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Repairing Damage When Hip Replacements Fail

Ruzanna Harutyunyan's picture

More people than ever are enjoying healthier and more active lives, thanks to hip replacements – but when these replacements fail, patients can be left immobile and in great pain.

New research at the University of Leeds will help doctors to repair the damage caused when hip replacements break down.

The research is led by orthopaedic surgeon Terry Tsiridis and bio-engineer Ruth Wilcox who have got together to tackle a growing problem. As Mr Tsiridis, of the Leeds Institute of Molecular Medicine, explains: “More people, and younger people than ever, are having these operations and they have a good record of success. Around 95 per cent are still working well after 10 years, and the best-performed ones can last 25 years.”

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But the prostheses – and the bone around them – can fail. Mr Tsiridis, who treats patients at Leeds General Infirmary, regularly encounters those whose new lease of life has suddenly ended as a peri-prosthetic fracture leaves them immobilised. And as younger people are treated, and life expectancies continue to grow, there is set to be a steady increase in the number of people suffering these setbacks.

There are already potential solutions. A second hip replacement can be put in, or plates inserted around the bone, using a number of different designs and fixings. The Leeds research will focus on classifying the various types of peri-prosthetic fracture, determining which treatment works best in which case, and publishing guidelines to ensure surgeons use the most appropriate techniques for the patients in their care.

Engineers from the University’s Institute of Medical and Biological Engineering will use sophisticated computer modelling techniques to simulate the fractures and their possible repairs, and to assess their durability over long periods. Alongside the simulation work, a testing rig will put potential solutions under further scrutiny, examining the bone, the prosthesis and different plates, screws and cements in the stressful conditions which might be encountered during a number of different physical activities.

“These fractures are a complication of one of the most common and successful prosthetic procedures,” said Dr Wilcox, who will work on the project with engineering colleagues Prof Zhongmin Jin and Dr Alison Jones. “The end result will be to classify these failures, and prescribe the best long-term solution for them.”

The research is being funded by Joint Action, with a £400,000 Latta Fellowship. Joint Action is the orthopaedic research appeal of the British Orthopaedic Association. The Fellowship was established by a legacy from Mrs Doreen Latta who was one of the first people to receive a Charnley Hip, developed by pioneering surgeon John Charnley, who was also one of her neighbours. Mrs Latta died in 2006, aged 93, leaving this lasting legacy to enable others to benefit from improved prosthetic techniques.