Joint revision procedures place a tremendous economic burden on the healthcare system. Current figures from the Norway show that the cost of revision surgeries exceeded NOK 2.5 Billion in 2012 . Data from The Norwegian Arthroplasty Register (NAR) demonstrate that 14.3% of all hip and 8.5% of all knee joint replacement surgeries are revision surgeries . In UK 2012 12% of all hip joint and 6.5% of all knee joint replacement surgeries are revisions .
Current figures from the US show that revision procedures account for approximately 19% and 8% of all total hip and knee replacements, respectively that is reimbursed by Medicare . Medicare reimbursements for revision of total joint replacements have been projected to exceed $8.5 billion by 2015.
As a result of improved surgical techniques and total joint artroplasty (TJA) becoming a routine surgery, the age of the patients receiving TJA is steadily decreasing and so is the threshold level of arthritis necessitating the procedure.
The current gold standard for diagnosing joint prosthesis loosening and osteolysis is medical imaging, mainly by radiography. All current methods of detecting osteolysis and prosthesis loosening have severe limitations [5,6], and not provide adequate diagnostic resolution, especially in the early phase of disease development.
Current imaging methods are highly dependent upon use of expensive equipment and require highly specialized competence. There is a clear and pronounced need for new diagnostic tools to enhance the sensitivity for osteolytic lesions and subsequent periprosthetic loosening.
Our aim is to generate a new product line for molecular diagnostics of prosthesis loosening. Similar approaches have been used in other disease areas [7, 8] and market segments, but this approach is novel in the field of joint prosthesis.
The project represents a first mover advantage to establish a novel diagnostic tool and a novel market segment, currently without satisfactory diagnostic methodology.
Helsedirektoratet, Prioriteringer i helsesektoren. Verdigrunnlag, status og utfordringer, 2012. The Norwegian Arthroplasty Register. Annual Report 2012 Porter, M., et al., 10th Annual Report 2013 National Joint Registry for England, Wales and Northern Ireland, 2013. Ong, K.L., et al., Risk of subsequent revision after primary and revision total joint arthroplasty. Clin Orthop Relat Res, 2010. 468(11): p. 3070-6. Claus, A.M., et al., Radiographic definition of pelvic osteolysis following total hip arthroplasty. J Bone Joint Surg Am, 2003. 85-A(8): p. 1519- 26. Cooper, H.J., et al., Early reactive synovitis and osteolysis after total hip arthroplasty. Clin Orthop Relat Res, 2010. 468(12): p. 3278-85. Attur, M., et al., Increased interleukin-1beta gene expression in peripheral blood leukocytes is associated with increased pain and predicts risk for progression of symptomatic knee osteoarthritis. Arthritis Rheum, 2011. 63(7): p. 1908-17. Julia, A., et al., An eight-gene blood expression profile predicts the response to infliximab in rheumatoid arthritis. PLoS One, 2009. 4(10): p.e7556.[/vc_column_text][/vc_column][/vc_row]