Biomaterials for Joint Soft Tissue Repair - Improving Health in Older Age

Osteoarthritis (OA) is a global condition and the most common degenerative joint disease. OA has a significant economic impact and is a major cause of functional disability in older adults. More than 25% of Caucasian and Chinese people over the age of 50 years have symptomatic OA of one or both knees and this incidence increases with age. As the longevity of a population increases there is a greater need to extend the length of an individual's economic working life and societal contributions. There is a clinical need for a cost-effective method to prolong the functional pain-free life of OA joints to maintain or restore patient mobility and independence and therefore quality of life.
This project proposes to develop a novel osteochondral implant for the treatment of osteoarthritis and traumatic lesions of the articular cartilage (to delay onset of OA). This will be an 'off the shelf', cell-free product that supports the regeneration of articular cartilage and bone tissue. Building on existing expertise and experience, we will develop water-containing poly-vinyl alcohol materials with inclusions of bioceramics (bony attachment), hyaluronic acid (viscosupplementation), and biological actives. By controlling the structure-properties relationship of our materials, through use of polymer chemistry and processing, we will also control the mechanical and gelation behaviour of these materials. In addition, this polymer system is highly biocompatible and is also known to have properties suitable for controlled release of biologically active compounds.

Osteoarthritis is a currently incurable condition and a leading cause of functional disability and loss of independence in older adults globally, causing significant economic impact (1-2% GDP). This project proposes a novel cell-conducting osteochondral implant for the treatment of osteoarthritis and traumatic lesions of articular cartilage, which have a similar prevalence in Chinese and Caucasian populations. The implant is a polyvinyl alcohol-based hydrogel nanocomposite, which exhibits compositional/structural regions that mimic the appropriate biomechanical properties of the different regions of native tissue (i.e. subchondral bone, mineralised cartilage and cartilage) and support regeneration of cartilage tissue in situ. This implant should extend the pain-free function of osteoarthritic joints, thereby enhancing patient quality of life and mobility while reducing patient demands on health and social support services. In addition, the need for total joint replacement, with its potential problems of prosthesis loosening and limited lifespan, would be delayed.
This collaboration brings together the requisite multidisciplinary and complementary strands of research, and essential scientific expertise, from the partner institutions into a world class team to conduct the project. The proposal builds on links made through the existing RCUK Science Bridges China programme and will receive additional support through the RCUK Global Exchanges programme.

Osteoarthritis is the most common of the degenerative joint diseases and represents a significant challenge to modern medicine globally and a significant economic impact: 1-2% of GDP in industrialised countries. Pharmacological and common surgical interventions give valuable symptomatic relief but do not significantly arrest further joint degeneration. The introduction of conservative therapies that can restore function and relieve pain without compromising any future total joint replacement, as outlined here, has enormous potential for tackling the issues associated with joint degeneration and consequential loss of the patient mobility. Restoring mobility will benefit the patient's wellbeing, quality of life and employability while lowering their demands on health care and social support services. In addition, use of the implant described above should delay and may prevent the clinical need for a total joint prosthesis. Delaying the need for joint replacement surgery provides patient benefit as well as reducing long-term healthcare costs and extending the patient's active contribution to society. Ultimately, if further in vivo animal trails and human clinical trials show the biomaterial implant developed in this project to have good efficacy, both European and Chinese medical device sectors could benefit.