Carbon fibre as a prosthetic material in orthopaedics
Jenkins, David Henry Rees
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The place for carbon fibre as a prosthetic material in orthopaedics is examined. The early development of implant materials and the problems associated with their use, both from the point of view of material strength and biological inertness is examined. A brief description of the historical milestones in implant surgery is described. A review of currently acceptable materials which are used in surgical practice is presented. The potential advantages of carbon fibre as a prosthetic material are outlined and the development of this material in recent years is described. A series of experiments on rats, chickens, rabbits and sheep are described in which both the rigid and flexible forms of carbon fibre are examined. Initial experiments on rigid carbon fibre suggested that this material exhibited a higher degree of biological inertness than other conventional implant materials. Experiments described demonstrate this to be the case but later attempts to use the material in clinical practice have proved disappointing. This is largely because the mechanical disadvantages outweigh the biological advantages of the material in this form. In the examination of filamentous carbon fibre, it has been shown that advantage can be gained from both its biological and mechanical properties. Pii'st in animals and later in humans, it has been possible to demonstrate the actual induction of new tendons and ligaments in response to the presence of filamentous carbon fibre. Experimental evidence is presented to support the statement that true tendon induction does in fact occur, and a small number of clinical cases are described to demonstrate the practical use of this material. In summary, this thesis describes the development of a hitherto unused material in orthopaedic practice and concludes with the suggestion that the material has a real and necessary place in the management of certain conditions in the human.