Aim 1: Provide Immediate Support
Basic Design Fix joint using scaffold
Fill in the bone cavity completely. Match shape using CT scan Exact shape discussed
later Need extra support
around the edges Metal Socket and contact
with bones.
Aim 1: Provide Immediate Support
Extra support comes from BMP in scaffold Most dense around the critical area Fastest bone growth in critical area
Aim 1: limitations and failures Forces on joint not always in
one direction For sake of discussion, think
2D first. Force acting on center of the
scaffold in the direction of the femoral neck is risky
May not always be safe for immediate walking for the patient
Aim 1: Alternative approach Redistribute BMP gradient
Extra “pillar” in the affected region. Supports the weight applied through the ball joint
better.
Aim 2: provide improved bone growth Design
BMP must cover all area by matching the patient’s bone shape Use CT scan Rapid prototype the scaffold.
BMP must avoid reconstructing bone too quickly Osteoblasts and Osteoclasts
Rapid Prototyping Cannot just “print” the scaffold Using casting method
Aim 2: provide improved bone growth As mentioned before…
BMP gradient Most dense area used for immediate support Least dense area used for slower but complete
bone growth in inner region Go slow to reduce risk!
Aim 2: Limitations and Failures Limitation in using BMP BMP may not be suitable for all patients
Case: patients with extra large amount of bone loss
Proportionally, these patients will lose more osteoblasts
Alternate approach Attempt reducing amount of BMP used.
No change in gradient Reduce overall usage of scaffold
Aim 2: Limitations and Failures 2 Limitation in application
The scaffold match patient’s bone by shape, but how to match it physically?
There are some case where you cannot physically insert the scaffold
Aim 2: Alternate Approach 2
“Simplify” the shape of the cavity using cement
Would require trimming of scaffold Double CT scan may be necessary
Aim 2: Limitations and Failures 3 Limitation in application Can fail to insert it into patient if correct
rotation is not recorded
Aim 2: Alternate Approach Limitation in application
Not so bad.
Would need another device to correctly store the rotation in z-axis for the scaffold
Or make an “indicator” on the scaffold during rapid prototyping process.
Aim 3: Reduce Overall Number of Surgeries 1. Successful bone growth would reduce risk
of returning to the hospital 2. Removing need to remove any of the
component of scaffold reduce risk and need of returning to the hospital Achieved this by making the scaffold using
biodegradable material
Aim 3: Reduce Overall Number of Surgeries Recall
Rate of bone growth = Rate which scaffold bio-degrades
Scaffold completely gone without causing excessive volume of BMP + scaffold in the joint for the patient
Limitations and Failures Scaffold itself is not in gradient At one point in time or space, amount of scaffold
remaining may too little to hold BMP
Aim 3: Alternative Approach Lower rate of bone growth
Reduce overall density of BMP in scaffold It is safer if the scaffold remains a little bit
longer than necessary