There are more than 300,000 hip and knee replacement surgeries performed each year in the United States. Sixty-five percent of hip replacements and seventy-two percent of knee replacements are received by people over the age of 65. Because the U.S. population is aging, the number of hip fractures is expected to exceed 500,000 annually by the year 2040. The average hospital stay for a knee or hip replacement: 5 days followed by four weeks using a walker.
Right: A human hip-joint, from Gray's Anatomy. [more]
Bob, a retired veterinarian from Golden, Colorado, knows the statistics because he's one of them. Between 1978 and 1999 Bob had two hip replacements and five revisions. "I kept three or four of them as mementos," he laughs. "I've been thinking of using them as bookends."
"The problem that faces medicine today is that the current implants last only about ten years," explains Dr. Frank Schowengerdt, a friend of Bob's and director of the Center for Commercial Applications of Combustion in Space (CCACS) at the Colorado School of Mines. (CCACS is a Commercial Space Center managed by NASA's Space Product Development program.) "Surgeons cut out the old joint and glue in a new one," continues Schowengerdt. "Time along with wear and tear cause the glue to deteriorate."
Bob recalls his own experiences: "The glue would loosen and the joint would pinch a nerve. The pain was intense."
Left: A normal hip (left) and an artificial hip implant (right). Learn more about hip replacement surgery from MEDLINEplus.
Most artificial bones nowadays are made from hydroxyapatite, which has the same chemical formula as bone itself. Synthetic hydroxyapatite, however, is neither as porous as real bone nor as strong.
Pores are important, says Schowengerdt. They are conduits for blood flow (blood is generated in bone marrow) and they allow bones to be strong without being too heavy. Pores also provide a way for living bone to attach itself permanently to an implant. "If we get good bone growth into the pores of an implant, then we've won," says Schowengerdt. It won't matter if the glue comes loose 10 years later.
Researchers have also tried sea coral as a bone substitute. "It's porous enough," says Schowengerdt, "but it lacks strength. Sea coral is mostly used for cranial restructuring."
Right: Living bones are porous. Learn more from MEDLINEplus.
"Making ceramic bones isn't like making a ceramic coffee cup," says Schowengerdt. "The process is completely different." Ordinary ceramics are made from powders mixed together with a binding agent. They're baked in an oven (about 1000 C), which evaporates the binder and leaves behind a grainy matrix stronger than the original powders. The chemical formula remains unchanged. Unlike coffee-cup makers, however, "we fire our ceramics at a much higher temperature, so that the powders react to form new substances."
For example, one of the most promising ceramics starts as a powdery mixture of calcium and phosphate compounds (CaO and P2O5). Schowengerdt and Moore ignite the mixture, which burns at 2600 C. CaO and P2O5 react to produce tricalcium phosphate (Ca3(PO4)2), a substance remarkably similar (chemically) to real bone. The reaction also yields heat and gaseous by-products that naturally form bubbly pores.
Left: Natural bone grows into the pores of a prototype ceramic implant. Image credit: F. Schowengerdt, CCACS.
Their technique, called self-propagating high-temperature synthesis or "SHS," is indeed hard to control. "During the firing process, the ceramic is molten. Gases rise and liquids sink. There's a lot of convective motion that make the reaction unpredictable," says Schowengerdt. "To understand this process, we really need to do our experiments in a weightless environment where gravity-driven convection is minimized."
CCACS researchers have flown furnaces onboard NASA's KC-135 'vomit comet'--a parabolic-flight aircraft that provides brief periods of weightlessness. They observed dramatic differences between ceramics prepared in normal gravity (1-g) and those prepared in flight. For instance, the low-gravity ceramics had larger and better-connected pores.
Right: Click on the image to learn more about Space-DRUMSTM.
"We don't intend to mass produce ceramic bones on the ISS," notes Schowengerdt. "That would be way too expensive. But if we can learn more about the role of gravity in pore formation, we might be able to duplicate our successes in space here on Earth."
Millions of people will benefit from fewer surgeries and less pain if this research produces marketable ceramic bone replacements. But there could be a problem: what to do with all those obsolete implants?
Bob Hayes has an answer: "They make great bookends."
Editor's Note: The Center for Commercial Applications of Combustion in Space is a NASA-sponsored Commercial Space Center (CSC) at the Colorado School of Mines. NASA's Space Product Development (SPD) program, located at the Marshall Space Flight Center, encourages the commercialization of space by industry through 15 such CSCs. Commercial partners for the research described here include Guigne International, Ltd., BioServe Space Technologies, Sulzer Orthopedics Biologics and Hewlett-Packard.more information
Space Product Development -- The goal of NASA's Space Product Development (SPD) program is to help American businesses explore the potential--and reap the rewards--of doing business in space. Doing this helps bring the benefits of space down to Earth where it can, and does, enrich the everyday lives of the American public. "Industry investment in space is high," says Mark Nall, manager of NASA's SPD program at Marshall Space Flight Center. "We assist companies developing experiments and help them explore how space research can contribute to the growth of their businesses."
Center for Commercial Applications of Combustion in Space -- a NASA-sponsored Commercial Space Center (CSC) at the Colorado School of Mines in Golden, Colorado.
NASA Space Commercialization -- learn more about NASA's efforts to increase the utilization of space for commercial product research.
The statistics cited in this story were compiled by the American Association of Orthopedic Surgeons.
Learn more about porous ceramics for bone replacement (CCACS) and glass ceramics (CCACS)
Bionic Eyes -- (Science@NASA) Using space technology, scientists have developed extraordinary ceramic photocells that could repair malfunctioning human eyes.
COMBUSTION SYNTHESIS OF POROUS CERAMICS ON SPACE-DRUMS -- an abstract
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