Impaired Bone Remodelling Leads To Failure Of Orthopaedic Prostheses
Funder
National Health and Medical Research Council
Funding Amount
$515,917.00
Summary
The failure of bone prostheses is becoming a major health problem. More than 26,000 hip, and an equal number of knee, replacements were performed in Australia in 2002 with the number increasing between 5%-10% each year for the previous 10 years. Disturbingly, the incidence of revision hip surgery in Australia is now more than 15%, meaning that, despite the impressive success of joint replacement surgery, a significant number of arthroplasties fail. It is becoming more common for young, active in ....The failure of bone prostheses is becoming a major health problem. More than 26,000 hip, and an equal number of knee, replacements were performed in Australia in 2002 with the number increasing between 5%-10% each year for the previous 10 years. Disturbingly, the incidence of revision hip surgery in Australia is now more than 15%, meaning that, despite the impressive success of joint replacement surgery, a significant number of arthroplasties fail. It is becoming more common for young, active individuals to receive joint replacement surgery to improve their quality of life. This, combined with increasing life expectancy, and the known higher rate of failure of joint replacements in younger patients, means that the morbidity of a failed replacement, and the mobidity and associated mortality of revision surgery, will become an increasingly important health issue, with a major impact upon health budgets. The overwhelming majority of hip and knee prostheses have metal or ceramic on polyethylene bearing surfaces. It is now apparent that most implants fail due to bone loss around them leading to loosening, and evidence is accumulating that polyethylene wear particles are a major contributing factor to this process. It is therefore vital that we obtain better understanding of the causes of implant failure in order to extend the life of these implants and this project is designed to do so.Read moreRead less
Artificial joint implants are widely used to replace diseased or damaged joints. Despite the impressive success of joint replacement many artificial joints do not last indefinitely. In many patients joints last for 25 years or more but in about 15% the artificial joints will fail prematurely. Artificial joints need to be replaced because of loosening resulting from the loss of bone from around the artificial joint. The bone loss is caused by large numbers of small particles generated by excessiv ....Artificial joint implants are widely used to replace diseased or damaged joints. Despite the impressive success of joint replacement many artificial joints do not last indefinitely. In many patients joints last for 25 years or more but in about 15% the artificial joints will fail prematurely. Artificial joints need to be replaced because of loosening resulting from the loss of bone from around the artificial joint. The bone loss is caused by large numbers of small particles generated by excessive wear of the artificial joint. We now know that specialised cells in the body react to the wear particles and try to destroy them. During this process they produce molecules which lead to bone destruction. This project seeks to investigate the way particles cause bone loss and to develop drug treatments that will either prevent the loss of bone or promote new bone to replace that which has been lost. The increasing use of joint replacement and an aging population means that the number of patients with artificial joint failure will increase. This will mean that an increasing amount of medical recourses will be needed to replace failed and painful artificial joints. It is planned that the findings obtained from this project will eventually result in drug treatments which can reduce the need for the replacement of artificial joints.Read moreRead less
Tooth wear is a significant clinical problem for both older people who have kept their natural teeth and for some younger individuals. The main causes of tooth wear are attrition (resulting from tooth to tooth contact), abrasion (from dietary and environmental abrasives) and erosion (caused by acidic food and drinks or from regurgitation of acid). At present our understanding of the relative significance of these types of wear and the exact conditions under which excessive wear occurs is limited ....Tooth wear is a significant clinical problem for both older people who have kept their natural teeth and for some younger individuals. The main causes of tooth wear are attrition (resulting from tooth to tooth contact), abrasion (from dietary and environmental abrasives) and erosion (caused by acidic food and drinks or from regurgitation of acid). At present our understanding of the relative significance of these types of wear and the exact conditions under which excessive wear occurs is limited. Furthermore our understanding of the wear characteristics of many commonly used dental materials is limited. The proposed study will provide important new information about: the interaction between applied bite forces and acids in the oral environment as determinants of the rate of tooth wear; the potential for wear prevention using mouth rinses and gels; the wear characteristics of dental materials commonly used to restore teeth.Read moreRead less
We will seek to address an important clinical problem in orthpaedics, namely the bone loss that commonly occurs around joint replacement prostheses. Termed peri-prosthetic osteolysis (PO), this bone loss can result in the loosening and ultimate failure and need for revision of the artificial joint components. PO is thought to be caused by the body's reaction to wear particles generated from the articulating surface of the prosthesis. However, it has not previously been possible to accurately exp ....We will seek to address an important clinical problem in orthpaedics, namely the bone loss that commonly occurs around joint replacement prostheses. Termed peri-prosthetic osteolysis (PO), this bone loss can result in the loosening and ultimate failure and need for revision of the artificial joint components. PO is thought to be caused by the body's reaction to wear particles generated from the articulating surface of the prosthesis. However, it has not previously been possible to accurately explore the relationship between prothesis wear and PO, or the progression of PO, because of a lack of techniques to image and measure the volume of PO around metal prosthesis components. We have developed a means to accurately and reproducibly measure the volume of bone loss, using CT, and will do so longitudinally in joint replacement patients to obtain the first information about the progression of PO. New computer based methods will be used concurrently to relate prosthesis wear and migration parameters to PO. Patients who come to surgery for replacement of failed prostheses will be investigated further by analysis of the tissues involved in the bone loss around prostheses. Basic science experiments will seek to understand the underlying causes of PO and the findings will be important in interpreting the clinical results. An animal model will be used to seek approaches to inhibiting the pathological response to wear particles. The significance of these studies is that they will lead to improved outcomes for joint replacement patients, increasing the interval to revision surgery, which is both extremely costly and brings an attendant morbidity and mortality.Read moreRead less
Case-control Study To Promote Oral Health In Asthmatic Children:Natural Dietary Strategies To Conserve Teeth Erosion
Funder
National Health and Medical Research Council
Funding Amount
$112,500.00
Summary
Asthmatic children are at risk of dental corrosion, from medications that shut off saliva. Saliva protects teeth from acids in soft drinks and stomach-acid reflux. Dentist, William George Young and Nutritionist, Peter Davies, at the University of Queensland study children’s teeth, diet and lifestyles for the best natural methods to promote oral health. They will counsel parents and children on diets that conserve the teeth from dental erosion and decay by salivary stimulation. Patients need to s ....Asthmatic children are at risk of dental corrosion, from medications that shut off saliva. Saliva protects teeth from acids in soft drinks and stomach-acid reflux. Dentist, William George Young and Nutritionist, Peter Davies, at the University of Queensland study children’s teeth, diet and lifestyles for the best natural methods to promote oral health. They will counsel parents and children on diets that conserve the teeth from dental erosion and decay by salivary stimulation. Patients need to self-manage their asthma and diets to avoid negative outcomes and costs in acute medical and dental therapy for these two chronic conditions.Read moreRead less