impact activities have many physical and mental health benefits, like making bones stronger, which cannot easily be achieved by low-impact activities. Additionally younger patients are now receiving joint replacements. Not knowing if and by how much, high-impact activities are harmful, automatically removes the possibility to reap many health benefits from such activities. This will reduce patient satisfaction with the surgery. This project will provide crucial information that clinicians and patients can use to make informed healthcare decisions about the safety of returning to different activities after a joint replacement.

髋关节和膝关节置换术是非常常见的手术。关节置换术包括切除疼痛的骨头部分，并用植入物代替。越来越多的患者希望在关节置换术后恢复高强度活动，如跑步。然而，外科医生不鼓励高冲击活动，因为担心它们会伤害新的关节植入物和周围的骨骼-因此，需要进行第二次手术。第二次手术比第一次手术更昂贵，对患者来说风险更大。该项目将是第一个量化关节置换术后植入物和周围骨骼在高冲击活动中所承受的载荷的项目。很难进行一项5到25年的研究，随着时间的推移跟踪患者，并精确测量他们在这些期间做了多少活动。然而，计算机模型可以让我们精确有效地衡量高影响和低影响活动的短期和长期安全性。我们的三个子项目将解决这一问题。在我们的第一个子项目中，我们将招募髋关节和膝关节置换术后成功重返高影响力活动的个人。所有参与者都将参加一次测试。参与者将完成一项调查，以收集有关他们的健康和活动水平的信息。我们将捕捉运动和力量的措施和肌肉激活模式，而他们将执行短回合的步行，跑步，跳跃，着陆，跳跃和改变方向运行。最后，参与者将佩戴一个小型传感器一周，以测量他们完成了多少步行和跑步。第一个子项目的目的是了解人们在关节置换后的高影响和低影响活动中如何移动。我们还想确定关节置换术后人们在日常生活中进行的高影响和低影响活动的数量。第二个子项目的目标是确定不同类型的活动（单独的高影响，单独的低影响，或混合），不同的体积和不同的运动技术如何影响新的关节植入物的磨损量。这对于理解恢复跑步的安全性至关重要，因为尽管跑步比步行产生更大的影响，但跑步的频率较低，并且可以使用不同的跑步技术来最大限度地提高其长期安全性。我们将使用第一个子项目的信息创建关节的计算机模型，并创建模拟多年行走和跑步的模型，并研究植入物的磨损速度和数量。最终子项目的目的是确定不同类型的活动和运动技术如何影响新关节植入物周围骨所承受的载荷。通过了解施加了多少载荷以及载荷集中在哪里，我们可以确定这些载荷是否会导致骨折，或者可能有利于建立更强壮的骨骼。我们将创建另一组关节的计算机模型，以确定不同活动施加的负载是否会超过骨骼的强度，从而导致断裂。随着关节置换术变得越来越普遍，人们的寿命越来越长，越来越多接受关节置换术的患者希望恢复某种形式的高影响力活动。高影响力的活动对身心健康有很多好处，比如让骨骼更强壮，这是低影响力的活动无法轻易实现的。此外，年轻患者现在正在接受关节置换。不知道高影响活动是否有害以及有害程度如何，就自动排除了从这些活动中获得许多健康益处的可能性。这会降低患者对手术的满意度。该项目将提供重要信息，临床医生和患者可以使用这些信息来做出关于关节置换术后恢复不同活动的安全性的明智医疗决策。