EPSRC - NIHR Healthcare Technology Co-operative (HTC) Partnership Award - Unify: A network focused on the treatment of fracture non-unions

Lead Research Organisation: Loughborough University
Department Name: Wolfson Sch of Mech, Elec & Manufac Eng

Abstract

This proposal is tightly focussed on addressing major unmet clinical needs in the repair and rehabilitation of non-union fractures, in particular for long-bone and cranio-facial trauma. A non-union is a broken bone that fails to heal. These result from both civilian and military injuries including the consequences of cancer and lead to pain, suffering and loss of dignity. Our aim is to create a co-ordinated self-sustaining network linking the Trauma HTC and other major UK clinical research centres, both civilian and military, in order to pull solutions from the science and technology research community and assist their translation to the clinic. The network will link with centres of expertise and research excellence in healthcare technologies supported by EPSRC and others, and to industry and other key stakeholders including patients. This network will ensure, by a programme of activities with both proven and novel components, that these disparate communities are empowered to explore together those areas where new scientific and technological opportunities have the promise to resolve important clinical problems.

Planned Impact

The network will build upon, and enhance, the existing relationships between Loughborough, Birmingham, Nottingham, Keele, Oxford, and Southampton Universities. It will construct a coherent and collaborative network linking the scale and depth of the culture of challenge-led, customer-driven applied science, engineering and industrial partnership embedded in all of our participant universities with the clinical needs of the University Hospitals of Birmingham NHS Foundation Trust Trauma Management HTC, the Botnar Research Centre (a part of the Nuffield Department of Orthopaedics, Oxford), The Royal Orthopaedic Hospital (Birmingham), the Joint Medical Command Royal Centre for Defence Medicine and the Defence Medical Rehabilitation Unit (Headley Court) together with the Arthritis UK Research Centre for Sport, Exercise and Osteoarthritis (Nottingham). The network will pull solutions from the science and technology research community meeting clinical needs and assisting their translation to the clinic. We will expand the network through engagement with additional academic collaborators / beneficiaries from complementary centres of expertise both in the UK and internationally as well as with further clinical and industry stakeholders. It is envisaged that patients will be the key beneficiaries of this network, and their opinions will be sought through PPI groups, from open-meetings, via clinician groups and the HTC itself.

The outputs of the network will be:
- A shared roadmap in order to assess and map scientific opportunity against clinical requirements in both the military and civilian arena;
- Three Requirements Documents describing current treatment modalities and identifying the need which any new technology and treatment must address;
- Pump-priming funding (£60,000 in total) distributed in a peer-reviewed manner to permit teams to progress their ideas in order to ultimately deliver adoptable science-based technology solutions;
- A web presence to aid knowledge exchange, continuation and dissemination as well as stimulating discussion;
- The development of young researchers in the requirements and commercialisation of treatments in this area.

It is estimated the average national cost of civilian acute care for non-union is £3.2 million (NICE January 2013) with correspondingly high long-term care costs and higher costs for military rehabilitation. Resolution of the non-union problem will ultimately bring public health benefit and individual patient benefit by improved health outcomes and personal quality of life, and economic benefit both by the commercialisation of products for non-unions and by permitting those with non-unions to return to economic activity.

Publications

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Description This project is tightly focussed on addressing major unmet clinical needs in the repair and rehabilitation of non-union fractures. A non-union is a broken bone that fails to heal. These result from both civilian and military injuries, including the consequences of cancer, and lead to pain, suffering and loss of dignity. Our aim was to create a co-ordinated self-sustaining network linking the NIHR Trauma Health Technology Co-operative and other major UK clinical research centres, both civilian and military, in order to pull solutions from the science and technology research community and assist their translation to the clinic.
Exploitation Route It is anticipated that the network will continue to deliver improved problem statements and that these in turn will lead to both pilot projects and larger projects where further funding is sought from research councils and others. The network is a collaboration of clinical, industrial and science based partners and is well positioned to take things forward. The successful funding of the EPSRC UNIFYPLUS network is a key mechanism to allow the funding of pilots.
Sectors Healthcare,Manufacturing, including Industrial Biotechology,Pharmaceuticals and Medical Biotechnology

 
Description UNIFY has delivered six significant events. The first was a clinically dominated stakeholder event (29/5/14, Queen Elizabeth Hospital, Birmingham) that shared the objectives of the network and defined a 'plan of campaign' for execution. This was followed by a launch event (1/12/14, Queen Elizabeth Hospital, Birmingham) to brief the community on civilian and military non-unions from a surgical and rehabilitation perspectives. An 'early wins sandpit' (29-30/1/15, Nottingham University) initiated work in key areas in particular in assessing fracture healing by bone conduction of vibrations. Parallel studies by Mr Rajpal Nandra (Queen Elizabeth Hospital, Birmingham) have given increased resolution on occurrence and a systematic review of potential solutions (Newcastle University) has also been initiated. A mid-term information day was held (2/6/15, Royal Society of Medicine, London) to permit consolidation of the network thinking and emphasised the need to focus on fundamentals. A rehabilitation sandpit was also held (3-4/12/15, Loughborough University) this took account of concomitant injuries (including TBI) for military and young civilian trauma (and co-morbidities for the elderly). This has initiated work to create a wearable tool to quantify the percentage of weight bearing by a patient undergoing rehabilitation. A final sandpit joint with UNIFY Plus was held 25-26/9/16 focussing on the science of abnormal ossification of non-union. Outputs included the funding of a project within UNIFY to fund the development of a synthetic hematoma environment. Defence has dominated thinking because of the clarity of the importance of non-unions in military settings. In over 100 meeting attendances players from 13 Universities have been engaged (Loughborough, Birmingham, Aston, Bath, Keele, Imperial, Leeds, Newcastle, Nottingham, Oxford, Southampton, UCL, Warwick). A bid to extend the work of UNIFY to military and civilian disease states where excessive bone formation is a pathological feature has been successfully submitted to EPSRC.
First Year Of Impact 2015
Sector Healthcare,Manufacturing, including Industrial Biotechology,Pharmaceuticals and Medical Biotechnology
Impact Types Societal,Policy & public services

 
Description EPSRC-NIHR Parlnership Award Plus
Amount £451,851 (GBP)
Funding ID EP/N027221/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 04/2016 
End 03/2018
 
Description AC 
Organisation University of Oxford
Country United Kingdom 
Sector Academic/University 
PI Contribution Collaborative bid for follow-on funding
Collaborator Contribution Collaborative bid for follow-on funding; Patient access.
Impact Follow-on funding is being confirmed.
Start Year 2015