Intervention for early stage osteoarthritis or cartilage injury

骨科医生治疗各种各样的软骨损伤患者，从软骨损伤的年轻运动员到晚期骨关节炎的老年患者。有多种治疗方案，这些都是根据患者的年龄选择。对于35岁以下的患者，生物修复是成功的。生物修复包括尝试通过刺激来自底层骨骼的再生细胞（微骨折）或从关节的非承重部分移除健康软骨细胞，在实验室中培养它们并重新植入缺损处来使软骨愈合的技术。对于老年患者，全关节或部分关节置换术更可靠。英国全髋关节和全膝关节置换术患者的平均年龄分别为69岁和70岁，在过去五年中保持不变，表明外科医生没有更换年轻患者关节的趋势。因此，对于35至60岁年龄段的患者来说，治疗存在很大的差距，这些患者被认为太老而不能进行生物修复，但又太年轻而不能被认为是关节置换的理想候选人。该奖学金的目的是为这个年龄组的患者开发技术，可以在不去除骨量的情况下替换软骨表面，以便将来可以作为正常的索引程序进行任何部分或全部关节置换。为了实现这一目标，该奖学金将使用先进的材料和制造技术来创造具有超低摩擦和磨损性能的软骨替代植入物所需的技术，以保护设备免受使用中的服务负载。除了为35-60岁的患者提供骨科医生的治疗选择外，开发这项技术将在整个骨科领域得到应用。它将产生力学边界条件和测试方法，用于进一步开发35岁以下患者的生物修复支架和修复材料（目前主要是纤维软骨，而不是所需的透明软骨）。聚合物技术的发展将提供低成本全聚合物植入物所需的信息，适用于功能要求较低的患者。所述制造方法还可适用于具有定制的摩擦特性和形态以防止脱位的插入植入物。这些主题中的每一个都将在奖学金范围内进行。

Orthopaedic surgeons treat a wide variety of patients with cartilage damage, from young athletes with cartilage injury to elderly patients with advanced osteoarthritis. There are a variety of treatment options, and these are chosen based on the age of the patient. For patients under the age of 35, biological repair is successful. Biological repair includes techniques that try and make the cartilage heal itself by stimulating regenerative cells from the underlying bone (microfracture) or removing healthy cartilage cells from a non load bearing part of the joint, growing them in the laboratory, and re-implanting in the defect. For older patients, total or partial joint replacement is more reliable. The average age of total hip and knee replacement patients in the UK is 69 and 70 years respectively, and these have remained constant over the past five years indicating no trend for surgeons to replace joints of younger patients. There is therefore a wide gap in the treatments available for patients in the 35 to 60 year age bracket who are considered too old for biological repair, but too young to be considered ideal candidates for joint replacement. The aim of the fellowship is to develop the technology for patients in this age group that can replace the cartilage surface without removing bone stock such that any future partial or total joint replacements can be performed as a normal index procedure. To achieve this aim, the fellowship will use advanced materials and manufacturing techniques to create the technology required for cartilage substitution implants with ultra low friction and wear properties that will protect the device from the service loads it will experience in use. In addition to providing the orthopaedic surgeon with a treatment option for the 35-60 year old patient, developing this technology will have application across the whole orthopaedic field. It will generate the mechanical boundary conditions and test methods for further development of biological repair scaffolds and repair material (currently mostly fibrocartilage rather than the desired hyaline cartilage) for patients under 35 years old. The development of polymer technology will provide the information required for low cost all polymer implants that would be suitable for less functionally demanding patients. The manufacturing methods may also be suitable for interpositional implants with tailored frictional properties and morphology to prevent dislocation. Each of these themes will be pursued within the fellowship.