Technique ‘tricks’ the body into accepting this common medical procedure

Breakthrough raises hopes of fewer rejections and infections after joint replacements.

knee replacement

Close to one million Australians have undergone joint replacement surgery and the numbers are growing as the population ages and older adults expect to remain more mobile for longer.

Our ageing population has led to a rise in osteoporosis-related bone fractures, bone cancers and joint replacement, according to a report on Replacement surgeries are set to hit the million mark and another 90,000 devices are inserted each year at a cost of around $1 billion.

A breakthrough by a multinational research team could lead to more successful outcomes through fewer rejections and complications due to infections.

The key is the development of a plasma coating.

The international research project, led by the University of Sydney’s School of Aerospace, Mechanical and Mechatronic Engineering and the School of Physics in collaboration with UMC Utrecht and the Heart Research Institute and three other research partners, has developed a plasma coating for bone implants that increases the likelihood of an implant fusing to surrounding bone and reducing the chances of rejection or infection.

Published in Applied Materials Today, the study investigated the interaction of plasma-generated coatings with human-derived stem cells. It found that the new coating could enhance the functionality of bone-producing cells, allowing an implant to bind firmly to a host bone.

The paper’s lead author, Dr Behnam Akhavan, a plasma surface engineering expert from the University of Sydney’s faculty of engineering, says the results are promising and are being tested in-vivo in the Netherlands.

“Our latest research presents great promise for the creation of a new class of robust, bio-active surfaces for orthopaedic implants,” he said.

The report explains that despite medical improvements in surgical implant techniques and postoperative care, a significant proportion of orthopaedic implants fail due to infection or poor integration with surrounding bone tissue. These complications then lead to further surgeries “that are risky, invasive and costly for the patient and healthcare systems”.

While orthopaedic surgeries involving implants have increased, many have yielded poor outcomes as implants require firm bone bonding to be successful.

“We have developed a highly robust plasma coating from a mixture of low-cost argon, nitrogen and acetylene gas that is placed on the implant,” said Dr Akhavan. “Bone-signalling molecules are then applied to encourage stem cells to produce bone.”

The organic plasma coating works by ‘shielding’ an implant, so that it is accepted by the body, he explained.

“The implants have been surface-engineered using the plasma technology and will be overgrown with bone-producing cells once implanted in the body, allowing them to firmly attach to bone tissue.

“The mechanically strong coating can remain on the implant surface for long durations, even if it is scratched during surgery. The bioactive molecule coating effectively ‘hides’ the metallic implant from the body, so it is treated as a biological structure rather than an invasion.

“Rapid implant integration reduces the chance of an implant loosening and failing, therefore eliminating the need for revision surgeries.”

Research team Professor Marcela Bilek says: “This coating is fully organic and is a significant advancement because it robustly adheres to titanium implants, while presenting strongly attached biological signalling molecules that guide tissue formation at its interface with the body.”

Do you think will need a joint replacement? Have you had a joint replacement? Was it successful or were there complications?

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    21st Aug 2019
    I was plagued with hip pain for nearly 8 months, had tests, saw doctor, possibly faced hip replacement which I did not want. I then lost 8 kilos - and have not had a single problem. Walking and cycling more, no pain killers.

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