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Orthopaedic patients in No 9 hospital in Shanghai are helping to improve outcomes for Australians with sporting injuries.

A new collaboration between UWA and Shanghai Jiaotong University Medical School will see Chinese patients taking part in clinical trials of innovative tendon surgery, developed at QEII by researchers in the School of Surgery and the Orthopaedic Research Unit.

Researchers and clinicians have been working for a couple of years on establishing the new Centre for Translational Orthopaedic Research (CTOR) and it looks like their first success will be autologous tendocyte implantation: a simple effective procedure for hard-to-treat tendon injuries.

Medical Director of CTOR, and head of Orthopaedics at QEII, Dr Gerard Hardisty, explained the process of extracting cells from a patient's healthy tendons, growing new tendon tissue, then implanting it back into the patient, at the injured site.

This treatment follows the School of Surgery's successful front-running in autologous chondrocyte implantation, for the growth and implantation of cartilage tissue.

Professor Ming-Hao Zheng, Research Director of CTOR, led the research group which pioneered this surgery in the southern hemisphere, about eight years ago.

He has also led a burgeoning collaboration with Shanghai Jiaotong University Medical School (SJUMS), which began around the same time. UWA's Faculty of Medicine, Dentistry and Health Sciences and SJUMS now have established student exchanges, a double-badged PhD program and regular translational medical research symposia.

Dr Qin An was the first graduate to receive his PhD jointly from UWA and Jiaotong. He is working with Dr Hardisty and Professor Zheng in the new centre.  He plans to spend six months at a time in Shanghai and six months in Perth.

He said that No 9 hospital was the best orthopaedic hospital in China.

"We are conducting clinical trials of the procedure here at QEII, but sometimes it's hard to get enough patients to take part," Dr Hardisty said. "So it's great that our partners can help us with that."

Professor Zheng said that about one in a hundred Australians suffered tendinopathy or tendon injury.  "They are often sporting injuries but it is also rife among elderly people. Achilles problems and ‘tennis elbow' are also very common."

Dr Hardisty said that, while being very common, tendinopathy was very hard to treat. "The best results for tendon surgery would be about 60 per cent success," he said. "But this looks like it's going to work."

Cells from healthy tendons can be taken from any part of the body.  Dr Hardisty said the knee was one of the best sites. "Around the knee, the tendon is close to the skin and easy to extract with a needle. It is a big tendon, to taking some of the tissue won't affect it very much."

The new tendon cells are injected back into the patient, at the site of the tendon injury, by a radiologist, using high definition ultrasound to pinpoint the spot.  It is simple day surgery.

Dr Hardisty said tendon cells died in tendinopathy, and so couldn't regenerate, which could be why so much traditional tendon surgery failed.

"We are developing models to tell us why. We think it is partly due to the load that has caused the problem with the tendon in the first place. Repetitive strain or extra load blocks blood supply to the area and the cells start to die," he said.

"We have done a lot of clinical research and we needed a centre where we could integrate researchers at the molecular level with clinicians, so we could translate the research into practice.

"With this new centre, we can design studies better, we can train practitioners better and take our work from the laboratory to the bedside."

Collaborative clinical trials on tendon and cartilage repair will start in Shanghai within 18 months.

The collaboration between SJTMS and UWA, the Sino-Australia Research Centre for Skeletal Medicine, will bring together medical researchers in both countries to develop advanced treatments for osteoporosis, osteoarthritis and sports injury. The centre will also provide a training ground for PhD students and postdoctoral fellows from around the world.

UWA's Deputy Vice-Chancellor (Research) Professor Robyn Owens, and Dean of Medicine, Dentistry and Health Sciences, Professor Ian Puddey, signed the agreement for the research centre in April.

Professor Zheng described Professor Dai Ke Rong, the SJUMS's 80-year-old world-renowned orthopaedic surgeon and academic, as "the orchestra conductor" who is making the link between UWA and SJUMS.

Professor Dai was a Raine Visiting Professor at UWA in 2007.