Biological Strategies for Improved Osseointegration and Osteoinduction of Porous Metal Orthopedic Implants
| Autor: | Amel Dudakovic, David G. Lewallen, Hilal Maradit Kremers, Carolina A. Bonin, Andre J. Van Wijnen, Scott M. Riester, Robert C. Cohen, Eric A. Lewallen, Jennifer J. Westendorf, Sanjeev Kakar |
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| Rok vydání: | 2015 |
| Předmět: |
Porous metal
medicine.medical_specialty Bone apposition Biomedical Engineering Dentistry Bioengineering Host tissue Models Biological Biochemistry Osseointegration Biomaterials Biological property medicine Animals Humans Orthopedic implant Review Articles business.industry Prostheses and Implants Orthopedics Bone Substitutes Orthopedic surgery Implant business Porosity Biomedical engineering |
| Zdroj: | Tissue Engineering Part B: Reviews. 21:218-230 |
| ISSN: | 1937-3376 1937-3368 |
| DOI: | 10.1089/ten.teb.2014.0333 |
| Popis: | The biological interface between an orthopedic implant and the surrounding host tissue may have a dramatic effect upon clinical outcome. Desired effects include bony ingrowth (osseointegration), stimulation of osteogenesis (osteoinduction), increased vascularization, and improved mechanical stability. Implant loosening, fibrous encapsulation, corrosion, infection, and inflammation, as well as physical mismatch may have deleterious clinical effects. This is particularly true of implants used in the reconstruction of load-bearing synovial joints such as the knee, hip, and the shoulder. The surfaces of orthopedic implants have evolved from solid-smooth to roughened-coarse and most recently, to porous in an effort to create a three-dimensional architecture for bone apposition and osseointegration. Total joint surgeries are increasingly performed in younger individuals with a longer life expectancy, and therefore, the postimplantation lifespan of devices must increase commensurately. This review discusses advancements in biomaterials science and cell-based therapies that may further improve orthopedic success rates. We focus on material and biological properties of orthopedic implants fabricated from porous metal and highlight some relevant developments in stem-cell research. We posit that the ideal primary and revision orthopedic load-bearing metal implants are highly porous and may be chemically modified to induce stem cell growth and osteogenic differentiation, while minimizing inflammation and infection. We conclude that integration of new biological, chemical, and mechanical methods is likely to yield more effective strategies to control and modify the implant-bone interface and thereby improve long-term clinical outcomes. |
| Databáze: | OpenAIRE |
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