Patient specific biological responses to total joint arthroplasties
Supervisor: Dr Joanne Tipper
The majority of hip replacements carried out each year comprise a metal femoral head articulating on a UHMWPE acetabular cup. The biological response to UHMWPE wear particles, generated at the articulating surface, is an inflammatory response mediated by specific cytokines, leading to bone resorption and eventual osteolysis. A revision surgery is subsequently required.
Recent research has shown that the major cytokine involved in osteolysis due to the presence of UHMWPE wear particles is the pro-inflammatory cytokine tumour necrosis factor alpha (TNF-α). Several polymorphic sites have been identified in the TNF-α gene promoter region. Individuals who are homozygous for the presence of these polymorphisms have been shown to have an increased incidence of osteolysis requiring a revision surgery.
The aim of this project is to correlate clinical outcome of the biological response to UHMWPE wear particles with cytokine promoter genotype. This will allow the identification of patients who are likely to respond aggressively to UHMWPE wear particles leading to osteolysis and surgical revision. Identification of such patients will permit selection of more suitable bearing material prostheses.