Stem cell science and orthopedic surgery may reduce failure rate in hip replacements

By combining stem cell science with orthopedic surgery, a team of researchers at the University of British Columbia and Vancouver Coastal Health Research Institute aims to reduce the 10 per cent failure rate in hip replacements and make repeat replacements and other joint repairs obsolete within 10-15 years.

With $1.5 million over five years in funding from the Canadian Institutes for Health Research, a group of seven UBC scientists will explore how stem cells – the body's "master cells" that can reproduce and develop many mature functional cells – can be used to regenerate bone cells to better secure artificial joints and other bone replacement structures. "We're very excited about the potential for long-term success for patients who need repeat surgery to repair or replace bone," says Fabio Rossi, UBC assistant professor of medical genetics and Canada Research Chair in Regenerative Medicine. "By using a well-understood stem cell and available technologies, we can accelerate research and have our discoveries quickly incorporated into patient care."

The team will create a new fixative mixture that combines minerals and slow-release growth factors. The mixture will be seeded with the patient's own mesenchymal stem cells – a type of stem cell that is easily extracted from adult bone marrow and capable of manufacturing bone cells and connective tissue. This "living glue" will form a strong, organic environment to secure artificial joints, vertebrae or other replacement structures where the original replacement has failed.

"Currently, these repeat replacements are difficult because considerable bone is lost as the joint gradually breaks down," says team member Tom Oxland, Canada Research Chair in Biomedical Engineering and director of The Centre for Hip Health, located at the Vancouver Coastal Health Research Institute (VCHRI). "New techniques will fill a critical need for the increasing number of people undergoing hip replacement and will also be useful for other bone loss patients." Hip fracture is one of the most common problems leading to bone loss and currently there is a 10 per cent failure rate in the 20,000 hip replacements performed annually in Canada. Problems include breakdown of the acrylic glue used to secure the prosthetic joint and weakened or damaged tissue surrounding the joint.

Team members include Don Brunette, associate dean, Research, Faculty of Dentistry; Pharmaceutical Sciences Prof. Helen Burt; Orthopedics Dept. Head Clive Duncan; Applied Science Assistant Prof. Goran Fernlund and Orthopedics Engineering post-doctoral fellow Hanspeter Frei.

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