Research to practice: Clinical Translation

Richie H. S. Gill, Professor, Department of Mechanical Engineering/Centre for Therapeutic Innovation, University of Bath, Bath

Osteoarthritis (OA) is a leading cause of global Years Living with Disability (YLD) with knee OA accounting for 85% of the burden. Over 57m people in Western Europe suffer from OA, this number has grown by 54% since 1990. About 45% of the people that suffer from OA are under the age of 65. Knee replacement is an effective treatment but is only suitable for end-stage disease and generally not recommended for people under the age of 65; this leaves many people suffering with pain and disability for over a decade. High Tibial Osteotomy (HTO) is a demonstrated clinically effective treatment for early knee OA, but its use has declined in part due to increased surgical confidence in knee replacement. HTO surgical technique is challenging and outcomes are dependent upon correction accuracy, and these issues are barriers to the treatment being widely offered by surgeons. A key advantage of HTO is that it can be used at considerably earlier stages of knee OA and is particularly suited to younger people. This talk details the programme of work done to create a new personalised HTO treatment aimed at addressing the barriers of surgical technique and correction accuracy.

Andrew Duckworth, Senior Clinical Lecturer at the University of Edinburgh and an Honorary Consultant Orthopaedic Trauma Surgeon at the Royal Infirmary of Edinburgh

Despite being one of the most common injuries around the elbow, the optimal treatment of olecranon fractures is far from established and stimulates debate amongst the surgeons who manage them. Internal fixation with wires, or plates and screws, is recommended for the vast majority of displaced fractures. However, concerns have been raised regarding the complication profile of these procedures, which are largely related to symptomatic metalwork resulting in high rates of further surgery for implant removal. This talk will cover the biomechanical and clinical literature highlighting these issues, which has led to the development of alternate techniques, one of which is now being assessed as part of a UK wide multi-centre clinical trial.

Bob Reuben, Professor Emeritus, School of Engineering and Physical Sciences, Heriot-Watt University

Alan McNeill, Hon. Professor University of Edinburgh and Heriot-Watt University, Consultant Urological Surgeon, Western General Hospital, Edinburgh

In this brief presentation, we will trace the (as-yet incomplete) journey from UK funding council research, through spin-out formation and early stage translational funding to commercialisation of a medical device. The device in question is a palpation-based actuator/sensor used to make an in vivo assessment of dynamic stiffness of the prostate gland. The application is for early stage screening for prostate cancer. The particular hurdle to overcome is to ensure that the negative predictive value is sufficiently high that we can bridge the gap between elevated PSA in a blood test (or other concern) and a biopsy, thus reducing the number of unnecessary biopsies. We are now embarking on seeking (the considerable amount of) funding needed to realise the potential of the device and will share some of the challenges involved in this.