Enabling Individualised Surgical Treatment of Osteoarthritis

实现骨关节炎的个体化手术治疗

基本信息

批准号：
EP/W003139/1
负责人：
Ruth Wilcox
金额：
$ 158.87万
依托单位：
University of Leeds
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2022
资助国家：
英国
起止时间：
2022 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=EP%2FW003139%2F1
关键词：
Enabling Individualised Surgical Treatment Osteoarthritis

项目摘要

Osteoarthritis affects over eight million people in the UK alone, with nearly three quarters of patients reporting some form of constant pain. Treatment for arthritis is estimated to cost the UK healthcare system over £10 billion per year, with significant additional societal costs for lost working hours and welfare payments.Although hip and knee replacement surgeries are considered successful, these treatments are not suitable for all patients and some devices fail early, requiring costly and less successful revision surgery. There are over 15,000 revision surgeries performed in the UK alone each year. Younger and more active patients, as well as rising numbers with obesity, are placing greater demands on these treatments: implants need to last for longer and withstand more extreme loading than ever before. There is evidence that both individual patient biomechanics and surgical choices influence the outcomes of these treatments. Improved outcomes, particularly for more challenging patient groups, can only be achieved by better matching the treatment to the functional requirements of the individual patient.This proposal will bring together complementary research expertise from two of the world's leading research institutes in the field to build the evidence needed to enable treatments for osteoarthritis to be better tailored to individual patient needs. The Institute of Medical and Biological Engineering at the University of Leeds has developed unique capability and expertise to evaluate artificial and natural joints. These include the world's largest academic facility for experimentally testing joint replacements, as well as computational modelling methods to simulate how implants perform in the body. These capabilities enable the mechanical performance of implants to be evaluated under a range of different conditions, for example to study how the implant wears over time or becomes damaged with usage.The Center for Orthopaedic Biomechanics at the University of Denver has developed world-leading capability in measuring patient joint mechanics in vivo, including methods of imaging patient joints as they undertake different activities, and parallel computational methods for deriving biomechanical information. These methods enable the forces and motions on an individual patient's hip or knee joints to be derived and, by collecting data on many patients, examine how these differ from one individual to another. By combining the expertise across both groups, this Centre-to-Centre Research Collaboration will enable relationships to be developed between an individual patient's characteristics (e.g. their anatomy and how they load their joints) and the mechanical performance of the implant. Specifically, in the hip we will combine methodologies developed at the two centres to evaluate how patient and surgical factors affect the risk of early failure in hip replacements due to the device components pushing into each other or the surrounding bone (impingement), or the way the components are aligned. We will also examine how different choices of implant can influence the outcomes. In the knee, we will combine methodologies to identify how patient factors (such as the anatomy of the knee and the way it is loaded during different activities) affect early-stage treatments for knee osteoarthritis. We will also examine the effects of a greater range of activities, such as squatting and stair climbing, on the outcomes of knee replacements. These studies will bring together different methodologies and build new pathways for acquiring and sharing data that can be adopted more widely and applied to other musculoskeletal systems in the future. The work will build the evidence needed to improve hip and knee implant design, inform clinical decision-making, enhance patient quality of life and reduce early complications.

仅在英国，骨关节炎就影响了超过 800 万人，近四分之三的患者报告称患有某种形式的持续疼痛。据估计，英国医疗系统每年要花费超过 100 亿英镑来治疗关节炎，而失去工作也会造成巨大的额外社会成本。尽管髋关节和膝关节置换手术被认为是成功的，但这些治疗方法并不适合所有患者，而且一些装置会过早失效，需要昂贵且不太成功的翻修手术。仅在英国，每年就会进行超过 15,000 例翻修手术。雅戈尔更活跃的患者以及越来越多的肥胖患者对这些治疗提出了更高的要求：植入物需要比以往更耐用并承受更极端的负载。有证据表明，个体患者的生物力学和手术选择都会影响结果。这些治疗方法的改善，特别是对于更具挑战性的患者群体，只能通过更好地将治疗与个体患者的功能需求相匹配来实现。该提案将汇集来自两个世界领先研究机构的互补研究专业知识。建立治疗所需证据的领域利兹大学医学和生物工程研究所开发了评估人工和天然关节的独特能力和专业知识，其中包括世界上最大的关节置换实验学术设施。以及模拟植入物在体内表现的计算建模方法，这些功能可以在各种不同条件下评估植入物的机械性能，例如研究植入物如何随着时间的推移而磨损或在使用过程中如何损坏。为了丹佛大学骨科生物力学在测量患者体内关节力学方面开发了世界领先的能力，包括在患者关节进行不同活动时对其进行成像的方法，以及用于获取生物力学信息的并行计算方法。获得单个患者的髋关节或膝关节，并通过收集许多患者的数据，检查这些关节之间的差异。通过结合两个小组的专业知识，这种中心对中心的研究合作将实现。具体来说，在髋关节中，我们将结合两个中心开发的方法来评估患者和手术因素如何影响。由于装置组件相互挤压或周围骨骼（撞击）或组件对齐方式而导致髋关节置换术早期失败的风险，我们还将研究不同的植入物选择如何影响膝盖的结果。，我们将结合方法论确定患者因素（例如膝盖的解剖结构及其在不同活动中的负载方式）如何影响膝骨关节炎的早期治疗，我们还将检查更大范围的活动（例如蹲下和爬楼梯）的影响。这些研究将汇集不同的方法，并建立新的途径来获取和共享数据，这些数据可以在未来更广泛地采用并应用于其他肌肉骨骼系统。这项工作将为改善髋关节提供所需的证据。和膝关节植入物设计，为临床决策提供信息，提高患者的生活质量并减少早期并发症。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A Finite Element Model to Investigate the Stability of Osteochondral Grafts Within a Human Tibiofemoral Joint

DOI：
10.1007/s10439-024-03464-6
发表时间：
2024-03-06
期刊：
ANNALS OF BIOMEDICAL ENGINEERING
影响因子：
3.8
作者：
Day，Gavin A.;Jones，Alison C.;Wilcox，Ruth K.
通讯作者：
Wilcox，Ruth K.

Inertial Tracking System for Monitoring Dual Mobility Hip Implants In Vitro.

DOI：
10.3390/s23020904
发表时间：
2023-01-12
期刊：
Sensors (Basel, Switzerland)
影响因子：
0
作者：
通讯作者：

Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients.

步态过程中的动态髋臼杯定向：对快走和慢走全髋关节置换患者的研究。

DOI：
10.3390/bioengineering11020151
发表时间：
2024
期刊：
Bioengineering (Basel, Switzerland)
影响因子：
0
作者：
Vasiljeva K
通讯作者：
Vasiljeva K

Impingement in total hip arthroplasty: A geometric model.

DOI：
10.1177/09544119211069472
发表时间：
2022-02-11
期刊：
Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine
影响因子：
0
作者：
Pryce GM;Sabu B;Al-Hajjar M;Wilcox RK;Thompson J;Isaac GH;Board T;Williams S
通讯作者：
Williams S