Peres Inês, Rolo Pedro, Soares Dos Santos Marco P
Department of Mechanical Engineering, Centre for Mechanical Technology and Automation (TEMA), University of Aveiro, Aveiro, Portugal.
Front Bioeng Biotechnol. 2022 Jun 8;10:912081. doi: 10.3389/fbioe.2022.912081. eCollection 2022.
Implantable medical devices have been developed to provide multifunctional ability to numerous bioapplications. In the scope of orthopaedics, four methodologies were already proposed to design implant technologies: non-instrumented passive implants, non-instrumented active implants, instrumented passive implants and instrumented active implants. Even though bone replacements are among the most performed surgeries worldwide, implant failure rates can still exceed 10%. Controversial positions multiply in the scientific community about the potential of each methodology to minimize the burden related to implant failures. In this perspective paper, we argue that the next technological revolution in the field of implantable bone devices will most likely emerge with instrumented active implants as multifunctional smart devices extracorporeally controlled by clinicians/surgeons. Moreover, we provide a new perspective about implant technology: the essence of instrumented implants is to enclose a hybrid architecture in which optimal implant performances require both smart instrumentation and smart coatings, although the implant controllability must be ensured by extracorporeal systems.
可植入医疗设备已被开发用于为众多生物应用提供多功能能力。在骨科领域，已经提出了四种设计植入技术的方法：非器械被动植入物、非器械主动植入物、器械被动植入物和器械主动植入物。尽管骨置换手术是全球最常进行的手术之一，但植入失败率仍可能超过10%。科学界对于每种方法在最小化与植入失败相关负担方面的潜力存在诸多争议。在这篇观点论文中，我们认为可植入骨设备领域的下一次技术革命很可能会随着器械主动植入物作为由临床医生/外科医生体外控制的多功能智能设备而出现。此外，我们提供了关于植入技术的新观点：器械植入物的本质是包含一种混合架构，其中最佳的植入性能既需要智能器械也需要智能涂层，尽管植入物的可控性必须由体外系统来确保。
