What materials come to mind when thinking of orthopaedic implants: stainless steel, polyethylene, cobalt chrome, titanium, or maybe ceramic and polyetheretherketone (PEEK)? It has been 55 years since the orthopaedic surgeon Sir John Charnley performed the first total hip implant, giving a patient a hip constructed of stainless steel and high molecular weight polyethylene (HMWPE). These materials have seen innovative changes over the years, such as 316L stainless steel, ultra-HMWPE and vitamin E-stabilised polyethylene. However, 55 years seems like a long time for these innovative materials to continue to be used unabated.

Incremental improvement

When looking for ways to improve the structural characteristics of orthopaedic materials, engineers always had to first consider biocompatibility, corrosion resistance and imaging. As a result, this led implant developers to incremental improvements, using cobalt chrome, titanium, ceramics and PEEK as materials for orthopaedic implants. While all of these materials have seen their own evolution as orthopaedic implant materials, the most recently introduced, PEEK, was first offered as a commercially available biomaterial nearly 20 years ago, in April 1998.

A glance at a number of other industries shows how a disruptive technology can arise seemingly from nowhere and start to displace the incumbents. Uber and Lyft are changing the way individuals get around in cities and changing whether they consider owning a vehicle at all. Is it likely that the hotel industry foresaw an online platform such as Airbnb coming along that allowed home and apartment owners to rent out their properties for short stays? The list of disrupters in stale industries has, and will, continue to arise with the likes of Amazon, Netflix, Bitcoin and Purple.

Moving on

This leads to the question, ‘How do orthopaedic materials move from innovation to disruption?’ A Harvard Business School professor, Clayton M Christensen, coined the term ‘disruptive technology’ in his bestselling book, The Innovator’s Dilemma. Christensen would say that the orthopaedic industry is making incremental improvements or ‘sustaining’ the current list of orthopaedic materials, because it has the mechanisms in place to focus on these existing materials. When a disruptive orthopaedic material is introduced to the orthopaedic industry, it will seemingly appeal to a limited audience and/or may not seem to have any practical application.

There is a potential answer to the above question. FiberLive is a high-strength, fully absorbable composite biomaterial. FiberLive disrupts a number of shortcomings of current orthopaedic materials. Firstly, it can approach strengths similar to incumbent metals, such as titanium, while possessing an elastic modulus much closer to bone. Secondly, this composite biomaterial introduces fully absorbable bioglass fibres into existing bioabsorbable materials to provide a high initial strength, followed by a slow loss of mass and strength to prevent stress-shielding of the underlying healing bone. Lastly, these bioglass fibres have been shown to stimulate bone regeneration more than any existing orthopaedic material.

New audience

Within the orthopaedic industry, a disruptive implant material will initially appeal to a limited audience, because the industry knows its customers and knows how to continually improve existing orthopaedic implant materials. Likewise, the orthopaedic industry will most probably have difficulty working out how a disruptive biomaterial has any practical application as an orthopaedic material. However, FiberLive, with its unique properties, has the potential to disrupt and will have application in segments of the orthopaedic industry, such as sports medicine, craniomaxillofacial, trauma and spine.