生物分析および生物医学ジャーナル

A Strategy to Optimize Recovery in Orthopedic Sports Injuries

Abstract

Michael P Sealy, Ziye Liu, Chao Li, Yuebin Guo, Ben White, Mark Barkey, Brian Jordon J, Luke N Brewer and Dale Feldman

An important goal for treatment of sports injuries is to have as short a recovery time as possible. The critical problem with current orthopedic implants is that they are designed to be permanent and have a high complication rate (15%) that often requires removal and replacement with a second surgery; and subsequently a second rehabilitation cycle. This study was designed to test the feasibility of having a device that could provide the needed mechanical properties, while promoting healing, for a specified amount of time and then degrade away, to shorten the recovery time. The specific strategy was to create a surface layer on a degradable metal alloy with a controllable degradation rate. Previous studies have shown the feasibility of using surface treatments to alter the surface integrity (i.e., topography, microhardness, and residual stress) leading to increased fatigue strength and a decreased degradation rate. This study was an extension of these previous studies to look at the changes in surface integrity and mechanical properties initially as well as the degradation over time for two surface treatments (shot peening and burnishing). Although the treatments improved initial properties and the burnishing treatment slowed degradation rate, the faster degradation of the base material in vitro (compared to previous studies) probably reduced the overall impact. Therefore although the study helped support the feasibility of this approach by showing the ability of the surface treatment to modify surface integrity, initial mechanical properties, and degradation rate; the degradation rate of the base material used needs to be slower and/or the surface treatment needs to create a bigger change in the degradation rate. Further it ultimately needs to be shown that the surface treatment can produce a material that will allow orthopedic devices to meet the required clinical design constraints in vivo.