Clinical Research Office. A partnership between Sheffield Teaching Hospitals NHS Foundation Trust and the University of Sheffield

Orthopaedics

Key Contacts

Name Role
Mr Andy Hamer
andrew.hamer@sth.nhs.uk
Research Lead
Mr Paul Sutton Clinical Director
Michael Harper General Manager
Paul Griffiths
paul.griffiths@sth.nhs.uk
Service Manager
Janet Barker Group Finance Manager
Fiona Sealey Directorate Accountant
Luke Barron
Clinical Research Office Coordinator (Portfolio and Non-Portfolio Studies)
Gaurika Kapoor
gaurika.kapoor@sth.nhs.uk
Clinical Research Office Coordinator
(Industry-Sponsored Studies)

Introduction

The Orthopaedic Directorate is one of the largest Directorates in the Trust, and the busiest Surgical Directorate. As a result the clinical activity offers many opportunities for clinical research. Research mainly centres on joint replacement of the hip and knee, surgery of the foot and ankle and the shoulder. The Department has strong links with the Mellanby Centre for Bone Research and the MRC-Arthritis Research UK Centre for Integrated research into Musculoskeletal Ageing (CIMA) both at the University of Sheffield.

Research Strategy

The Directorates research strategy encompasses the areas of clinical and translational research, with a particular emphasis on the interaction between patients and their prostheses. We also have a programme of orthopaedic basic science research in conjunction with the Mellanby Centre for Bone Research at the University of Sheffield. The Department has an active research training program, offering research degrees at both undergraduate and postgraduate level. The Directorate looks forward to developing its collaborations with the Trust through the University, and external collaborators including industry and pharma.

Research Topics and Leaders


• Hip and Knee Arthroplasty and Associated Cellular and Genetic Translational Research – Mark Wilkinson
• Prosthesis Infection – Ian Stockley
• Adult Foot and Ankle Surgery – Mark Davies & Christopher Blundell
• Shoulder – David Stanley
• Soft Tissue Knee Surgery – Paul Sutton

Topic 1: Hip and Knee Arthroplasty and Associated Cellular and Genetic Translational Research

Research Direction

This encompasses several research areas covering clinical translational and basic science research. The research topics include understanding the mechanisms of prosthesis failure, the interaction between host and implant, implant infection, and therapeutic strategies to prevent or treat the complications of joint replacement surgery. The investigational tools used include advanced imaging techniques, bone densitometry, bone biomarkers, high throughput genotyping and functional molecular biology techniques. This work is supported through strong collaboration with the Mellanby Centre for Bone Research and external collaborators.

Current Grants


• National Institutes of Health Research, Biomedical Research Fellowship; 2012-2014;JM Wilkinson
• Amgen Inc, Effect of denosumab on osteolytic activity after THA; 2011-2014:JM Wilkinson
• Healthcare Quality Improvement Partnership, Development of an NJR DNA Biobank 2011-2013:JM Wilkinson
• Arthritis Research UK; Effect of bisphosphonate therapy on healing and clinical outcome of wrist fractures:Randomised controlled trial: 2011-2014 S Ralston, R Atkins, A Blom, C Court-Brown, M McQueen, G Murray, J Tobias, JM Wilkinson
• Weston Park Hospital Cancer Charity; Genetic alterations responsible for initiation of breast cancer metastases to bone 2011-2012:P Ottewell, M Jones, RE Coleman, JM Wilkinson, I Holen
• Sheffield Hallam Biomedical Research Centre; Role of cannabinoids in cartilage degeneration, 2010-2013: Rowena Bunning, C Le Maitre, JM Wilkinson

Publications (2010-2013)


• Thiagarajah S, Macinnes SJ, Yang L, Doherty M, Wilkinson JM. Quantifying the Characteristics of the Acetabulum and Proximal Femur Using a Semi-automated Hip Morphology Software Programme (SHIPS). Hip International (In press)
• KS Elliott, et al. Evaluation of the genetic overlap between osteoarthritis with BMI and height using genome-wide association scan data. Ann Rheum Dis (in press)
• G Hudson, et al. No evidence of an association between mitochondrial DNA variants and osteoarthritis in 7393 cases and 5122 controls. Ann Rheum Dis 2013; 72: 136-139.
• Jayasuriya RL, Buckley SC, Hamer AJ, Kerry RM, Stockley I, Tomouk W, Wilkinson JM. Effect of sliding-taper versus composite-beam cemented femoral prosthesis loading regime on bone remodeling of the proximal femur: A randomized clinical trial. Journal of Bone and Joint Surgery 2013; 95-A: 19-27.
• arcOGEN Consortium and arcOGEN collaborators. Identification of new susceptibility loci for osteoarthritis (arcOGEN): a genome-wide association study. Lancet 2012; 380 (9844): 815-823.
• Dunn SL, Wilkinson JM, Crawford A, Le Maitre CL, Bunning RAD. Cannabinoids: novel therapies for arthritis? Future Med Chem 2012; 4: 713-725.
• Wilkinson JM. Bisphosphonates in the management of avascular necrosis and joint arthroplasty. Osteoporosis Review 2012; 20: 16-18.
• Wilkinson JM. Metal-on-metal hip prostheses: Where are we now (Editorial). BMJ 2012 Nov 16:.e7792
• C Lindner, S Thiagarajah, JM Wilkinson, arcOGEN Consortium, G.A. Wallis and T.F. Cootes. Accurate fully automatic femur segmentation in pelvic radiographs using regression voting. Med Image Comput Comput Assist Interv. 2012; 15(pt 3): 353-360.
• Wilkinson JM, Little DG. Bisphosphonates in orthopaedic applications. Bone 2011; 49: 95-102
• C. Lindner, S. Thiagarajah, J.M. Wilkinson, arcOGEN Consortium, G.A. Wallis and T.F. Cootes. Short-term variability of proximal femur shape in anteroposterior pelvic radiographs. Proc 15th Conf Med Image Understanding and Analysis, London, U.K. BMVA Press, pages 69-73, 2011
• R Andrews, K Shah, JM Wilkinson, A Gartland. Effects of Cobalt and Chromium Ions at Clinically Equivalent Concentrations after Metal-on-Metal Hip Replacement on Human Osteoblasts and Osteoclasts: Implications for Skeletal Health. Bone 2011; 49: 717-723
• AG Day-Williams, et al. A variant in MCF2L is associated with osteoarthritis Am J Hum Genet 2011; 89: 446-450.
• K. Panoutsopoulou, et al. Insights into the genetic architecture of osteoarthritis: interim analysis of the arcOGEN study. Ann Rheum Dis 2011; 70: 864-867.
• HJM Kerkhof et al. Recommendations for standardization and phenotype definitions in genetic studies of osteoarthritis: the TREAT-OA consortium. Osteoarthritis and Cartilage 2011; 19: 254-264.
• K Panoutsopoulou et al. The effect of genome-wide association scan quality control on imputation outcome for common variants. European Journal of Human Genetics 2011; 1-5.
• Evangelou V et al. Meta-analysis of genome-wide association studies confirms a susceptibility locus for knee osteoarthritis on chromosome 7q22. Ann Rheum Dis 2011; 70: 349-355.
• Emms N, Stockley I, Hamer AJ, Wilkinson JM. Long term outcome of a cementless, hemispheric, press-fit acetabular component: Survivorship analysis and dose-response relationship to polyethylene wear. J Bone Joint Surg 2010; 92-B: 856-861.
• Gordon A, Greenfield EM, Eastell R, Kiss-Toth E, Wilkinson JM. Individual Susceptibility to Periprosthetic Osteolysis is Associated with Altered Patterns of Innate Immune Gene Expression in Response to Pro-inflammatory Stimuli. J Orthop Res 2010; 28: 1127-1135

Topic 2: Prothesis Infection

Topic 3: Adult Foot and Ankle Surgery

Research Direction


The Sheffield Foot and Ankle Unit’s approach to research is towards improved clinical management of foot and ankle pathologies through both basic scientific study and clinical studies alike. Basic scientific research has been directed at anatomical studies, pedobarographic work, tendon biology and 3-dimensional geometric modelling but forthcoming work will involve investigation of articular cartilage. The use of diagnostic intra-articular local anaesthesia has been extensively studied. SFAU is involved with both national (UK Heel fracture trial) and international (Cartiva MOTION) clinical trials.

Current and Recent Grants


• Cartiva MOTION study - £40,000. A prospective, randomized, non-inferiority study to evaluate the effectiveness of Cartiva synthetic cartilage implant in the treatment of first metatarsophalangeal joint osteoarthritis as compared to a control
• UK Heel Fracture Trial - £12,000 UK Heel fracture Trial
• SFAU Research Fund - £6,000 The geometric effects of five first metatarsal osteotomies

Important Publications


• MR Carmont, JE Tomlinson, C Blundell, MB Davies, DJ Moore. Variability of joint communications in the foot and ankle demonstrated by contrast-enhanced diagnostic injections. Foot & Ankle International 2009; 30(5): 439-442
• Tryfonidis M, Whitfield CG, Charalambous CP, Baraza WK, Blundell CM, and
• Sharp RJ. The distance between the sural nerve and ideal portal placements in lateral subtalar arthroscopy: a cadaveric study. Foot Ankle International 2008: 29(8): 842-4
• AD McCarthy, MB Davies, KR Wembridge, CM Blundell. Three-dimensional analysis of different first metatarsal osteotomies in a hallux valgus model. Foot & Ankle International 2008; 29(6): 606-612
• Tryfonidis M, Whitfield CG, Charalambous CP, Baraza WK, Zubairy AI and
• Blundell CM. Posterior ankle arthroscopy portal safety regarding proximity to the tibial and sural nerves. Acta Ortop Belg 2008: 74(3): 370-3
• Murphy RJ and Blundell CM. Are routine postoperative X-rays needed following surgery for hallux valgus? An evaluation of their use after scarf osteotomy. Annals of The Royal College of Surgeons of England 2007: 89(3): 281-284
• MB Davies, S Dalal. Gross anatomy of the interphalangeal joint of the great toe: Implications for excision of plantar capsular accessory ossicles. Clinical Anatomy 2005; 18(4): 239-244
• S Jones, HA Al-Hussainy, F Ali, RP Betts, MJ Flowers. Scarf osteotomy for hallux valgus: A prospective clinical and pedobarographic study. J Bone Joint Surg [Br]. 86-B: 830-836, 2004
• MB Davies, RP Betts, IR Scott. Optical plantar pressure analysis following internal fixation for displaced intra-articular os calcis fractures. Foot & Ankle International 2003; 24(11): 851-856
• Repair of lacerated tibialis anterior tendon using Achillon limited open repair technique

Topic 4: Shoulder
Topic 5: Soft Tissue Knee Surgery