The Development of Metallic Biomaterials

Roger J Narayan MD PhDAssociate Professor,

North Carolina State University and theUniversity of North Carolina

Abstract• Man’s intrinsic desire to be active propelled the

development of biomaterials. Hip joint replacement surgery is of the most revolutionary advances in modern orthopaedic surgery, which both relieves pain and improves function. The development of metallic biomaterials has emerged as the result of a process of evolution in a Darwinian manner. By the middle of the nineteenth century, physicians began performing systematic studies in order to better understand tissue-metal interaction. Unfortunately, the development of metallic biomaterials was limited by a lack of knowledge about durable and biocompatible materials. This historical review illustrates how surgeon-scientists who used off-the-shelf metallic biomaterials to treat their patients. The modern field of biomaterials science owes a great deal to these pioneering surgeons.

Hip Joint

http://www2.ma.psu.edu/~pt/384hipj2.gif

Common Reasons for Hip Replacement

Condition Incidence• osteoarthritis 60 percent• fracture-dislocations 11 percent• rheumatoid arthritis 7 percent• aseptic bone necrosis 7 percent• revision of previous hip operations 6 percent

Bone replacement criteria include the following:

• 1. Appropriate tissue-material interface • 2. Non-toxic• 3. Non-corrosive• 4. Adequate fatigue life• 5. Proper design • 6. Proper density• 7. Relatively inexpensive • 8. Elastic and mechanical properties comparable to

those of bone

Early history

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John Rhea Barton

from page 2, Raymond G. Tronzo, Surgery of the Hip Joint, Lea and Febiger, Philadelphia, 1973.

John Rhea Barton’s patient

from page 2, Raymond G. Tronzo, Surgery of the Hip Joint, Lea and Febiger, Philadelphia, 1973.

Joseph Lister

http://history.amedd.army.mil/booksdocs/misc/evprev/fig23.jpg

Hey-Groves examined use of metals to immobilize fractures in a cat model

from page 4, Charles O. Bechtol, A. B. Ferguson, and Patrick G. Laing, Metals and Engineering in Bone and Joint Surgery, Williams and Wilkins Company, Baltimore, 1959.

Sherman observed failure of metal plates

from page 5, Charles O. Bechtol, A. B. Ferguson, and Patrick G. Laing, Metals and Engineering in Bone and Joint Surgery, Williams and Wilkins Company, Baltimore, 1959.

Zierold showed cobalt-chromium alloy superior to high carbon steel

from page 8, Charles O. Bechtol, A. B. Ferguson, and Patrick G. Laing, Metals and Engineering in Bone and Joint Surgery, Williams and Wilkins Company, Baltimore, 1959.

Mold arthroplasty using glass, Viscaloid, Pyrex, Bakelite, and

Vitallium

from page 201, P. G. Laing, Clinical Experience with Prosthetic Materials: Historical Perspectives, Current Problems, and Future Directions, in Corrosion and Degradation of Implant Materials ASTM STP 684, ASTM, West Conshohocken, 1979.

Early Moore Prostheses

from page 14, Raymond G. Tronzo, Surgery of the Hip Joint, Lea and Febiger, Philadelphia, 1973.

Judet Prosthesis

news.bbc.co.uk/2/low/in_pictures/4949528.stm

John Charnley

from page 15, Raymond G. Tronzo, Surgery of the Hip Joint, Lea and Febiger, Philadelphia, 1973.

John Charnley

news.bbc.co.uk/2/low/in_pictures/4949528.stm

Charnley Prosthesis

news.bbc.co.uk/2/low/in_pictures/4949528.stm

Today, there are many new frontiers in biomaterials engineering, including:

• 1. Porous Coatings• 2. Bioactive Ceramics• 3. Bulk Metallic Glasses• 4. Tissue Engineering

Conclusions

• The development of metallic biomaterials has emerged as the result of a process of evolution.

• By the middle of the nineteenth century, physicians began performing systematic studies in order to better understand tissue-metal interaction.

• Surgeon-scientists originally used off-the-shelf metallic biomaterials to treat their patients.

• The modern field of biomaterials science owes a great deal to these pioneering surgeons.