Category: Implants and Prostheses

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Ultrasound Implant at Spinal Cord Injury Site Could Help Guide Recovery

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A biomedical team has completed their first feasibility study to investigate the ability to place a temporary ultrasound device at the site of a spinal cord injury, which supports ongoing research to study its ability to monitor and modulate blood flow after surgery 

Researchers are studying how an ultrasonic neural interface device, which would be temporarily implanted at the site of injury following surgery, may be used to support recovery and personalise care for people recovering from spinal cord injuries.

A team of engineers and surgeons from Johns Hopkins Medicine has published its first proof-of-concept study that shows temporarily implanting a tiny ultrasonic device into the location of a spinal cord injury can be feasible, safe and potentially useful. These findings, which mark an early midpoint in a multitiered research journey to develop and study how the device could be used in clinical care, published today in Science Advances. 

“When the biology of spinal cord injury is local, our devices should also be able to track and treat local physiology,” says Amir Manbachi, PhD, the principal investigator and an associate professor of neurosurgery and biomedical engineering at the Johns Hopkins University School of Medicine. 

The device that Manbachi and researchers developed and studied, which is called Multimodal Ultrasound System for Injury Care (MUSIC), is designed to enhance feedback about what is happening at and around the site of injury following surgery and to support clinical decisions about care when a patient is recovering in the intensive care unit. 

Manbachi explains that the ultimate goal of developing and studying the device is to identify a way to support people while they are in the hospital and minimise risks for complications, such as stroke, blindness or losing additional control of movement, that they may face while recovering from a spinal cord injury.

To achieve this, the device was designed to double as a “mobile MRI” that could alleviate the need to move immobile patients in the days following their recovery from injury, while providing on-demand and as-needed feedback to medical teams, as opposed to single points in time. 

The device is designed to have dual capabilities of diagnostic ultrasound (sonography) and therapeutic ultrasound (physical therapy).

The diagnostic/imaging aspect of the device provides real-time insight about blood flow and changes surrounding the spinal cord injury, and it enables analysis of other measures, such as spinal fluids and excess fluid accumulation, how a person is responding to medication and what is happening outside of the injured area, which can help indicate how well a person is healing. This type of real-time detection in the days and weeks after surgery could provide instant feedback to medical teams, while helping to personalise treatment decisions. 

Therapeutic ultrasound (also known as focused ultrasound) is the more futuristic and exploratory aspect of the device that has been studied for its potential ability to identify and respond to changes in blood flow at and around the site of the injury (when blood flowing through the small vessels around the affected area drops below or above acceptable levels).

This ultrasound device, which received FDA Breakthrough Device Designation in 2023, is the size of a small Band-Aid and created to be placed over the spinal cord at the site of injury during the expected surgery. This publication reports the first proof-of-concept study in animals to show that MUSIC was able to be temporarily implanted and provide real-time feedback about blood flow and imaging around the site where it is located. 

Source: Johns Hopkin Medicine

Categories : Implants and Prostheses NeurologyTags :

Experimental Brain Implants are on the Rise. What Happens After the Trials are Over?

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AI image created with Grok

Nathan Higgins, Monash University

In 2024, Elon Musk’s Neuralink put its first brain implant into a human amid doubt from scientists and allegations of animal cruelty.

Two and a half years later, that first patient is one of more than 20 “neuralnauts” who use their implants to participate in the online world.

Brain implants are becoming smaller, more compatible with human bodies, and dramatically more capable. People with paralysis can use brain-computer interfaces to produce speech almost instantaneously. Earlier this year, researchers in the United Kingdom showed volunteers wearing a headset could control robotic limbs and their natural ones at the same time.

As the industry takes off, we will see more and more clinical trials of devices that are implanted in the brain. In a recent study, my colleagues and I tried to address an increasingly important question: when a clinical trial of an experimental neural device ends, what does that mean for the human participants?

Tough questions

There is no simple answer. Some participants may be able to continue using an implanted device “off-label” as part of a special access scheme, or if the trial sponsor enrols participants into a follow-up study.

But if the trial sponsor is funded by a research grant or venture capital, they may not be able to cover the costs of potentially lifelong device support.

Participants may need to have their device removed at the end of the trial, even if they have benefited from it.

These scenarios are not hypothetical.

This is becoming a significant issue in Australia, where a new generation of neurotech companies is taking off.

Last year, Melbourne-based company EpiMinder received FDA authorisation to market their continuous seizure monitoring system for epilepsy.

Synchron has raised well over A$300 million for its “minimally invasive” endovascular brain-computer interface and has recently commenced its latest Australian clinical trial.

No rules, yet

Yet Australia currently has no rules about how trial organisers should be required to support participants for the long term.

Nor are there rules about how participants should be supported when trials are suspended or devices discontinued.

Current guidance offers little direction on what ethical arrangements should involve.

The Australian clinical trial handbook requires researchers to “clearly explain” whether participants will have continued access. However, this is difficult in practice.

Trials of implantable systems often last several years. This makes it difficult for participants to anticipate what their future needs and preferences will be once the trial comes to a conclusion.

Asking the experts

We brought together an expert panel of 24 clinicians, bioengineers, consultants, bioethicists and research governance professionals to develop recommendations on post-trial responsibilities in Australia.

If the sponsor is able to give participants the option of post-trial use, we recommend giving participants and their loved ones a realistic picture of what continued use will look like.

Which clinical and technical supports will remain available, and who will provide them? Will surgery and maintenance be covered by public healthcare or private health insurance? What costs might participants face themselves?

Years may pass before a device receives regulatory approval or becomes eligible for reimbursement. Participants should be provided with updates on changes to funding, regulatory status or manufacturers’ commercial plans that could affect their ongoing care.

This does not always happen in neurotechnology research. Transparency helps participants assess their participation and plan for life after the trial.

Geographic barriers

Geographic and socioeconomic factors also bear on continuing access to device support. Trials are often run from metropolitan teaching hospitals. Some participants may need to make repeated visits to the trial site for outpatient care or inpatient stays.

Flights and accommodation may need to be arranged for participants who must travel interstate, particularly as laws around psychosurgery vary between states. This can complicate access to local care.

We recommend anticipating barriers to continuing device use that may disproportionately affect some participants. During recruitment and study design, research teams should engage participants’ primary treating physicians to discuss what aspects of post-trial support can be safely (and lawfully) taken on locally.

Some procedures will still require specialist expertise, but sharing post-trial support could reduce travel costs and dependence on the original research team. Better treatment for pioneersThe end of a clinical trial should not mean losing access to a device when better planning and coordination between trial organisers could have made continued use possible.

Ultimately, these trial participants are pioneers who put their brains in researchers’ hands to help develop promising new treatments.

Nathan Higgins, Postdoctoral Research Fellow, Monash Bioethics Centre, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Categories : Implants and Prostheses Surgeries & ProceduresTags :

Robotic Hip and Knee Surgery Fails to Cut Overall Risk of Repeat Surgery

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The robotic arm working in the hospital. Credit: Queen Mary University London

Two major studies involving researchers at Queen Mary University of London have found that robotic-assisted hip and knee replacement does not reduce the overall early risk of repeat surgery compared with conventional surgery.

Published in The BMJ, the studies analysed more than one million joint replacements recorded in the National Joint Registry between 2018 and 2024. Together, they provide the largest real-world evaluation to date of whether the greater technical precision offered by robotic-assisted surgery translates into better outcomes for patients.

Researchers from Queen Mary, the University of Oxford and the University of Bristol found that, although robotic technology is designed to help surgeons position joint implants more accurately, this did not translate into a lower overall early risk of repeat surgery following either hip or knee replacement.

In robotic-assisted joint replacement, the surgeon remains in control of the operation, using computer and robotic technology to help plan and guide the placement of the implant.

The findings come as the NHS plans a major expansion of robotic surgery, aiming to increase the number of robotic-assisted procedures sevenfold by 2035. Robotic systems require substantial investment, costing around £1 million to introduce and adding approximately £1,000 to £2,500 to the cost of each procedure.

In the hip replacement study, researchers found no overall reduction in repeat surgery or mortality associated with robotic surgery. However, robotic hip replacement was associated with a lower risk of further surgery for problems related to implant positioning. This specific benefit did not translate into an overall reduction in the need for repeat surgery.

For knee replacement, researchers found no difference in the risk of repeat surgery between robotic-assisted and conventional procedures.

The studies examined early outcomes, and the researchers say longer-term follow-up will be needed to establish whether differences in implant survival emerge over time.

The team used a method known as target trial emulation to analyse large-scale real-world registry data. The statistical approach aims to make comparisons between groups more closely resemble those of a clinical trial by balancing patients according to known differences in their characteristics.

Dr Hasan Mohammad, Academic Clinical Lecturer in Trauma and Orthopaedics at Queen Mary University of London and lead author, said:

“This study, which uses novel methodology and represents the largest real-world analysis of its kind worldwide, provides important independent evidence for patients, surgeons and policymakers at a time when robotic hip and knee replacement surgery is being adopted rapidly.

“New technology should deliver meaningful benefit for patients and represent good value for a publicly funded health service.”

Source: Queen Mary University London

Categories : Implants and Prostheses NeurologyTags :

Can Total Joint Replacement Particles Reach the Brain?

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A study shows they do – but without causing cognitive decline

Photo by Anna Shvets

Total joint replacement is a proven treatment to relieve chronic knee pain, but there have been concerns raised that particles from the device may migrate to the brain and cause memory problems. New research from Rush University shows that may not be a worry.

In a study published by Acta Biomaterialia, researchers found that particles in some people with total joint replacements travelled to the brain but did not cause cognitive decline.

Researchers did find an association of cobalt, a key element of most implants, with more Alzheimer’s disease pathology in the brain.

The particles, called wear debris, are caused by friction and movement in the joint, or, in some cases, corrosion. The newer materials used in joint replacements today make this less likely to occur.

“Implants have a very specific combination of metals such as cobalt, and when they show up together in one particle in the brain in the exact same composition that the implant is, we know it can’t come from any other source,” said Robin Pourzal, PhD, associate professor and director of implant materials analysis.

“For years, we’ve known that particles can deposit in tissues surrounding the joint, but this is the first study to look at the particles deposited in the brain.”

In working with Puja Agarwal, PhD, in the Rush Alzheimer’s Disease Center, the team took a closer look at what was happening cognitively in this group of people

The study included data collected among 701 deceased participants in the ongoing Memory and Aging Project conducted by David Bennett, MD, which include older adults residing in the greater Chicago area. The participants had no dementia at the beginning of the study and were followed annually with cognitive assessments using a 19-test battery, a standard collection of memory and thinking skill tests.

A total of 229 people in the study had a total hip, knee or shoulder replacement. The control group was made up of 472 people who had no total joint replacement. Due to a higher likelihood of the metal cobalt being found in total hip replacement, the participants were studied in two groups: 146 with hip replacements and 83 with knee or shoulder replacements. 

Pourzal notes that the collaboration was led by faculty members from the Department of Orthopedic Surgery, including leaders from Rush Orthopedic Research, in collaboration with colleagues from the Rush Alzheimer’s Disease Center and international partners.

“Total joint arthroplasty remains one of the most successful and life-changing interventions in modern medicine. But it does suggest that wear particles from the implant, particularly in certain hip replacements involving accelerated wear, may travel beyond the joint and warrant further study.”

Source: Rush University Medical Center

Categories : Implants and ProsthesesTags :

Dual Mobility Hip Replacements Reduce Dislocation Risk by 70%

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The new implant (to the right) consists of a small ball encased in a larger ball, which gives better stability. Photo: Sandra Gunnarsson. Credit: Queen Mary University of London

A major international clinical trial had found that an emerging type of hip replacement implant dramatically reduces complications in people with pelvic fracture. The study, published in The Lancet, involved 1600 patients across 44 hospitals in the UK and Sweden. The DUALITY trial is the largest clinical trial to compare dual mobility total hip replacements (DM-THR) with standard total hip replacements (THR). The team found that people treated with DM-THR were 70 per cent less likely to experience a dislocation post-surgery – the most common complication after hip replacement for fracture.

A broken hip in older people is one of the most common serious injuries worldwide, affecting more than 14 million individuals each year and accounting for 1.4% of total direct healthcare expenditure in established market economies. The type of hip fracture studied in the DUALITY trial represents approximately half of all hip fractures experienced globally.

A total hip replacement where both the ball and socket of the hip are replaced, is recommended for older, active individuals with some types of hip fracture. For most patients, the procedure improves mobility and quality of life, but dislocation post-surgery can be common and can have serious consequences for those affected. When dislocation occurs, patients often require emergency hospital admission, procedures to reset the joint, and sometimes further surgery. This can lead to longer recovery times, added distress, and increased risk of further health problems.

Dual mobility-THR uses a small ball encased in a much larger plastic ball, and was developed specifically to reduce the risk of dislocation. In the DUALITY trial, the team aimed to establish if DM-THR reduced the risk of dislocation compared to THR. The results showed that the DM-THR implant does improve stability in the hip joint, making it less likely to dislocate after surgery. They found that within one year of surgery, just 1.3 per cent of patients receiving DM-THR experienced a dislocation, compared with 4.2 per cent of those given a standard THR. Importantly, the study found no increase in other risks such as infection or death, and overall complication rates were lower in patients receiving DM-THR.

The researchers conclude that dual mobility implants should be considered the preferred option for suitable older patients undergoing total hip replacement after a broken hip. Crucially, DM-THR requires no new technology or training. Surgeons are already familiar with both implant types, meaning the change could be implemented immediately within existing practice.

Professor Xavier Griffin, study author and Chair of the Centre of Bone and Joint Health at Queen Mary University of London and Honorary Consultant Orthopaedic Surgeon at Barts Health NHS Trust, said:

“Dislocation is the most common major complication following hip replacement for a broken hip. People that experience this painful complication often require further surgery and the recovery following this is usually long, slow and painful. So, it has been an area that I, along with our surgeons around the world, have been wondering if there is any benefit to using these type of hip replacements in people with a broken hip. The fantastic news from DUALITY is that we can make a really substantial reduction in the risk. I hope that this research will make a real difference to many future patents who might avoid this catastrophic problem.

I’ve tried to run similar studies before but never been able to deliver one that is big enough to give us a reliable answer to the question. Meeting the team in Uppsala and making this international collaboration a reality has been a game changer for accelerating how quickly we can discover the answers to these sorts of questions.”

Professor Nils Hailer, study author, Chair of Orthopaedics at Uppsala University and Consultant Orthopaedic Surgeon at Uppsala University Hospital, said:

”After many years of analysing registry data and seeing both advantages and limitations of dual mobility hip replacements, I was eager to obtain solid evidence for or against the concept. Together with colleagues at Queen Mary, we succeeded in delivering a large, pragmatic, orthopaedic randomized trial involving both smaller hospitals and major referral centres across two countries.

“The results provide robust support for the use of dual mobility constructs in hip fracture patients in need of a total hip replacement. Beyond the findings themselves, I believe this collaboration sets a new benchmark for future randomized trials in European orthopaedic research, and we will jointly continue working towards that goal.”

Researchers say that beyond improving outcomes for patients, reducing dislocations could have a significant impact on healthcare systems. Complications such as post-surgery dislocations increase hospital stays, require additional operating time, and drive unplanned readmissions. Although dual mobility implants are currently more expensive than standard implants, researchers believe the reduction in complications could offset the higher upfront cost. A full economic analysis is underway.

Source: Queen Mary University of London

Categories : Implants and Prostheses NeurologyTags :

Neural Stimulation and Exoskeletons Improve Hand Function in Neurological Injuries

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Study demonstrates the potential of personalised assistive technologies for people with impaired hand function

Researchers at the Medical University of Vienna, in collaboration with ETH Zurich, the Technical University of Munich and Medical Faculty Belgrade, have developed a wearable neurorobotic system that combines electrical neurostimulation with hand exoskeletons. In a clinical trial involving 14 patients with hand impairments caused by neurological injury, the technology supported finger mobility, tactile perception and grip control. The results demonstrate the potential of personalised assistive systems for people living with the consequences of spinal cord or brain injury. The study has recently been published in the journal Science Advances.

Hand movements and the sense of touch are essential for everyday activities such as grasping, eating, dressing or personal hygiene. However, after damage to the central nervous system, motor and sensory impairments of the hand often persist. Conventional rehabilitation can achieve improvements, but does not always lead to sufficient restoration of hand function. There is therefore a great need for assistive technologies suitable for everyday use.

A research team led by study director Stanisa Raspopovic from the Center for Medical Physics and Biomedical Engineering at MedUni Vienna has developed the “SensoExo” system for assisting people with hand sensorimotor impairements. It combines a wearable hand exoskeleton with a custom-fitted neurostimulation sleeve. The sleeve stimulates specific nerves and muscles in the forearm through the skin. Sensors on the fingers detect touch and gripping forces and translate this information into electrical stimulation, providing users with tactile feedback. In addition, functional electrical stimulation can assist users open and close their fingers more easily.

“Our aim was not only to provide mechanical support for movement, but also to restore their sense of touch,” says Stanisa Raspopovic. “The interplay of strength, movement and the sense of touch is crucial, particularly when gripping. Without feedback on how firmly an object is being held, hand function remains significantly limited in everyday life.”

Individualised support depending on the impairment

The system was tested on 14 patients with neurological hand impairments. All study participants exhibited sensory deficits and therefore received tactile feedback via transcutaneous electrical nerve stimulation. In seven individuals with particularly severe motor impairments, functional electrical muscle stimulation was also used to support hand opening and grip strength.

The study compared three conditions: no support, support from an exoskeleton alone, and the combined use of an exoskeleton and neurostimulation. Eight of the 14 participants also completed functional grasping and releasing tasks with bulky and fragile objects. This investigation revealed that the combination of exoskeleton and neurostimulation provided additional benefits compared to an exoskeleton alone. In patients with severe motor impairment, SensoExo improved finger mobility to a greater extent than the exoskeleton alone. The artificially mediated tactile feedback also increased the areas of the hand where touch sensations could be perceived.

“The results show that motor assistance and sensory feedback must be considered together,” explains lead author Andrea Cimolato from the Center for Medical Physics and Biomedical Engineering at MedUni Vienna. “The system can be adapted depending on the individual’s impairment profile. People with more severe motor impairments benefited particularly from additional motor support, while those with pronounced sensory loss used the sensory feedback to grasp fragile objects more precisely.”

Improved grasping of everyday objects

In the functional tests, participants using SensoExo achieved the highest success rates when grasping and carrying objects. With bulky objects, muscle stimulation supported grip strength. With fragile objects, sensory feedback helped to avoid applying too much pressure.

“The technology is currently a prototype and not a fully developed medical device for everyday use,” emphasises Raspopovic. “However, the study provides early clinical evidence that non-invasive neurostimulation combined with wearable robotics can form a realistic basis for future personalised assistance systems.”

Source: Medical University of Vienna

Categories : Dentistry Implants and ProsthesesTags :

Why Antibiotics Fail Against a Common Dental Implant Disease

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By Alexmit art – Own work, CC BY-SA 4.0, Link

Dental implants have given tens of millions of people something dentures never could: a full set of fixed and fully functioning teeth. Unfortunately, 10% to 20% of implant patients eventually experience an aggressive jawbone infection called peri-implantitis. 

Antibiotics usually fail to stop the infection for reasons that researchers have never understood – until now.

A new study in PNAS Nexus by researchers with the Rutgers School of Dental Medicine found that bacteria corrode implants, causing them to shed microscopic titanium particles into the surrounding tissue. Those particles hijack the immune cells sent to clear the infection and lock them into a state of inflammation that destroys the jawbone they are supposed to protect.

Working with human tissue samples, cultured human immune cells and a genetically engineered mouse model, the team pinpointed a specific calcium channel in the body’s bacteria-eating macrophages that the titanium particles activate. Switching that channel off in mice prevented the disease. The result is the first credible drug target for a condition that affects up to one in five implant recipients and costs the global health system more than a billion dollars a year.

“For the first time, we show why all the antibiotic treatments that work around teeth do not work around implants,” said Georgios Kotsakis, the study’s senior author and the assistant dean for clinical research at the dental school. “Now that we know the cause, we can start developing therapeutics.”

Peri-implantitis has long been a puzzle because it initially looks like its counterpart in natural teeth, which is called periodontitis and begins with the same oral bacteria. In patients with natural teeth, antibiotics and routine cleaning resolve the infection. In patients with implants, the same drugs against the same bacteria succeed less than half the time, while the bone underneath continues to disappear.

Most research over the past 20 years has focused on the bacteria. Members of Kotsakis’ lab took a different approach and began looking at the implants. Bacteria living on the implant surface produce acidic biofilms that slowly corrode the titanium, releasing billions of particles smaller than a red blood cell. The same shedding can occur during routine cleaning, especially with instruments that dentists typically use on natural teeth.

Inside the gum, those particles get coated with a bacterial toxin called lipopolysaccharide. To the immune system, they suddenly look like enormous, indigestible bacteria – but macrophages cannot digest metal. The cells become trapped in a hyperinflammatory state, pumping out signalling molecules including interleukin-1 beta, an inflammatory protein also implicated in rheumatoid arthritis and Alzheimer’s disease. 

That inflammation eats away at bone. Worse, the immune cells lose their ability to deal with the original infection. In the lab, macrophages exposed to titanium particles took up less than half as many bacteria as unexposed cells. 

“These particles are little magnets that attract the bacterial toxin, and they hijack the immune system, preventing it from clearing bacteria,” said Kotsakis. “You have a perfect storm that defies antibiotics.”

Team members traced the cascade to a calcium channel (a specialised, pore-forming protein structure within cell membranes) called TRPC1. In mice engineered without it, the immune cells handled the same titanium-plus-bacteria challenge normally: abscesses were dramatically smaller, inflammatory cytokines dropped, and bacterial clearance was restored. 

Funded by the National Institutes of Health, members of Kotsakis’ group are testing drug candidates that target the same pathway in human cells.

For people who already have implants, the most useful finding may be a quieter one. The strongest known protective factor is regular professional cleaning, but the kind of cleaning matters. Until roughly a decade ago, many dentists scraped implants with the metal scalers used on teeth, a method the Rutgers lab and others have shown can itself corrode the implant and accelerate the disease. Nonabrasive techniques are now standard. 

By Andrew Smith

Source: Rutgers University

Categories : Implants and ProsthesesTags :

Clinical Trials Are Part of UP Professor’s Dream of ‘Making Deafness History’

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University of Pretoria’s Professor Mashudu Tshifularo is leading a groundbreaking clinical trial for 3D-printed ossicles,

Forty-five patients with conductive hearing loss from middle-ear damage are eagerly awaiting the start of clinical trials, led by University of Pretoria’s Professor Mashudu Tshifularo, on a ground-breaking procedure to restore hearing.

The trials, due to begin within weeks at Steve Biko Academic Hospital in Pretoria, come seven long years after Prof Tshifularo successfully performed the world’s first middle-ear transplant using 3D-printed bones made from titanium. The patient was Thabo ***, whose middle-ear bones – the ossicles – had been injured in an accident, causing almost total hearing loss until he had the transplant in March 2019.

In a video screened at a UP Roundtable event held in April this year to announce the launch of the upcoming clinical trials, a beaming Thabo *** confirmed he had regained his hearing after the transplant and had continued to enjoy excellent hearing ever since.

While this procedure was hailed as a surgical breakthrough at the time, its full acceptance by the South African and global ear, nose and throat (ENT) community depends on formal clinical validation. Despite the many obstacles he knew would lie ahead, Prof Tshifularo, joint head of UP’s Department of Otorhinolaryngology, was determined to take his innovation through clinical trials.

“Today is a culmination that I never thought would come. There was a time when I cried, there was a time when I was very depressed, there was a time when I nearly gave up, but something inside me told me to remain steady,” he said at the Roundtable, where the announcement was made that clinical trials could finally move ahead now that all the necessary regulatory, ethical and licensing clearances have been obtained, including from the South African Health Products Regulatory Authority (SAHPRA).

The years since Prof Tshifularo performed that first transplant have also been spent developing, perfecting, testing and patenting a prototype of the titanium material and implants for the clinical trials. UP’s engineering partner on this project, the Council for Scientific and Industrial Research (CSIR), was responsible for the materials and prototype development, while HH Industries manufactures the implants, using 3D printing technology, and Marcus Medical is providing the robotic technology to be used during the surgery. Seed funding was provided by the Motsepe Foundation.

Ready to transform lives

Now that it is all-systems-go for this all-South African collaborative effort, Prof Tshifularo and his team aim to perform this life-changing surgery in the next 12 months on all 45 patients who have expressed interest in participating in the clinical trials.

The team will then focus on publishing their research and training future researchers and medical teams so that the work can be amplified far and wide for the benefit of humanity.

“My dream is to make deafness history,” Prof Tshifularo said, noting that an estimated two billion youth are living with undiagnosed, mostly noise-induced hearing loss, which would become a severe problem in the next 20 to 25 years. Hearing loss is also common among the world’s rapidly ageing population.

The procedure itself takes about three hours and uses advanced robotics to remove the damaged middle-ear bones and replace them with the 3D printed titanium bones. This is minimally invasive, carries significantly less risk than conventional procedures and leaves minimal scarring. The titanium used to manufacture the ossicles is biocompatible, meaning it can be introduced into the ear without causing harmful reactions.

“This innovation will ultimately transform the lives of many people, including newborn babies born with congenital middle-ear defects,” said Prof Themba Mosia, Vice-Principal: Student Life, who gave the opening address at the Roundtable. “It exemplifies the spirit of innovation and collaboration at the university, combined with the deep medical expertise needed to restore hearing.”

UP at the forefront of healthcare advancements

Prof Flavia Senkubuge, Dean of UP’s Faculty of Health Sciences, said innovations such as Prof Tshifularo’s middleear surgical procedure place the university “front and centre” of healthcare advancements on the African continent and the world stage.

She reiterated UP’s commitment to deploying its innovations for the benefit of local communities, such as by establishing a “one-stop shop” – most likely in the form of a private day hospital – where community members could benefit from advanced clinical technologies and the expertise of its researchers.

Paying tribute to Prof Tshifularo, long-time colleague Dr Christian Quitter thanked Prof Tshifularo “for having the guts” to persevere with his innovation, even when it was not always supported by the ENT establishment.

He also thanked the university for supporting researchers who “think out of the box in seeking to improve the lives of all humanity”.

Provided by the University of Pretoria

Categories : Implants and ProsthesesTags :

New Magnesium Coating Could Improve Safety of Medical Implants

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Photo by DanR. CC BY-NC-SA-2.0

A team of scientists from the University of the Sunshine Coast in Australia and around the world has developed a promising way to reduce the risks from biodegradable medical implants. 

Scientists from UniSC’s Centre for Bioinnovation and advanced materials and manufacturing scientists from the School of Science, Technology and Engineering collaborated with Foshan’s First People’s Hospital in China and the University of Tokyo to develop a new coating for medical magnesium implants. 

The implants are coated in bioactive peptides, which are small, naturally occurring protein fragments that can support health and wellbeing. 

The new coating combines advanced metal processing with biomolecular science to improve compatibility with the body, reduce inflammation and boost antibacterial activity, enabling the implant to degrade safely as the bone heals. 

It has shown promising results, published recently in Biomaterials Research. 

Associate Professor Tianfang Wang said the technology could be most beneficial for orthopaedic implants such as plates, screws and pins used to repair fractures, as well as certain dental implants. 

“Our ultimate goal is to create self-absorbing implants that support healing then naturally disappear once no longer needed. This would reduce the physical and emotional burden associated with implant removal, giving patients greater confidence and comfort in their recovery. 

“It may also be suitable for cardiovascular stents or other devices where antibacterial protection and immune compatibility is essential in the critical early stages after implant,” he said.  

Traditionally, metallic implants are made from stainless steel or titanium and remain permanently in the body or sometimes require surgical removal after healing, which can cause pain, anxiety, and added costs. 

Magnesium alloys are among a new generation of degradable implant materials currently being developed based on naturally occurring trace elements in the body and designed to degrade naturally over time in unison with healing, so that they don’t require removal.  

 “While the magnesium alloys are biodegradable, these implants may still need to be removed if they degrade too rapidly, or cause infection,” said Professor Xiaosong Liu, the lead Chinese collaborator from the First People’s Hospital of Foshan. 

“Degradable, biocompatible magnesium implants with built-in antibacterial activity could eliminate these issues, reducing patient distress, surgical risks, and healthcare costs while promoting more sustainable medical practices,” said AMM materials scientist Dr Hejie Li.  

Associate Professor Damon Kent, leader of AMM, said the next step is to move the alloy to production for early pre-clinical trials, while exploring partnerships with biomedical companies to support the scale-up. 

“We are also exploring use of the coatings on other suitable metals and 3D metal printing options. There are a lot of possibilities,” he said. 

UniSC Deputy Vice-Chancellor (Research and Innovation) Professor Ross Young said the innovation was the latest in a growing body of world-class translational research and impact at the University, particularly in the health and medical space. 

“Expert researchers at UniSC continue to deliver new insights into cancer, chronic diseases, mental wellbeing such as PTSD and youth mental health, healthy ageing, nutrition and sports science,” Professor Young said. 

“Coupled with our commitment to introducing a Medical Program, UniSC is truly establishing its position on the world stage for its leadership and expertise in human health.” 

Source: University of the Sunshine Coast

Categories : Implants and Prostheses Lab Tests and ImagingTags :

Is it Safe to Have an MRI After Hip or Knee Replacement Surgery?

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A patient with a knee replacement undergoing an MRI where modern technology reduces the distortions in the images.

It is a common concern for patients that metal implants, such as hip or knee replacements, may prevent them from having an MRI scan. In most cases, this is not true. Patients with modern joint replacements can safely undergo MRI, depending on the materials used in the implant. It is important to inform the radiology team about the implant before your scan.

Dr Jean de Villiers, a radiologist and director of SCP Radiology, answers some of the questions most frequently asked by patients, specifically around the process from referral to reporting in radiology imaging.

What is Magnetic Resonance Imaging (MRI)?

MRI is a non‑invasive imaging technique that uses powerful magnets and radio waves to create detailed images of the body’s internal structures. Unlike X‑rays or CT scans, MRI does not involve ionising radiation and is used extensively to diagnose a wide range of conditions.

Because MRI uses strong magnetic fields, many patients ask whether it is safe to have an MRI after a hip or knee replacement.

Can you have an MRI after a hip or knee replacement?

Yes, you can have an MRI scan on other parts of the body, as well as on the knee or hip where the implant is. Although some older MRI scanners may not be compatible with certain prostheses, the vast majority of MRI equipment in use today is safe and compatible with modern hip and knee implants.

How safe is MRI if the implant is made of metal?

Most implants are made from titanium or cobalt‑chromium alloys. Although these materials are metallic, they are not significantly affected by the magnetic field of an MRI scanner, nor do they heat up during the scan. Many implants also contain hard plastic components, all of which are designed to be compatible with MRI scanners. They are not attracted to the powerful magnet in the same way as older or highly magnetic materials.

Dr de Villiers explains, “The vast majority of joint replacements used today are MRI‑safe. The key is that we know about them in advance, so we can adjust the scan if needed.”

What is the main challenge with MRI and an implant?

The main challenge is image quality. Metal can sometimes cause image distortion, known as artefact, on MRI images. This may make it more difficult to assess structures close to the implant. However, modern MRI techniques have improved significantly and can often minimise these effects, allowing radiologists to assess surrounding tissues such as muscles and ligaments, and to detect complications such as infection or loosening. MRI is often the best imaging method for evaluating pain or complications after joint replacement surgery.

What happens if MRI does not produce clear diagnostic images?

In some cases, alternative imaging techniques such as CT or ultrasound may be recommended, depending on the clinical question. However, MRI remains safe and highly valuable for many patients with joint prostheses.

Are there implants that prevent you from having an MRI?

Certain implants and devices may be unsafe or require special precautions during MRI, including:

  • Implanted pacemakers
  • Intracranial aneurysm clips
  • Cochlear implants
  • Certain prosthetic devices
  • Implanted drug‑infusion pumps
  • Neurostimulators
  • Bone‑growth stimulators
  • Any other iron‑based metal implants

MRI is also contraindicated in the presence of some internal metallic objects such as bullets or shrapnel, as well as certain surgical clips, pins, plates, screws, metal sutures or wire mesh.

Having a hip or knee replacement does not automatically exclude you from having an MRI scan. With modern implants and appropriate planning, MRI is both a safe and important diagnostic tool. As technology continues to evolve, future developments are expected to further enhance MRI compatibility with hip and knee implants, making it an even more reliable tool for ongoing patient care.

It is crucial for patients to inform their healthcare providers about their joint replacement before undergoing an MRI. This allows the medical team to adjust the MRI settings and take appropriate precautions to ensure both safety and diagnostic accuracy.