Rajpal Singh Nandra
MBBS Bsc (Hons) MRCS MRCGP DRCOG
NIHR Academic Fellow. ST4 Trauma and Orthopaedics. Health Education West Midlands
Osteoconductive and Osteoinductive solutions for bone defects or fracture non-union
National Institute of Health Research (NIHR)
A fracture non-union, where the healing prematurely arrests. Without intervention the injury will progress to a pseudoarthrosis. Non-union is surprisingly more common than anticipated. In Scotland of 850,000 adult fractures each year, between 2-11% of those become non-unions, affecting young active working adults and the elderly, with direct cost implication to the NHS estimated to average at £29,204 per patient.
Numerous biological products exist to augment healing following stabilisation of the fracture. However, there is no standardised product available to act as space filler in fractures with bone defects which offer a physical conduit for new bone formation, sustained local antibiotic delivery and local retention of biomolecules at the site of injury to maximise therapeutic effect.
We aim to develop an injectable and self-setting gel system containing a novel calcium pyrophosphate material to provide physical support for the non-union site and as a means to locally deliver and retain antibiotic agents. The calcium pyrophosphate particles are enzymatically degraded by osteoblasts recruited into the non-union site, with the by-products (Ca and P ions) in turn acting as the raw materials to form new bone.
Raj joined TRAILAB in 2015 after obtaining a clinical research fellowship. He is currently part of Birmingham Orthopaedic training program and aspires to specialise in Civilian trauma and injuries associated with the upper limb. He studied medicine at Bart’s and the London school of medicine and dentistry and was simultaneously awarded a first class honours degree in Experimental Pathology.
Outside of work; Raj is a keen golfer and cricketer.