Functional Evaluation of the Meniscus and Meniscus Replacement using MRI

The knee is the most common site for osteoarthritis, affecting over 4 million people in the UK alone.
The aim of this PhD study is to develop new methods for examining the human knee joint under load, including through the use of magnetic resonance imaging (MRI). The particular focus is on the meniscus, a fibrous horseshoe-shaped soft tissue that sits between the two cartilage surfaces of the knee joint. Both damage and degeneration of the meniscus are linked to the progression of osteoarthritis. A number of surgical techniques have been developed to repair or replace damaged meniscal tissues, however their mechanical performance has no tyet been rigorously evalauted to define which patient groups they are most suitable for.
The techniques developed in this PhD will be used to evaluate the mechanical performance of meniscus replacement grafts, in comparison to the natural healthy joint. The main objectives of the PhD will be to develop a novel loading system that can be used to apply physiological loading states to cadaveric knees within an MRI machine, alongside the necessary image analysis and computational modelling tools to be able to determine the meniscal deformations under different loading states. The methods developed will then be used to evaluate the performance of the natural meniscus and meniscus grafts under different patient and surgical variables. The results will provide greater insight into the performance of the meniscus within the knee capsule, and under what cases healthy biomechanics can be restored through use of meniscal grafts. These results will provide evidence for future graft design and for surgical decision making around graft selection and placement.