MGH surgeon tells 40-year tale of investigation and innovation into the challenge of hip implant failure
A remarkable story of how a new disease was inadvertently caused by successful medical treatment, ultimately understood, and eventually defeated by scientific innovation is being told a major player in the process. In the December issue of Clinical Orthopedics and Related Research, William Harris, MD, DSc, of Massachusetts General Hospital (MGH), describes how the development of total hip replacement led to an unexpected problem, erosion of bone adjacent to the implant, and how his team and others both identified the process underlying that breakdown and helped to develop new materials that avoid the problem. "The history of the unraveling and prevention of this worldwide, unique, severe disease is a fascinating story of the integration of surgical innovation, molecular biology and material science," writes Harris, who is Alan Gerry Clinical Professor of Orthopaedic Surgery at Harvard Medical School.
Harris was a pioneer in the field of joint replacement, beginning in the late 1960s. But he and other surgeons gradually observed that hip implants could loosen starting about 5 years after surgery and eventually fail completely. There were many theories about the cause of that loosening, several which focused on the adhesive used or the possibility of infection.
Sue McGreevey | EurekAlert!
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Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.
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