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PP11 - OBV - Valdoltra Orthopaedic Hospital

Orthopaedic medicine, materials science, microscopy,histology, chemical analysis and statistics.


DESCRIPTION OF ORGANIZATION/DEPARTMENT 

The Valdoltra Orthopaedic Hospital is located in the Italian/Slovenian cross-border region (within Slovenian Littoral Region). The main clinical activity is devoted to the maintenance and development of orthopaedics, but in the last decade the Hospital itself has established its own Research department. At the Research department the surgeons and researchers are joined in an interdisciplinary team which performs research work and activities directed to the understanding of prosthesis performance from several aspects including mechanical, biological, material and clinical aspects. Studies are largely based on the hospital’s Arthroplasty Register which represents a valuable source of information for data-based analysis of arthroplasty treatments. Our register is special in that it includes the implant retrieval program for explanted prosthetic components and periprosthetic tissue samples. Research is versatile and interdisciplinary, and is a challenge for young researchers searching for new knowledge and scientific results. Moreover, the Research department at the hospital has built its own research laboratory which is strictly dedicated to the research on protective naocoatings for orthopaedic implants.
 
 


TECHNOLOGIES AND EXPERTISE AVAILABLE 

Technologies/Expertise available:
- Implant retrieval program (IRP, Implant retrieval program is included in the Arthroplasty Register of the Valdoltra Orthopaedic Hospital and represents a valuable source of information for scientific, data-based analysis of arthroplasty treatments and for now it is meant only for all primary and revision hip and knee surgeries. In IRP are collected the explanted prosthetic components and periprosthetic tissue samples, that are the basis for various research analyses aimed to reveal changes on the surface of the component and in the periprosthetic tissue, induced during in vivo functioning of the prosthesis. Another, the most important advantage of using IRP is the possibility of long-term follow-up of individual types of prostheses and early recognition of possible deviations from expected results and subsequent fast reaction, i.e. alarm).
  • Histological analysis of the periprosthetic tissue around failed joint arthroplasties;
  • Isolation of wear particles from the periprosthetic tissue around failed joint arthroplasties;
  • Analysis of periprosthetic aspirate in the diagnosis of prosthetic joint infection;
  • Microbiological diagnostics (clinical isolates diagnostics);
  • Preparation of protective – antibacterial coatings for implants based on natural biopolymers, additionally functionalized with antimicrobial peptides, AMPs (ongoing collaboration with T2C project partner PP8 – University of Udine).
 
 


FIELD OF RESEARCH/ACTIVITIES

The research at the hospital is divided into two parts: a) clinical aspect - The Research department at the Valdoltra Orthopaedic hospital was formally founded in 2002. It is devoted to the research studies in orthopaedics, primarily to long-term performance of various prostheses. Our aim was to join the surgeons and researchers in an interdisciplinary team which would perform research work and activities directed to the understanding of prostheses performance from several aspects including mechanical, biological, material and, of course, clinical aspect. Research studies at the hospital are largely based on the hospital’s Arthroplasty Register which represents a valuable source of information for data-based analysis of arthroplasty treatments. Following the example of Scandinavian arthroplasty registries we have established the Arthroplasty Register of the Valdoltra Orthopaedic Hospital in 2002 in order to assure the results of arthroplasty treatment and long-term follow-up of clinical results. The Register comprises all primary and revision hip and knee operations. For that purpose, forms and date-base have been developed. Based on the analysis of the data given in the forms, annual reports are prepared. There are numerous advantages of Arthroplasty register, among them the most important are long-term follow-up of individual types of prostheses and the possibility of early recognition of possible deviations from the expected results and subsequent fast reaction, i.e. alarm; b) scientific aspect – in the last year, more precisely upon beginning of the project Trans2Care, the Research department has opened a new laboratory devoted only to research work (basic and applicative). The research is focused mostly on the fabrication of antibacterial coatings, chemically and mechanically stable, to be used to cover the surface of the orthopaedic implants. In this manner, the implants would be highly protected from severe bacterial infections, thus, generating long-term stability of the prosthesis and preventing its loosening.
 

 
KEY WORDS

orthopaedic implants, implant survivorship, material science, nanotechnology, antibacterial coatings


OTHER

The Research Lab has been opened very recently, in the Spring 2012. For now, the Lab is equipped with some basic instruments and other material stuff in order to proceed with the basic research on fabrication of antibacterial coatings for orthopaedic implants. The long-term plans include the establishment of a top level Research Lab (also with the help of external financial inputs as EU projects) in the field of design and fabrication of antibacterial protective coatings for various orthopaedic implants.

The Research Lab, directed by Prof. Dr. Ingrid Milošev, has already a long-term steady collaboration with ``Jožef Stefan`` Institute and Faculty of Health Sciences, University of Primorska. Moreover, Valdoltra has been being part of many national and EU projects, as:
EU (cross-border) projects – both will close in Fall 2014:
 
  • Trans2Care (ongoing collaboration with PP8 – University of Udine);
  • E-Health
 
National (bilateral) projects:
 
  • Classification of peri-prosthetic tissues of totally replaced hips based on the pathomechanism leading to revision operation – Bilateral project with Finland, ended in 2012;
  • Analysis of elementary activities and adaptation of skeletal muscle system on some factors affecting modern lifestyle of children aged between 4 and 7 years, in collaboration with Univeristy of Primorska, ended in Spring 2012;
  • Genetic factors in osteoporosis, in collaboration with University of Ljubljana, General Hospital Celje, ended in Spring 2012;
  • Diagnostic of infection at revision of total hip prostheses, in collaboration with University of Primorska and Institute of Public Health Koper, ended in Spring 2012;
  • Surface modification of metal biomaterials and theirs interaction with bio-environment, in collaboration with Institute ``Jožef Stefan`` and Faculty of electrical engineering (University of Ljubljana), still ongoing till June 2014.
 
 
 
Valdoltra Orthopaedic Hospital
  Ingrid Milošev
Jadranska cesta 31 6280 ANKARAN Slovenia
Slovenia