About the Project
Summary:
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 (ranked 1st for Bioengineering), onsite at the largest orthopaedic hospital in the UK.
You will use state-of-the-art measurement technology and work directly with leading orthopaedic surgeons to develop novel implant analysis methods. You will have access to engineering equipment and expertise across all UCL sites (e.g. at Stanmore and central London).
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 develop an understanding of the use of blood tests and imaging (e.g. X-rays and CT scans) in helping 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 implant 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:
The recall of the DePuy ASR hip replacement devices in 2010 is the largest in the history of orthopaedics, having impacted more than 96,000 patients. There has been much speculation about the reasons for failure, with an emphasis on the role of the acetabular cup design. However, 7 years following the recall, the surgical, implant and patient (SIP) factors associated with the higher revision rates are still poorly understood.
This PhD project marks the culmination of a 5-year worldwide retrieval programme run independently by the London Implant Retrieval Centre (LIRC) which has seen the collection and analysis of 6,000 failed ASR components. A large subset of these have been collected together with very detailed and complete clinical and imaging data for each patient. This offers a unique opportunity to untangle the SIP factors influencing failure and identify differences between the stemmed and resurfacing design of this hip. In particular, this project will investigate the role of damage at the junction between the femoral stem and head in the total hip replacements.
Aim
The overarching aim of this project is to understand why the ASR hip design had a higher revision rate than any other contemporary hip replacement design.
To answer this, the following research questions will be considered:
1. How does the volume of metal lost from the bearing and taper junction surfaces of these hips compare with hips of other similar designs?
2. What are the surgical, implant and patient factors associated with increased material loss at the bearing and taper surfaces?
3. Does the tapered head-stem junction explain differences in revision rates between the ASR-XL and ASR resurfacing?
Key Milestone Requirements of 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.
Track Record
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. It houses the largest spinal injuries centre in Europe and a £25 million academic centre is planned to open in early 2019.
The successful candidate will join a highly motivated team in the Biomedical Engineering hub, consisting of over 20 PhD students and post-doctoral researchers supported by 2 professors, 2 senior lecturers, 2 lecturers and 3 senior technicians. 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.