10129279CoxAdjust - Digital Soft Tissue Balancing ToolClosedCollaborative R&DInnovate UKThe optimum range of a \`balanced' soft tissue tension within the hip joint is not simple to determine and subjective amongst surgical professionals during hip replacement surgery. It forms the basis for intraoperative evaluation of impingement, subluxation, dislocation and prediction of postoperative functional outcome. The current approach involves a sequence of dislocating the hip joint whilst applying axial traction to gauge the tightness of the reduction. This "shuck" test is subjective and reliant upon surgeon skill and expertise requiring support from back-table surgical personnel to manually exchange multiple femoral neck and head implant trials of different sizes. This increases the opportunity for dropped tools, loss of sterility and interference with surgeon concentration during joint manipulation. Therefore, successful soft-tissue balancing contributes towards accurate leg-length and offset reducing the need for a walking aid and/or unnecessary restrictions in daily activities during recovery. Our CoxAdjust is an autoclavable easy-to-clean femoral implant trial that uses a pair of leadscrews and sixteen adjustable segments to automatically and independently adjust length, offset and head diameter respectively during soft tissue balancing. The adjustment range is comparable with existing manual trials, however, it does not require multiple exchanges to achieve a stable and balanced hip. CoxAdjust also measures the forces exerted through the joint during trial adjustment to help achieve a balance between stability and mobility for a given range of motion. Our project team brings together a large (Smith+Nephew) and a small company (Industrial Design Consultancy) with combined expertise in medical device design, manufacture and micro-actuators. Collaboration with sub-contractor(s) Strain Measurement Devices and South Tees Hospital provides access to thin-film strain gauges and clinical governance respectively. Access to SMART funding will advance CoxAdjust from a lab-demonstrator to a device tested in cadavers. A successful outcome will propel CoxAdjust for internal funding and Class IIa and 510(k) registration.