In vitro and in vivo studies of 3D orthopaedic implants with cell-instructive nanotopographies

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The demand for total hip and knee replacements (THR & TKR) has been steadily increasing worldwide. This is due to an ageing population, the rise in obesity and a change to more active lifestyles; together, these factors are leading to more osteoarthritis and degeneration of cartilage and subchondral bone in joints. The two leading causes of this type of orthopaedic implant failure are loosening (due to poor bone contact with the implant) and infection (due to bacterial infiltration and biofilm formation). In the case of THR/TKR, the incidence rate of joint infections is reported to be 1%- 4% in primary surgery and up to 30% in revision surgery. Our previous work showed that certain nanostructured surfaces on titanium (many orthopaedic implants are made from titanium) surfaces could be both bactericidal and bioactive (bone forming). However, most of the work so far was carried out on nanostructured 2D surfaces rather than real implant surfaces.This project is aimed at conducting in vitro and pre-clinical studies based on 3D porous Ti implants with nanostructured surfaces, hence translating our current understanding in 2D into real 3D implants. We have assembled a multidisciplinary team from universities of Bristol, Glasgow and Cambridge, in partnership with clinical and industrial partners, to progress our research findings from previous EPSRC projects focusing on the basic science of bactericidal topographies on 2D surfaces towards the real world applications. We will bring together expertise in biomaterials, nanotechnology, stem cell biology, microbiology and pre-clinical studies, with a clear vision to apply new smart cell-instructive surfaces to orthopaedic implants. We hope to improve the quality of life of patients who require implants and save the costs of NHS by avoiding the need for revision due to implant loosening and infection.