In a blog on Qmed, Shana Leonard has written about the future of All-Metal Hip Implants in an interesting and contentious article in which she suggests metal-on-metal hip prosthesis technology might “resurface”…pardon the pun.
The article can be found here and in it the author suggests that a number of research strands could address the problems associated with Metal-on-Metal implants. If you remember, the issue of wear particles and their down the line consequences were at the heart of the controversy, and indeed made us all lose sight of the originally universally accepted advantages of the configuration, namely longevity and consequent appeal for younger patients.
Strand 1: Nanoparticles
Researchers at the University of Alabama at Birmingham (UAB), found that applications of nanodiamond coatings to metal implants could enhance wear characteristics and while not avoiding wear particles altogether, the team believes that the particles in this case would be reduced in quantity and size and furthermore that they appear to be non toxic to living cells.
Strand 2: Graphitic Carbon Lubricant
We’ve reported on these pages in recent weeks about researchers who are investigating development of so-called self-lubricating components in some all-metal prosthesis experiments. These “graphitic carbon” films, also known as Tribofilms appear to originate in the synovial fluid surrounding the hip implant and act as lubricants. The success of the Cobalt Chromium (CoCr) implants may be determined by the formation or otherwise of this film and research is targeted at gaining a better understanding of it in order to predict or engineer in the conditions predictive of film formation.
Strand 3: Move away from CoCr
“Today, cobalt-chromium with molybdenum is used in metal-on-metal implants,” Markus Wimmer, associate professor of orthopedics at Rush University Medical Center, told MPMN in a recent interview. “But other metals such as newly developed high-nitrogen stainless steels may have even better properties.”
The article questions whether the successful delivery of any of these solutions will ever be enough to see the rehabilitation of all-metal joint prostheses and we agree. As much as we like a marketing challenge that one might be a toughie. Then again, in the world of evidence-based medicine, if the evidence can be found and the regulatory pathways become trusted by patients and clinicians, why not?
Source: Qmed, Medical Products Manufacturing News, medlatest staff