Functional Evaluation of the Meniscus and Meniscus Replacement using MRI

膝关节是骨性关节炎最常见的部位，仅在英国就有400多万人受到影响。这项博士研究的目的是开发新的方法来检查人类膝关节的负荷，包括通过使用磁共振成像(MRI)。尤其关注的是半月板，这是一种位于膝关节两个软骨表面之间的马蹄形纤维软组织。半月板的损伤和退变都与骨关节炎的进展有关。许多手术技术已经被开发出来修复或替换受损的半月板组织，然而它们的机械性能还没有被严格地评估以确定它们最适合哪些患者组。在这项博士论文中开发的技术将被用来评估半月板替代移植物的力学性能，并与自然健康关节进行比较。PHD的主要目标将是开发一种新的加载系统，该系统可用于在MRI机器中将生理加载状态应用于身体膝盖，并提供必要的图像分析和计算建模工具，以便能够确定不同加载状态下的半月板变形。开发的方法将被用来评估自然半月板和半月板移植物在不同患者和手术变量下的性能。这一结果将提供更多关于半月板在膝关节囊内的表现，以及在什么情况下可以通过使用半月板移植物恢复健康的生物力学。这些结果将为未来的移植物设计和围绕移植物的选择和放置的外科决策提供证据。

The knee is the most common site for osteoarthritis, affecting over 4 million people in the UK alone.The aim of this PhD study is to develop new methods for examining the human knee joint under load, including through the use of magnetic resonance imaging (MRI). The particular focus is on the meniscus, a fibrous horseshoe-shaped soft tissue that sits between the two cartilage surfaces of the knee joint. Both damage and degeneration of the meniscus are linked to the progression of osteoarthritis. A number of surgical techniques have been developed to repair or replace damaged meniscal tissues, however their mechanical performance has no tyet been rigorously evalauted to define which patient groups they are most suitable for. The techniques developed in this PhD will be used to evaluate the mechanical performance of meniscus replacement grafts, in comparison to the natural healthy joint. The main objectives of the PhD will be to develop a novel loading system that can be used to apply physiological loading states to cadaveric knees within an MRI machine, alongside the necessary image analysis and computational modelling tools to be able to determine the meniscal deformations under different loading states. The methods developed will then be used to evaluate the performance of the natural meniscus and meniscus grafts under different patient and surgical variables. The results will provide greater insight into the performance of the meniscus within the knee capsule, and under what cases healthy biomechanics can be restored through use of meniscal grafts. These results will provide evidence for future graft design and for surgical decision making around graft selection and placement.