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The aging population and the prevalence of traffic and other accidents have led to an increase in the incidence of fractures, which requires some form of bone fixation implants to help solve this. A recent study published in the journal Materials outlines the role of titanium dioxide nanotubes (TNT) as a drug delivery method and subsequent local release at specific surgical sites (for example, implant sites designed to help hold bones in place) Outstanding potential.
Research: Structure of titanium dioxide nanotubes synthesized on 3D printed Ti-6Al-4V implants and evaluation of vancomycin release protocol. Image Credit: belekekin/Shutterstock.com
These fractured or broken bones must be supported and stabilized until they can regain sufficient strength before they can be used again. Castings and splints have traditionally been used to provide this stability, but improved aseptic procedures have allowed fractured bones to be fixed with internal implants (such as plates, screws, or rods).
Internal fixation provides many benefits for patients, including reduced hospital stay, faster healing, and reduced chances of incorrectly healing or incorrectly positioned fractures.
These internal fixation implants are usually made of steel, titanium, chromium or cobalt.
Despite these advances, there is still a risk of infection or rejection after implants are implanted to help stabilize fractures or broken bones. In the worst case, these infections can lead to the need for further surgery, and even loss of limbs or death.
The use of antibiotics can help reduce the risk of these infections, but when using oral or intravenous antibiotics alone, ensuring that they reach the implant site in a sufficiently targeted manner has always been a challenge.
The schematic diagram depicts the protocol for the gradual release of vancomycin from the surface of titanium dioxide nanotubes fabricated on 3D printed Ti-6Al-4V implant materials. The printed sample is ground and chemically etched to a suitable roughness surface. Titanium nanotubes (TNT) are synthesized at different anodization durations. Master Credit: Chunate, H et al., materials
More local drug delivery methods, such as antibiotic-loaded bone cement, provide better targeting options, but the ability of this method to release antibiotics at sufficient and sustained levels is problematic.
A recent study in Materials magazine outlined the outstanding potential of titanium dioxide nanotubes (TNT).
These TNTs can be integrated into the surface of custom-made 3D printed implants that have been specifically developed to adapt to the patient's specific fractures.
Studies investigating the use of TiO2 nanotubes coated on the surface of a series of biomedical implants have shown that these nanotubes have excellent biocompatibility and good cell adhesion and proliferation potential.
These TNTs not only help reduce the risk of implant rejection, but also provide a promising way to incorporate specific antibiotic drugs directly into nanotubes, allowing these drugs to be released at the target site in a controlled manner.
In order to improve and optimize this process, the research used anodization technology to synthesize titanium dioxide nanotube arrays on the surface of the 3D printed implants. The antibacterial drug vancomycin was then loaded into these TNTs, and their release properties were analyzed within 24 hours.
FESEM micrographs showing the top and side morphology of titanium oxide nanotubes manufactured at 1 h (a,e), 2 h (b,f), 3 h (c,g) and 4 h (d,h) view. The morphological image depicts the orientation of TNT and the size of the pores. The pore size of the nanotube increases with the anodization time, while the length decreases. Master Credit: Chunate, H et al., materials
The implant itself consists of a Ti-6Al-4V plate implant, which has been designed and modeled using specialized software before manufacturing.
The researchers used a number of high-end characterization techniques including field emission scanning electron microscopy (FESEM), contact angle meter, Fourier transform infrared (FTIR) and atomic force microscopy (AFM) to comprehensively study the morphology of TNTs. Wetness, functional groups and surface morphology.
The results of this study confirm that when TNT is incorporated into the surface of 3D printed implants, they can effectively act as a reservoir for local drug delivery.
Studies have found that by controlling parameters such as electrolyte composition, voltage, atmospheric temperature, and anodizing time, TNT can be optimized to enhance the release of vancomycin, which may increase its effectiveness and help minimize infections within the critical 24 hours risk. Some time after implantation.
These exciting findings provide excellent potential to help minimize infection and improve fracture healing with 3D printed implants. The roughness, nanostructure, and nanoporous properties of TiO2 on the surface of the implant are the key to improving the biocompatibility and osseointegration of the implant. Drug loading provides a powerful and targeted alternative to oral or intravenous antibiotics. method.
This will not only have a significant impact on the health, healing and overall well-being of patients, but it may also have significant economic advantages in improving the success rate of bone fixation implants and reducing the risk of infection.
(a) Water contact angle of printed Ti-6Al-4V, (b) TNTs_1h, (c) TNTs_2h, (d) TNTs_3h and (e) TNTs_4h. A wetting angle of "0" degrees was found on all nanotube surfaces, indicating that the fabricated TNT surface has high hydrophilicity. Image source: Chunate, H et al., materials
With the cost of orthopedic infection treatment and additional implant surgery reaching more than $1.6 billion in 2020 alone, the potential to reduce the risk of implant-related infections can greatly reduce the burden on the already overwhelmed global healthcare system.
Chunate, H-thaichnok, Jirapon Khamwannah, Abdul AA Aliyu, Saran Tantavisut, Chedtha Puncreobutr, Atchara Khamkongkaeo, Chiraporn Tongyam, Krittima Tumkhanon, Thanawat Phetrattanarangsi, Theerapat Chanamuangkon, Torrentp Synthetic titanium dioxide nanotube structure on 6Al-4V implants and evaluation of vancomycin release protocol" Material 14, No. 21: 6576. https://www.mdpi.com/1996-1944/14/21/6576
Lowe, Jason, 2019, American College of Orthopaedic Surgeons, internal fixation of fractures. https://orthoinfo.aaos.org/en/treatment/internal-fixation-for-fractures/
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David is an academic researcher and interdisciplinary artist. David's current research explores how science and technology, especially the Internet and artificial intelligence, can be put into practice to influence a new shift to utopianism and the reemergence of commons theory.
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