Bioengineering Research Partnership in Total Joint Replacements

描述（由申请人提供）：在这个大学-工业合作伙伴关系中，我们专注于开发和测试金刚石对金刚石和金刚石对聚乙烯表面，以最大限度地减少矫形装置中关节部件之间的磨损。磨损引起的并发症包括组件松动、有害的生物反应、骨溶解、机械不稳定、关节活动能力下降、疼痛增加以及最终种植体失败。在这个项目中，UAB和Smith & Nephew， Inc.合作开发和测试金属（CoCrMo或Ti-6Al-4V）矫形装置上独特的纳米结构多层金刚石涂层，目的是减少关节部件的摩擦和磨损。具体目标1：通过化学气相沉积（CVD）具有多层结构的金刚石涂层，通过纳米和微结构层状组件交替，开发纳米技术，以减少髋关节和膝关节金属植入物的关节和承重部件的摩擦和磨损。具体目标2：证明多层金刚石涂层（用于金刚石对金刚石或金刚石对聚乙烯关节）与单层金刚石对金刚石关节或目前用于商业矫形装置的金属对聚乙烯或金属对金属偶联相比，具有更好的耐磨性。具体目标3：使用Smith & Nephew公司的行业标准多轴髋关节和膝关节模拟器，进行涉及钻石涂层髋关节和膝关节关节组件的磨损模拟器研究。具体目标4：与聚乙烯和钴铬碎片颗粒相比，评估细胞对金刚石磨损碎片颗粒的反应。具体目标5：进行体内研究，以表征对照和金刚石生物材料对整体生物相容性的初始短期有机和细胞反应。从摩擦学研究中收集的磨损碎片将被短期（数小时至数天）植入（注射）成年大鼠滑膜样气囊模型，以评估临床、细胞、组织学和细胞因子的生物相容性。将椎间盘植入兔的小梁骨区域，在数小时至数月的时间点上评估初始组织液体和血液与对照和涂覆的植入物表面的相互作用。该建议的BRP的总体临床影响是将全关节置换术的使用寿命提高到30年以上，从而大大减少了复发性多次手术的需要。公共卫生相关性：我们建议使用纳米技术方法来控制髋关节和膝关节植入物与周围组织之间的界面。该资助申请的主要重点是改善全关节置换术的固定、耐久性和骨整合，以实现长期成功，并降低复发性多次手术的需要。此外，新的纳米技术工具和方法的发展将导致用于生物医学植入工业的钛和钴铬合金的新型功能化纳米结构表面。金刚石-金刚石组件的一个好处是减少了整个装置的尺寸，这将最终允许临床较少侵入性的关节修复途径和更长的体内植入寿命。

DESCRIPTION (provided by applicant): In this University-Industry Partnership, we are focused on development and testing of diamond-on-diamond and diamond-on-polyethylene surfaces for minimizing wear between articulation components in orthopaedic devices. Complications arising from wear include component loosening, deleterious biological responses, osteolysis, mechanical instability, decreased joint mobility, increased pain, and ultimately implant failure. In this project, UAB and Smith & Nephew, Inc. team up to develop and test unique nanostructured multilayer diamond coatings on metal (CoCrMo or Ti-6Al-4V) orthopaedic devices with the goal of reducing friction and wear in articulation components. We propose a five-year study to focus on the following specific aims: Specific Aim 1: Develop nanotechnology for reducing friction and wear on the articulating, load-bearing components of hip and knee metallic implants by chemical vapor deposition (CVD) of a diamond coating having a multilayer structure with alternating nano- and micro-structural layered components. Specific Aim 2: Demonstrate that the multilayer diamond coatings (intended for diamond-on- diamond or diamond-on-polyethylene articulation) exhibit improved wear resistance when compared to single- layer diamond-on-diamond articulation or to the metal-on-polyethylene or metal-on-metal couples currently used in commercial orthopaedic devices. Specific Aim 3: Perform wear simulator studies involving diamond coated hip and knee articulation components using the industry-standard multi-axis hip and knee simulators located at Smith & Nephew, Inc. Specific Aim 4: Evaluate cellular response to diamond wear debris particles, as compared to polyethylene and cobalt chrome debris particles. Specific Aim 5: Perform in vivo investigations to characterize the initial short term organic and cellular responses of control and diamond biomaterials to overall biocompatibility profiles. Wear debris collected from the tribological studies will be implanted (injected) into the synovial-like air pouch model in the adult rat for short term (hours to days) in order to assess clinical, cellular, histological and cytokine biocompatibility profiles. Implants of discs into trabecular bone regions of rabbits will assess initial tissue fluid and blood interactions with control and coated implant surfaces for time points ranging from hours to months. The overall clinical impact of this proposed BRP would be in improving the service life time of total joint replacements to more than thirty years and hence dramatically reducing the need for recurrent multiple surgical procedures. PUBLIC HEALTH RELEVANCE: We propose the use of nanotechnology approaches for controlling interfaces between the hip and knee implants and the surrounding tissues. The primary focus of this grant application is to improve the fixation, durability and osseointegration for long-term success of Total Joint Replacements and lower the need for recurrent multiple surgical procedures. Also, development of new nanotechnology tools and methods will lead to a new class of functionalized nanostructured surfaces for titanium and cobalt chrome alloys for use in biomedical implant industry. One benefit of the diamond-diamond components will be reductions in overall device size that will ultimately allow for a clinically less-invasive route to joint restoration and longer implant lifetime in vivo.