| Abstract |
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. |
