Developing capacity for assessment of early interventions in the hip

Hip osteoarthritis causes debilitating pain and function loss. Current treatment includes pain relief, then possibly early intervention surgery if a patient is less than 50 years old and has a bony deformity accelerating osteoarthritis progression, and finally total hip replacement (THR). Significant scope to optimise early interventions exists by developing novel computational and anatomical experimental simulations that will enable stratification of patient variables related to their effect on outcomes, and inform the surgical intervention.
The hip is a ball and socket joint with conforming cartilage surfaces, and the acetabulum socket is deepened by a fibrocartilage rim (labrum). Factors associated with hip damage include trauma, labral tears and extremes in anatomical shape including femoroacetabular impingement (where there is excessive bone at the anterior neck-head junction or a deepened acetabulum) and dysplasia (shallow, less constraining acetabulum).
In both conditions, there is scope for surgery to restore more "normal" contact mechanics reducing bony impingement and repairing the labrum. These interventions are rapidly increasing in frequency, but support for technique efficacy is limited, with a lack of scientific evidence to demonstrate the extent of the intervention that might indicate patient benefit. Research to date in the iMBE has demonstrated the potential for whole joint natural hip testing in a hip simulator (Pallan PhD thesis) and parametric geometric analysis in computational models (Cooper et al, Numerical Method in Biomedical Engineering, 2017). The aim of this project is to develop and assess experimental simulations of the natural hip joint that can inform early intervention hip surgery to optimise patient outcomes.