A 14- year-old patient has a tumor on the head of the femur that has to be remov

Question

A 14- year-old patient has a tumor on the head of the femur that has to be removed and replaced with an implant. There are three candidate implants available: (a) Custom made titanium filling; (b) PMMA bone cement; (c) tissue-engineered bone filling. (1) List two factors you should consider when choosing the best implant for this patient. (2) Discuss the advantages and disadvantages of the three implants. (3) If the surgeon decides to use the tissue-engineered bone filling, discuss your approach to create this implant.

Explanation / Answer

1. a) Custom made titanium filling failed to show significant improvement in implant longetivity. Becuase their surface finish, either smooth or proximal titanium mesh pads was not optimal for bone ongrowth.

2. a) PMMA bone cement can be used for to affix implants and to remodel lost bone. Although it is sticky, it does not bond either the bone or implant. It can be used to fill spaces between prosthesis and the bone preveiting motion.

b) It does not bond either the bone or implant it is not advisable for bone implant.

c) It has good degree of compatibility with human tissue.

3. a) It works based on the priciple of native bone development and fracture healing.

b) Engineered bone graft have the capacity for osteogenesis,osteoconduction, osteoinduction and osteiointegration. These are esseitial for establishing good connection between host bone and implant.

c) Cells form various anatomical sources in conjunction with scaffolds and osteogenic factors.

d) Culture cell on scaffolds before implantation further improves the quality of bone graft.

e) Embryonic stem cells are used in cell culturring to produce implant graft.

4. The approaches used to creat implat are: 1. In situ prevascularisation 2. In Vivo prevascularisation 3. Endochondral bone tissue engineering 4. Gene theraphy are the aproaches used in this proces.

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