[Biological coating of implants in trauma and orthopedic surgery]

In spite of improved operation techniques and optimized implants in trauma and orthopedic surgery complications like delayed fracture healing, non-unions or broad osseous infections may occur. This may be explained by more complex patterns of injuries, more extensive operative procedures and more complex fractures in cause of osteoporosis with increasing age. In the last years some growth factors for local application were approved (BMP-2, BMP-7), however not widely accepted. Reasons may be the high quantities of these limited and expensive proteins, which have to be implanted. Furthermore the local release from a bovine collagen carrier in tissue is not evident. The use of coated implants with incorporated active ingredients could release drugs locally and thereby obtain a high concentration in the area of interest without systemic side effects. Possible compounds for the improvement of fracture healing could be growth factors as well as antibiotics for prophylaxis of implant related infections. A biodegradable poly (D,L-lactid)-coating of implants could release incorporated growth factors in a controlled manner directly into the fracture. Furthermore the coated implant remains as a fracture treatment device. Different models are demonstrated (fracture healing--intervertebral fusion--infection model) to prove the efficiency of the coating technology. These findings seem to justify the transfer of this technology into clinic.