Predict and prevent early hip arthroplasty complications

Two major and increasingly common early complications jeopardize outcomes after total hip arthroplasty (THA): Periprosthetic joint infection (PJI) and dislocation. Around 1,000 Swedish patients are annually re-operated for one of these two complications. Our specific aims are to:1) Identify novel risk factors for PJI or dislocation after THA.

This includes a search for genetic risk factors, by expanding our already initiated biobank and by performing a genome-wide-association study.

Furthermore, we will develop and externally validate risk assessment tools for PJI or dislocation after THA surgery.2) Develop implants that inhibit bacterial colonization.

We will develop antimicrobial silver nano-coatings and antibiotic hydrogels for titanium implants, and measure their osteoconductivity and antimicrobial activity.

Our coatings should allow for cementless implant fixation in high-risk patients.3) Investigate the safety and efficacy of implants designed to minimize the risk of PJI or dislocation in clinical trials. We here apply for a pragmatic multinational RCT nested within Dutch and Swedish arthroplasty registers.

Its primary objective is to investigate whether there is a difference in the risk of hip dislocation within one year following elective THA performed through a posterolateral approach, comparing dual mobility to standard cups in elderly patients.Our approach has the potential of taking “precision medicine” to arthroplasty surgery.