TRR 298:  Safety Integrated and Infection Reactive Implants

• Subject Area: Materials Science and Engineering ; Biology ; Chemistry ; Computer Science, Systems and Electrical Engineering ; Mechanical and Industrial Engineering ; Medicine ; Social and Behavioural Sciences
• Term: since 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 426335750

Implants are inserted after organ and tissue loss due to tumour, trauma or inflammation and are of consid-erable importance for the restoration of fundamental and, in some cases, life-sustaining functions. Despite international research efforts in implantology there remain major deficits in the area of implant safety, re-sulting in loss of implant function and stressful, sometimes life-threatening, reoperations. The high number of implant failures in various medical disciplines represents one of the greatest challenges in medicine, and the lack of suitable diagnostic and therapeutic strategies underlines the need for innovative research approaches to develop safety-integrated and infection-reactive implants. In this CRC, a fundamentally new approach to implant research is being pursued via the synergistic and integrative collaboration of scientists from a wide range of disciplines. Through the scientific use of safety-relevant concepts from the engineering sciences, smart implant systems will be developed which for the first time enable continuous monitoring for the early detection of implant complications and, accordingly, allow a response to restore the initial status. By developing chemical, biological or physical detection systems, early detection of technical or biological complications will be facilitated and transmitted, either externally to the physician or internally to autonomous implant-associated systems. Following detection, reactions are triggered, which promote technical or biological regeneration. The new detection and reac-tion systems and the co-generated data will converge into an implant lifecycle management system and lead to increased implant and patient safety in the long term. As physician-patient interactions will be crucial for improving implant safety and sustainable treatment success, communication research will provide an innovative contribution to this process. The proposed CRC is designed for a period of 12 years. The focus in the first funding period is on research into new detection and reaction systems. In further funding periods, scientific advances will be pursued on the basis of data obtained by the detection systems, together with further development of simulation mod-els up to the calculation of risk profiles and lifetime predictions. Furthermore, the combination and technical implant adaptation of the systems developed will be addressed – with a shift towards autonomous systems – and transfer to various medical disciplines and implant systems will be pursued.The basic science-oriented pioneering research in the fields of innovative detection and reaction systems, biological interface engineering, multi-physics numerical predictions and personalised medicine not only means an important gain in knowledge for the corresponding research fields, but also promises sustainable improvements in implant and patient safety through integration into the development of safety-integrated and infection-reactive implants

• DFG Programme: CRC/Transregios

Current projects

• A01 - Implant safety through individualisation of revision and regeneration of primary prosthetic components (Project Heads Denkena, Berend ;  Dittrich, Marc-André ;  Ettinger, Max ;  Wichmann, Marcel )
• A02 - Mechanisms of implant failure during aseptic loosening of hip endoprostheses (Project Heads Hoffmann, Andrea ;  Melk, Ph.D., Anette ;  Stukenborg-Colsman, Christina )
• A03 - New diagnostic methods to detect loosened hip arthroplasties (Project Heads Behrens, Bernd-Arno ;  Jakubowitz, Eike ;  Zimmermann, Stefan )
• A04 - Demand-oriented design and manufacture of damage-tolerant implant junctions (Project Heads Denkena, Berend ;  Hurschler, Christof ;  Krödel-Worbes, Alexander )
• A05 - Sensory cochlea electrode: Sensory safety through detection of critical processes at the electrode-nerve interface (Project Heads Lenarz, Thomas ;  Maier, Hans Jürgen )
• A06 - Detection of cell occupation on cochlear implants and implant position for atraumatic insertion and long-term monitoring of stimulation efficiency (Project Heads Maier, Hannes ;  Zimmermann, Stefan )
• A07 - Surrogate-modelling for monitoring of implants (Project Heads Budde, Stefan ;  Nackenhorst, Udo ;  Nogueira, Waldo )
• A08 - Tissue-conserving hip and knee arthroplasty removal (Project Heads Nürnberger, Florian ;  Windhagen, Henning )
• B01 - Autonomous chemical and cell-based sensor-actuator systems for the detection and combat of implant-associated infections (Project Heads Menzel, Henning ;  Stiesch, Meike ;  Wirth, Dagmar )
• B02 - Uncovering of molecular mechanisms involved in biofilm-associated peri-implant infections (Project Heads Häußler, Susanne ;  Stiesch, Meike )
• B03 - Optical sensors for responsive implants (Project Heads Heisterkamp, Alexander ;  Nikutta, Katharina ;  Scheper, Thomas )
• B04 - Active stimulus-responsive implants (Project Heads Klose, Christian ;  Maier, Hans Jürgen ;  Pott, Philipp-Cornelius )
• B05 - Autonomous sequential drug release systems (Project Heads Behrens, Peter ;  Gellrich, Nils-Claudius )
• B06 - Tracking and localised therapy of inflammation and infections on surfaces of established implants (Project Head Wirth, Dagmar )
• B07 - Simulation of biofilm growth and drug-induced degradation (Project Heads Szafranski, Szymon Piotr ;  Wriggers, Peter )
• B08 - Implant coating facilitating an intentional implant removal (Project Heads Behrens, Peter ;  Menzel, Henning )
• Z01 - Trust and patient-centred communication as determinants of implant acceptance and compliance with advanced implant treatment (Project Heads Baumann, Eva ;  Klimmt, Christoph ;  Link, Ph.D., Elena )
• Z02 - Integrated research training group (IRTG) “Implant Technologies” (Project Heads Behrens, Peter ;  Melk, Ph.D., Anette )
• Z03 - Central Task (Project Head Stiesch, Meike )

• Applicant Institution: Medizinische Hochschule Hannover
• Co-Applicant Institution: Gottfried Wilhelm Leibniz Universität Hannover
• Participating University: Hochschule für Musik, Theater und Medien Hannover; Technische Universität Braunschweig
• Participating Institution: Helmholtz-Zentrum für Infektionsforschung (HZI)
• Spokesperson: Professorin Dr. Meike Stiesch