About stem cells and the hip prosthesis and possible future developments for teh hip prosthesis.

2. Content
‘The low-down’
• The replacement- ‘The enemy’
• The problem with Hip prosthesis
• 3 Possible ways to improve the Hip prosthesis
• Summary

3. Stem Cells
The replacement
Stem cells therapy
used in a patient.
Spire hospital,
Southampton
.
• The patient’s own bone marrow to harvest stem cells
• Stem cells grown in lab and injected into Hip with
platelet rich plasma
• Problems: Expensive, storage, availability and
regulatory issues.

4. Problems with Hip Prosthesis
1 2 43
Mechanically-assisted
crevice corrosion
Micro motion + crevice corrosion
between head and stem
High Wear rates
Usually between Head and Cup
Capsule formation
Host reaction to bacterial
infection of implant.
Infection liability
Can be infected very easily
during surgery.
Hard to solve all at once

5. MPC Polymer
2-methacryloyloxyethyl phosphorylchlorine (MPC).

6. MPC Polymer
Solution 1
About MPC
• Resemble phospholipid bilayer through polar groups
• Can radically decrease wear between head and cup
• Can prevent bacterial attachment due to
‘superhydrophilicity’/ inhibiton of cell adhesion
• Does not cause inflammatory response when in contact with
macrophages
“Discovered in 1978 but could only produce
1mg per year!”
Fig1,2. Moro T, Takatori Y, Kyomoto M, Ishihara K, Hashimoto M, Ito H et al. Long-term
hip simulator testing of the artificial hip joint bearing surface grafted with biocompatible
phospholipid polymer. J Orthop Res. 2013;32(3):369-376.

7. PEEK FIBRES
Self Reinforced Composite

8. PEEK FIBRES
Solution 2
About PEEK Fibers
• Placed in between the taper region of the implant
• Usually two fibres, which spread out to cover the neck of the
implant
• Forms a tighter connection between head and neck
• Results in soft, non-conducting layer, preventing the loss of
the oxide film.
“Compulsory with Metal implants in the US
since 2014!”
Fig3. Google Books, (2015). Patent US20140197571 - Prevention of fretting crevice
corrosion of modular taper interfaces in orthopedic implants. [online] Available at:
http://www.google.com/patents/US20140197571 [Accessed 15 Feb. 2015].

9. CAPE LOADED PMMA
Bone Cement

10. CAPE LOADED PMMA
Solution 3
About CAPE loaded PMMA
• Active component of bee propolis ( used to fill holes in bee
hives)
• Has antimicrobial, anti-inflammatory, antioxidant and anti-
cancer effects
• Better compressive strength than GM-PMMA. Similar to
native PMMA
• Higher packing density caused by reinforced chemical
bonding between the PMMA and CAPE
• More controlled and sustained microbial release
Fig3: Lee H, Chang J. Antimicrobial spine-bone cement with caffeic acid phenethyl
ester for controlled release formulation and in vivo biological assessments. Med
Chem Commun. 2015;6(2):327-333.

11. 1
2
3
4
5
6
The Stem cell revolution is taking over
from the Hip prosthesis
.
There are numerous problems with the
Hip prosthesis
MACC, Wear, Capsulation and infection
are the main ones
MPC can decrease wear rate
significantly
PEEK can reduce MACC between the
head and stem of a metal implant
CAPE loaded PMMA is a good
replacement to GM-PMMA.
KEY TAKEAWAYS
The Important Stuff

12. That’s all. Thank you! 
Any Questions?

13. References
• Spirehealthcare.com. Stem cell technique prevents hip replacements [Internet]. 2015 [cited 26 February 2015]. Available from:
http://www.spirehealthcare.com/southampton/news/stem-cells-technique-to-prevent-hip-replacements/
• Plancher Orthopedics. Are Stem Cells the Future of Hip Replacement? - Plancher Orthopedics [Internet]. 2014 [cited 25
February 2015]. Available from: http://plancherortho.com/stem-cells-future-hip-replacement/
• J Centeno C. Efficacy and Safety of Bone Marrow Concentrate for Osteoarthritis of the Hip; Treatment Registry Results for
196 Patients. Journal of Stem Cell Research & Therapy. 2014;04(10).
• Moro T, Kawaguchi H, Ishihara K, Kyomoto M, Karita T, Ito H et al. Wear resistance of artificial hip joints with poly(2-
methacryloyloxyethyl phosphorylcholine) grafted polyethylene: Comparisons with the effect of polyethylene cross-linking and
ceramic femoral heads. Biomaterials. 2009;30(16):2995-3001.
• Moro T, Takatori Y, Kyomoto M, Ishihara K, Hashimoto M, Ito H et al. Long-term hip simulator testing of the artificial hip joint
bearing surface grafted with biocompatible phospholipid polymer. J Orthop Res. 2013;32(3):369-376.
• Google Books, (2015). Patent US20140197571 - Prevention of fretting crevice corrosion of modular taper interfaces in
orthopedic implants. [online] Available at: http://www.google.com/patents/US20140197571 [Accessed 15 Feb. 2015].
• Nakahara I, Takao M, Bandoh S, Sugano N. Fixation strength of taper connection at head–neck junction in retrieved carbon
fiber-reinforced PEEK hip stems. Journal of Artificial Organs. 2014;17(4):358-363.
• Rsc.org. From beehive to bone cement | Chemistry World [Internet]. 2015 [cited 25 February 2015]. Available from:
http://www.rsc.org/chemistryworld/2014/11/bone-cement
• Lee H, Chang J. Antimicrobial spine-bone cement with caffeic acid phenethyl ester for controlled release formulation and in
vivo biological assessments. Med Chem Commun. 2015;6(2):327-333.