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Prosthetic infection following total joint replacement remain a serious complication despite improvements in implant design and operating room hygiene. The consequences of late infection affect patients both physically and psychologically for patients, leading to complete failure of the arthroplasty fixation, possible amputation, prolonged hospitalization to treat infection, and in rare circumstances amputation or death. Although with the use of prophylactic antibiotics and greatly improved operating room techniques the infection rate has decreased markedly during the years, challenges still remain for better preventive and therapeutic measures. The risks of prosthetic infection are exacerbated with implants that have complex surface geometries and the project envisages the benefits of developing osteoconductive surfaces that also provide antibacterial activity to limit or preclude local prosthetic infection. Medacta, Swiss implant manufacturer, have developed and patented electrolytic oxidation process and specific electrolyte to build calcium phosphate rich layer on the surface of titanium alloys. Applying such coatings on complex geometry surfaces are challenging. BioCera Medical, UK have developed and patented a novel electrochemical surface conversion process to yield a bioceramic layer on complex convoluted surfaces. The companies believe that a combination of their innovative technologies will result in a process for treatment of complex surface topography, beneficial for ingrowth, with a dense bioceramic layer capable of including specific elemental compositions to improve cellular proliferation throughout the complex surfaces that enhances osteo integration to host bone and include specific antibacterial elements to reduce the incidence of prosthetic joint infections, a cause of late failures with orthopaedic implants. Project objectives: * To develop robust integrated bioceramic surfaces onto established orthopaedic ingrowth surfaces applicable at a commercial scale to facilitate the regulatory pathway and clinical introduction. * Establish the bioactivity of bioceramic surfaces regarding inhibition of prosthetic joint infections through the addition of antibacterial additives. * To develop validated process and pilot scale facility to advance the development onto orthopaedic implants and accelerate into clinical use.

Scientists have long considered magnesium to be a very promising material for use in degradable bio-implants, but early promise has been offset by issues surrounding accelerated resorption leading to reduced strength in vivo and to hydrogen gas release. BioCera Medical Ltd (BioCera) aims to provide enabling innovations to enhance the performance of magnesium-based alloys currently in use and under development as resorbable metal implants for orthopaedic trauma interventions by the introduction of an ECO bioceramic surfaces to promote osseointegration via proliferation of osteogenic and fibroblastic cells that support both hard and soft tissue integration to achieve long-term success under real world clinical conditions. The goal of this feasibility project is to develop and demonstrate these ECO bioceramic surfaces provide enhanced clinical utility for resorbable magnesium alloys in respect of reducing stress shielding, controlling resorption, minimizing effects of harmful corrosion and limit hydrogen release. In summary to provide an enabling surface technology for magnesium alloy-based implants to control resorption and lead to a new generation of metal alloy implants that deliver compatible mechanical characteristics falling within the range of bone and titanium alloys and that are higher than resorbable polymers. For the benefits of patients and the overall healthcare system the strong yet resorbable implants reduce or eliminate the requirement for second surgeries to remove trauma implants, reducing emotional stress of additional surgery on the individual patients and reducing healthcare costs associated with conventional implant removal. The project is a collaborative venture between BioCera (SME, the surface technology developer and coating provider) and the University of Portsmouth (the provider of characterisation work and in-vitro evaluation studies). The outcome is supporting a novel surface conversion technology that aims to improve biocompatibility, reduce corrosion and advance the application of resorbable magnesium alloys for medical implant applications.