Hydrogels as an interface between bone and an implant

The use of fully hydrated hydrogels in the body has been well established. The forces a hydrogel generates on swelling when it is placed in a constrained space were investigated with a view to providing a mechanism for fixing a prosthesis in the intramedullary cavity. A cross-linked poly(2-hydroxyethyl methacrylate) [p(HEMA)] hydrogel was investigated as a potential material. In vitro mechanical tests were carried out to determine the stresses generated in the p(HEMA) when it was placed in water and not allowed to swell. Pull out loads of up to 375 N indicated that the system could be used successfully in vivo. Consequently, the material was placed intraosseously at two sites in a rabbit animal model, in the mid-shaft (diaphysis) and the lower end (metaphysis) of the femur. Histological examination showed there was no adverse bone response; bone was growing from the endosteal surface up to and into the hydrogel in the diaphyseal implants and surrounded the hydrogel in the metaphysis. As a result of the shape and size variations in the rabbit femur, in vivo mechanical tests were found to give lower values than those obtained in vitro.