Bona fide bone substitute could revolutionise surgery worldwide

Professor Hala Zreiqat has pioneered a 3D-printed ceramic implant that could transform the lives of millions of people with bone defects. That invention is just the beginning of her team’s suite of musculoskeletal marvels – tendon, ligament and cartilage substitutes are also on the horizon.

Surgery for large, challenging bone defects and trauma cases is extremely common in Australia and around the globe. Each year around 2.2 million bone graft surgeries are performed worldwide, and a total of 71,000 Australians get new hips and have knee replacements in the operating room, according to Australian Institute of Health and Welfare statistics.

Professor Hala Zreiqat, a world-renowned biomedical engineer, has invented a remarkable synthetic bone substitute that could revolutionise surgery for millions of patients and the medical profession.

Her 3D-printed ceramic scaffold redefines ‘one-off surgery’ because it is designed to minimise costs for patients and complications, and improve their quality of life for the long term. She hopes that the scaffold will make conventional implant technology – which relies heavily on metal plates and screws and donated bones – obsolete.

Because the scaffold draws on the human body’s own healing powers to regenerate natural bone, and gradually dissolves away after it is implanted, costly follow-up surgeries will be unnecessary.

At the moment metal plates and screws cause patients significant discomfort, wear out and even fall apart. Some patients have “10 surgeries in 10 years”, Professor Zreiqat adds.

Bone donations are also highly problematic, because donors are hard to come by and the bones they provide are often rejected by recipients. Those whose bodies accept donated bones commonly face healing and unreliability issues.

Professor Zreiqat’s creation is believed to be a world first, because, unlike alternatives, it is made from materials that are both mechanically strong – for load bearing –  and highly porous.

Each implanted scaffold holds the broken bones together but also mimics natural bone, allowing blood vessels and real bone to grow back and create new skeletons.

“It is unique. I haven’t seen any scaffold that is as strong and bioactive,” Professor Zreiqat, the University’s Professor of Biomedical Engineering, says.

As Professor Zreiqat explains, the technology is also a game changer because “we can personalise implants for the patients. We know that for doctors repairing bones as a result of trauma, our materials can fix the challenging large-bone defects, under load”.

The implant process is set to be highly efficient and portable. For example, when a patient arrives at hospital with a trauma case – a large-bone defect – in a matter of minutes they will be able to have a CT scan and then the results are fed into a 3D printer to create the scaffold. The new implant is sterilised and inserted by the surgeon into the target area, all within 1-2 days. Currently this process can take several weeks.

Trials to test the scaffolds on large-scale bone injuries in sheep have had excellent initial results, and human trials are one or two years away. In the latest trial of eight sheep, within three months a quarter of fractures had completely healed, with 88 percent fully healed after a year.

With this technology, precision is paramount. Professor Zreiqat is working towards each scaffold being made to order and 3D printed to fit perfectly.

“You don’t have a fixed design. You can tailor it to exactly fit the defect. It has to be 100 percent snug,” Professor Zreiqat says.

Professor Zreiqat’s team has broadened its regenerative medicine focuses to cover the musculoskeletal spectrum – scaffolds for tendons, ligaments and cartilage as well as bone. She hopes that future applications will include the ability to implant both synthetic cartilage and bone in the knee. Within 20 years, her utopia is surgery that is completely metal free.

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Professor Hala Zreiqat has received numerous national and international awards, including the Order of Australia; the 2018 New South Wales Premier’s Woman of the Year and the King Abdullah II Order of Distinction of the Second Class – the highest civilian honour bestowed by the King of Jordan (2018). In 2019 she became a Eureka Prize winner for Innovative Use of Technology and received a University of Sydney Payne-Scott Professorial Distinction. Professor Zreiqat is also a Fellow of International Orthopaedic Research (FIOR) and Australian Academy of Health and Medical Sciences.