Synergistic integration of biomaterials in orthopedic implantation for infection preventing and tissue engineering

In the context of orthopedic surgery, managing infected bone defects (IBD) is particularly complicated not only due to the diverse underlying problems leading to the IBD, but also due to the high rates of re-occurence of the problem. Common approaches to treating IBD do not strike the necessary balance between dealing with the underlying infection and ensuring solid bone regeneration. Because of this, patient treatment is dragged out, the approaches have limited clinical efficacy, and patient morbidity increases. In the implant related infections, patient related co-morbidities, the type of material used, and even the surgery itself play a role in making the infection worse, further proving the point that more

flexible and multifunctional approaches are needed. Biocomposites are a new class of bone graft materials that can provide the needed multifunctionality through the combined use of several different materials and bioactive agents. Biocomposites that provide multiple, active means of combatting infection (i.e. sustained anti-microbial activity, immunomodulation, and increased osteogenesis) along with bone healing, provide an effective means of addressing the complex problems associated with IBD. This paper will discuss the different types of biocomposites and their respective advantages to IBD treatment, specifically with infection control and the regeneration of the necessary tissues. The paper will also discuss the gaps around the clinical use of these new materials, and will provide

a science based, regulatory proposal to form a new, comprehensive, lifecycle framework to define and evaluate the regulatory and control parameters around these materials.

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