Scientists at a Newcastle city centre biotech firm have made a discovery they say could usher in a new era of orthopaedic surgery.
Helix-based ExplantLab discovered a genetic link that points to why some people experience pain and early failure of joint replacements such as new hips. Around 10% of the UK population will have a joint surgically replaced in their lifetime, and ExplantLab says a significant number experience early failure that can lead to potentially dangerous and costly repeat surgery.
Dr David Langton, a trained surgeon and CEO of the biotech outfit, said: "A large percentage of joint failures are due to adverse immune responses, where small particles from the joint implant are released into the blood through wear and tear, stimulating an immune response in the body.
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"Essentially, the immune system attacks the implant in a process similar to how a patient rejects an organ transplant. How quickly this 'sensitisation' happens is variable and unpredictable, but it appears to be dependent on the type of material, the amount of wear debris released and other patient specific factors."
Dr Langton and his team studied failed replacement joints and specifically the material they are made from. Cobalt chrome (CoCr) is one such material used in about 70% of implants globally. It can release small particles into patients' blood, which can trigger a response.
ExplantLab found that a significant proportion of patients carry a genotype - the genetic makeup of an individual cell - which puts them at a greater risk of developing sensitivity to CoCr. The discovery was published in the key biomedical research journal, Nature Communications Medicine.
Now the Newcastle team has worked with staff and patients at Newcastle University, University Hospital of North Tees and Hospital for Special Surgery, New York and Royal Perth Hospital, Australia, to develop an algorithm called Orthotype, which profiles a patient's risk. The technology - which has been registered for use in the UK - can be used before or after joint replacement surgery, either to help determine the best implant for a patient or to assist a clinical diagnosis.
Dr Langton added: "Orthotype helps to identify patients and understand the risks prior to surgery, representing a significant advance in orthopaedic care for patients, and a step-change for orthopaedic surgeons, with potentially significant financial repercussions for global healthcare systems, through the avoidance of repeat surgery."
The breakthrough is just the latest success for ExplantLab which also delivered award-winning research into Covid. Working with Newcastle University, Northumbria Healthcare, Newcastle Hospitals Trust and University of Oslo, the firm identified a gene which offers protection against severe complications related to the virus.
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