Osteoarthritis Technology NetworkPlus (OATech+): a multidisciplinary approach to the prevention and treatment of osteoarthritis

在英国，每年有超过875万人因骨关节炎(OA)而寻求治疗。它影响13%的55岁-和70%的65-74岁的人，以关节疼痛和软骨丧失为特征，涉及关节负荷、形状和结构的变化。这些因素与导致关节炎退变和疼痛的潜在分子机制之间的联系尚不清楚。我们对导致骨性关节炎关节退变的过程缺乏了解，阻碍了对那些有发展为骨性关节炎风险的患者的及时诊断，并阻碍了最佳治疗。手术、康复和疼痛管理通常用于与骨性关节炎和肌肉骨骼(MSK)疾病相关的疼痛和残疾患者；然而，对于相当大比例的患者来说，治疗结果并不理想。如果临床医生能够预测哪些患者对哪种治疗形式的反应最好，这将允许进行具有临床和健康经济效益的量身定制治疗。患者将在正确的时间得到正确的治疗，避免疼痛和不适当的手术或康复。目前缺乏(1)适当的实验和临床相关工具来监测关节结构、生物力学和代谢的细微变化，以便早期发现骨性关节炎；(2)通过有针对性的药物、手术和康复干预进行疾病控制，作为标准做法；(3)手术和康复干预措施的有效性。该网络将解决这一问题，以引发未来诊断和治疗骨性关节炎所需研究的颠覆性变化，确保这一高影响疾病的国际竞争力。它包括70多名学术、临床和工业界英国和国际参与者，他们拥有人类、动物和细胞实验和建模方面的经验和专业知识；数据和成像分析，为医疗设备的安全性和有效性提供高水平证据，并将工程技术、生物力学和生物学融入临床研究，具有强大的最终用户指导性。它将促进新的机制，将研究学科联系起来，并通过技术、工程和物理科学的进步发展MSK研究领域。通过确定英国研究必须解决的技术发展挑战和障碍，它将确保未来的研究包含必要的科学进步，与临床和生物解决方案相结合，通过诊断、预测和基于证据的干预来优化治疗。治疗分类将指导未来治疗方法的发展，以提高疗效、恢复功能、优化手术并利用健康自我管理。网络活动，从人的发展(学科跳跃、创新奖、学生)、创意产生(沙坑、黑客松)、网络(研讨会、会议)；外联(展览、科学咖啡馆S)；资助的旗舰、可行性项目(通过第一年的网络活动)和具有创新和影响潜力的想法将确保成功，并展示工程师、物理和计算机科学家、生物学家和临床医生如何合作优化、审查和设置研究，这些研究整理生物力学、临床、患者和生物信息，用于技术开发和验证实验和临床工具和目标。通过嵌入在OA/MSK技术研究方面具有经验的生物医学工程社区，以及领导动物、细胞和患者研究的关键临床医生和生物学家，确保影响和翻译。用户参与和管理将通过临床和行业合作伙伴、患者公共参与和公共卫生链接提供支持。衡量成功的标准是研究(研究收入、高影响力论文)、在启动新的跨学科研究人员和最终用户方面开展新合作的有效性；以及从事开放式获取研究的新学者、研究员、学生和公众成员。

In the UK, over 8.75 million people seek treatment for osteoarthritis (OA) each year. It affects 13% of people aged 55-64 and 70% aged 65-74, is characterised by joint pain and loss of cartilage and involves joint loading, shape and structure changes. The links between these factors and the underlying molecular mechanisms that lead to arthritic degeneration and pain are not well understood. Our lack of understanding of the processes that drive joint degeneration in OA prevents timely diagnosis for those at risk of developing OA and hinders optimal treatment. Surgery, rehabilitation and pain management are commonly used for patients with pain and disability associated with OA and musculoskeletal (MSK) disorders; however for a significant proportion of patients, treatment outcome is sub-optimal. If clinicians could predict which patients respond best to which form of treatment, this would allow tailored treatment with clinical and health economic benefits. Patients would get the right treatment at the right time, avoiding pain and inappropriate surgery or rehabilitation. There is a currently a lack of (i) appropriate experimental and clinically relevant tools to monitor subtle changes in joint structure, biomechanics and metabolism for early OA detection; (ii) disease control via targeted drug, surgical and rehabilitation intervention, as standard practice; (iii) validation of surgical and rehabilitation interventions. The Network will address this to trigger the disruptive change in research necessary for future diagnosis and treatment of OA, ensuring international competitiveness for this high impact disease. It includes over 70 academic, clinical and industry UK and international participants with experience and expertise in human, animal and cell experimentation and modelling; data and imaging analysis to provide high-level evidence for safety and efficacy of medical devices and incorporating engineering technology, biomechanics and biology into clinical studies with strong end user steerage.It will facilitate novel mechanisms to link research disciplines and develop the MSK research area through advances in technology, engineering and physical sciences. By identifying challenges and barriers to technology development that UK research must address it will ensure future studies encompass the necessary scientific advances, fused with clinical and biological solutions to optimise treatment via diagnosis, prediction and evidence-based intervention. A treatments taxonomy will direct the development of future therapies to enhance efficacy, restore function, optimise surgery, and exploit self-management of health.Network activities, from people development (discipline-hopping, innovation awards, studentships), ideas generation (sandpits, hackathons), networking (seminars, conferences); outreach (exhibitions, science cafés); funded flagship, feasibility projects (informed by network activities in year one) and ideas that have high potential for innovation and impact, will ensure success and demonstrate how engineers, physical and computer scientists, biologists and clinicians team up to optimise, review and setup studies that collate biomechanics, clinical, patient and biological information for technology development and validation of experimental and clinical tools and targets. Impact and translation are guaranteed by embedding the Biomedical Engineering community with experience in OA/MSK technology research, with key clinicians and biologists who lead research in animal, cell and patient based studies. User engagement and steerage will be supported via clinical and industry partners, Patient Public Involvement and Public Health links. The metrics for success are research (research income, high impact papers), effectiveness in initiating new collaborations in terms of new cross-disciplinary researchers and end-users; and new academics, fellows, students and members of the public engaged with OA research.