Innovative Research. Moving Results.
Orthopaedic care is recognized the world over as one of the greatest healthcare challenges of the 21st century. Approximately 11 million Canadians are living with impaired mobility and disabling pain. It is estimated that up to one-half of women and one-third of men over age fifty are affected by fragility fractures as a result of osteoporosis. One in three adults will be affected by arthritis during their lifetime.
Today, an estimated 20,000 Canadians are waiting for hip or knee replacement surgery. An increasing rate of joint replacement in middle-aged adults, combined with longer life expectancies, is placing new pressure on the design of joint replacement technology. While replacement remains the treatment of choice for severely damaged joints, today’s metal and plastic replacements have a limited lifespan and are not practical for active adults younger than 55. Many live in suffering without any surgical treatment options at all.
Immobility and suffering impose a substantial economic burden on patients, their caregivers, and society. A new wave of minimally invasive, early repair procedures is needed to improve orthopaedic care.
The Human Mobility Research Centre is a leader in pioneering innovative treatments for damaged bone and joint tissues. The combined expertise of the Centre’s researchers has fuelled significant advances in repairing and reconstructing bone, cartilage, and other tissues that are critical to mobility. We foresee a future where computer-based treatment strategies, tailored to each individual patient, will lead to vast improvements in the early diagnosis of bone and joint degeneration, the treatment of complex fractures, as well as joint reconstruction.
Pioneering Research from Laboratory Bench to Bedside
Focusing on practical challenges identified by clinical faculty, the Centre employs a unique multidisciplinary approach in the development of innovative treatments for bone and joint disorders. A core staff of eight professionals facilitates the interaction of over forty-two participating faculty members and over fifty graduate students from the faculties of Engineering and Applied Science, Arts and Science, and Health Sciences, working together in integrated multidisciplinary research teams.
The Centre’s ground-breaking work in computer assisted orthopaedic surgery illustrates how information technology can be combined with engineering technology in the operating room. In a computer assisted orthopaedic procedure, a three-dimensional image of the damaged area is first obtained using computed tomography (CT) scan. This patient scan is presented as a 3D model to the surgeon on the computer screen, and allows the surgeon to determine the proper placement of tissue and implants, and to plan the proper position and orientations of the surgical tools. Finally, in the operating room, a computer vision tracking system guides the surgeon to position the tools according to the surgical. The result is greater repair accuracy and improved patient outcomes.
These techniques underpin the Centre’s leadership in mobility research and innovation, fuelling rapid advances toward enhanced treatment methods for bone and joint damage. The Centre’s teams are now focusing on complex fracture management and methods for joint tissue repair using biomaterials and grafting. At the same time, tissue substitutes are being created that will fully integrate into the body, and techniques are being developed to detect early damage to joint tissues. Current team projects include:
Stem Cell-Based Tissue Engineering and Regenerative Medicine: The use of stem cells is an exciting new area of research, in which these naturally occurring cells can be stimulated to form almost any kind of tissue. New approaches are being developed to form cartilage and bone using stem cells from skin and fat tissue.
Tissue Repair Technologies: Tissue engineered cartilage repair involves the preparation of “constructs” composed of biocompatible support materials that are fabricated with an anatomically correct shape to replace the damaged portion of the joint of a particular patient. Harvested patient donor cells are then seeded in the construct and grown in the laboratory to produce strong, healthy replacement tissue to be implanted into the defect site. To enhance the rate of tissue growth and weight-bearing ability of the synthesized tissues, the Centre is also studying novel biochemical and biomechanical stimuli as well as nutritional supplementation.
Joint Surface Repair: In cartilage replacement, it is critical to match the surface shape of the implanted tissue to the original surface shape in order to minimize stress on the implanted tissue during healing. We have developed computer assisted methods to estimate the original surface shape, to automatically plan a surgery that achieves this shape, and to guide the tools during the operation to achieve this plan. Our initial studies have shown that this computer assisted method results in significantly better healing than the conventional, manual method.
Structural Drug Delivery: An innovative biomaterial, developed at Queen’s, has been further enhanced to stimulate cartilage regeneration. This material will enable viable and durable cartilage repair, and may also provide a strategy for the repair of small cartilage lesions in early stages of degeneration.
In-situ Tissue Characterization: Early detection of changes in bones and joints will enable earlier targeted treatment for tissues damaged by disease or injury. Employing a combination of radiographic and biochemical technologies, the Centre is developing innovative approaches to earlier and more accurate diagnosis of structural changes to enable earlier, less-invasive treatment.
Motion Performance Laboratory: This new facility has been developed to measure the motion and forces in joints during high demand activities of daily living. Much like a stress test for cardiac assessment, observing performance under these conditions can help detect early signs of joint degeneration.
Mobility is the Key to Independent Living
Natural, pain-free mobility enables an active daily life. With healthy aging, this functional independence can be achieved for a lifetime. Building on the Centre’s achievements and ongoing research, we envision a future where Canadians will enjoy greater mobility and independence throughout their lives. Early detection and treatment of degenerative bone and joint conditions, combined with minimally invasive surgical treatments which optimize patient outcomes, will reduce the burden of suffering as well as the economic costs currently associated with musculoskeletal disorders.