Biometalle in der orthopädischen Chirurgie

Zusammenfassung

Bei nahezu jeder zweiten Operation in der orthopädischen Chirurgie werden Biomaterialien eingebracht, bei etwa jeder dritten Biometalle. Von den kommerziell erhältlichen Materialien sind zum momentanen Zeitpunkt lediglich metallische Werkstoffe in der Lage, der statischen Beanspruchung und der Dauerfestigkeit, die von hoch beanspruchten Werkstücken der internen Stabilisatoren bzw. des künstlichen Gelenkersatzes gefordert werden, gerecht zu werden. Allgemein wird akzeptiert, dass es kaum gelingen wird, einen biologisch vollkommen inerten Werkstoff zu produzieren. Aufgrund der biologischen und mechanischen Anforderungen haben sich im Lauf der vergangenen dreißig Jahre Legierungen auf Basis der Metalle Eisen, Titan und Kobalt durchgesetzt. Inzwischen sind nahezu alle Implantate an ihrer Oberfläche bearbeitet und behandelt. Dieses dient zur Verbesserung der Gewebeverträglichkeit und des Einwachsverhaltens sowie zur Reduzierung von Abrieb. In Zukunft dürfte sich durch Mikrobeschichtungen mit nahezu inerten Materialien oder biologischen „Tarnkappen” die Bioakzeptanz der metallischen Werkstoffe nochmals steigern lassen.

Summary

Biomaterials are used in almost every second procedure in orthopaedic surgery, with biometals being used in approximately every third intervention. Of the commercially available biomaterials, only metals have the fatigue strength to cope with the static force sencountered in highly stressed internal fixations and in joint replacements used in bone surgery, respectively. It is generally accepted that it is virtually impossible to produce an inert biomaterial. Due to the biological and mechanical requirements, alloys based on the metals iron, titanium and cobalt are prevalent in orthopaedic surgery. Virtually all implants are surface treated for improved biocompatibility and bone ingrowth, and also to diminish wear. In the not too distant future, it seems likely that there will be an improvement in the biological acceptance of implants by micro-surfacing with layers of a practically inert material or biological “camouflage”.

Schlüsselwörter

Biometalle - Biomaterialien - Implantatwerkstoffe - orthopädische Chirurgie

Keywords

Biometals - biomaterials - implant materials - orthopedic surgery

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