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Anisotropy is a fundamental characteristic of tissues regeneration replicating those in the tissues development. If design of an
implant is not addressing it properly, the long-term bond between implant and the hosting tissues can-not be sustainable
neither in total joint replacement, nor in direct skeletal attachment (DSA) of limb prostheses. Advantages in utilizing anisotropy
of regeneration were demonstrated by preferred properties and orientation of the components of the Skin and Bone Integrated
Pylon (SBIP) developed by Poly-Orth International, Sharon, MA. Besides optimizing porosity, pores size, particle size and volume
fraction, we improved skin-implant and bone-implant interface via preferred orientation of the pylonsâ?? parts.
Skin-implant interface: The SBIP is deeply porous perpendicular to the implantâ??s longitudinal axis and also has perforations in the
solid enforcing inserts. Skin cells can therefore penetrate the structure and grow throughout the entire volume of the implant in
the â??naturalâ? anisotropic direction of regeneration. That creates a skin seal, thus addressing the principal failure modes in existing
percutaneous devices: skin regression, marsupialization, permigration, and avulsion.
Bone-implant interface: Bone loss after implantation to the marrow canal is observed, and is caused by shield stresses. A variant
of the SBIP and a new method of fixation are addressing this problem. Our SBIP-F pylon has side fins that are inserted into precut
slots inside the cortical bone walls. The cut out bone activates an Ilizarov type distractional osteogenesis in which the regenerated
bone has greater strength than the original bone.
Biography
Mark Pitkin has completed his PhD in Biomechanics at the Central Institute of Prosthetics Research in Moscow, Russia. He is Professor of Physical Medicine and Rehabilitation at the Tufts University School of Medicine, Boston, MA.
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