Novel implants offer hope for small joint arthritis patients
The prevalence of small joint arthritis in the hands and feet is on the rise in part due to our ageing population. Young adults are also becoming increasingly vulnerable to finger joint arthritis from the extended use of computers and other electronic devices. “We need our hands to do basic everyday tasks such as opening doors, grabbing objects or carrying bags,” says APRICOT project coordinator Martin Browne from the University of Southampton in the United Kingdom. “It is therefore important that this debilitating condition is treated effectively.”
Improving current implant procedures
Browne notes that finger joint arthritis is usually treated with painkillers and drugs in the first instance. When these can no longer be used, a surgeon will either fuse the bones together in one position to stop them moving, or put in an expensive joint replacement implant that lets the joint move again. “These operations involve removing lots of bone and tissue, and between 10 and 12 weeks of rehabilitation,” adds Browne. “Up to two in five implants fail within 10 years.” The consortium behind the APRICOT project therefore focused on improving current implant procedures. “Our aim was to develop an ultra-thin, minimally invasive implant that does not require tissue sacrifice, and can treat a wide patient population,” explains Browne. “In addition, our hope was that the negligible size of the implant would allow for the restoration of the natural movement of the joint, and reduce post-operative rehabilitation time.”
Breakthrough technology from concept to reality
The project was able to take this breakthrough technology from concept to reality, thanks to a wide-ranging consortium of partners. Each partner focused on different aspects of design and development, as well as computational and physical testing, lubrication and surface treatment, and implant fixation. Biocompatibility assessments, as well as the manufacture of the implant, were also achieved. “Each part was critical to the creation of the device,” says Browne. “We needed to ensure that it was the right size, that it moved like the natural joint, and that it stayed in place.” The team then conducted implantation trials in cadaver hands in the Netherlands and the United Kingdom. An unanticipated outcome, adds Browne, was the rapid operation time. It took less than 10 minutes from first incision to closure of the wound post-implantation.
Moving to first-in-person clinical trials
The consortium is currently seeking further funding in order to progress the development of the device to a first-in-person clinical trial. This will help to confirm the benefits of the device in living patients. The project has also succeeded in shedding new light on a relatively underreported area of clinical need. Small joint arthritis, Browne believes, tends not to receive the same levels of research interest that larger joints such as the hip or the knee enjoy. Furthermore, potential applications are not necessarily restricted to finger joints – many small joints in the body could benefit from this technology. “The most rewarding aspect of the work will be seeing the positive response of patients and how the device changes their lives,” remarks Browne. “We believe this technology represents a disruptive change in the way small joint osteoarthritis is treated, and our aspiration is to see it adopted in clinical practice.”
Keywords
APRICOT, arthritis, implant, patients, osteoarthritis, painkillers, surgeon
