The Biotechnology and Genetics Race: Biomaterials Versus Biological Materials in Orthopaedic Applications SciDoc Publishers | Open Access | Science Journals | Media Partners

Bone consists of mature osteoblast cells and stem cells. In joints like the knee, for example, the large femur bone and the lower tibial bone are separated by cartilage and a fibro-cartilage meniscus spacer, both of which are composed of chondrocyte cells and which act as a shock absorber. These cartilage materials are often deteriorated by the accumulation of arthritic crystal aggregates and related deposits in this inter-bone region to create a variety of osteoarthritic knee problems. As these arthritic deposits build up, varying degrees of cartilage and meniscus granulation and tearing can occur. In the early stages, a minimally invasive surgical procedure called debridement or washing of the knee capsule to clean the accumulating debris along with dead chondrocycte cells can be performed. In some cases microfracture, drilling, and abrasion orthroplasty are performed to create scar-tissue to toughen the damaged cartilage. In severe circumstances of meniscus tearing it can be arthroscopically trimmed to reduce the tearing, but this can create stress displacement irregularities which can lead to further tearing and deterioration. Since the separated bones are alive, they will react to these stress variances by remodeling, which can lead to further joint deterioration, ultimately resulting in bone-on-bone situations which require surgical intervention to replace the damaged joint with implanted biomaterials. These are usually metallic alloy appliances fitted with a highly cross-linked polyethylene pad which acts as an artificial meniscus. In total knee replacement surgery, the existing or remaining knee components are removed and replaced with a prosthetic implant appliance by first creating a skin incision down the center of the knee. Blunt dissection follows the natural cleavages between ligaments and muscles and no cutting of muscle tissue is involved. This moves the quadriceps muscle and the patella aside to expose the knee joint in a bent position. Once exposed, cutting guides and robotic devices are used to shape the end of the femur to fit the femoral appliance while the tibia is cut normal to the bone axis and a depression drilled into the cut surface. The respective prostheses are then inserted and and secured with cement such as polymethyl methacrylate (PMMA) impregnated with antibiotics to mediate infections which can cause a wide range of residual problems; the worst case involving the removal of the implants until the infection is healed, and then reinserting them [1]. Other residual problems can include the loosening of the appliances