MAKING ARTIFICIAL JOINTS MORE RELIABLE

Each year about 700,000 patients nationwide bring home more than a few good anecdotes and vials of medicine from their trip to the hospital. They also pack within their bodies a nice shiny artificial joint--usually a knee or hip, but sometimes an ankle, elbow, shoulder, or finger or toe joint, made of titanium.

Usually the new body part operates flawlessly for decades, but nearly 20 percent of patients end up with problems because the new joint loosens. That means immobility and pain for the patient, either reducing the quality of life or making another joint replacement necessary.

Now, armed with a $1.4 million research grant, physicians at Strong Memorial Hospital are investigating the genetic roots of the problem. A team from the Department of Orthopaedics led by Regis J. O'Keefe and Edward M. Schwarz is one of the first in the nation to target the genes that contribute to joint loosening.

Scientists have begun identifying the key molecular players in the cascade of events that sometimes leads to a misdirected feeding frenzy, where the body's own cells attack healthy bone that surrounds an artificial joint. O'Keefe and Schwarz are studying ways to knock out two of the genes responsible. The four- year project is being funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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