Project Title: Clinical-Engineering Post-Market Surveillance of Growing Spine Rods
Degree Level: PhD (note all UCL students first register as MPhil students)
Primary Supervisor: Prof Alister Hart
Secondary Supervisor: Dr Harry Hothi
Research Site: Implant Science Centre, University College London, Royal National Orthopaedic Hospital, Stanmore, UK.
Funding: Fully funded (UK fees & stipend) 3-year project.
Start Date: October 2023 (this is flexible).
Contact: [Email Address Removed]
Introduction
Come and join the exciting area of bioengineering research to help innovate orthopaedic implant technology. During this fully funded studentship you will work in the leading medical implant retrieval research group, at the largest university in Europe, onsite at the largest orthopaedic hospital in the UK.
The best orthopaedic engineers are those that can put clinical meaning to their measurements. To train you for this, you will regularly visit operating theatres, multi-disciplinary clinical team meetings (led by surgeons, radiologists and arthroplasty practitioners) and have opportunities to interact with patients. You will work from data from blood tests and medical imaging (e.g. X-rays and CT scans) and use this to interpret your engineering analysis.
Career Opportunities
You will complete this PhD with: (1) a track-record of peer-reviewed publications, (2) an expertise in clinical-engineering analysis methods and (3) an ability to interact with engineers and surgeons of all levels. This unique PhD will offer a strong foundation for building an academic career but equally, your experience will position you very well for a successful career in industry, where clinical knowledge in engineers is sought after (we have worked with all major orthopaedic manufacturers).
Background to the Project
Magnetically Controlled Growing Rods (MCGRs) are used in the surgical treatment of children with early onset scoliosis (EOS). These rods are used to brace the spine and minimise the progression of scoliosis as the child grows. An external magnet is used to extend the length of the rods, in line with the growth of the child.
MCGRs are one of several ‘growing rod’ devices available to surgeons to treat their EOS patients. The majority of these, including MCGRs, are composed of titanium alloy. MCGRs have been the subject of several Field Safety Notices (FSNs) issued by the UK based Medicines and Healthcare products Regulatory Agency (MHRA), primarily due to evidence of wear and corrosion of the device.
Measuring the levels of metals in blood samples captured from these patients may help us identify which patients have rods that have begun to wear and/or corrode. Relating this blood metal ion data to clinical and imaging data from the patient will help to establish the role of blood metal ion testing as a ‘biomarker’ for function of the rods. Finally, by analysing the retrieved rods after they are removed from the patient, we will be able to understand the source of the metal ions measured and the precise mechanisms by which they are released into the patient.
This use of blood metal ion testing will be applied to other growing rod constructs to investigate the differences in blood metal levels between patients implanted with different designs.
Aim and Objectives
The overarching aim of this project is to establish the role of blood metal ion testing as a biomarker for function of growing spine rods used in children with early onset scoliosis. This will be achieved through analysis of metal ion data captured from patients with different growing rod designs as part of a prospective, longitudinal study. You will compare this data with clinical and imaging data for each patient. Following removal of the rods from patients, you will perform detailed engineering analysis of each device to determine the extent and mechanism of any wear/corrosion that may have occurred.
This clinical-engineering data will be combined to enhance the post-market surveillance of these devices.
Key Milestone Requirements of the Project
You will be encouraged to attend UCL courses (e.g. in research study design, good clinical practice, medical statistics, time management, paper writing).
Your thesis will consist of at least 4 well-developed chapters, in addition to chapters discussing a detailed literature review, introduction and discussion. You will be expected to publish peer-reviewed papers for each chapter of your thesis.
Impact of the Project
This research will inform manufacturers, surgeons and regulators about the utility of blood metal ion testing as a means of post-market surveillance of growing spine rods. It is expected that the data generated from this project will contribute to changes in how patients with these devices are monitored, helping to identify sooner those patients likely to develop implant related issues. This data will also help inform manufacturers about how to improve future designs to minimise the extent of wear/corrosion in situ.
Track Record
This PhD project will take place at the Implant Science Centre, based on site at the Royal National Orthopaedic Hospital (RNOH). This lab is leading research in understanding failure in orthopaedic implants. Since 2007, we have collected over 10,000 spine, hip and knee components from 29 countries, published 130 papers in peer-reviewed journals with 200 co-authors and been cited more than 3,000 times. Our worldwide surgeon network consists of over 150 surgeons.
The RNOH is the largest orthopaedic hospital in the UK with over 1,500 NHS and UCL staff working together. There are 300 hip and knee revision procedures performed annually here and 20% of all UK orthopaedic surgeons will have some form of training here.
The successful candidate will join a highly motivated team, and all research students have access to training and personal development opportunities offered by UCL across a wide range of campuses. The student will interact and build working relationships with other engineers, scientists, orthopaedic surgeons and other clinicians.
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