DC3-project 3: Biomechanical factors in Charcot neuro-osteoarthropathy and deformity
Background
One of the most complex and devastating complications of foot disease in diabetes is Charcot neuro-osteoarthropathy (or Charcot foot). In this condition, inflammatory processes in persons with neuropathy result in damage to bones, joints, and soft tissues of the foot and ankle. While biomechanical factors are important in the cause and development of the Charcot foot, there are gaps in our knowledge concerning the extent and mechanisms through which biomechanical and other factors contribute to the development of foot deformity, ulceration and amputation. In this DIALECT project, we go beyond state-of-the-art to develop, validate and implement comprehensive and novel biomechanical analyses and models of the Charcot foot. The knowledge acquired will improve the understanding of factors contributing to disease outcomes in this complex, and devastating condition, and pave the way for personalised medicine in ulcer and amputation prevention in these patients.
Approach
The doctoral candidate will retrospectively assess 3 unique clinical datasets on Charcot feet from Amsterdam UMC, King’s College Hospital and Glasgow Caledonian University, to identify risk factors for Charcot foot and disease progression. Subsequently, more in-depth prospective analyses in patients with Charcot neuro-osteoarthropathy will be done. These will include biomechanical and structural assessment, e.g. lower-extremity gait kinematics and kinetics and barefoot and in-shoe plantar pressures, 3D reconstruction and segmentation of foot bones using computer tomography (CT) imaging, and soft tissue morphology using magnetic resonance imaging (MRI). Prospective inclusion will be done in Amsterdam and London. The doctoral candidate will derive from this multiscale data: Insight in the risk factors for Charcot foot and midfoot deformity; Insight in biomechanical and other markers of Charcot foot; Characterisation of foot deformities (type, distribution and prevalence) in Charcot feet; A biomechanical model of Charcot foot and midfoot deformity.
Our research team
Amsterdam UMC is a leading institute on clinical, biomechanical and radiological research on diabetic foot disease, in particular, in the prevention of foot ulceration and amputation. The candidate will learn from, and collaborate with, a multidisciplinary team of clinicians, movement scientists and radiologists and also with the two other Doctoral Candidates from DIALECT in Amsterdam UMC who will focus on the foot in remission and on footwear development for ulcer prevention. The research group is embedded within the Department of Rehabilitation Medicine that has high-class facilities for biomechanical research, among which a motion analysis laboratory, and Department of Radiology, which is equipped with advanced imaging techniques such as MRI, weight-bearing and dual energy CT, and ultrasound. The research group is also embedded in the Amsterdam Movement Sciences research institute, where collaboration exists with many Amsterdam partners in the field of movement sciences, among which the Faculty of Behavioural and Movement Sciences of the Vrije Universiteit.
External supervision in this project comes from DIALECT partners at King’s College Hospital (London, United Kingdom) and Steno Diabetes Center, Copenhagen (Denmark). The Diabetic foot Clinic at King’s College Hospital is renowned for their multidisciplinary treatment of people with diabetic foot disease, and has a longstanding clinical and research experience in Charcot foot. Steno Diabetes Center is one of the world’s largest diabetes centers, with a dedicated and experienced foot team, and track record in care and research in Charcot foot.
Your experience
- Candidates should be eligible to enrol for a doctoral program in the Netherlands, for example by having a Master’s degree in health, biomedical or movement sciences, medicine, or related field
- Strong higher education track record and strong, broad scientific curiosity
- Strong analytical and scientific communication skills
- Experience with quantitative data analysis, preferably large datasets
- Demonstrable fluent spoken and written English skills
- Capable of functioning in a multidisciplinary environment, with researchers, clinicians and patients, requiring interpersonal curiosity and soft skills
In addition, the following experience would be helpful, but not essential:
- Experience with gait analyses (e.g. pedobarography, 3D gait analyses)
- Experience with medical imaging techniques (e.g. radiography, MRI, CT, Ultrasound)
We seek a highly motivated scientist who enjoys an interdisciplinary environment and an interdisciplinary project, able to work independently but also as part of a team. The research project should result in a PhD thesis.
Our offer
This PhD position is funded by the Marie Skłodowska-Curie Actions (MSCA) of the European Union’s “Horizon Europe 2022” research and innovation program under grant agreement No 101073533. You will be appointed as fulltime PhD for 3 years and 6 months with Amsterdam University Medical Centers, part of the University of Amsterdam. The MSCA programme offers competitive and attractive working conditions. The successful candidates will receive a salary in accordance with the MSCA regulations for early-stage researchers. Gross salary will consist of a Living Allowance (= €40.800/year, correction factor to be applied for the Netherlands: 1.10) and a monthly Mobility Allowance of €600. An additional monthly allowance of €660 is applicable depending on family situation. Please be aware that these amounts are subject to taxes, the exact salary will be confirmed upon appointment; for more information contact our financial controller, see below. In addition to their individual scientific projects, all Doctoral Candidates in DIALECT will benefit from further continuing education, which includes internships and secondments, a variety of training modules as well as transferable skills courses and active participation in workshops and conferences.
Amsterdam University Medical Centers
The Amsterdam UMC is the largest hospital and foremost medical research institution in the Netherlands with over 13,000 employees, combining what were previously the Academic Medical Center and Vrije Universiteit Medical Center. The location of Amsterdam UMC at Meibergdreef is part of the University of Amsterdam. Some 2500 staff members are fully or partially employed in medical research. Amsterdam Movement Sciences is one of the 8 research institutes of Amsterdam UMC that conducts world-class research on many different aspects of movement, both fundamental and clinical (see here for more info). Amsterdam UMC houses high quality core facilities including a movement analysis lab, advanced imaging techniques, medical physics department.