Research Notes — New test may detect signs of joint replacement failure

More than 1.5 million total joint replacement operations are performed worldwide each year. While the success rate is 90 percent, almost 10 percent of implants fail and require additional surgery.

Dong Wang, Ph.D.

Now, UNMC researchers have discovered a promising test to detect the early stages of a major cause of failure in joint replacement implants so patients can be treated and possibly avoid additional surgery.

The research, published online in the American Chemical Society’s Molecular Pharmaceutics, highlights the work of Dong Wang, Ph.D., associate professor of pharmaceutical sciences in the College of Pharmacy.

Researchers know that wear and tear in a joint replacement can create tiny bits of debris that cause local inflammation and lead to bone loss. When this happens, the implant can become loose and set the stage for failure. Treatment usually comes too late because it’s difficult to detect the problem in its early stages.

Additional collaborators Others who contributed to the project are UNMC’s Ke Ren, Ling-dong Quan and Geoffrey Thiele, Ph.D., and P. Edward Purdue, Ph.D., and Lyndsey Burton from the Hospital for Special Surgery (HSS) of New York.

Dr. Wang has developed a polymer-based system to image the inflammation associated with the wear debris.

Tests of the agent in mouse bone suggest that it can help detect the early stages of bone loss that might cause a joint implant to become loose and/or painful. Researchers also could tether an anti-inflammatory drug to the polymeric system in order to treat inflammation and bone loss in these early stages of wear.

The idea for the agent originated more than two years ago when Ed Fehringer, M.D., associate professor of orthopaedic surgery at UNMC, and Dr. Wang met to brainstorm potential collaborations.

Dr. Wang also credits Steven Goldring, M.D., chief scientific officer and St. Giles Chair at the Hospital for Special Surgery in New York, for his contributions.