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A novel treatment for knee arthritis – an in silico clinical trial with 3,360 patient models.

Computational modelling has given Dr Alisdair Macleod and the TOKA team the opportunity to experiment with a new medical implant for arthritis patients.


TOKA is an innovative surgical procedure that uses 3D printed titanium implants to treat knee arthritis, especially for younger sufferers. Throughout the project, Alisdair, Professor Richie Gill and the TOKA team have used supercomputers such as Balena to create simulations of the implant to assess its safety and functionality. Results from these simulations also indicate whether the implant needs any improvements or adjustments. Whilst some results are still being evaluated, the vast amount evidence from the simulations has been positive and has resulted in TOKA securing an NHS trial to test the implant out on real-life patients later this year.

Alisdair's Work

Alisdair was awarded the prize for 'best talk' at the 2019 HPC Symposium for his presentation of how Balena helped him and the TOKA team undertake the world's first virtual orthopaedic clinical trial. He made realistic simulations of knee implants for arthritis patients and compared the safety of the new implant against the market leader. Alisdair used Python scripting as a modelling tool as well as for generating slurm codes which helped him identify whether the simulation or results had any errors. Alisdair is going to continue using Balena for his simulations and evaluations and hopes to move on to more cloud-based options such as Jupyter Notebooks in the future.

Alisdair and the TOKA team have gained many benefits from using HPC to conduct medical research, such as:

  • The ability to run thousands of simulations without the difficulties of finding large numbers of willing volunteers to participate, which medical research usually requires.

  • Using simulations helps reduce the amount of animal testing which is typical before medical trials can take place.

The Future for TOKA

The simulations have made the TOKA team confident that the implants are risk-adverse and safe for clinical trials. This strong case study was made possible with Balena and showed that simulations are suitable for medical trials in the future. The team hope to perform another virtual trial during the NHS clinical trial to demonstrate the value of HPC simulation in medicine.

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