The latest ADVANCE sub-study – Bio-Mil-OA – formally began earlier this year. The study looks at changes in the ADVANCE participants’ joints, mainly knees in the first instance. These changes – which result in pain and reduced use of the joints – are called osteoarthritis. Osteoarthritis can be more common both in military people and in people who have been exposed to trauma.

The Bio-Mil-OA study uses X-rays and blood tests to investigate joints and osteoarthritis. The aim is to understand how changes in X-rays and blood tests are related to how individuals feel about their joints, how much pain they are in and how they use their joints.

Bio-Mil-OA receives funding from Versus Arthritis, a dedicated arthritis charity, and is a collaboration with the University of Nottingham. The study is military doctor Major Oliver O’Sullivan’s PhD research project. He works between Nottingham University and ADMR at DMRC Stanford Hall.

The study uses specific biomarkers and other tests from the ADVANCE baseline and first follow-up visits. Biomarkers are compounds found in your blood, for example, proteins and metabolites.

Major O’Sullivan commented: ‘We hope that looking at these biomarkers will help us understand the progression of osteoarthritis and see if any of the markers can predict joint changes. We are hoping to find specific markers in blood that could be used to identify changes in the joints before they become an issue.’

The Bio-Mil-OA does not involve any additional tests for the ADVANCE participants but aims to use existing collected data, e.g. X-rays. The study will build on the work done by teams led by Prof Marc Dumas in biomarkers and Prof Anthony Bull in osteoarthritis, both from Imperial College London.

Alongside Major O’Sullivan, there is a wealth of knowledge in biomarkers and osteoarthritis from Professor Ana Valdes, Professor Stefan Kluzek and Dr Joanne Stocks from Nottingham University. They are supported by the ADVANCE Chief Investigator Group Captain Alex Bennett.