Advances in Biomaterials and Surface Technologies

Abstract

Tremendous advances in quality, reliability, performance, and versatility of surgical instrumentation and devices have been achieved over the past 50 years using biomaterials. The global orthopaedic implant industry is expected to grow to $41.8 billion by 2016, driven primarily by advancements in implant designs, including materials that provide improved biocompatibility, durability, and expanded clinical applications. Biomaterials have evolved through 3 clinical "generations": (1) "bio-inert materials," (2) materials with intrinsic bioactivity and degradability, and (3) biomaterials that stimulate specific biological host responses. In all cases, surface modifications, including coatings, represent a key strategy for improvements in tissue-contacting properties. Surfaces continue to be a focus for many device improvements and for tissue interfacing, especially for many orthopaedic structural implants comprising metal and metal alloys. Progress in implant materials processing, coating technologies, and coating combinations with therapeutic agents provide new properties and functionalities to improve device-tissue integration and reduce foreign body reactions and infections. Performance criteria for these surface modifications success in clinical practice are daunting, and translation of several technologies from in vitro proof-of-concept to in vivo applications has proven challenging.

Implant Strategies in Orthopedics

“…Currently, orthopedic implants are the big part of all implantable devices at a cost of around $10 billion. By the advanced developments in biomaterials, clinical applications, and designs, the global orthopedic implant industry is expected to reach to $41.8 billion by 2016 Sports Injuries DOI 10.1007/978-3-642-36801-1_273-1 # Springer-Verlag Berlin Heidelberg 2014 (Richards et al 2012). According to the AMGA Medical Group Compensation and Financial Survey, the 2012 Medscape Orthopedist and Orthopedic Surgeon Compensation Report, and the 2012 LocumTenens.com Compensation and Employment Report, the average orthopedic surgeon compensation is $501,808.2; the average compensation for a joint replacement specialist is $503,809.3; the average orthopedic spine surgeon compensation is $677,158.4; the average pediatric orthopedic surgeon compensation is $435,318; the average orthopedic surgeon compensation in a hospital setting is $251,000; around 19 % of orthopedic surgeons make $100,000 or less; and around 46 % of orthopedic surgeons would prefer a pay-for-performance model over bundled payments and shared savings arrangements (OrthoStreams 2013).…”

“…Several countries have arthroplasty registry systems established as post-market surveillance systems for the purposes of obtaining statistical data about implants; monitoring revisions, failures, and complications; determining effective surgery techniques; tracking implant survival; and analyzing cost-benefit ratio. The goal of these registry systems is to increase the quality of implants and surgeries with the help of statistical analysis (Richards et al 2012). …”

Fabrication and characterization of polyacrylamide/silk fibroin hydrogels for peripheral nerve regeneration

“…In recent years, the physical property as one of most important surface properties of biomaterials has attracted more and more attention in the fields of tissue engineering [8]. The effect of various surface physical properties on tissue regeneration has been widely investigated [9,10].…”

Beyond conventional antibiotics — New directions for combination products to combat biofilm

“…Benefits of local delivery include greater control over the antimicrobial delivery rate, the ability to co-deliver one or more agents, and potential for high local drug concentrations with significantly lower overall systemic exposure [13, 18, 22]. Agents that may be considered for co-administration include those that work synergistically with the primary antimicrobial or agents that improve overall device patency by preventing fouling or promoting healing and tissue integration.…”