During last five decades, biomaterials have seen a rapid growth, due to its direct relation and impact on healthcare and advancements in the fabrication of synthetic biomaterials. The biomaterials market, including medical device and implants, is estimated to be greater than $130.17 billion US Dollars by the end of 2021 and is expected to increase by 13.2 % every year [1, 2]. The largest market size amongst all biomaterial products belongs to orthopedic devices and it is expected to reach $41.2 billion US Dollars by 2019. The current size of the Indian orthopedic devices market is ~$375 million US Dollars (Rs. 2,400 crores) and it will grow ~ 20% every year for the next decade to reach $2.5 billion US Dollars (Rs. 16,000 crores) by 2030 .
Owing to an increase in the aging population and active sedentary lifestyle, musculoskeletal (MSK) disorders are the second most cause of disability worldwide, according to a report by international experts, published in The Lancet on 15th December 2012. Musculoskeletal conditions, which affect over 1.7 billion people globally, include joint diseases, such as, osteoarthritis, osteoporosis, fragility fractures, back and neck pain, soft tissue rheumatism, injuries due to sports, workplace and road traffic accidents . In India, 12-15% of the population seems to suffer from MSK . Sharp increase in the number of primary total hip orthroplasties (THA) and primary total knee orthroplasties (TKA) are noticed in last two decades, due to increasing cases of osteoarthritis . Osteoarthritis is degenerative joint syndrome, resulting from sickness, generic factors and obesity. It makes cartilage to worn out and creats severe pain during movement, due to bone to bone contact . Implants are suggested medically as an option only when all non-surgical treatments have failed. The advantages of orthopedic implants should offer enhanced mobility of patient, reduced pain, restored function of the joint and higher quality of life. According to 2007 estimation, ~1.5 million joint replacements are performed around the world . In India, over 70,000 hip and knee replacements are being performed every year . However, even after decades of successful track record, ~10% of these implant fail prematurely, within the first 10 to 20 years, thereby affecting many tens of thousands of patients annually. The two primary causes of prostheses failure are aseptic loosening and peri-prosthetic joint infection. Strategies to tone down these two failure modes is most necessary. Recently most of the study focused on bioactive coatings on orthopedic implants, either to prevent antibacterial infection, while ignoring implant osseointegration or vice versa, to promote bone mineralization ignoring the antibacterial resistance property. However, all the functionalities are essential to achieve the long-term success of an implant. Therefore, these two modalities must be addressed parallelly during the development of new orthopeadic implant materials . The current research and development is focusing on multifunctional surfaces for implants in total hip arthroplasty for efficient performance in various biological and mechanical tasks. The response depends on the specific abilities of the surfaces/coatings acquired during fabrication.
In our lab, we modified the surface of acetabular cup liner and femoral metallic implant either with chemical route or coating and impregnating the drug contained biodegradable polymer through impregnation chamber . Our present invention has shown long term drug delivery in a controlled manner to inhibit the bacterial infection and also to promot the osseointegration. On other hand, improved mechanical and tribological properties of the implant shows great promise for future implants and potentially targeted drug delivery systems. This will improve the success rate of hip implants and longevity of replacement surgery. It definitely has the potential to offer for a group of people for whom, at the moment, hip implants are not surviving long enough. Indian government is taking steps to strengthen the policy and regulatory framework and campaigns, such as, ‘Make in India’ to improve the R&D capability of domestic industries. This is planned to be achieved through collaboration with academic institutions to introduce innovative products that can expand the market and also emerge as an export hub for medical devices to the rest of the world.
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- Raphel, Jordan, Mark Holodniy, Stuart B. Goodman, and Sarah C. Heilshorn. “Multifunctional coatings to simultaneously promote osseointegration and prevent infection of orthopaedic implants.” Biomaterials84 (2016): 301-314.
Kumar, R. Manoj, Pallavi Gupta, Sandan Kumar Sharma, Akshat Mittal, Manish Shekhar, Vijayesh Kumar, BV Manoj Kumar, Partha Roy, and DebrupaLahiri. “Sustained drug release from surface modified UHMWPE for acetabular cup lining in total hip implant” Materials Science and Engineering: C 77 (2017) 649-661.
About the author:
Manoj Kumar R is a Ph.D. candidate in the Department of Metallurgical and Materials Engineering from Indian Institute of Technology, Roorkee, working under the supervision of Prof. Debrupa Lahiri. His research interest includes developing innovative drug eluting system for orthopeadic application, nano filler reinforced polymer composites and ceramics based composite for orthopedic and structural applications, multiscale mechanics and Biotribology.
Dr. DebrupaLahiri is an assistant professor in the Department of Metallurgical and Materials Engineering, Indian Institute of Technology, Roorkee, India. She has received her PhD from Florida International University, USA in 2011. Prior to that, she has completed her M. Tech in Materials & Metallurgical Engineering from IIT Kanpur, India and B.E in Metallurgical Engineering from Bengal Engineering College, India (IIEST). She has seven years of experience in industry and research environment and three years in academia. She has also served as Scientist in Nuclear Fuel Complex (NFC), Dept. of Atomic Energy, India. She has 75 publications in peer reviewed journals, 4 book chapters and one book to her credit. She is also the recipient of prestigious Zwick Science Award 2013, which is given for innovations in materials’ testing. Currently, her group ‘Biomaterials and Multiscale Mechanics Group’ performs research in the areas of developing biomaterials for hard and soft tissue engineering, nano-phase reinforced composites with different functionalities and multiscale mechanics of wide variety of materials. The aims of her different research activities lies in developing novel material systems particularly for support and regeneration of orthopedic, neural and skin tissues. (Link for Website: http://faculty.iitr.ac.in/~dlahifmt).