Additive manufacturing of advanced medical devices for cartilage regeneration: minimally invasive early intervention

目前没有一种外科技术可以再生关节软骨，也没有一种设备可以模仿软骨的特性。这一合作将加速创新软骨愈合医疗设备的交付，这将跨越骨科手术的前沿，允许关节软骨再生而不是置换。该装置将使软骨恢复到健康状态。手术技术将通过一种新的精确和微创锁孔技术进行优化。手术后患者可以立即使用膝盖，恢复时间也会很快。骨关节炎影响四分之一的人，使人衰弱，使英国经济生产力损失100亿英镑，失业福利损失24亿英镑，并使英国国民健康保险制度每年花费54亿英镑用于治疗肌肉骨骼疾病。目前治疗严重骨关节炎的方法是全关节置换术，目前治疗软骨冲击损伤的最佳方法是微骨折，这需要在骨头上钻孔以释放骨髓，骨髓可以在缺损处形成脆弱的纤维软骨。早期干预是重要的，因为完全退变导致全关节置换术。问题是，软骨只能维持2-5年，然后必须重复进行手术，而全关节置换是一项大手术，需要移除大量组织，可以维持15-25年。琼斯之前在EPSRC的研究资助下发明了一种新型材料，这种材料在强度、柔韧性和生物降解方面具有独特的性能。事实上，机械性能可以精确地选择，以匹配软骨或骨头。这种材料也可以自愈。当3d打印时，这种材料能够指导软骨细胞产生关节软骨而不是纤维软骨。帝国创新公司提交了一项专利，提供了强大的知识产权地位。我们的医疗影响合作伙伴关系将带来生物力学、精密外科、医疗设备制造、技术转让和监管程序以及产品交付方面的专业知识。该团队将对该设备进行评估并开发制造能力，以生产具有成本效益、可靠和有效的医疗设备。手术将在尸体膝盖上进行测试，以确定它们是否适合，并确保它们能够提供即时的关节表面。然后，生物学测试将确定我们的假设，即该装置是否可以在关节载荷下引导软骨再生。最终，外科医生将能够将植入物的设计规格发送给医疗设备公司，并在几天内收到定制的、针对患者的设备。

No current surgical technique can regenerate articular cartilage and no current device can mimic the properties of cartilage. This Partnership will accelerate delivery of an innovative medical device for healing cartilage that will cross a frontier in orthopaedic surgery, allowing regeneration of articular cartilage rather than replacement. The device will restore cartilage to its healthy state. The surgical technique will be optimised through a new precise and minimally invasive keyhole technique. Patients will be able to use their knee immediately after the operation and recovery time will be rapid. Osteoarthritis affects 1 in 4 people, is debilitating and costs >£3bn in UK lost economic productivity, >£2.4bn in out-of-work benefits and contributes to the NHS's £5.4bn annual spend on musculoskeletal disorders. Current treatment for severe osteoarthritis is total joint replacement and current best practice for cartilage impact damage is microfracture, which involves drilling into bone to liberate the marrow, which can form weak fibrous cartilage over the defect. Early intervention is important as complete degeneration results in total joint replacement. The problem is that the cartilage only lasts 2-5 years before the procedure must be repeated and total joint replacements are major operations, which involve removing a lot of tissue, and last 15-25 years. Previous EPSRC research grants by Jones led to the invention of a new type of material that produced unique properties in terms of strength, flexibility and biodegradation. In fact, the mechanical properties can be precisely selected to match cartilage or bone. The material can also self heal. When 3-D printed, the material is able to instruct cartilage cells to produce articular cartilage rather than fibrous cartilage. Imperial Innovations submitted a patent, providing a strong IP position. Our Healthcare Impact Partnership will bring expertise in biomechanics, precision surgery, medical device manufacture, technology transfer and regulatory procedures and product delivery. The team will evaluate the device and develop manufacturing capability, producing cost-effective, reliable and effective medical devices. Surgery will be tested in cadaver knees for how they fit and ensure they can provide an immediate articular surface. Then, biological testing will determine whether our hypothesis that the device can guide the regeneration of the cartilage under joint loading. Eventually, surgeons will be able to send implant design specifications to the medical device company and receive a bespoke, patient specific device within a few days.