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Cited by 37Bone fractures and treatmentsSpinal Fractures and Fixation TechniquesShape Memory Alloy Transformations

The DOI matches its Crossref record; 127 of the 128 references it cites were found in a registry or an index.

Concepts and clinical aspects of active implants for the treatment of bone fractures

Open access
Ganse, Bergita, Orth, Marcel, Roland, Michael, Diebels, Stefan, Motzki, Paul, Seelecke, Stefan, Kirsch, Susanne-Marie, Welsch, Felix, Andres, Annchristin, Wickert, Kerstin, Braun, Benedikt J, Pohlemann, Tim·2022·Acta Biomaterialia
DOI 10.1016/j.actbio.2022.05.001
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Abstract

Nonunion is a complication of long bone fractures that leads to disability, morbidity and high costs. Early detection is difficult and treatment through external stimulation and revision surgery is often a lengthy process. Therefore, alternative diagnostic and therapeutic options are currently being explored, including the use of external and internal sensors. Apart from monitoring fracture stiffness and displacement directly at the fracture site, it would be desirable if an implant could also vary its stiffness and apply an intervention to promote healing, if needed. This could be achieved either by a predetermined protocol, by remote control, or even by processing data and triggering the intervention itself (self-regulated 'intelligent' or 'smart' implant). So-called active or smart materials like shape memory alloys (SMA) have opened up opportunities to build active implants. For example, implants could stimulate fracture healing by active shortening and lengthening via SMA actuator wires; by emitting pulses, waves, or electromagnetic fields. However, it remains undefined which modes of application, forces, frequencies, force directions, time durations and periods, or other stimuli such implants should ideally deliver for the best result. The present paper reviews the literature on active implants and interventions for nonunion, discusses possible mechanisms of active implants and points out where further research and development are needed to build an active implant that applies the most ideal intervention. STATEMENT OF SIGNIFICANCE: Early detection of delays during fracture healing and timely intervention are difficult due to limitations of the current diagnostic strategies. New diagnostic options are under evaluation, including the use of external and internal sensors. In addition, it would be desirable if an implant could actively facilitate healing ('Intelligent' or 'smart' implant). Implants could stimulate fracture healing via active shortening and lengthening; by emitting pulses, waves, or electromagnetic fields. No such implants exist to date, but new composite materials and alloys have opened up opportunities to build such active implants, and several groups across the globe are currently working on their development. The present paper is the first review on this topic to date.

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  1. Harrison, 2021, Low-intensity pulsed ultrasound (LIPUS) for stimulation of bone healing - a narrative review, Injury, 52, S91, 10.1016/j.injury.2021.05.002 · DOI

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Metadata

Authors
Ganse, B., Orth, M., Roland, M., Diebels, S., Motzki, P., Seelecke, S., Kirsch, S.-M., Welsch, F., Andres, A., Wickert, K., Braun, B. J., & Pohlemann, T.
Affiliations
  • Saarland University (DE)
  • Zentrum für Mechatronik und Automatisierungstechnik (DE)
  • University of Tübingen (DE)
Corresponding author
Ganse, Bergita
ORCID
Venue
Acta Biomaterialia
Publisher
Elsevier BV
Published
2022-07
Volume
146
Pages
1-9
ISSN
1742-7061 (ISSN-L)
DOI
10.1016/j.actbio.2022.05.001
OpenAlex
W4229332544
Cited by
37
References
128
Citations by year
2026: 5 · 2025: 14 · 2024: 15 · 2023: 2 · 2022: 1
FWCI
1.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Acta Biomaterialia (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Publications of the UdS (Saarland University)
Funders
Werner Siemens-Stiftung
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone fractures and treatments
  • Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
  • Physical Sciences › Materials Science › Materials Chemistry › Shape Memory Alloy Transformations
Keywords
active implants, shape memory alloys, smart implants, electromagnetic stimulation, implantable sensors
MeSH terms
Alloys, Bone and Bones, Humans, Reoperation, Fracture Healing, Fractures, Bone

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