Potential of stem cell to tailor the bone-ceramic interface for better fixation of orthopedic implants

Abstract

The main cause of premature failure of an orthopedic implant in vivo is due to various biological reactions with the surrounding tissues/environment. Therefore, to combat this situation, continuous efforts have been concentrated to improve biocompatibility of the implant material by adopting different strategies. Extensive study is being made to modify the implants by plasma-spraying bioactive materials, introducing specific surface groups, immobilizing proteins with certain conformations, or by immobilizing certain cell lines. In addition, investigations are in progress to modify the implant/biology interface and study its influence on long-term stability of the material to improve the integration by augmenting the tissue regeneration. Such modification of the devices for enhanced biocompatibility following varying techniques is a subject of extensive research today. In last few decades, though the innovative use of long-lasting bioceramic-based implants have revolutionized the treatment procedure, it is strongly felt that the implant integration/fixation with the surrounding tissue improvement can be obtained by developing a more biofriendly interface through reconstructive surgery. Thus, the implant integration with the damaged/diseased tissue needs a biofriendly interface. For this purpose, bioactive ceramics in the form of scaffold, powder, or granule is used more extensively to fill the space of the damaged hard tissue or bioactive coating plasma sprayed on the surface of the implant cement-less fixation. Recently, for reconstruction surgery, ceramic scaffolds are manufactured from the computer tomography (CT) scan data of the patient by adopting rapid prototyping method that, however, needs to be stably fixed to the operation site, although this may not be applicable in case of load-bearing implants. Human leukocyte antigen (HLA)-matched stem cells, which are less prone to immune rejection and capable of self-renewal and has compatibility to all cell lineages, are being considered to be an effective alternative to address this problem in future. © Springer-Verlag London Limited 2009.