Patrick Ashcroft is a senior lecturer in orthopaedics at Aberdeen University and a consultant orthopaedic surgeon at Aberdeen Royal Infirmary.
What does your work involve?
My work involves the development of research imaging techniques to allow the study of arthritis and its treatments (including joint replacement), in order to enable the introduction of safe, novel treatments.
How long has Arthritis Research UK been funding you?
My first grant in 1998 helped establish the stereo x-ray technique of radiostereometry (RSA) in Aberdeen. RSA measures the tiny movements of joint replacements in bone that occur in the early years after an operation and accurately predicts the long term survival of the joint. More recently we have been using positron emission tomography, a radio-isotope technique to study hip re-surfacing, and assess the effects of this surgical approach on the blood supply of the bone.
What’s the most important thing you have found out in the past 12 months? And why?
In the last 12 months Arthritis Research UK has funded one of the most exciting projects on which I’ve worked. Aberdeen is world-famous for the technique of magnetic resonance imaging (MRI). We have now developed a totally new type of MRI called fast field cycling (FFC-MRI) and have been testing the technique on samples of articular cartilage taken from patients undergoing hip and knee replacement. This work has shown that FFC-MRI has the potential to measure the very earliest changes seen in osteoarthritis, ie the alteration in protein concentrations which precede all the changes we would normally see on any x-ray. If FFC-MRI fulfils its promise, this unique technique will enable us to assess early arthritis and aid in the introduction of new drugs and other treatments for arthritis in the future.
What do you hope or expect to achieve as a result of your Arthritis Research UK funding?
The current funding is vital in the development of the technique of FFC/MRI. We hope to prove its effectiveness by examining normal and abnormal tissue removed from patients and comparing results to microscopic and chemical assessment of the cartilage. Should this study prove positive, it will provide the key data that will allow the development of FFC-MRI for use in patients.
What do you do in a typical day?
As a clinical academic I have to juggle treating NHS patients with the responsibilities of developing and supervising research projects. Many days are filled with out-patient clinics or performing surgery. This clinical work is combined with research; taking samples of tissue for the basic science research and enrolling patients in studies of joint replacement. My research days are busy and involve meetings with young researchers, discussing results and potential future research grants. The beginning and end of the days are rounded off by reviewing patients on the wards.
What is your greatest research achievement?
In the years following our first Arthritis Research UK grant, we continued to work on the technique of radiostereometry (RSA). In the past three years we have developed and carried out research with the world’s first custom-built digital stereo radiostereometry x-ray. This equipment, along with novel software, radically improves not only the accuracy of the technique but also its ease of use. This will potentially enable RSA to be used not only for research but also as a routine follow-up tool for all patients, with consequent improvement in care. This year we hope to use our new equipment to re-examine our original Arthritis Research UK patients 14 years on from the first grant.
Why did you choose to do this work?
I have enjoyed the excitement of research since my very first house officer job in Manchester. I still find the seeking of answers to research questions as thrilling now as I did all those years ago. Although heavily involved in research I still see and operate on patients with arthritis every week. The improvement that such surgery can make in people’s lives is very rewarding and is the reason for my continuing to work in the NHS.
Do you ever think about how your work can help people with arthritis?
Whilst treating patients, I am constantly thinking of how research can potentially improve their lives. I think the link between clinical doctors and researchers is vital to help target research.
What would you do if you weren’t a clinician/researcher?
When I was younger I wanted to be a marine biologist, and live a life like Jacques Cousteau, the famous French developer of the aqualung. I was fortunate in my younger days to have been medical officer on a number of diving expeditions and fulfil at least part of my ambitions
I will have been happily married to my wife Liz, a paediatrician, for 30 years in December of this year. Our son is now 18 and will soon leave home for university. We all enjoy dinghy sailing (despite the cold water) and regularly race at our local sailing club. In winter we ski.