Bioengineering Research Partnership in Total Joint Replacements

描述（由申请人提供）：在该大学-行业合作伙伴关系中，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，以最大限度地减少骨科器械中关节组件之间的磨损。磨损引起的并发症包括部件松动、有害生物反应、骨质溶解、机械不稳定、关节活动度降低、疼痛增加和最终植入物失效。在本项目中，UAB和Smith & Nephew，Inc.我们的团队在金属（CoCrMo或Ti-6Al-4V）骨科器械上开发和测试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。我们提出了一项为期五年的研究，重点关注以下具体目标：具体目标1：开发纳米技术，通过化学气相沉积（CVD）金刚石涂层，减少髋关节和膝关节金属植入物的关节，承重组件的摩擦和磨损，该涂层具有多层结构，交替纳米和微观结构分层组件。具体目标二：证明多层金刚石涂层（预期用于金刚石对金刚石或金刚石对聚乙烯关节面）与单层金刚石对金刚石关节面或目前用于市售骨科器械的金属对聚乙烯或金属对金属对组合相比具有更好的耐磨性。具体目标3：使用Smith & Nephew，Inc.的行业标准多轴髋关节和膝关节模拟器进行涉及金刚石涂层髋关节和膝关节部件的磨损模拟器研究。具体目标4：评价与聚乙烯和钴Chrome碎屑颗粒相比，金刚石磨损碎屑颗粒的细胞反应。具体目标五：进行体内研究，以表征对照和金刚石生物材料对总体生物相容性特征的初始短期器官和细胞反应。将从摩擦学研究中收集的磨损碎屑短期（数小时至数天）植入（注射）到成年大鼠的滑膜样气囊模型中，以评估临床、细胞、组织学和细胞因子生物相容性特征。将椎间盘植入家兔的松质骨区域，将在数小时至数月的时间点评估初始组织液和血液与对照和涂层植入物表面的相互作用。该拟定BRP的总体临床影响是将全关节置换术的使用寿命延长至30年以上，从而大幅减少多次手术的复发需求。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。该补助金申请的主要重点是改善全关节置换术的长期成功的固定，耐用性和骨整合，并降低对复发性多次手术的需求。此外，新的纳米技术工具和方法的发展将导致一类新的功能化纳米结构表面的钛和钴Chrome合金用于生物医学植入物工业。金刚石-金刚石组件的一个受益是减小了整体器械尺寸，最终实现了关节修复的临床微创途径和更长的体内植入物寿命。

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.