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The foundations of the NRR collaboration rest at the University Hospital of North Tees, in the North East of England.

In 2007, a consultant orthopaedic surgeon, Mr Antoni Nargol, embarked on an audit of his patients into whom he had implanted what was meant to be a revolutionary new hip replacement: the ASR (Articular Surface Replacement). The ASR, manufactured by DePuy (a subsidiary of Johnson and Johnson), was developed and marketed as a precision engineered product, designed to such high standards that younger patients would be able to return to full activities following their procedures.

Unfortunately, problems began to emerge with patients a number of years after they had undergone surgery. Patients presented with unexplained pain, and it became apparent that they were suffering reactions to wear debris produced by their artificial hips. Mr Nargol, using research funds provided by Depuy, employed a full time researcher, David Langton.


It was recognised at that time that there were no facilities in place to have the removed devices (“explants”) examined to determine the cause of their failure. The doctors at North Tees Hospital therefore teamed up with Professor Thomas Joyce at Newcastle University in order to address this.


Using a grant awarded by Joint Action, specialised equipment was purchased and bespoke computer software developed to reverse engineer the explanted ASR prostheses and determine how much wear debris had been shed in to the patients. It became clear that the ASR was producing much greater amounts of metal than was expected.


These investigations helped inform regulatory action and the ASR was removed from operating theatres across the world. The story is told in the New York Times article "The Implants Loophole"


Nargol, Langton and Joyce began to work closely with doctors from other units, including Glasgow, Sunderland, Gateshead, Durham, Newcastle, Coventry and Warwick.


The NRR has recently moved to a new custom built unit with greater capacity for explant processing and storage. It is sited at ExplantLab, in The Biosphere, Newcastle Helix, in Newcastle Upon Tyne. 


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