Tomorrow's Health, Today's Research

Dr. Josh Giles

Assistant Professor, Department of Mechanical Engineering
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Phone: 250-853-3179
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Research areas: Orthopaedic Biomechanics: In-Vitro Experimentation & In-Silico Modeling,  Orthopaedic Device Design,  Integration of Biomechanical Models & Mechatronic Systems,  Patient-Specific Biomechanically-Informed Surgical Planning

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Research Profile

Engineering Recovery: Using biomechanics to improve orthopaedic outcomes

“I like the design elements of engineering,” says Dr. Joshua Giles, an assistant professor in UVic’s Department of Mechanical Engineering, “but I also like being able to solve problems and answer questions.”

When it comes to the world of orthopaedics, one of the questions that Giles is working to address is, “How can we use clinical knowledge and biomechanical techniques to make new technologies that are actually effective?”

Giles uses two different, but complementary, approaches to his biomedical work: biomechanics research and orthopaedic systems development.

Biomechanical research. Giles’ research covers everything from basic bench top experiments all the way to developing complex mechatronics testing systems.

He uses material testing to subject experimental samples to the same kinds of forces that a bone might be subjected to in everyday human movements, generating important information, such as how a load is transferred through a bone.

Cadavers also play a key role in Giles’ research by providing his team with the unique opportunity to conduct repeated tests and directly compare multiple treatment options.

“You take a joint that you are interested in,” says Giles, “and try to replicate the environmental conditions you would have in a living person the muscle forces, kinematics of the joint and injury states and then you can investigate the effects of different surgical interventions.”

While pursuing his PhD at Western University, Giles developed an in-vitro hybrid cadaveric-robotic/mechatronic testing system that he used with cadavers to assess the efficacy of a range of surgical techniques used in shoulder joint stabilization. The resulting biomechanical evidence ultimately led to a shift in the way shoulder stabilization surgery is now conducted.

“Both local and international clinicians ended up changing their practice,” says Giles.

While working at Imperial College in the UK, following the completion of his PhD, Giles designed, developed and patented a novel technique for conducting shoulder replacement surgery, a technique that may soon be licensed by commercial enterprises.

While traditional surgical techniques involve a massive incision, the dislocation of the shoulder joint and extensive muscle re-section, Giles’ technique, which uses novel devices to guide and assist the surgeon, is much less invasive. This translates into faster recovery times and a lower risk of post-surgical complications.

Orthopaedic systems development. Currently, Giles is working on integrating biomechanical knowledge and computer modeling techniques with existing technologies. His goal is to develop new systems that will lead to improvements in clinical training, patient assessments, surgical planning and, ultimately, patient outcomes.

Clinical training. “Surgeons who do a lot of a certain procedure can usually look at their patients, how they move and look at the imaging, and say, ‘Ok, this is what I need to do,’” says Giles.

The evidence clearly shows that the more surgeries of a given type a clinician performs, the better the results. So, how can we offer new clinicians training aids that foster the wisdom that comes with repetition and experience?

Giles is developing a robotic system, coupled with a biomechanical computational model, which provides clinicians with the opportunity to practice their assessment skills.

“It provides them with force feedback on their hand of what the joint feels like,” says Giles. “You can basically flip a switch in the computer system to simulate a healthy shoulder, or a shoulder with an anterior instability, an inferior instability and so on.”

Patient assessment. Giles is also developing a robotic assessment tool that is capable of providing clinicians with quantitative data about the type and degree of injury to a joint, specifically in Giles’ research project, a patient’s wrist.

Giles is looking at developing a wearable, monitoring device that can provide patients with real-time feedback about their movements, feedback that is integral to the successful rehabilitation of damaged joints.

Physicians often tell their patients to stay off injured limbs or avoid load-bearing activities. Giles’ device could give a much more definitive answer to the question, “Are you really following your doctor’s advice?”

Patient-specific surgical planning. Currently, Giles’ most ambitious project focuses on developing a system that can improve surgical planning by incorporating patient functional data and biomechanical modeling into existing planning procedures.

“Right now, surgical planning is based on surgical experience and looking at CT scans,” says Giles. “Can we acquire functional data from patients how their limb moves, what sort of muscle function they have and use that to drive a computational model that can actually tell us what the optimal surgical plan is for that person?”

While Giles hopes to see his current research facilitate surgical planning and improve surgical outcomes, he is keenly aware that one of the greatest challenges with developing new technologies is simply one of adoption.

“Change is something that clinicians are averse to because they need to be as conservative as possible,” says Giles. “Because if something goes wrong, in the end, they are responsible.”

Clinician engagement. This means that fostering working relationships with local clinicians is crucial to the success of Giles’ work. Sourcing out valuable data and recruiting physicians to participate in his research is key. “You have to get buy in from physicians,” says Giles. “You need their feedback.”

Giles hopes that at the end of his career, he can look back and say that his team’s work had a significant impact on patient care.

“I think there are big challenges out there, such as surgical planning, that I would really like to have an impact on,” says Giles. “Knowledge is great but I am a practical person. I want to see that I actually did something.”