HYPORTH · New approaches in the development of Hypoallergenic implant material in Orthopaedics: steps to personalised medicine

Europe is confronted by a demographic challenge as a decreasing work force has to support an increasing elderly population. The economic risk implied by this burden could be addressed by efforts to achieve an increase in Healthy Life Years. One key element would be to ensure unrestricted mobility for especially the elderly, allowing them to stay at work for longer. Irreversible joint deterioration often requires a joint replacement. Implantation of artificial joints is one of the most successful orthopaedic interventions. However, an increasing number of patients receive revision surgery with these 10 % of these contract an infection and 50 % develop an adverse immune reaction (AIR) to conventional implant material. At the moment the reasons for the development of AIR are inadequately understood. Our proposal contains innovative solutions concerning this problem. A predictive approach using biomarkers will identify patients with risk to develop AIR. These patients will receive hypoallergenic endoprostheses, avoiding AIR to conventional material. Novel hypoallergenic material combinations will be developed in the frame of this consortium by material scientists and implant manufacturer. Via immunological, microbiological and biocompatibility testing the development and production process will be improved constantly. The matching of implant material with the allergenic background of patients will avoid complicated and cost-intensive reverse reactions and is a step towards personalised medicine. A further approach is to achieve a better understanding of mechanisms of AIR, and its faster and easier diagnosis using sensitive diagnostic biomarkers for an accurate differentiation from low-grade infection. Additionally, mathematical modelling of results from different methods will show us the gene regulatory network that leads to an amplification of the adverse immune response triggered by prosthetic implants and will develop predictive models of AIR process.