[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/9419\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003ESpinning silk into next-generation eye and knee implants\u003C\/h2\u003E\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe first word that comes to mind when you think of silk is probably not \u201cstrength\u201d, yet when it comes to toughness, pound-for-pound, smooth silk is\u0026nbsp;stronger than steel. Few materials in the world match the flexible fibre produced by the silkworm.\u003C\/p\u003E\n\n\u003Cp\u003E\u2018Silk has immense potential to be developed into materials that have the same functional properties as healthy tissue, without any of the downsides of traditional implants,\u2019 said Dr Nick Skaer, chief executive of the UK-based biomedical company Orthox. \u2018I\u2019m confident that very soon \u2013 in the next few years \u2013 we\u2019ll be seeing some very large clinical needs being met by this versatile fibre.\u2019\u003C\/p\u003E\n\n\u003Cp\u003EThere are good reasons to turn silk into replacement parts for the human body. This \u201csuper-fibre\u201d is hard-wearing, highly elastic, is permeable to oxygen and water, biocompatible (is not rejected by the body when transplanted), stable and versatile (it can be engineered into a solid, a mesh or a gel). It is also able to block infection and supports the regeneration of new tissue.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003EWeak at the knees\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EDr Skaer is part of \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/947454\u0022\u003EFibroFix Cartilage\u003C\/a\u003E, a research team focused on transforming silk into substitute knee cartilage. Clinical trials launch in Hungary and the UK later this year with the hope that the orthopaedic implants will soon be available to European patients.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003ESilk has immense potential to be developed into materials that have the same functional properties as healthy tissue, without any of the downsides of traditional implants.\r\n\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EDr Nick Skaer, Orthox\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\n\n\u003Cp\u003EWhen knee cartilage is damaged, and people develop osteoarthritis (OA) they may be referred for knee replacement surgery (arthroplasty). The painful condition causes bones to rub together in the joints and reduces mobility. It\u2019s also a widespread issue, with Europeans facing a 45% chance of developing OA. The risk increases with age and weight. It\u2019s estimated to cost European countries over \u20ac7.2 billion and rising to treat OA every year.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EKnee-replacement surgery has reasonably good results but it\u2019s expensive, painful and recovery is long. It\u2019s also complex and not easily corrected if something goes wrong.\u0026nbsp;Silk-based implants offer a tantalising solution to these drawbacks.\u003C\/p\u003E\n\n\u003Cp\u003EFibroFix is made entirely of silk protein (known as fibroin) which has almost identical mechanical properties to real cartilage. \u2018It\u2019s strong, it\u2019s slippery like cartilage and it deforms when you put pressure on it,\u2019 said Dr Skaer.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003EKnee implants\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EDamaged cartilage is unable to repair itself easily and if left alone, a knee with cartilage damage will usually only get worse. The FibroFix researchers have developed a way to extract and purify fibrofin and mould it into a shape suitable to use as an implant.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThis is inserted into the knee in a dry, compressed state. It quickly fills with fluid from surrounding tissue which plumps it up to form a cushion-like barrier between bones.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003ECritically, the porous material also supports tissue regeneration. The silk protein implant provides a scaffold for bone and connective tissue to grow on so that even slow-repairing cartilage begins to regenerate.\u003C\/p\u003E\n\n\u003Cp\u003EThe implant\u2019s benefits are two-fold. \u2018Once the implant is locked in place, you get the function of your missing cartilage back straight away, and you also get new natural tissue growing over time,\u2019 said Dr Skaer.\u003C\/p\u003E\n\n\u003Cp\u003ETests show the implant surgical procedure is quick, post-operative pain is minimal and recovery is straightforward. Dr Skaer hopes for positive results in the clinical trials. \u2018We expect people to be on their feet soon after surgery and back to work fast, which will be a big win for everyone,\u2019 he said.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003ESilky looking\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003ELive long enough and the day will come when you need glasses. \u2018Presbyopia affects precisely 100% of the population over the age of 45,\u2019 said Susana Marcos, professor of research at Spain\u2019s Institute of Optics (CSIC) and the SILK-EYE principal investigator.\u003C\/p\u003E\n\n\u003Cp\u003EThe team working on\u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/833106\u0022\u003E SILK-EYE\u003C\/a\u003E \u2013 an EU-funded project head-quartered in Madrid\u2019s Spanish National Research Council \u2013\u0026nbsp; have found a way to engineer the silk fibroin protein into a clear membrane that may one day be used to restore eyesight.\u003C\/p\u003E\n\n\u003Cp\u003EPresbyopia is the inability to focus on nearby objects. The condition is caused by hardening of the lens and gets progressively worse with age. The standard treatment here is to invest in a pair of glasses or contact lenses. There is no treatment to restore the lost functionality of the young lens.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003EWe\u2019re hopeful that silk will be an affordable option for many people in Europe and around the world who are currently losing their sight.\r\n\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EProfessor Susana Marcos, SILK-EYE\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\n\n\u003Cp\u003EThe goal is to develop a silk-based implant that will replace the hardened lens in a simple surgical procedure. The new membrane will change shape as it\u2019s pulled by the eye muscles to focus on objects near and far.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u2018We\u2019re doing well with this project,\u2019 said Prof. Marcos. \u2018We\u2019ve developed the silk membranes and fine-tuned the material so it has the properties we desire. It\u2019s transparent, elastic, easy to work with, has the right thickness and the right levels of permeability.\u2019\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003EHoly Grail\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EMore work is required but the researchers have a clear target in mind - Prof. Marcos calls it the Holy Grail of ophthalmology - restoring older eyes to the capability of their 20-year-old selves. \u2018It\u2019s on the mind of everyone in this field,\u2019 she said.\u003Cbr \/\u003E\nSilk-based corneal implants may also be used to replace vision-correction laser surgery.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u2018Laser surgery (such as LASIK) removes a part of the corneal tissue, so your cornea becomes thinner,\u2019 said Marcos. \u2018But surgery using silk would be additive \u2013 we\u2019d be adding the implant to what is already there, and therefore preserving tissue.\u2019\u003C\/p\u003E\n\n\u003Cp\u003EGlobally, millions of people become blind as a result of corneal injury. It is a major public health challenge. The SILK-EYE researchers are working on affordable, implants and corneal bandages to address the problem.\u003C\/p\u003E\n\n\u003Cp\u003EThe team has already had success fixing silk membranes onto the corneal surface using a light-enabled technique called photobonding \u2013 a technique that replaces the need for stitches.\u003C\/p\u003E\n\n\u003Cp\u003EThere is a financial cost to silk lens and corneal implant treatments, but \u2018We\u2019re hopeful that silk will be an affordable option for many people in Europe and around the world who are currently losing their sight from highly prevalent ocular conditions,\u2019 said Prof. Marcos.\u003C\/p\u003E\n\n\u003Ch5\u003EThe research in this article was funded by the EU. 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