BIOSTEM

The development of biologically active metal implants for improved osseointegration

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 Obiettivo del progetto (Objective)

'Osteoarthritis (OA) is the most common musculoskeletal disorder and affects approximately 355 million people world-wide. At present, no definitive cure exists for OA. Current treatment involves total joint replacement (TJR) which accounts for approximately 35% of arthritis related procedures. Presently more than 200,000 total knee replacements and 70,000 total hip replacements procedure are performed annually in the UK. One of the key aspects contributing to successful fixation is the rapid and complete integration of the device with bone (osseointegration). Without this biological reaction, stability is compromised potentially resulting in aseptic loosening which generally requires revision surgery. This can be detrimental for OA patients as the quality of bone is compromised, therefore, the potential for adequate implant stabilisation is substantially reduced. Several studies have identified the surface properties of an implant as being a major determinant of osseointegration. The addition of coatings have attracted interest, however, a major stumbling block for reliable application of coating technologies is potential failure during long-term implantation. Recent data suggests that impaired peri-implant osseointegration is associated with declined osteoprogenitor recruitment. The scientific objective of this project is to identify a strategy for enhancing rapid osseointegration of implant devices through 1) increased recruitment and attachment and 2) modulation of mesenchymal stem cell (MSC) differentiation. To this end, we aim to develop specific cell targeting antibodies for optimal MSC recruitment and modulation of MSC differentiation for improved osteogenesis. If successful this project would achieve in providing a clinically feasible strategy for improving TJR which would directly impact several million patients annually.'

Introduzione (Teaser)

A European study worked to develop a novel approach for coating joint implants. The outcome should improve the success of joint replacement surgeries.

Descrizione progetto (Article)

Osteoarthritis (OA) is the most common musculoskeletal disorder affecting hundreds of millions of people globally. Currently, there is no definitive cure for OA and treatment usually involves total joint replacement. The success of this method depends on the rapid and complete biological integration of the prosthetic device with the existing bone, a process known as osseointegration.

So far, hydroxyapatite has been used in coating prosthetic implants, but it often fails during long-term implantation and may result in osteolysis. The EU-funded BIOSTEM (The development of biologically active metal implants for improved osseointegration) project aimed to develop biologically active metal implants for improved osseointegration after joint arthroplasty procedures.

To address coating issues in implants, BIOSTEM proposed to deliver collagen onto the surface of poly-(ether-ether)-ketone (PEEK). PEEK is a biologically inert clinical polymer that has had significant clinical success in spinal and craniomaxillofacial applications.

Researchers successfully modified collagen for coating PEEK to facilitate bone apposition while retaining desired chemistry as assessed by spectroscopy methods. Additionally, the hybrid material increased the attachment of mesenchymal stem cells and their osteogenic differentiation. Moreover, the plasma device used for implant coating could easily be housed in hospitals for on-site fabrication.

The BIOSTEM approach was validated in an in vivo preclinical rabbit model with femur PEEK implants. A series of methods were utilised such as mechanical testing, histomorphometric analyses and micro-computed tomography to assess bone volume at the implant interface.

Overall, the BIOSTEM approach addresses current limitations in the field of prosthetics related to implant coatings. It provides a clinically viable, long-term and stable modification of PEEK that has the potential to facilitate osseointegration in OA patients.