A personalised approach to chronic knee problems
Knee osteoarthritis is a chronic musculoskeletal disorder that affects over eight million people in the EU. The EU-funded KNEEMO project is developing a unique personalised approach to treatment and training a new generation of biomechanical specialists.
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There is currently no cure for knee osteoarthritis (KOA), although we know that adverse biomechanics lie at the heart of the disease. Fundamentally, these are the forces we exert on our knees, which are often influenced by our experience of the major health issues of our time, such as ageing, obesity and a sedentary lifestyle.
The EU-funded KNEEMO project is supporting research into targeted and tailored interventions for KOA. “Essentially, our focus is on identifying the right treatment at the right time for the right patients,” says project coordinator Martijn Steultjens of Glasgow Caledonian University in Scotland.
“There are currently no drugs that can reduce chronic knee osteoarthritis,” explains Steultjens. “And the disease presents across a varied patient population so there is no general ‘one-size-fits-all’ approach to treatment. We think much of the disease is caused by overloading joints and inducing stress in the knee.”
A model for change
A major part of KNEEMO’s research programme focuses on the development of a detailed computer model of the knee that can be personalised.
“Key characteristics of a patient’s knee are obtained from MRI scans and functional testing,” says Steultjens. “This personalised model then allows us to apply and assess various interventions and see what the optimum would be for that particular patient.”
Typical interventions include modified insoles for shoes or knee braces that change the alignment of the forces around a patient’s knee. “Even changing the way a person walks their gait or stride pattern can make a significant difference,” explains Steultjens. “The new knee model will be a great aid to informed decision-making to ensure the right intervention is selected.”
A second strand of research is seeking a better understanding of the various sub-groups of patients suffering from KOA. “The patients form a very heterogeneous group,” says Steultjens. “Some have serious inflammation, others have metabolic issues due to diabetes and/or obesity treatment that is good for one group may not be effective for others.”
In parallel, KNEEMO’s training programme exposes the fellows, who are supported via the EU’s Marie Skłodowska-Curie funding programme, to current best practice established among the project’s consortium members.
Each fellow has an individual training plan and tackles specific research tasks linked to the project. “At the end of the project we should have a cohort of excellent medical scientists possessing a range of generic and transferable skills,” says Steultjens. “They will have an excellent understanding of biomechanics and also insights from epidemiology on the risk factors that influence progression of disease a unique combination of skills.”
KNEEMO aims to deliver a better understanding of the biomechanical mechanisms involved in KOA. Furthermore, by enabling measurement of the key factors provoking the disorder and identifying people most at risk, its goal is to provide personalised treatment to improve the well-being and quality of life of those suffering from chronic knee problems.