The main focus behind introducing orthopedic implants in the healthcare sector is to improve patient’s well-being and increase life expectancy. However, their ability to deliver the expected results completely depends on how these work efficiently. The success rate of these products varies with respect to many factors, such as placement technique, adjoining tissues, implant quality, and patient's health condition.
If any of the mentioned factors go haywire, there are high chances of encountering an orthopedic implant failure. Even the latest advancements and technologies cannot avoid such a situation of failures and mishaps.
Hence, it is important to understand the core reasons why such incidents happen and how they can be prevented. This ultimately helps ensure that the patients getting these orthopedic instruments can achieve a healthy life, as expected. And, can also aid the surgeons in exploring different tips to avoid any emergencies caused by failures.
What are the Main Reasons for Orthopedic Implant Failure?
In this section, we shall explain some of the possible reasons for the failure of implants.
1. Excessive Wear and Tear of Implants
The biocompatible implants are coated with materials such as polymers, ceramics, and metals that align with the body. However, repeated frictional movements and early usage of the prosthesis cause the release of debris from the wear and tear. The wear particles, such as metal ions and polyethylene molecules get released into the adjacent tissue which then causes an immune response. The activated macrophage consumes the wear particles that are less than 20 μm.
2. Mechanical Failure of Implants
The two most prevalent reasons for mechanical failure are stem breakage and septic loosening of the implant due to the metal stress. It affects the various components of the implant system for patients who undergo treatment. The implants can fracture due to non-union of the fractured bone or the patient’s failure to follow the post-operative management tips which can further aggravate the condition. And, yet, another reason for such breakage is the bacterial infection occurring at the surgical site.
Loosening of implants can occur due to holding too much weight before the damage is entirely healed. Other possibilities include poor surgical approach, weak bone density, prosthesis biocompatibility, and infection.
Any manufacturing defect can also be a scenario in which the orthopedic implants can prove to be inefficient for patients. The defective implants can break easily even due to routine activities. The best way to avoid this is to ensure that you consider finding the top implant companies for your assistance.
3. Implant Infection
An implant should have both surface and structural compatibility with the adjacent tissues. This makes the mechanical and physio-chemical compatibility necessary for the bone implants.
The goal of these orthopedic products is to treat the load-carrying joints that are worn off and experience regular mechanical stress. Implants are prone to infection caused by bacterial adhesion occurring on the external surface and the biofilm formed at the placement site. One of the most common and significant complications is postoperative spinal implant infection.
If left unattended, then these implant infections can result in amputation of the affected joint or fatality.
Some of the most common sources of infection are:
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Existing bacterial fauna in the patient’s body
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Environment of the operation theater
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Unsterilized surgical equipment
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Clothes worn by the patient and doctors during surgery
4. Inflammatory Response
Over the years millions of such surgeries failed due to the inflammatory response from the body even though a success rate of around 90% has been noted in Arthroplasty. It is because of the prosthetic debris that gets collected around the implant due to excessive wear and leads to the innate immune response.
This periprosthetic inflammation occurs due to the activation of macrophage and in response activates the osteolysis process which increases the releases of osteoclasts (bone cells), causing aseptic loosening. And, in layman's terms, aseptic loosening is defined as a complete failure in the fixation of the prosthesis to the bone even if there is no infection.
The inflammatory response is primarily carried out by the basic immune system, especially the macrophages. It helps to maintain homeostasis in the body by eliminating waste from cells and guarding against foreign intruders.
5. Surgical Failure
An implant failure could also occur due to an incorrect selection of implant material or structure by the orthopedic for a particular patient. For the appropriate selection of an implant, it is mandatory to consider the patient's anatomy, daily life activities, and bone quality.
The surgical risks can also be managed by following a proper approach to implant insertion, minimal injury to supporting tissues, and careful surgical wound suturing. Highly trained and experienced surgeons are primarily responsible for reducing surgical complications.
Key Strategies & Tips for Preventing Orthopedic Implant Failures:
Given below are some of the important suggested tips from Vivek Sharma (CEO at Sharma Orthopedic Pvt. Ltd. – the leading orthopedic implant manufacturer and global supplier company based in India) on how to avoid orthopedic implant failures. Following these guidelines will ensure the best results from your orthopedic implants:
Focus on Material Selection
The primary step in selecting implants is to keep a tab on the material used to manufacture them. One must choose a biocompatible material which does not cause toxicity in the body. Besides this, it should also withstand the mechanical stress and strain caused by the surrounding joints, muscles, and bones.
Proper Shape Selection
The next strategy that can prevent an implant failure is choosing a shape that is designed as per the anatomy of the affected bone so that it does not hinder normal functions. A proper shape selection ensures that there are fewer chances of implant loosening, mismatch, or breakage.
Surface Adjustments
It is necessary to make modifications to the external surface of an implant so that it can interact properly with the adjacent tissues and structures. This step can improve biocompatibility and reduce the chances of bacterial infections caused by wear debris or frictional tears.
Surface changes include coating an implant with titanium dioxide, plasma spraying, anodization, etc. It can also help the implant merge with the bone tissue, which is necessary for its stability and durability.
Complete Supervision & Follow-Up
This is the most important tip for adhering to after the surgical procedure. It aids in assessing the condition of the implant during its initial adjusting phase in the body and keeps your doctor updated. Monitoring the progression of implant surgery can identify and prevent possible problems like implant infection, wear, fracture, and all of which can cause implant failure.
Patient Awareness and Training
The last step for preventing implant failure is creating awareness amongst the patients, which involves providing guidance and help to them. It helps people become acquainted with the benefits and hazards of the implant, as well as how to care for it properly.
In addition to the surgeons and patients, proper education and training can also help the medical experts and engineers get feedback on improving the design and function of the implant.
Conclusion
It is a fact that equipment like orthopedic implants are meant to ease
human life and instill comfort in it. However, such mishaps can make
us paranoid about their usage. So, it is always considered wise for
patients to know the risks and preventive steps associated with
orthopedic implant placement, be it something as major as a hip
prosthesis or tiny implants such as a mini fragment plate.
If you are stuck with any questions or concerns about your treatment with the implants, then, in that case, you should consult with your doctor first and then look for the best orthopedic implant companies around.