Optimising knee therapies through improved population stratification and precision of the intervention

我们的目标是让膝盖疼痛的患者在正确的时间接受正确的治疗。在英国，45岁以上的人中有三分之一寻求骨关节炎的治疗，这种疾病每年花费NHS超过50亿英镑。膝关节是骨关节炎最常见的部位，仅在英国就有400多万患者。随着老龄化人口对更积极的生活方式的期望，加上对更年轻、更活跃的患者治疗需求的增加，对目前的膝关节退行性变治疗提出了挑战。目前主要需要有效的早期干预措施，以延迟或预防全膝关节置换术的需要。病人的膝盖和它们的功能有很大的差异，在开发治疗方法时考虑到这种差异是很重要的，这样正确的治疗才能与正确的病人相匹配。通过这项雄心勃勃的研究计划，我们将开发新的测试方法，结合实验室模拟和计算机建模来预测膝关节新疗法的机械性能，并使其设计和使用得到优化。重要的是，这些测试将考虑到患者解剖结构和膝关节生物力学的变化，以及设备设计和手术技术的变化。这将使不同的疗法或设备的不同变体能够与不同的患者群体相匹配。这些工具将应用于现有的治疗，使用临床数据来帮助验证我们的模型预测是正确的。结果将更好地确定哪些患者将从特定的干预中受益，并帮助优化他们的使用。然后，我们将把这些方法应用于新的和新兴的治疗方法，包括再生设备，以便在进行昂贵的临床试验之前对它们进行测试和优化。我们将使用这些例子作为案例研究，展示新的检测方法如何在产品到达患者之前优化产品，我们将与行业，标准机构和监管机构合作，促进整个行业采用这些方法。该项目将使患者、英国国民健康保险制度以及正在发展的英国工业和科学基地受益，这些工业和科学基地正在开发新的膝关节治疗方法。

Our vision is that patients with knee pain receive the right treatment at the right time.In the UK, one third of people aged over 45 have sought treatment for osteoarthritis, and the disease costs the NHS over £5 billion per year. The knee is the most common site for osteoarthritis, with over four million sufferers in England alone. The aging population with expectations of more active lifestyles, coupled with the increasing demand for treatment of younger and more active patients, are challenging the current therapies for knee joint degeneration. There is a major need for effective earlier stage interventions that delay or prevent the requirement for total knee replacement surgery. There are large variations in patients' knees and the way that they function, and it is important that this variation is taken into account when treatments are developed, so that the right treatment can be matched to the right patient. Through this ambitious programme of research we will develop novel testing methods that combine laboratory-based simulation and computer modelling to predict the mechanical performance of new therapies for the knee and enable their design and usage to be optimised. Importantly these tests will take into account the variation in patients' anatomy and knee biomechanics, as well as variations in device design and surgical technique. This will enable different therapies, or different variants of a device, to be matched to different patient groups.The tools will be applied to existing treatments using clinical data to help validate that our model predictions are correct. The outcomes will better define which patients will benefit from a particular intervention and help optimise their usage. We will then apply the methods to new and emerging treatments, including regenerative devices, so that they can be tested and optimised before costly clinical trials take place. We will use these examples as case studies to demonstrate how the new testing methods can optimise the products before they reach the patient, and we will work with industry, standards agencies and regulators to promote the adoption of these methods across the sector. This programme will benefit patients, the NHS and the growing UK industry and science base that are developing new therapies for the knee.