Development Of Orthopedic Implants Research Articles

Fabrication, bacteriostasis and osteointegration properties researches of the additively-manufactured porous tantalum scaffolds loading vancomycin.

Infected bone defects (IBDs) remains a challenging problem for orthopedists. Clinically, routine management for IBDs has two stages: debridement and systematic antibiotics administration to control infection, and secondary grafting to repair bone defects. Whereas the efficacy is not satisfactory, because the overuse of antibiotics may lead to systemic toxicity, and the emergence of drug-resistant bacteria, as well as the secondary surgery would cause additional trauma and economic burden to the patients. Therefore, it is imperative to develop a novel scaffold for one-stage repair of IBDs. In this study, vancomycin (Van) was encapsulated into poly(lactic co-glycolic acid) (PLGA) microspheres through the double emulsion method, which were then loaded into the additively-manufactured porous tantalum (AM-Ta) through gelatin methacryloyl (GelMA) hydrogel to produce the composite Ta/GelMA hydrogel (Gel)/PLGA/vancomycin(Van) scaffolds for repairing IBDs. Physiochemical characterization of the newly-developed scaffold indicated that the releasing duration of Van was over 2 weeks. Biological experiments indicated good biocompatibility of the composite scaffold, as well as bacteriostasis and osteointegration properties, which showed great potential for clinical application. The construction of this novel scaffold would provide new sight into the development of orthopaedic implants, shedding a novel light on the treatment of IBDs.

Nanostructure and biomimetics orchestrate mesenchymal stromal cell differentiation: An in vitro bioactivity study on new coatings for orthopedic applications

The choice of the appropriate material having suitable compositional and morphological surface characteristics, is a crucial step in the development of orthopedic implants. The purpose of this paper is to elucidate, on this regard, the influence of two important hits, i.e., biogenic apatite with bone-like composition and nanostructured morphology, providing the evidence of the efficacy of nanostructured biogenic apatite coatings in favoring adhesion, growth, proliferation, and in vitro osteogenic differentiation of human mesenchymal stromal cells (hMSCs) isolated from the bone marrow. The specific features of this coating in terms of topographical and biochemical cues, obtained by Ionized Jet Deposition, are perceived by hMSCs, as suggested by changes in different morphologic parameters as Aspect Ratio or Elongation index, suggesting the impact exerted by the nanostructure on early adhesion events, cytoskeleton organization, and cells fate. In addition, the nanostructured CaP coating sustained the metabolic activity of the cells and facilitated the osteogenic differentiation of MSC by supporting the osteogenesis-related gene expression.These findings support the use of a combined approach between technological advancement and instructive surfaces, both from the topographical and the biochemical point of view, in order to manufacture smart biomaterials able to respond to different needs of the orthopedic practice.

The Relevance of Biomechanical Analysis in Joint Replacements: A Review

Biomechanical analysis, numerical and experimental, has been extensively used for more than 3 decades to investigate the mechanical behaviour of bone and implant–bone structures in joint replacement. In this review article, a detailed overview of the state-of-the-art techniques used for the development and pre-clinical testing of orthopaedic implants has been presented, with special focus on the hip-joint and hip implants. The efficacies of biomechanical analysis in analysing failure mechanisms in joint replacement, its clinical relevance, challenges and limitations, and future directions have been highlighted. Finite element (FE) modelling and analysis have contributed immensely towards testing of clinical hypotheses and evaluation of implant designs. Over the last few decades, the size and sophistication of the FE models have increased considerably. A critical analysis of the currently available subject-specific FE modelling techniques has been presented including, development of computed tomography-scan-based FE models of bone and implant, assignment of heterogeneous bone material properties, loading and boundary conditions. The relationship between stress–strain analysis and implant failure needs careful interpretation for clinical relevance. Verification and validation of these models are essential for assessing the validity of the predicted results. The salient features of adaptive simulations including bone remodelling and tissue differentiation and its prominence in investigating potential failure mechanisms and implant design evaluations have been discussed. The key considerations for design and development of orthopaedic implants have been suggested. It is envisaged that the FE simulations would be more holistic in nature, incorporating the complexities and variabilities of the clinical problems.

Surface Modification Techniques to Enhance Osseointegration of Spinal Implants

Biomechanical function, specifically implantation technique and immediate surgical fixation, of orthopaedic implants is the primary consideration during the development of orthopaedic implants. Biologic and material characteristics are additional factors to include in the design process because of the direct impact on short- and long-term implant performance. The body's initial interaction with implant materials can affect protein- and cell-based function, thereby either promoting or impeding osseointegration. An understanding and inclusion of the biologic response, material surface morphology, and material surface chemistry in implant design is crucial because these factors ultimately determine implant function and patient outcomes. Highlighting the biologic- and material-related advantages and inadequacies of current and potential implant materials as well as applications may guide further research and development of implant materials and designs.

Improved Osteogenesis of Selective-Laser-Melted Titanium Alloy by Coating Strontium-Doped Phosphate With High-Efficiency Air-Plasma Treatment.

Surface treatment and bioactive metal ion incorporation are effective methods for the modification of titanium alloys to be used as biomaterials. However, few studies have demonstrated the use of air-plasma treatment in orthopedic biomaterial development. Additionally, no study has performed a direct comparison between unmodified titanium alloys and air-plasma-treated alloys with respect to their biocompatibility and osteogenesis. In this study, the biological activities of unmodified titanium alloys, air-plasma-treated titanium alloys, and air-plasma-treated strontium-doped/undoped calcium phosphate (CaP) coatings were compared. The strontium-doped CaP (Sr-CaP) coating on titanium alloys were produced by selective laser melting (SLM) technology as well as micro-arc oxidation (MAO) and air-plasma treatment. The results revealed that rapid air-plasma treatment improved the biocompatibility of titanium alloys and that Sr-CaP coating together with air-plasma treatment significantly enhanced both the biocompatibility and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Overall, this study demonstrated that low temperature air-plasma treatment is a fast and effective surface modification which improves the biocompatibility of titanium alloys. Additionally, air-plasma-treated Sr-CaP coatings have numerous practical applications and may provide researchers with new tools to assist in the development of orthopedic implants.

Fabrication of Sr-functionalized micro/nano-hierarchical structure ceramic coatings on 3D printing titanium

ABSTRACT Effective and fast osseointegration is significantly affected by the topographic features and chemical compositions of titanium (Ti)-based orthopedic implants. In this study, strontium (Sr) ions functionalized ceramic coatings with cortex-like micro/nano-hierarchical structure were successfully fabricated on 3D printing Ti by micro-arc oxidation and hydrothermal treatment technology. The obtained coatings, which combine micron-scale pores and nano-scale flakes simultaneously, show rough and porous morphology, good surface wettability, and superior apatite induction ability. Therefore, Sr-incorporated biomimetic hierarchical structure coatings on 3D printing Ti may provide an alternative for the development of orthopedic implants, showing high-potential clinical application.

Electrochemical Evaluation of Some Mg-Ca-Mn-Zr Biodegradable Alloys

Biodegradable magnesium alloys represent a class of materials with high properties that are used in a wide range of fields, such as medicine, aeronautics and automotive. Alloying the Mg-based alloys with small percentages of elements such as Ca, Mn and Zr can conduct to the obtaining of some materials that can be the basis for the development of orthopedic implants. Calcium contributes to the formation of the Mg2Ca lamellar compound, low concentrations of zirconium helps the microstructure refinement and corrosion resistance and the alloying with manganese leads to the increase of the mechanical characteristics.In this paper, the electrochemical behaviour of four biodegradable alloys from the Mg-Ca-Mn-Zr system was evaluated, with variable concentrations (0.5% -1%) of Mn, respectively Zr. Alloying the system with 1% of each element (Ca, Mn, Zr) led to the obtaining of the alloy with the highest corrosion resistance and the lowest degradation rate.

Challenges for Product Development of Orthopedic Implants

The paper represents the complete product development activities and challenges in orthopedic implants. The need for patient comfort and ease of surgeon’s skills in implant placement enhance the challenges for the development of accurate in geometry and orientation with the help of medical devices or fixtures. The aim is to reduce operating time with preplan surgery with minimum risk and also with minimum cost. All these processes are done more effectively with the help of advanced computing technology.

3D finite element analysis of porous Ti-based alloy prostheses

In this paper, novel designs of porous acetabular cups are created and tested with 3D finite element analysis (FEA). The aim is to develop a porous acetabular cup with low effective radial stiffness of the structure, which will be near to the architectural and mechanical behavior of the natural bone. For the realization of this research, a 3D-scanner technology was used for obtaining a 3D-CAD model of the pelvis bone, a 3D-CAD software for creating a porous acetabular cup, and a 3D-FEA software for virtual testing of a novel design of the porous acetabular cup. The results obtained from this research reveal that a porous acetabular cup from Ti-based alloys with 60 ± 5% porosity has the mechanical behavior and effective radial stiffness (Young’s modulus in radial direction) that meet and exceed the required properties of the natural bone. The virtual testing with 3D-FEA of a novel design with porous structure during the very early stage of the design and the development of orthopedic implants, enables obtaining a new or improved biomedical implant for a relatively short time and reduced price.

Application of the Finite Element Method in Orthopedic Implant Design

The finite element method (FEM) was first introduced to the field of orthopedic biomechanics in the early 1970s to evaluate stresses in human bones. By the early 1980s, the method had become well established as a tool for basic research and design analysis. Since the late 1980s and early 1990s, FEM has also been used to study bone remodeling. Today, it is one of the most reliable simulation tools for evaluating wear, fatigue, crack propagation, and so forth, and is used in many types of preoperative testing. Since the introduction of FEM to orthopedic biomechanics, there have been rapid advances in computer processing speeds, the finite element and other numerical methods, understanding of mechanical properties of soft and hard tissues and their modeling, and image-processing techniques. In light of these advances, it is accepted today that FEM will continue to contribute significantly to further progress in the design and development of orthopedic implants, as well as in the understanding of other complex systems of the human body. In the following article, different main application areas of finite element simulation will be reviewed including total hip joint arthroplasty, followed by the knee, spine, shoulder, and elbow, respectively.

Materials selection and design for orthopaedic implants with improved long-term performance

Design and materials selection are equally important in the development of orthopaedic implants. Two case studies are presented to illustrate this: the development of a femoral component of a total hip prosthesis and the study of alternative designs of a tibial component of a total knee prosthesis. Bioactive surface coatings may be applied to enhance the stability of fixation of the implant, even in difficult clinical cases. It is argued that an improved long-term performance of an implant can only be achieved by considering the biomechanics and biomaterials aspects of joint replacement together, and at the same time guaranteeing the quality of surgery by providing the surgeon with better pre-surgical planning systems and advanced surgical tools.

Polysulphone inhibits final differentiation steps of osteogenesis in vitro.

Biocompatibility is an important factor in the development of orthopedic implants as well as in the development of new tissue culture devices. Polysulphone has been used for orthopedic implants because of its mechanical properties, ease of sterilization, molding capacity, and biocompatibility. Therefore, polysulphone has been chosen as the prime material for the construction of tissue culture devices to be used for the cultivation of osteogenic cells (preosteoblast-like MN7 cells and primary bone marrow fragments), as well as complete fetal long bone explants under space flight conditions. Whereas polysulphone did not interfere with the proliferation in early stages of bone-forming cells, we show that leachable factors within the polysulphone polymer prevented the final steps of matrix formation as measured by collagen synthesis and matrix mineralization. These data argue against polysulphone as a material for orthopedic implants.