The implantation of orthopaedic devices is associated with a high risk of post-operative complications that increases substantially with each revision surgery.
Revision surgeries are required primarily for two reasons: 1) implants frequently do not integrate successfully leading to loosening and; 2) bacterial infections that result in biofilm formation.
In the last 10 years, there were 410,767 revision hip replacements and and 480,440 knee replacements in Australia alone (Source: The Australian Orthopaedic Association National Joint Replacement Registry, 2016 Annual Report); and the number of these replacements conducted annually continues to grow.
Although the cumulative rate of revisions over a 10 year period is less than 5% for all patients, it is unacceptably high at 16% for patients suffering from bone-related conditions such as osteoporosis, osteoarthritis and ostomalacia or having poor bone structure.
The situation is similar with knee replacement surgeries, with up to 10.5% of knee implants requiring revision. The significant increase in the number of patients requiring revision surgery is driven by our aging population, who more frequently have poor bone quality and worse implant integration.
An international research team from Japan and Australia now have proposed a two-pronged strategy to address this outstanding clinical problem by combatting infections and providing bioactivity for titanium implants. They report their findings in Nanomaterials (“Two-in-One Biointerfaces—Antimicrobial and Bioactive Nanoporous Gallium Titanate Layers for Titanium Implants”)
“Our nanostructured surfaces simultaneously are highly antimicrobial as well as bioactive,” Dr. Wojciech Chrzanowski, a Senior Lecturer at the Australian Institute for Nanoscale Science and Technology, tells Nanowerk. “The goal of combining both functions without inducing cytotoxicity has thus far proved elusive. Unlike other approaches that use highly toxic antimicrobial compounds and induce undesired cytotoxicity, our approach not only exhibits outstanding antimicrobial activity but also it promotes the formation of bone-like structures.”
Image Credit: Michael Berger/Nanowerk