IKC Annual Review 2016 1 | Page 18

Medical Technologies IKC | 18 WIDENING OUR IMPACT Biomimetic scaffold for cartilage repair Plans are underway for a ‘first in man’ clinical trial of a biomimetic PLGAtitanium scaffold which aims to repair large osteochondral defects before they cause osteoarthritis. The scaffold is being developed by a team from UCL and the Royal National Orthopaedic Hospital, in collaboration with Oxford MEStar Ltd and Collagen Solutions Plc. Early observations from an in vivo sheep condyle model show that the sheep recover well and long-term performance is being monitored. The scaffold was also used in a clinical dog shoulder model, in an operation performed by Channel 4’s ‘SuperVet’, Professor Noel Fitzpatrick. Post-operative scan results demonstrated that the scaffold has both the strength needed to bear the physical load of the joints and encourages consistent cartilage fill and a smooth articular surface. The team is assessing the pre-clinical performance of the scaffold using human tissue from patients undergoing joint replacement surgery and is preparing for clinical trials that will take place at Royal National Orthopaedic Hospital in Stanmore. “We’re very happy with progress to date and we’re confident the scaffold has the potential to address this unmet clinical need,” says UCL’s Dr Chaozong Liu, who leads the project. Arthroscopic device to identify early osteoarthritis Dr Jayesh Dudhia, from the Royal Veterinary College, together with chemists Professor Paul McMillan and Dr Steve Firth from UCL, are progressing a prototype arthroscopic device for surgeons to identify the early stages of osteoarthritis in articulating joints. The device uses Raman spectroscopy and incorporates an optical probe to detect a known biomarker of subclinical cartilage degeneration to inform treatment decisions in real time. An early design was successfully tested in four patients undergoing minimally invasive knee assessment. “For knee surgery, surgeons frequently perform partial replacements but these sometimes require revision surgery because it’s difficult to visually identify subclinical disease elsewhere in the joint,” says Dr Dudhia. “Our probe will help to make the right decision first time, which would be better for the patient and prevent the need for remedial surgery.” Proof of concept funding has progressed validation of the technology and the team is in discussions with a UK SME whose expertise could significantly amplify the true signal from the background noise to produce a simple, quantifiable signature which can be translated into a ‘traffic light’ system. The team is also discussing commercial development with a further UK SME with specialist manufacturing knowledge of orthopaedic devices.