Total hip arthroplasty (THA) is a surgical procedure for the replacement of hip joints with artificial prostheses. Several approaches are currently employed in the treatment of this kind of defect. Overall, the most common method involves using a quite invasive metallic support (a Burch–Schneider ring). Moreover, valid alternatives and less invasive techniques still need to be supported by novel material development. In this work, we evaluated the performance of SmartBone®, a xenohybrid bone graft composed of a bovine bone matrix reinforced with biodegradable polymers and collagen, as an effective support in acetabular prosthesis reconstruction. Specifically, the material’s mechanical properties were experimentally determined (E = ~1.25 GPa, Ef = ~0.34 GPa, and Et = ~0.49 GPa) and used for simulation of the hip joint system with a SmartBone® insert. Moreover, a comparison with a similar case treated with a Burch–Schneider ring was also conducted. It was found that it is possible to perform THA revision surgeries without the insertion of an invasive metal support and it can be nicely combined with SmartBone®’s osteointegration characteristics. The material can withstand the loads independently (σmax = ~12 MPa) or be supported by a thinner titanium plate in contact with the bone in the worst cases. This way, improved bone regeneration can be achieved.
Bioresorbable pins are experiencing a growing interest and a likewise increasing use in orthopedic surgery for bone fixation. Indeed, such devices are naturally degraded by the human body and a subsequent surgery for their removal is not needed. However, bioresorption has a remarkable side effect on the performance of the devices, since mechanical properties decay over time. This aspect is essential for bone healing. In the first 60 days, the pin must bear continuous mechanical stress while preventing torsional slip of bone fragments. Although torsional support can be improved with suitable pin section design, degradation kinetics and the consequent loss in mechanical stability are slowed down while using high molecular weight polymers, whose slow bioresorption increases recovery time and negatively affects patient care. Herein, a bioresorbable pin of new conception, in terms of cross‐sectional shape and material formulation, is presented. Both section and polymer design are optimized through comprehensive mathematical modeling, which synergistically combines degradation and mechanical loads. As a result of the model, bioresorption time is minimized, whereas adequate mechanical resistance is ensured for the first 60 days. The most promising device is then injection molded, sterilized, mechanically tested, and successfully evaluated ex vivo in human femoral heads.
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