Materials perspective - Biomedical materials for new millennium: perspective on the future
Materials perspective - Biomedical materials for new millennium: perspective on the future
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DOI：
10.1179/026708301101510762
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发表时间：
2001-08-01
影响因子：
1.8
通讯作者：
Hench, LL
中科院分区：
文献类型：
--
作者：
Jones, JR;Hench, LL
数以百万计的由生物惰性材料制成的矫形假体已被植入，其15年存活率高达75%-85%。改进的金属合金、特殊聚合物和医用级陶瓷是这一成功的基础，它提高了数百万患者的生活质量。然而，我们老龄化人口中越来越多的人要求设备的生存能力超过30年。有人建议，为了满足这种日益增长的对非常长期的骨科修复的需求，需要一种范式的转变；重点从组织的替换转移到组织的再生。从材料和力学方法到组织修复的这种转变需要增加对生物学方法的理解和利用。讨论了新千年骨科生物材料的两种新的面向生物的替代方案：组织再生，即在宿主组织中启动原位修复；组织工程，在细胞种子支架上进行体外修复，然后移植到接受者身上。介绍了使用A类生物活性材料促进松质骨再生的概念及临床应用。11个反应阶段促进了成骨细胞的增殖和分化，重建了骨小梁结构。最近的研究结果表明，微化学梯度对骨细胞遗传激活的影响与用于骨组织工程的分级生物活性可吸收支架的分子设计有关。(C)2001年国际移民组织通信有限公司。
Millions of orthopaedic prostheses made of bioinert materials have been implanted with an excellent 15 year survivability of 75-85%. Improved metal alloys, special polymers, and medical grade ceramics are the basis for this success, which has enhanced the quality of life for millions of patients. However, an increasing percentage of our aging population require greater than 30 years survivability of the devices. It is proposed that to satisfy this growing need for very long term orthopaedic repair a paradigm shift is needed; a shift in emphasis from the replacement of tissues to the regeneration of tissues. Such a shift from a materials and mechanics approach to tissue repair requires an increase in the understanding and utilisation of biologically approaches. Two new biologically orientated alternatives in biomaterials for orthopaedics in the new millennium are discussed: tissue regeneration, where in situ repair is initiated in the host tissue, and tissue engineering, where repair is initiated in vitro on cellularly seeded scaffolds and then transplanted to the recipient. The concept of the use of class A bioactive materials to stimulate the regeneration of trabecular bone is described along with clinical applications. Eleven reaction stages lead to the enhanced proliferation and differentiation of osteoblasts and the recreation of trabecular bone architecture. Recent results showing the effects of microchemical gradients on the genetic activation of bone cells are related to the molecular design of hierarchical bioactive resorbable scaffolds for the tissue engineering of bone constructs. (C) 2001 IoM Communications Ltd.