Large numbers of patients worldwide owe their quality of life to innovations in orthopaedic technology and treatment. Researchers and manufacturers are concentrating their efforts on improving materials and processes, developing new technology, and improving knowledge transfer from related areas. OrthoTec Europe, which will be held at the Mövenpick Hotel Zürich-Regensdorf (Zürich) on September 28–29 will showcase cutting-edge ideas of industry leaders.

Last year’s event attracted 900 attendees from 23 countries. In its second year, the OrthoTec Europe conference and exhibition will give designers and manufacturers a chance to gather in Switzerland, the heart of European orthopaedics manufacturing, and share knowledge about the future of orthopaedic products. Attendees will have ample opportunities to network, whether with the conference speakers or representatives from any of the 73 exhibiting companies. Exhibitors will be showcasing the latest state-of-the-art systems in development, design, and rapid prototyping in areas that include biomaterials, metals and plastics processing, instruments, testing services, finishing, and packaging.

Biologics and Intelligent Implants

Intelligent implants of the future will be smaller, versatile, and more complex than today’s devices. They will be designed for maximum compatibility with the human body and offer a significant medical benefit to patients by enabling them to avoid the stress of follow-up operations. During the OrthoTec Europe conference program, speakers will discuss the strategic and technical aspects of market trends, new production technology, quality management, and orthopaedic device construction.

Future medical technology, particularly in orthopaedics, will combine biological ingredients with implant hardware. New implants, such as resorbable meshes, are specially designed for this purpose. Yves-Alain Ratron, director of global research at Tornier (Saint-Ismier, France), says that any orthopaedic implant could be seen as a framework for tissue structure, replacing or complementing muscular or skeletal functions. Ratron is the chairperson for the conference session on biomaterials and implant technologies on September 28.

Implants with resorbable materials also boost cell activity, facilitating and accelerating healing. For example, flexible, tissue-like products could be used to repair tendons, by supporting mechanical stress at the beginning of the healing process. Coatings and other treatments support cell adhesion and encourage implant bonding and tissue growth and regeneration. These cell carriers gradually break down during the healing process. A great deal of research is also being carried out in the area of cartilage replacement, which Ratron says is a daunting and complex subject.

Rapid advances in nanotechnology are also paving the way for improved surface design and better ingrowth, according to Ratron. In this case, surface coatings are being used as carriers for biologically active molecules. “One of the most interesting developments is antibacterial coatings that release drugs to reduce the risk of infection,” says Ratron.

Biologics add new treatment options for patients and doctors. Metals and polymers can be used to make screws, nails, and artificial implants, while newer materials such as the bioresorbable copolymer polylac-tic-coglycolic acid, pyrolitic carbon, and human tissue-based additives are among the products now available to technologists. This wider choice of materials means, for example, that prostheses can be more easily adjusted for elasticity.

“Lightweight materials make orthopaedic technology more comfortable, and simulation know-how makes it easier to design and develop implants,” says Urs Schneider, MD, head of the orthopaedics and locomotor systems department at Fraunhofer IPA (Stuttgart, Germany). Schneider is cochairing two conference sessions—one on advanced production processes for orthopaedic implants and the other on potential drivers of future orthopaedic technology. “New technology isn’t automatically better or cheaper, so cost-effective, quality-controlled production processes are still a challenge,” says Schneider.

He will also discuss new resorbable and nonresorbable implant production, and various aspects of simulation in development, including hygienic design and improved operating-theater efficiency. These improvements could streamline orthopaedic surgery in the future.

Other implant advances include intelligent technology, which will provide and respond to feedback related to stress, movement, and wear to help prevent adverse events (see the sidebar “Current Developments in Smart Implants”). It will also help doctors and patients effectively monitor implants and take prompt action, if necessary.

However, predicting the capabilities of intelligent implants before they exist is a risky undertaking, says Ratron, adding that it still isn’t clear whether the technology is mature enough to be used in all implants at a reasonable cost. “As with so much other technology, there will be a market for intelligent implants as soon as they become sufficiently cost-effective,” he says.

Hybrid Manufacturing

Hybrid manufacturing is a combination of forming and machining processes, with sheet materials being formed into shapes that are as close as possible to what will be needed in the finished product so that minimal machining is required. It is particularly suitable for complex expanded structures with thin walls made from expensive materials.

Large ball diameters for artificial hip joints give increased freedom of movement and a reduced tendency of joint dislocation. Because sliding surfaces made from materials such as cobalt chrome and ceramics must have a specific thickness, designers are trying to use very thin osteoconductive metal backs to reduce wall thickness. Making these from bars or forging blanks requires a great deal of time and materials, so alternative production methods are being sought. “Hybrid manufacturing allows thin-walled shells to be made at low cost,” says Martin Schmidt of Jossi Orthopedics Ltd. in Switzerland. Even macrostructures, such as fins and barbs, can be formed, and a coating can be applied. The shells, some of which are less than 1-mm thick, are mostly made from Ti-6AI-4V. The metal back can be fitted to the sliding surface in-house. Schmidt will be discussing future drivers in orthopaedics on September 29.