title: Selfprotective smart orthopedic implants.
abstract: In this review, we discuss current advances leading to an exciting change in implant design for orthopedic surgery. The initial biomaterial approaches in implant design are being replaced by cellular-molecular interactions and nanoscale chemistry. New designs address implant complications, particularly loosening and infection. For infection, local delivery systems are an important first step in the process. Selfprotective 'smart' devices are an example of the next generation of orthopedic implants. If proven to be effective, antibiotics or other active molecules that are tethered to the implant surface through a permanent covalent bond and tethering of antibiotics or other biofactors are likely to transform the practice of orthopedic surgery and other medical specialties. This new technology has the potential to eliminate periprosthetic infection, a major and growing problem in orthopedic practice.
authors.affiliation: Thomas Jefferson University, Rothman Institute of Orthopedics, 925 Chestnut Street, Philadelphia, PA 19107, USA. parvj@aol.com
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Valentin
authors.initials: V
authors.lastname: Antoci
authors.forename: Noreen J
authors.initials: NJ
authors.lastname: Hickok
authors.forename: Irving M
authors.initials: IM
authors.lastname: Shapiro
mesh_terms: D019072:Antibiotic Prophylaxis; D001672:Biocompatible Materials; D016503:Drug Delivery Systems; D006801:Humans; D007595:Joint Prosthesis; D008422:Materials Testing; D009984:Orthopedic Fixation Devices; D009985:Orthopedics / Q000639:trends*; D019736:Prostheses and Implants / Q000009:adverse effects / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D012449:Safety; D013499:Surface Properties; D013673:Technology Assessment, Biomedical
chemical_list: D001672:Biocompatible Materials