Orthopaedic Implant as Drug Delivery System: a Numerical Approach

Abstract There is a current trend to propose cementless total joint arthroplasty (TJA) to younger patients. These patients have more demanding physical activity resulting in an increased failure rate of the implants. In particular for these type of patients, the desired service life of the implant should be extended. The actual implant used do not fulfil this requirement. In this study, a new concept of orthopaedic implant is presented where the implant is not only a structural support but also a local drug delivery system. The delivered drug is meant to influence the bone remodeling in a way so as to compensate the effects of peri-implant osteolysis. To test this concept, we extended an existing bone remodeling model to include the effect of a drug. The results show that a more homogeneous bone density distribution can be obtained around the implant. Implants used as drug delivery systems could then be an alternative way to increase implant service life.

[1]  H. Skinner,et al.  Current concepts in orthopaedic biomaterials and implant fixation. , 1993, Instructional course lectures.

[2]  N. Davies,et al.  Alendronate induces gastric injury and delays ulcer healing in rodents. , 1997, Life sciences.

[3]  C. Engh,et al.  Influence of Porous Coating Level on Proximal Femoral Remodeling: A Postmortem Analysis , 2000, Clinical orthopaedics and related research.

[4]  D T Davy,et al.  Telemetric force measurements across the hip after total arthroplasty. , 1988, The Journal of bone and joint surgery. American volume.

[5]  A. Terrier,et al.  Adaptation Models of Anisotropic Bone. , 1997, Computer methods in biomechanics and biomedical engineering.

[6]  Hwj Rik Huiskes,et al.  Finite element analysis of acetabular reconstruction. Noncemented threaded cups. , 1987, Acta orthopaedica Scandinavica.

[7]  R. Crowninshield,et al.  A physiologically based criterion of muscle force prediction in locomotion. , 1981, Journal of biomechanics.

[8]  Frederick J. Dorey,et al.  Total Hip Arthroplasty Outcomes , 1997 .

[9]  H. Fleisch Bisphosphonates in Bone Disease: From the Laboratory to the Patient , 2000 .

[10]  H. Rubash,et al.  The John Charnley Award. Inhibition of wear debris mediated osteolysis in a canine total hip arthroplasty model. , 1997, Clinical orthopaedics and related research.

[11]  H Weinans,et al.  Effects of fit and bonding characteristics of femoral stems on adaptive bone remodeling. , 1994, Journal of biomechanical engineering.

[12]  P. Leyvraz,et al.  The morphology of the proximal femur. A three-dimensional radiographic analysis. , 1992, The Journal of bone and joint surgery. British volume.

[13]  J. Galante,et al.  ESB Research Award 1992. The mechanism of bone remodeling and resorption around press-fitted THA stems. , 1993, Journal of biomechanics.

[14]  L. Rosenthall,et al.  Bone densitometry: influence of prosthetic design and hydroxyapatite coating on regional adaptive bone remodelling , 1999, International Orthopaedics.