Session 1: Orthopaedic Biomaterials
Virginie Gauvreau (Clinical Perspective)
Hôtel-Dieu de Gaspé
Title: Brainstorming the Future of Orthopaedic Surgery
Abstract: The future of orthopaedic surgery implant design takes into account variables known from the past to be required for the ideal orthopaedic biomaterial such as inertia, non-toxicity, corrosion proof, great strength, high resistance to fatigue, inexpensiveness and ease of processing. In the past decade, these concepts lead to the development of various new implant designs and uses of new alloys that should revolutionize our world. However, more recently, fatigue failures attributed to corrosion at the trunnion-neck junction of newly designed hip prothesis, development of pseudo-tumours attributed to metallic ion release in big femoral head metal-on-metal hip replacement, evidences of systemic metal toxicity effects on patient’s vital functions, ceramic component fractures, rapid polyethylene wear accentuated by oxidation have been reported. Newly designed implants were recalled has they were associated with catastrophic consequences for the patients. From these lessons learned, we may still try to improve a fail design or material, or we could reinvent the future to design implants perfectly fitted for every cases. Consider using modern imaging technologies, software solutions, robotic assistance implantation, personalized implant design and production, self regeneration promoting materials, intrinsic infection resistance and life lasting implants. There is no limit to our imagination but that of our past experience acquired anchored biais. Young researchers can make a difference precisely because they haven’t absorbed corporate conventions. Let’s brainstorm the future of orthopaedic implants !
Biography: Dr Virginie Gauvreau is an orthopaedic surgeon with a specialty in hip and knee reconstruction surgeries. After completing a bachelor degree in Biochemistry, she obtained a Masters degree in Experimental Medicine at the Biotechnologies and Bioengineering Unit of the Laval University Surgical Department working on the development of micropatterning printed activated biomaterial surfaces while completing a medical degree. She was board certified in orthopaedic surgery in 2012. She further completed a fellowship at the University of Western Ontario acquiring a strong experience in complicated hip and knee joint restoration while pursuing research at their renowned orthopaedic biomaterial retrieval research lab. She presented at the world biomaterial conference on printing of activated peptides on PTFE Films to promote endothelialization and at the international symposium of regenerative medicine about micropatterning of cell signals onto biomaterial surfaces to improve endothelialization.Awarded by Laval University Surgical Department for research on determinant factors of pain, functional limitations and quality of life after a total knee replacement, and for study assessing metallic ions release in total knee replacements. Was previously granted by the Natural Sciences and Engineering Research Council of Canada and recently granted by the Current Concepts in Joint Replacement foundation.
Geoffroy Rivet-Sabourin (Industrial Perspective)
Title: Custom Devices in Orthopedic: Changing the Way to Think About Patient Treatment and Surgical Procedure
Abstract: Since more than 30 years, the orthopedic domain treats patients with standard devices. We are currently at the beginning of a new revolution in this domain going from standard off-the-shelve products to patient specific products. This kind of product are currently available for niche procedures like complex revision or tumor treatment. Now, the number of players developing personalized primary knee, primary hip or primary shoulder is growing rapidly. This is now possible because of the new manufacturing techniques like 3D printing and also availability and improvements of the imaging machine like CT and MRI. What are benefits for the patients and health care system?
Biography: Geoffroy Rivet-Sabourin is computer engineer. He has a master degree in computer vision and a PhD in medical imaging processing. He is currently Research Director at Bodycad where he is leading development of new products. Mister Rivet-Sabourin also trains orthopedists around the world to use Bodycad technology. He is a member of the Standards Council of Canada for Bone and joint replacements. He has been working in medical technology research and development for more than 10 years with an emphasis on patient specific solutions using imaging technology.
Thomas Willett (Academic Perspective)
University of Waterloo
Title: Biomaterials for Skeletal Reconstruction: What Are We Looking for?
Abstract: Reconstruction of large structural defects in the skeleton is a significant clinical challenge with unmet needs. Large structural defects can result from tumour resection, infection resection, traumatic fractures, and even revision arthroplasty. If the defect is large enough (critically sized), bone biology is insufficient to close the gap and a therapeutic intervention is required. Current options include metal prostheses and allograft-based approaches. Various structural biomaterials and tissue engineered products are in development. Metal prostheses and allograft have high failure rates due to mechanical issues, uncontrolled resorption, infection and non-union. In this presentation, Prof. Willett will discuss his groups work on cortical bone as a high performance biomaterial, allograft bone as a structural biomaterial, and current endeavors to develop 3D printable, bone-mimetic nanocomposite biomaterials in order to offer a robust solution to the large structural defect problem.
Biography: Thomas L. Willett, PhD, PEng, is an Assistant Professor in the Biomedical Engineering program in the Department of Systems Design Engineering at the University of Waterloo. He has recently established his new Composite Biomaterial Systems Laboratory, which includes facilities for composite biomaterials formulation, additive manufacturing (3D printing) using biomaterials, thermomechanical testing, and state-of-the-art mechanical testing. He trained in mechanical engineering at Queen's University (BASc, 2001; MASc, 2003) and received his PhD (tissue mechanics) from the School of Biomedical Engineering at Dalhousie University in 2008. He worked on bone and orthopaedics research at Mount Sinai Hospital/University of Toronto from 2007-2015. During that time, he developed a patented method for protecting the mechanical properties of bone from damage that occurs during irradiation sterilization used in tissue banking. His research interests include: mechanics of biomaterials and skeletal tissues (especially cortical bone), development of composite biomaterial systems for use in skeletal reconstruction, and biomedical technology design and innovation.
Session 2: Vascular Biomaterials
Jean-François Tanguay (Clinical Perspective)
Université de Montréal, Montreal Heart Institute
Title: From Pre-Clinical to Clinical Development of the Bioresorbable Scaffold: A 25 Years Discovery Journey
Abstract: Since Gruentzig’s first percutaneous balloon angioplasty in 1977, significant advances have been made in the percutaneous treatment of coronary artery disease. The development of bare metal stents (BMS) addressed the issue of acute vessel closure, and while BMS prevented elastic recoil and constrictive remodeling, high rates of in-stent restenosis remained because of neointimal hyperplasia. This prompted the development of drug eluting stents (DES), which were able to reduce the incidence of in-stent restenosis with the addition of anti-proliferative drugs to the stent platform, thereby reducing the occurrence of neointimal hyperplasia. Safety issues were however described with the first generation of DES, when a new entity of late stent thrombosis became a significant problem, with risk quoted at 0.6% per year. Second generation DES, with more biocompatible antiproliferative drugs and thinner struts/improved designs were able to significantly decrease the incidence of major adverse cardiac events and late stent thrombosis. Newer bioresorbable scaffolds were designed to overcome some limitations of DES. The presence of a metallic structure that will forever remain in the vessel comes at a cost: decreased vaso-reactivity/impaired physiology of the artery, prevention of positive remodeling, obstruction of the side-branch by stent struts, impaired lesion imaging with computed tomography of magnetic resonance, and inability to insert a coronary bypass graft at the site a stent was implanted. This led to the development of bioresorbable scaffolds (BRS), that would theoretically allow for the benefits of transient scaffold support by preventing acute vessel recoil/closure, but overcome the limitations of metallic stents such as impaired vasomotor response, and late stent thrombosis, while facilitating repeat treatments of the lesion site. The development of BRS technology has been an extraordinary journey with opportunities for engineers, scientists and interventional cardiologists to interact and address multiple challenges.
Biography: Dr. Jean-François Tanguay is an expert in Interventional Cardiology with a strong interest in translational research. He is involved in undergraduate and postgraduate medical training and CME education. Dr. Tanguay is Director of the Coronary Unit at the Montreal Heart Institute and Clinical Cardiologist, combining work in the emergency room, the coronary care unit, the outpatient clinic and the catheterization laboratory (1995-ongoing). He is Director of the MD-PhD and Interventional Cardiology Training Programs and professor at the Faculty of Medicine of the Université de Montréal. He was President of the Canadian Interventional Cardiology Association (2002-2005) and Director of the Interventional Cardiology Montreal Symposium (2004-2015). He is Fellow of the Royal College of Physicians and Surgeons of Canada (FRCPC), the Canadian Cardiovascular Society (FCCS), the American Heart Association (FAHA), the American College of Cardiology (FACC), and the European Society of Cardiology (FESC). Dr. Tanguay is Chair of the CCS Anti Platelet Guidelines Committee and their guidelines’ recommendations were published in the Canadian Journal of Cardiology in 2011, 2013 with an updated version in 2017. His research is focused on understanding the interactions between platelets, leukocytes and endothelial cells in order to improve vascular healing. Dr. Tanguay’s investigations brought promising discoveries related to 17beta-estradiol and the specific contribution of estrogen receptors in vascular healing. During his research fellowship, Dr Tanguay studied the early prototypes of bioresorbable drug eluting stents platforms in pre-clinical and thrombosis models. With his colleagues at MHI, he performed the first coronary implantation of a drug-eluting bioresorbable scaffold (ABSORBTM) in North-America. Dr. Tanguay is member of steering committees for NIH-, CIHR- and industry-sponsored clinical trials. He has written 180 papers in peer-reviewed journals, 6 book chapters & guidelines, and 266 abstracts & posters. He has given more than 250 invited lectures or oral presentations at national and international scientific meetings. His research team received more than $40 million from academic and from other granting agencies. In addition to his clinical, teaching and research background, he is the father of four teenagers, and has been happily married for 26 years.
Stephen Pacetti (Industrial Perspective)
Title: Developing New Cardiovascular Biomaterials Applications: Challenges and Successes with the XIENCE and Absorb Coronary Implants
Abstract: Percutaneous coronary intervention is a major, and often preferred, option for the treatment of coronary artery disease. Restoration of coronary flow is the primary objective and stenting of coronary lesions is widely done. Coronary stents have improved steadily since they were introduced in the 1980s. However, further improvements are still sought for lowering restenotic and thrombotic complications. The cardiovascular biomaterials that go into stents must meet multiple stringent criteria for biocompatibility, mechanical properties, processability and regulatory requirements. Two case studies will be presented focusing on the XIENCE drug eluting fluoropolymer coating and the bioresorbable polylactide polyester polymers used in the ABSORB totally bioresorbable coronary stent. The XIENCE fluoropolymer coating, combined with the antiproliferative drug everolimus, represents a new application for fluoropolymer implants and has advanced the performance of drug eluting stents. ABSORB was the first totally bioresorbable stent to be approved. Its goal is to provide improved long-term outcomes compared to permanent coronary stents. The development process, and experimental data, which led to these products will be summarized.
Biography: Stephen D. Pacetti joined Abbott Vascular in 2005 as a Biomaterials Manager of Research and Development. Currently, he is a Senior Principal Scientist of DES Technologies. Previously, he was a Technical Advisor at Guidant Vascular Intervention, where he worked in the areas of controlled drug delivery and cardiovascular biomaterials. With the goal of a better stent alloy than stainless steel, Mr. Pacetti’s research into high strength and radiopaque alloys resulted in selection of CoCr L-605 for the MULTI-LINK VISION coronary stent. He studied multiple drug eluting stent coating polymers for biocompatibility, drug delivery and processability. The result of this team development was the PVDF-HFP based fluoropolymer drug delivery coating of the XIENCE coronary stent. For the Absorb program, he played a key role in bioresorbable polymer characterization and degradation chemistry. He currently works on next-gen drug delivery stents, endovascular therapies, and biological response to coronary implants. Mr. Pacetti received a Master’s degree in chemical engineering from the University of Houston and a Master’s degree in physical-organic chemistry from the University of California, Berkeley. He has been granted 365 U.S. patents, authored six scientific publications, and presented on multiple occasions for physician groups, regulatory agencies and at scientific meetings.
Diego Mantovani (Academic Perspective)
Title: Vascular Biomaterials: What are we looking for? An academic perspective.
Abstract: Over the last 50 years, biomaterials, prostheses and implants saved and prolonged the life of millions of humans around the globe. Today, nano-biotechnology, nanomaterials and surface modifications provide a new insight to the current problem of biomaterial complications, and even allow us to envisage strategies for the organ shortage. In this talk, the portrait of what we are looking for in the design and development of the next generation of vascular biomaterials will be discussed. Focusing on biodegradable metals, the academic perspective of what does developing a new class of biometals mean will be presented. Finally, what might be a suitable model for academic teams working in the biomaterial and the biomedical field aiming at clinical translation will be illustrated. Few real examples from joint academic/industrial/clinical partnerships will complement the portrait.
Biography: Holder of the Canada Research Chair Tier I in Biomaterials and Bioengineering for the Innovation in Surgery, professor at the Department of Min-Met-Materials Engineering at Laval University, adjunct director at the Division of Regenerative Medicine of the Research Center of the CHU de Québec, Diego Mantovani is a recognised specialist in vascular biomaterials. At the frontier between engineering, medicine and biology, within his team, his works aim to improve the clinical performances of medical devices for functional replacement, and to envisage the next generations of biomaterials to develop artificial organs enhancing the quality of the life of patients. In 2012, he was nominated Fellow of the International Union of Societies for Biomaterials Science & Engineering (FBSE) for his leadership and contribution to biomaterials for medical devices. He was Executive Co-Chair of the 10th World Biomaterials Congress 2016. He is advisor of few medical devices consortiums in the Americas, Asia and Europe.
Session 3: Skin Substitutes
Geneviève Mercier-Couture (Clinical Perspective)
CHU de Québec
Title: Skin Grafts and Skin Substitutes
Abstract: Scarring and wound contraction are the first mechanisms in place to heal a skin wound. For large wounds, this process leaves the body at risk of infection, hypothermia and articular contracture that can affect functionality. Wounds that are left open can also degenerate into skin cancer. For these reasons, methods that facilitates wound coverage or resurfacing are desired.
Biography: Genevieve Mercier Couture is a plastic surgeon with a specialty in reconstruction. She completed her plastic surgery training at Université de Montréal and was board certified in June 2016. She then did a microvascular surgery fellowship at MD Anderson Cancer Center, Houston. She is now part of the plastic surgery team working at CHU de Quebec where she gets to treat burn patients frequently.
Jean-Philippe Therrien (Industrial Perspective)
Title: Industry Perspective on the Use/Need of Human Engineered Skin Models for Topical Product Development
Abstract: Since its conception more than 30 years ago, tissue engineering has made significant progresses, especially in the field of human skin. Tissue engineering of the human skin was initially developed for clinical/treatment purposes, but quickly recognized as a powerful tool for the different phases of research and development of dermatological products. Different variations of human skin equivalent have been developed to test safety and efficacy of active ingredients and topical products. In the over-the-counter/cosmetic industry, these models have been validated to test the product safety in order to replace animal use. In the pharmaceutical industry these models have become of a particular interest to de-risk topical drug development of new drugs and optimize formulation development. The use and the application of these different models will be discussed as well as their limitations.
Biography: Jean-Philippe Therrien joined EnDev Laboratories in November 2016 having held positions of increasing responsibility as Director of Skin Biology with the Dermatology Therapeutic Area at GlaxoSmithKline (GSK), previously Stiefel, a GSK company and Stiefel. Prior to joining Stiefel/GSK, Jean-Philippe spent 6 years at the National Cancer Institute/National Institute of Health on the Dermatology Branch as Post-Doctoral and Research fellow working on human skin gene therapy. He received a B.S. in Biochemistry from University of Sherbrooke (Quebec, Canada) and Ph.D. in Molecular & Cellular Biology/Photobiology from Laval University (Quebec, Canada). Jean-Philippe brings more than 20 years of experience in dermatological research and more than 8 years of experience in topical product development for both, prescription (Rx) and consumer healthcare/cosmetic (Cx) products, where his work has been extensively published in high-impact journals, scientific presentations, patent applications, and sale aids. Jean-Philippe is also a member of the Board of Directors of the Society of Investigative Dermatology.
Francois Berthod (Academic Perspective)
CHU de Québec, LOEX
Title: Development of a Vascularized, Innervated and Immunocompetent Tissue-Engineered Human Skin
Abstract: The main purpose of my research is to use tissue engineering techniques of in vitro organ reconstruction to study different diseases that can be induced or modulated by the nervous system to better understand their mechanism and find new therapeutic approaches. We have produced a model of innervated reconstructed skin to investigate the influence of various parameters on sensory innervation of skin physiology, such as angiogenesis or inflammation. We then developed skin models to recapitulate in vitro the phenotypes of skin pathologies such as diabetic ulcers and psoriasis, using cells from patients in order to assess the role of sensory nerves in these diseases. We have also established a model to grow motor neurons in three dimensions and to promote the migration of axons while achieving their myelination by Schwann cells. These neurons can then be combined with astrocyte and microglia to mimic the spinal cord. This model is being developed to reproduce the in vitro process of motor neurons degeneration in amyotrophic lateral sclerosis, using cells derived from mice developing the disease, or ALS patients cells.
Biography: François Berthod obtained his PhD in Biomedical Engineering from the Lyon 1 University, France. He is currently full Professor at the Department of Surgery, Faculty of Medicine, Université Laval, and researcher at the Centre LOEX de l’Université Laval, centre de recherche du CHU de Québec-Université Laval in Quebec City, Canada.