Evolving the design of unicondylar knee replacement to improve post operative function

该项目的目的是在当代自然膝关节运动学知识的基础上，发展当前的单髁膝关节置换术(UKR)设计范例。设计理念应考虑专门用于膝关节内翻和外翻畸形的植入物，以及完全从替换的关节中移除金属的全聚合物配置。为了实现这些目标，将生成正常、内翻和外翻膝盖的计算机断层扫描的大型数据集。将使用主成分分析和多元统计方法分析这些数据的几何和形态，以便确定关键关系。这些数据应用于生成正常、内翻和外翻膝关节的植入物设计概念，以便在屈曲时重建胫股内侧关节的自然前后约束。应使用我们小组先前生成的经过实验验证的有限元(FE)协议，评估种植体应力、骨应变和界面微运动的设计概念。一旦FE给出可接受的值，设计的快速原型应由经验丰富的外科医生制造并植入身体膝盖。屈曲时的运动学将使用我们实验室建立的方法进行测量，并与自然膝关节进行比较，以验证原型设计的概念。该提案的成功交付将导致UKR的开发，与现有设备相比具有显著优势，包括更自然的运动学和软组织张力、适合常见畸形的形态，以及潜在的较低成本的材料和制造方法。通过支持最终的设计概念，拟议的研究可用于支持该设备的临床试验或任何后续的监管提交。这项拟议的研究非常有可能成功，因为我们的实验室与整形外科医生有着密切的关系，我们在将概念商业化方面的记录以及备受尊敬的行业合作伙伴的支持。因此，进行拟议研究的环境将使该项目蓬勃发展。

The aim of this project is to evolve current unicondylar knee replacement (UKR) design paradigms based on contemporary knowledge of natural knee kinematics. The design concepts shall consider implants specific for knees with varus and valgus deformity, and an all polymer configuration that would remove metal from the replaced joint entirely. To achieve these aims, a large dataset of computed tomography scans of normal, varus and valgus knees will be generated. The geometry and morphology of these data will be analysed using principal component analysis and multivariate statistical methods such that key relationships are identified. These data shall be used to generate implant design concepts for normal, varus and valgus knees that can recreate the natural anterioposterior constraint of the medial tibiofemoral articulation during flexion. Design concepts shall be assessed for implant stress, bone strains and interface micromotion using an experimentally validated finite element (FE) protocol previously generated in our group. Once the FE gives acceptable values, rapid prototypes of the designs shall be manufactured and implanted in cadaver knees by an experienced surgeon. The kinematics during flexion shall be measured using established methods in our laboratory and compared to the natural knee to prove the concept of the prototype design. Successful delivery of the proposal will lead to the development of a UKR with significant advantages over existing devices including more natural kinematics and soft tissue tension, morphology to suit common deformities, and potentially lower cost materials and manufacturing methods. By supporting the final design concepts, the proposed research can be used to support clinical trials of the device or any subsequent regulatory submission. The proposed research is highly likely to succeed due to the close relationship our lab has with orthopaedic surgeons, our track record of commercialising concepts and the support of a well respected industry partner. The environment in which the proposed research will be conducted will therefore allow the project to thrive.