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Two Versus Arthritis Fellowships have been awarded to NDORMS researchers for the study of frozen shoulder and for management of osteoarthritis among the oldest adults.

Steph Dakin and Pippa Nicolson
Lead researchers (from left to right): Stephanie Dakin and Philippa Nicolson

Unlocking frozen shoulder

Professor Stephanie Dakin has been awarded a Versus Arthritis Career Development Fellowship investigating frozen shoulder, a common cause of shoulder pain that affects 3% of the global and 10% of the working population.

Frozen shoulder disrupts life quality and severely limits activities of daily living. Caused by profound inflammation and fibrosis of the joint capsule, the shoulder is effectively 'stuck' or 'frozen' with patients experiencing symptoms for 2-5 years. Current treatments including physiotherapy, corticosteroid injection, manipulation under anaesthesia and arthroscopic capsular release surgery do not dramatically improve symptoms for patients, highlighting the requirement for effective new treatments.

"Many forms of chronic inflammatory joint disease such as rheumatoid arthritis and osteoarthritis are persistent diseases that do not get better. In contrast, frozen shoulder is a unique example of a chronic inflammatory fibrotic disease that almost always resolves, albeit over a period of several years," said Stephanie. "Understanding frozen shoulder harnesses the potential to identify new treatments to accelerate resolution of this disease, and also inform the biological cues to push other inflammatory fibrotic joint diseases down a proresolving pathway."

The study will use patient tissues collected during surgery to create a cellular atlas of the shoulder joint capsule. The team will then be able to identify the biological processes that occur in joint capsule cells that helps inflammation to resolve, and determine if new therapies called "proresolving mediators" can kickstart resolution of inflammation in cells from frozen shoulder patients.

Stephanie will be working with Fellowship Sponsors Professor Andrew Carr, Professor Christopher Buckley and NDORMS collaborators Dr Stephen Sansom, Professor Mark Coles, Professor Jesmond Dalli (QMUL) and Professor Derek Gilroy (UCL) and the clinical teams involved in the ICECAP study.

Further information on Stephanie's research can be found here.

Tailoring exercise for over 80's with osteoarthritis

Dr Philippa Nicolson has been awarded a Versus Arthritis Foundation Fellowship to develop and test an exercise intervention for people aged 80 years or older with hip and knee osteoarthritis.

Over 80 year olds are the fastest growing age group in the UK. Osteoarthritis is becoming more common as the population ages, and the accompanying costs are increasing dramatically. While many clinical trials have demonstrated the benefits of exercise for people with hip and knee osteoarthritis, people aged 80 years or older are poorly represented in these trials.

"Findings in younger populations cannot reliably be applied to people aged 80 or older for a number of reasons, including the increase in other health conditions that can impact on function and mobility, and the rapid loss of muscle that occurs beyond 70 years of age," Philippa explained. "By focusing on this population, involving patients throughout the development process and tailoring exercise to common conditions that present alongside osteoarthritis, this research aims to design a programme that maximises the benefits of exercise for each individual."

The exercise programme will be developed and tested over four packages of work, including a systematic review of existing evidence; analysis of cohort data to identify other conditions presenting with osteoarthritis and the impact these have on mobility and function; patient and clinician prioritisation of programme components, and a randomised feasibility trial and qualitative evaluation to test whether the programme can be delivered and is acceptable within the NHS.

Philippa will work with Fellowship Sponsors Professor Sallie Lamb, Associate Professor Sally Hopewell and Dr Esther Williamson at NDORMS, and Professor David Hunter (University of Sydney), Professor Anthony Redmond (University of Leeds) and Dr Melanie Holden (Keele University).

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