Nanomaterials play a significant role in biomedical research and applications because of their unique biological, mechanical, and electrical properties. In recent years, they have been utilized to improve the functionality and reliability of a wide range of implantable medical devices ranging from well-established orthopedic residual hardware devices (e.g., hip implants) that can repair defects in skeletal systems to emerging tissue engineering scaffolds that can repair or replace organ functions. This review summarizes the applications and efficacies of these nanomaterials that include synthetic or naturally occurring metals, polymers, ceramics, and composites in orthopedic implants, the largest market segment of implantable medical devices. The importance of synergistic engineering techniques that can augment or enhance the performance of nanomaterial applications in orthopedic implants is also discussed, the focus being on a low-intensity direct electric current (LIDC) stimulation technology to promote the long-term antibacterial efficacy of oligodynamic metal-based surfaces by ionization, while potentially accelerating tissue growth and osseointegration. While many nanomaterials have clearly demonstrated their ability to provide more effective implantable medical surfaces, further decisive investigations are necessary before they can translate into medically safe and commercially viable clinical applications. The article concludes with a discussion about some of the critical impending issues with the application of nanomaterials-based technologies in implantable medical devices, and potential directions to address these. WIREs Nanomed Nanobiotechnol 2013, 5:191–204. doi: 10.1002/wnan.1201
Conflict of interest: Drs. Richard A. Wysk and Paul H. Cohen are Principals in ArgentumCidalElectrics Inc., Lewistown, PA, a company with multiple patents pending on the LIDC activated antimicrobial technology discussed in this article. Drs. Rohan A. Shirwaiker and Nancy A. Monteiro-Riviere have previously received a research grant from the company to study the cytotoxic effects of the LIDC activated antimicrobial technology.
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