Longer-life hip replacement hope for arthritis patients
A surgeon based at Sheffield University's Bone Metabolism Group has been awarded a grant from the Arthritis Research Campaign to find out if a person's genetic make-up has an effect on how long their hip replacement lasts.
Andrew Gordon, an orthopaedic surgeon at the Northern General Hospital, has been awarded a £54,000 three-year clinical research fellowship by the Chesterfield-based medical research charity, and is also being funded by the Royal College of Surgeons of England.
More than 50,000 hip replacement operations are carried out in the UK every year, making it one of the most common - and successful - forms of orthopaedic surgery. But some hip replacements become loose, causing pain, and may need further surgery. Some people appear to be more susceptible to loosening to others.
Mr Gordon will recruit patients who have undergone a hip replacement, and identify genetic differences between them that result in different responses to the loosening process. Patients whose hips became loose after surgery will then be compared to patients with a long-lasting hip replacement, to find out how their genetic make-up differs.
"Loosening is the main reason why hip replacements fail and need revising," explained Mr Gordon. "The plastic socket in the pelvis wears against the metal ball of thigh prosthesis generating wear debris. One theory is that the small plastic wear debris particles stimulate an inflammatory process by activating chemical messengers. It was thought that people react in a similar way to the plastic particles; however, this may not be the case.
"In previous work we've shown that some genetic differences between people may contribute to the risk of artificial joint loosening, and in the current study we plan to determine the effects of a number of genetic differences between individuals, and examine which of the genetic differences are specifically responsible for the different activity of the chemical messengers."
If a patient's genes are found to affect the lifespan of their hip replacements, it could lead to preventative treatment for those people at risk, for example prophylactic bone strengthening therapy. It could also identify new therapies which reduce inflammation.
