Focusing on the Patient

Regardless of the implant’s design or materials it is inevitable that some amount of debris will be released from the implant over time, says Dr. Jacobs. For some people that will elicit a response that ultimately results in prosthesis failure. (Read more about why implants fail.)

 Understanding the body’s response to an implant can help by predicting who is most likely to respond to a certain implant material and finding ways to prevent or stop the response in susceptible individuals.

If doctors can understand the local cell responses to implant debris and the molecular pathways involved in implant failure, they will have a potential targets for therapy, meaning a drug that could be delivered either locally or systemically to stop block the process and keep implants secure.

Dr. Jacobs and other researchers suspect the response will be different for different people. Researchers are looking for genetic factors or hypersensitivities to some debris that would cause some individuals to be more reactive than others. “Some studies have shown that certain individuals, because of their genetic make-up may be more reactive to certain types of implants and that is an intriguing finding that researchers can follow up on, ” he says.

Although there are currently no tests that predict implant reactions, Dr. Jacobs suspects that in the future there may be a panel or battery of tests – looking at one’s genome, individual cell response or sensitivity to certain materials – that will guide doctors in selecting the best implant for a particular patient or the enable to stop or prevent a reaction if there are indications a patient is at risk of one.

“For example, if you know a patient is at high risk, there may be some kind of pharmacologic agent that you can use intermittently to block the localized cell response,” says Dr. Jacobs. “That is the sort of vision many of us have as we look into the future.”