Novel research to develop interventions to repair large bone gaps in trauma and cancer patients

By: Avant Media

Feb 19, 2016

Specialising in translational medicine, Dr Lloyd Reeve-Johnson has been awarded a part-time 2015 Avant Doctor in Training Research Scholarship to test novel synthetic bone matrix scaffolds in animals to develop simple and affordable surgical interventions to heal large bone deficits in patients.

Dr Reeve-Johnson, (pictured) who is also a veterinary surgeon, is currently Principal House Officer at the West Moreton Health Authority, Queensland Health. He also completed a PhD in the United Kingdom. He has held roles across veterinary, pharmacology and medicine fields both in Australia and internationally and has published well over 100 studies on pre-clinical research topics. His diverse background also includes working in aid-in-development programmes in developing and war torn countries. 

Research hopes to make a difference in remote areas and developing countries

“The purpose of translational medicine approaches is to work across geographical, cultural, language and training boundaries - it’s incredibly exciting and it makes you think in very different ways,” he says. “I have been lucky enough to live on five continents and travel in over 100 countries, so I have seen the differences in people’s experiences.”

What struck Dr Reeve-Johnson while working in these countries was how, for example, a prosthesis which may not have been in his words the “Ferrari of its day,” could still significantly improve people’s lives. “The success was very often astounding with patients being able to walk again or walking again with a slight limp rather than not walk at all,” he says.

“Our research considers how we can diffuse these innovations to obtain the greatest impact and often that’s in rural areas and developing countries.”

Testing of novel prototype implants in animal models   

Healing of large bone deficits remains a considerable challenge for orthopaedic surgeons; most notably, following resection of cancer or massive trauma.  

Dr Reeve-Johnson aims to conduct a literature review on the use of bone matrix scaffolds to repair large bone defects in animals and select the best model to test a synthetic bone matrix implant developed at the Queensland University of Technology.

A proof-of-concept study in which biodegradable composite scaffolds made up of medical grade polycaprolactone and calcium phosphates, and tissue growth stimulators were implanted in three and six centimetre tibial bone defects in sheep, has demonstrated its viability to heal large bone gaps.

“The results were very encouraging and the synthetic bone matrix definitely helped to give more stability over large bone gaps,” he says. “Preliminary data suggests this synthetic bone matrix has several advantages over the current practice of autograft repair.” 

Validating safety and effectiveness before moving into human use 

A second phase of the study is intended to  focus on developing the current animal model and evaluate the use of bone morphogenic proteins to increase the rate of healing and strength of the repair and validating its safety and effectiveness to progress to use in humans.

“If we can show that there is no major risk of cancer or toxic effects and it has positive healing properties, we could then consider human patients, ” Dr Reeve-Johnson says.   

The research will be supervised byhis mentor, Professor Michael Schuetz, an international research leader in trauma care and orthopaedic implant design and Professor and Chair of Trauma, Queensland University of Technology. His collaboration with Professor Schuetz, also Director of Trauma, Princess Alexandra Hospital, Brisbane, began after he assisted him as a final year medical student on a major operation.

“Ironically, the research came about during the course of a very complex hip operation. There had been a tragic accident in Papua New Guinea and the patient was flown into the Wesley Hospital for specialist treatment,” Dr Reeve-Johnson says. “I heard that Professor Schuetz was performing the operation and I asked if I could scrub in. It gave me a great opportunity to chat over the course of a very long operation and he became very interested in some of the work I had done.”

Avant scholarship provides opportunity for collaboration 

Dr Reeve-Johnson is very grateful to Avant for the scholarship and says the funding has helped to get this innovative research off the ground.   

“The funding has been a great boost because it is so difficult to win funding,” he says. “It gives us a starting point and although the results are important, it’s more about the opportunity to make contacts and get involved in research.”

He says the scholarship has already been extremely valuable, allowing him to pay for flights after being invited to speak on translational medicine at the International European Association for Veterinary Pharmacology and Toxicology Congress in France and the Royal Academy of Sciences in Madrid in 2015. Attending the congresses has enabled him to forge new collaborations and share ideas with senior international scientists.

After his presentation at the congress in Madrid Dr Reeve-Johnson became the first Australian to be elected to join the Royal Academy of Sciences of Spain and given a medal on behalf of the  King of Spain. He has also been appointed to the Royal Academy of Veterinary Sciencesas an international corresponding scientist and now maintains a strong collaboration with the large Complutense University of Madrid as an honorary collaborator. “My objective is to continue to find other areas of knowledge cross-fertilisation between human medicine and other species,” he says.

Does your research deserve funding? 

Applications for the Avant Doctor in Training Research Scholarship Program 2016 are open. Twenty-two scholarships are available – more than any other year to date – worth $450,000, for both emerging and experienced researchers.

Apply online on the Avant website or for more information download our Doctor in Training Research Scholarship Information Pack.

If you have any questions, please contact the Doctor in Training Research Scholarship team at scholarship@avant.org.au. Applications close 31 May 2016.