Transforming treatment for severe ankle arthritis patients

The next generation of ankle implants could change the lives of patients young and old by restoring pain-free mobility, according to an industry-academia team.

Their research programme, Engineering Advanced Solutions for End-stage Ankle Osteoarthritis (EASE-ankle OA), brings together leading researchers, clinicians and industry partners to rethink how ankle implants are designed and tested.

Led by the University of Sheffield and drawing on expertise from Cardiff University, the project has been awarded a £12m Engineering and Physical Sciences Research Council (EPSRC) grant for the work, which they say will bridge the gap between engineering and healthcare.

Researchers from Cardiff University’s Musculoskeletal Biomechanics Research Facility (MSKBRF) in the School of Engineering will contribute advanced biplane video X-ray imaging and musculoskeletal biomechanics expertise to the project.

These measurements will provide detailed insights into joint motion and implant performance in real patients, helping to inform future implant design and evaluation.

“One of the most exciting aspects of this programme is the opportunity to measure how the ankle and foot move during real-world activities and use that information to inform the next generation of treatments,” explains Dr David Williams, a post-doctoral research associate in Cardiff University’s School of Engineering.

Ankle osteoarthritis causes chronic pain, limited mobility and reduced independence, often affecting people earlier in life following injury.

Current surgical options – such as ankle fusion or replacement – are not suitable for everyone and can have limited success, with up to one in five implants failing within 10 years.

As a result, many patients delay surgery for years, living with pain and restricted movement.

The EASE-ankle OA programme aims to change this by developing:

• Improved ankle implant designs tailored to a wider range of patients
• Advanced tools to better understand how ankles move and function
• New ways to test implants before they are used in patients

By combining expertise in engineering, medicine, and patient experience, the team will create a more complete picture of how ankle replacements should work in real life.

A key feature of the programme is its strong focus on patient needs.

Researchers will work closely with people living with ankle arthritis, as well as surgeons and healthcare professionals, to define what a “successful” outcome looks like – not just clinically, but in terms of pain relief, mobility, and everyday quality of life.

Professor Cathy Holt, Director of Biomechanics Research at Cardiff University’s School of Engineering, added: “A key element of this programme emerged from work originally supported through an EPSRC Osteoarthritis Technology Network Plus award led by Cardiff University. That funding helped establish a collaboration between researchers here and at the University of Sheffield, supporting the development of pilot studies and novel research concepts that have contributed to securing this major EPSRC investment.”

“Seeing the collaboration develop into a £12 million programme with the potential to transform treatment options for patients with end-stage ankle osteoarthritis is tremendously exciting.”

The project runs for five years and is led by the University of Sheffield, drawing on a consortium of academic expertise from Cardiff University, Warwick University, the Universities of Birmingham and Leeds, Dartmouth College in the USA and KU Leuven in Belgium.