Mind the gap: is there consensus between surgeons and biomaterial scientists on biomaterial development for bone defects? An international online survey study

Osteologie/Osteology, vol. 32, pp. S30

Abstract

Introduction Consensus on relevant factors in biomaterial development for bone defects is crucial for developing effective treatment strategies and advancing implant development in a goal-oriented way. Therefore, we addressed this question in an international online survey among surgeons and biomaterial scientists. Methods Demographic data, professional background, experience with bone defect treatment including biomaterials, options and decision making in bone defect treatment concepts, options of different bone materials and bone graft substitutes, and medicolegal aspects of 3D-printed medical devices for bone defect treatment were recorded electronically in Qualtrics software. Results Surgeons (n >200) and biomaterial scientists (n >80) had different opinions about the need to develop new technologies. Less experienced surgeons and researchers perceived a greater need for naturally derived and/or synthetic bone substitutes than more experienced surgeons and researchers. In addition, the need for new technologies such as 3D-printed implants, e.g., titanium-based cages or polycaprolactone-based scaffolds, was perceived to be greater by more experienced surgeons and scientists. As clinical and scientific experience with biomaterials, including 3D-printed implants, increased, surgeons' reluctance to use them decreased. Uncertainty about the medicolegal aspects, of 3D-printed implants in particular, was related to reluctance to use them. Discussion This study pioneers the evaluation of decision making in the treatment of bone defects with particular emphasis on (non-biodegradable and biodegradable) 3D-printed implants. Insufficient knowledge and experience of surgeons in the use of novel technologies such as 3D-printed implants has been shown to be a barrier to their use. The decision-making processes and competitive understanding in the emerging industry for bone graft substitutes and 3D-printed biomaterials to treat bone defects vary widely among surgeons and biomaterial scientists. The development of a consensus, such as through a stakeholder workshop, seems urgently needed.

Authors 7

1. Markus Laubach

   Queensland University of Technology

   Affiliation as printed

   Queensland University of Technology, Brisbane

2. Stephen Whyte

   Queensland University of Technology

   Affiliation as printed

   Queensland University of Technology, Brisbane

3. Frank Hildebrand Aachen

   Universitätsklinikum Aachen

   Affiliation as printed

   Uniklinik RWTH Aachen, Aachen

4. Boris Michael Holzapfel

   Ludwig-Maximilians-Universität München

   Affiliation as printed

   Ludwig-Maximilians-Universität München, München

5. Ulrich Kneser

   Berufsgenossenschaftliche Unfallklinik Ludwigshafen

   Affiliation as printed

   BG – Unfallklinik Ludwigshafen, Ludwigshafen

6. Uwe Dulleck

   Queensland University of Technology

   Affiliation as printed

   Queensland University of Technology, Brisbane

7. Dietmar Werner Hutmacher

   Queensland University of Technology

   Affiliation as printed

   Queensland University of Technology, Brisbane