BIG-DATA ANALYTICS USING THE UK BIOBANK RESOURCE
Does knee cartilage repair surgery prevent arthritis or the need for a joint replacement?
Nikki Kuiper, Charlotte Hulme, Martyn Snow, Karina Wright and Jan Herman Kuiper
Nikki holds a Daphne Jackson Trust fellowship co-sponsored by Orthopaedic Research UK and the Medical Research Council. This research has been conducted using the UK Biobank Resource with funding kindly provided by the Orthopaedic Institute Ltd. and Keele University.
Musculoskeletal conditions such as arthritis account for around 20% of GP visits. Osteoarthritis (OA) is the most common type, affecting one in five people over 45 in the UK, with the knee most frequently affected. OA develops when cartilage wears out, and a knee injury in young adults can increase the risk of knee OA by up to six times. Treatments include physiotherapy, pain relief, surgery, and, as a last resort, joint replacement.
Cartilage repair surgery aims to reduce pain and improve knee function and may help slow the progression of OA. To understand how well these surgeries work, doctors measure outcomes such as other knee operations, imaging results, laboratory tests, blood markers, and patient questionnaires. These outcomes are often stored in large health databases. In this study, we use big‑data analytics to collect, process, clean and statistically analyse these health data (see picture insert).
The UK Biobank is one such big-data resource. Since 2006, medical, biological and lifestyle information has been collected from 500,000 adults aged 40–69. Participants provide samples such as blood, urine and saliva, and their data is linked to their health records. The UK Biobank can help researchers understand how diseases like OA develop since it includes participants who have had cartilage repair surgery, along with information about their OA status.
In a recent study, we used the UK Biobank resource to find out whether men and women differ in how long it takes to progress from cartilage‑related knee surgery to total knee replacement. Among 3,708 participants, women had a higher risk of needing a joint replacement than men, especially after debridement—a procedure that removes damaged cartilage and loose fragments from the joint—or microfracture, a technique where small holes are created in the bone to stimulate new cartilage growth. Older age also increased the likelihood of progressing to joint replacement. Overall, women showed worse long‑term outcomes than men following these surgeries.
Currently, we are estimating the incidence and time sequence of other conditions e.g., respiratory, cardiovascular or musculoskeletal conditions that these 3,708 participants might develop after their cartilage surgery. We want to find out if these conditions influence long-term outcomes following cartilage surgery.
