Development of an intraosseous transcutaneous orthopaedic implant (ITAP) resistant to bacteria infections through the combination of passive and active strategies

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If a leg, arm, finger or thumb has had to be amputated, or is missing at birth, an artificial substitute (known as aprosthetic limb or prosthesis) may be fitted. Prosthetic limbs usually have a socket and are held in place eitherby suction or by being strapped to the stump of the missing limb. However, this leads to major drawbacks suchas irritation of the stump or phantom limb syndrome. In this context, the implantation of intraosseoustranscutaneous prostheses (ITAP) was described as the most physiological, and thus probably successful,approach to prevent the previously evoked problems. In this procedure, a metal implant is inserted through theskin and into the centre of the bone of the stump. A prosthetic limb is then attached to the metal implant. Theaim is to produce a more comfortable and securely attached prosthetic limb.Unfortunately, the point where ITAP exits from the human body is often the site for infections which could bepotentially eliminated by proper integration of dermal and epidermal tissues around the implant, creating a softtissue seal around it. In addition, a complete prevention of the infection also requires endowing the prostheticdevice with bacteria-killing properties.Accordingly, our objective is to provide titanium (which is the material used by our industrial partner tobuild-up orthopaedic implants) with two functional properties that are both likely to prevent bacterialcolonization. These properties are 1) the capability of promoting skin cell adhesion and spreading on thesurface; this is a passive functionality and 2) providing the surface with antibacterial properties; this is anactive functionality.