PROSTHETIC ACETABULAR LABRUM IMPLANT

Anindyojati, Adhi and Boughton, Philip and Ruys, Andrew J. (2014) PROSTHETIC ACETABULAR LABRUM IMPLANT. In: Materials Forum. Institute of Materials Engineering Australasia. ISBN 978-1-876855-07-9

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Abstract

Acetabular labrum is a fibrocartilage tissue that surrounds the hip acetabulum. The presence of labrum influences the biomechanics of the hip joint, to enhance hip stability and as a seal to protect the lubrication of the articulating joint. Tears in the labrum could progress to osteoarthritis, and can occur in both young and elderly patients. Osteoarthritis, which commonly leads to total hip replacement, can be an expensive condition to treat and can diminish quality of life. The prevalence of hip replacement surgery has also been increasing in recent years. Considering the essential role of acetabular labrum, its preservation is important in the treatment of labral tears, either by repair or reconstruction. However, labral repair may also bring the risks of imperfect healing or recurrence of injury, while reconstruction by autograft requires additional surgery and has risks of tissue morbidity. A synthetic implant could offer an alternative solution for the treatment of labral tears. Various implants have been developed to replace damaged fibrocartilage tissues, thus similar strategies could potentially be applied for labral injury. Additionally, a tissue engineering approach offers further benefits in facilitating healing and regeneration. The objective of this study is to explore the prospective development of labrum implant to recover the mechanical function of the damaged tissue and to take a role as a scaffold to enhance tissue regeneration. This paper will address literature reports on the role of acetabular labrum, the treatment of labral injuries, and reported fibrocartilage replacements, with a view to developing potential designs and candidate biomaterials for synthetic labrum implants. Ideally, an implant should be able to mimic the structure and mechanical properties of the replaced tissue. From this study, a fabric-based implant could be applied to mimic the fibrous architecture of acetabular labrum. Ultra-High Molecular Weight Polyethylene (UHMWPE) appears to be the promising material for implant macrostructure that provides mechanical strength. Conversely, a nanofibrous polycaprolactone (PCL) could take fit the role of bioresorbable scaffold to facilitate tissue remodelling and regeneration. Additionally, bioactive glass coating offers potential of stimulating interfacial bonding with surrounding tissue, as well as enhancing the process of healing. In summary, this presentation will outline a viable concept for a labrum implant. To the author’s knowledge, there are no reports of labrum implants in the literature. Hence, this research represents a novel biomaterials approach to fibrocartilage replacement with potential long term clinical benefits.

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