Dr JL Tipper

Senior Lecturer in Bioengineering

Patient specific biological responses to total joint arthroplasties: New engineering solutions
EPSRC Advanced Fellowship
Supervisor: Professor Eileen Ingham, Professor John Fisher

Wear particles released from the articulating surfaces of total joint replacements induce biological reactions, which ultimately lead to bone loss around the implant and loosening of the prosthesis. This often leads to pain and the need for a revision operation. The biological response to wear particles is variable, with some patients exhibiting low reactivity, some intermediate reactivity and some an aggressive response. It is these patients that experience an aggressive response that are likely to be more susceptible to prosthesis failure. The identification of those patients that exhibit the most aggressive response to UHMWPE particles, and the correlation of this response with carriage of a particular genotype may provide the basis for a valuable diagnostic tool capable of identifying patients most at risk of implant failure. The most suitable prosthesis type will then be selected for individual patients. With routine screening of patients prior to total joint arthroplasty, the risk of osteolysis and the need for revision will be greatly reduced.

As the ageing population becomes more active and lives longer, and an increasing number of prostheses are being implanted into younger patients, implant longevity has become more important. Currently, there is great interest in alternative bearing materials such as cross-linked polyethylene's and ceramics, however, suitability is often assessed on wear volume alone prior to clinical use. Biological activity of wear particles is an important indicator of clinical performance, and determination of the biological activity of the wear particles released from these alternative bearing materials remains to be determined.

Research Institute Membership

• Institute of Medical and Biological Engineering