Biomechanical precision diagnostics in osteoarthritis

Project summary

Osteoarthritis (OA) is an age related joint disease and a leading source of disability affecting over 1.2 million Dutch citizens. There is no cure and at best we can offer modestly effective symptomatic treatments.

We aim to introduce novel in-vivo precision-diagnostics of biomechanical disturbances in OA by using high-speed dual fluoroscopy. This method enables us to precisely quantify in-vivo intra-articular joint motions during joint load and is not yet available in the Netherlands. Combined with muscle forces, joint shape, and morphology by MRI, we will create robust patient-specific biomechanical models that we will use as inputs into computerized finite element models. We then can explore how the biomechanical features all interact and influence joint motions and forces, and which interventions might favorably alter biomechanics. In this program we therefore will:

1.Realize a bi-planar fluoroscopy setup to measure precision knee kinematics combined with measurements of reaction forces and EMG.

2.Develop a comprehensive and personalized biomechanical model to precisely estimate meaningful biomechanical parameters of intra-articular tissue load in post-traumatic knees (high-risk group for OA) and in early stage knee OA.

3.Validate the precise biomechanical parameters of intra-articular tissue load as an intermediate OA outcome measure.

After this program we will be able to apply precision diagnostics to assess biomechanical disturbances and we will have defined promising targeted biomechanical interventions that we can further investigate in clinical populations. We also will have a valid surrogate outcome measure to test these interventions against. These are long term innovative drivers to our research program that aims to comprehensively characterize each patient in order to provide early-personalized treatments in patients who are at high risk for OA initiation or progression.