Lifelong heath and wellbeing: improving orthopaedic practice and patient care

The Orthopaedic Research Institute at Bournemouth University offers world-class research, the latest professional thinking and clinical best practice, and has grown rapidly since opening in October 2015

The Orthopaedic Research Institute (ORI) at Bournemouth University is driven by the needs of patients, clinical colleagues and wider society to produce high-quality academic and patient outcomes across the fields of orthopaedic surgery, related diseases, treatments, technologies and devices. It aims to fuse world-class research, the latest professional thinking, and clinical best practice to create a rich environment that stimulates new ideas, technologies and orthopaedic products.

The Institute works across the university, local hospitals, industry partners and the community to carry out research aimed at improving current orthopaedic treatments, developing better surgeries, testing new technology and developing better rehabilitation processes. It takes a very interdisciplinary approach to its research, and draws on the expertise of other health professionals, psychologists, technologists, sports scientists and engineers. ORI has particular expertise and focus in completing research for industry partners, and is currently working with orthopaedic multinationals, SMEs and technology start-ups on a range of research and development projects.

ORI is led by Professor Robert Middleton, a consultant orthopaedic surgeon at The Royal Bournemouth Hospital and director of trauma at Poole Hospital. Middleton specialises clinically in hip replacement, hip arthroscopy and revision hip surgery, and is the former national clinical lead for hip and knee replacement at the NHS Institute for Innovation and Improvement. He was also on the NICE guidelines committee for the conservative treatment of osteoarthritis. Associate Professor Tom Wainwright, a physiotherapist, clinical researcher and quality improvement specialist, is the deputy head of ORI. He has published and presented widely on orthopaedic and musculoskeletal research, and has held managerial and leadership roles within the National Health Service. He was named by the Institute of Consulting as the 2010 Young Consultant of the Year for his work on a portfolio of quality improvement projects.

Dorset boasts one of the largest populations of older people in the UK, and carries out a significantly higher than average number of orthopaedic surgeries compared with other regions. Poole Hospital performs more hip fracture operations than any other hospital in England; and the Royal Bournemouth Hospital is a leading European hip and knee replacement unit. ORI is therefore ideally positioned as a centre of excellence in orthopaedics.

As Wainwright explains: “Dorset has a very high proportion of orthopaedic surgeries, so potentially there is a large number of people we can benefit. We currently have several trials in local hospitals which are looking at different ways to improve medical technology used in orthopaedics. This means that not only are we contributing to improving future care, we are also bringing the latest technology to Dorset, and improving care in the local area”.

One of ORI’s biggest successes so far is speeding up the recovery process after hip and knee surgery, which has led to their work being cited in best practice health guidelines around the world. The enhanced recovery after surgery approach seeks to minimise the impact of surgery and accelerate recovery by employing strategies throughout the patient pathway, to improve outcomes and reduce the need for medical interventions. Their research into this area was a first in the UK for orthopaedics and demonstrated its value to patient care, as well as showing an improvement in patient and staff satisfaction and leading to significant cost savings to hospitals.

A more recent example of their work is a programme developed with local partners in Dorset called CHAIN – Cycling Against Hip Pain – which is designed to help people to live well with conditions such as osteoarthritis and to improve their mobility, through a combination of education and static cycling sessions. The results have been excellent, with patients reporting improvements in walking, greater ease in carrying out daily living tasks and, most importantly, decreases in pain. Even the least likely candidates have seen improvements, demonstrating the value of education and exercise in improving patient care and in helping to reduce or delay the need for further medical interventions.

ORI is extremely well placed to capitalise on the research opportunities of local demographics and surgical volume and has received a £700,000 equipment grant from the Dorset Local Enterprise Partnership. This significant investment combined with funding from the Wessex Academic Health Science Network and Bournemouth University has allowed ORI to establish a series of state-of-the-art research labs.

The ORI gait lab is a world-class facility centred on the Motekforce Link GRAIL system, which uses an instrumented dual-belt treadmill, Vicon motion‐capture system and synchronised virtual reality environments next to three video cameras and electromyography. There is also a fully equipped biomechanics lab with state-of-the-art equipment such as the PrimusRS for muscle testing.

Use of virtual reality training in orthopaedic surgery is a developing area of expertise within ORI. The Institute has two world-leading virtual reality trainers: a Virtamed arthroscopy training simulator and an OSSIM Technologies knee replacement simulator, and by the end of the year will have the first hip arthroscopy simulator in the world from Virtamed. ORI’s situation within the university means that it is ideally positioned to provide training for surgeons, and other high-value healthcare professionals in collaboration with industry partners. High-quality lecture theatres, seminar rooms and workshop areas are all available.

ORI is currently completing projects involving a number of multi-national orthopaedic companies, such as ZimmerBiomet, Lima Corporate and Firstkind Ltd, to deliver clinical trials on the latest orthopaedic technology; however, there is further capacity and ORI is now actively seeking further partners to work with on research and educational projects.

Orthopaedic Research Institute

Website: https://microsites.bournemouth.ac.uk/ori

Twitter: @BU_Orthopaedic

Caption: Robert Middleton and Tom Wainwright, of the Orthopaedic Research Institute based in Bournemouth.

Staff Writer