The Concept

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 [1]. 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 [2]. In UK 2012 12% of all hip joint and 6.5% of all knee joint replacement surgeries are revisions [3].

 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  [4]. 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.