Vanishing Bone. Conquering a Stealth Disease Caused by Total Hip Replacements

Description

• Unravels the mystery of periprosthetic osteolysis, a never-before-seen disease which causes the massive destruction of bone in individuals with total hip replacements
• Traces the disease from its discovery on a single x-ray to its elimination via the creation of an new material for hip implants
• Includes compelling patient case reports woven through the narrative
• Reveals the unique challenges faced by clinician-scientists who provide both patient care and conduct medical research

When dozens of holes appeared in a patient's femur alongside his hip prosthesis, experts were baffled as such a phenomenon had never been seen before. Over the first four decades of total hip surgery, the severe bone destruction multiplied, crippling many thousands ofpatients. Eventually identified as "periprosthetic osteolysis," this devastating disease affected over 1 million patients and was the leading cause of failure in total hip surgery. While total hip surgery dramatically reversed severe arthritis of the hip, the same operationsimultaneously created a relentless 'particle generator' in the body. Ironically, in the effort to do good, doctors were simultaneously doing major harm.

Vanishing Bone: Conquering a Stealth Disease Caused by Total Hip Replacements takes readers on a detective adventure in contemporary medical science, from the identification of the cause of the disease through the complex process of affecting its cure. Dr. William H. Harris and his colleagues played an important role in solving the mystery of this disease, pointing to its molecular biology, recognizing the unusual wear of the prostheses, and ultimately developing a new material for use in the manufacture of hip implants. With more than 6 millionpeople walking on this stable, low-wear material, the disease has been virtually eliminated among those with total hip replacements worldwide. Diseases are rarely observed, revealed, and eliminated in one lifetime. Vanishing Bone tells the captivating story of one such diseasethrough an engaging account of scientific and medical innovation.

Contents

Part I. Astonishing Discoveries
Chapter 1: The Game is Afoot!
Chapter 2: The Cart Before the Horse
Chapter 3: Uniquely Creative, but Dangerous
Chapter 4: The First Real Breakthrough
Chapter 5: Meanwhile, Back at the Ranch…
Chapter 6: Is It Really Cement Disease?
Chapter 7: An Unexpected First Step
Chapter 8: Flying Blind
Chapter 9: The Gamble Pays Off
Chapter 10: Success at Last!
Part II. Final Hurdles
Chapter 11: Terra Incognita: Here Be Dragons
Chapter 12: Suddenly, to the FDA
Chapter 13: A Regrettable Diversion
Chapter 14: Unforeseen Complications
Chapter 15: Panic
Chapter 16: Ubiquitous Success
Chapter 17: Reprise: The Reward of the Clinician-Scientist
Part III. Appendix
Further Reading
Timeline of Key Events
About the Author

William H. Harris, MD, DSc is the Alan Gerry Clinical Professor of Orthopaedic Surgery, Emeritus at Harvard Medical School and Massachusetts General Hospital in Boston, Massachusetts. The Harris Orthopaedic Laboratory at Massachusetts General wasfounded in 1969 and directed by Dr. Harris until 2004.