Second Elopes Conference on Biometrics (I) Gothenburg, Sweden, 27-29 August, 1981

The conference was coordinated with the Annual Meeting of the European Society for Artificial Organs which was held during the three preceding days in Copenhagen, Denmark. The fact that these two meetings were held close together, both geographically and in time, was greatly appreciated by visitors from overseas. As the Proceedings will appear in Volume 4 of Advances in Biomaterials. the purpose of this report is not to summarize individual papers but rather to describe the personal impression of one participant.

The first biomaterials session was held in Copenhagen, organized jointly by the two Societies and dealt with problems of standardization, testing and certification, Schaldach (Germany) stated that in the cardiovascular field the present status of knowledge is not adequate to propose rational testing programs. Heimke (Germany) described the situation in orthopaedic surgery. Progress is being made, but it is slow and better coordination between the various groups involved in designing procedures would be desirable. Mjor (Norway) described the current situation as related to dental materials. The first testing program has been set up in the U.S.A., followed by Australia. He criticized the approach taken in the past because the biological testing requirements were set up before adequate tests were described. Therefore, some of the prescribed tests do not fulfil their purpose. Cooper (Canada) outlined the approach taken by the Canadian authorities which is closely coordinated with that of the United States. Melrose (United Kingdom) eloquently defended the attempt to design a system in the European Common Market which will be different from the approach taken in the United States. One of the most important requirements at the present time is the standardization of test procedures. Melrose recommended that a rush into legislation would be ill-advised at the present time. The European concensus appears to favour supervision of the regulatory activities by the professions rather than by the bureaucrats. The interests of the patients need to be safe- guarded without discouraging research and development.

After the meeting in Copenhagen, the participants of both conferences travelled by bus to Gothenburg just in time to arrive for the Mayor’s Reception at the City Hall.

Almost 50 papers and 12 posters were presented in sessions on orthopaedics, biomechanics, dentistry, chemistry, biology and physics. The highlights of the conference were, in this reviewer‘s opinion, the papers presented by Branemark and his colleagues on the osseointegrated dental implants and related research. This technique has been in clinical practice in selected patients for 16 years and a careful follow-up is in progress. The success of the technique appears to be due to two factors: (If a clever design of the implants and of the instruments used for the implantation, (2) an extremely careful surgical technique. The follow-up studies included clinical functional assessments and studies of the titanium implants and of the tissue-metal interface for up to 8 years, including new methods used for the study of the bone-metal interface.

Reports from Germany described the interface between ceramics and bone: a contribution from Belgium described a method to produce a porous metal surface with a regular pattern and controllable pore size.

There appears to be an increasing interest in allergic reactions caused by surgical implants, as demonstrated in reports from the Netherlands and from the United States.

Other important contributions were biomechanical studies on total hip prostheses, histological studies on the interface and tissue culture studies from France, contributions on organometallic (rather than free metal ions), corrosion products, and on the effects of the presence of proteins on in vitro corrosion from the United States.

Several reports dealt with the histological and electron microscopic assessment of the tissue reaction including several new techniques.

As the reviewer is a biologist, few comments are made on the chemical and physical sessions. I was particularly impressed by a paper by Lundborg (Sweden) on the regeneration of nerve fibres as observed in implanted chambers. The same group also reported considerable progress in the design of transcutaneous implants, emphasizing the importance of immobilizing the implant to the underlying bone (skull) and avoiding motion between implant and skin.

The last session of the conference was a panel debate entitled ‘Interdisciplinary Approach to Interface Characterization’. Both by the panelists and during the discussion, different viewpoints were expressed. Both Skalak (United States) and Lee (United Kingdom) proposed that researchers should follow current trends, concentrate on the application of presently available materials rather than on the introduction of new materials. On the other hand, Schaldach (Germany) emphasized that in the cardio- vascular field, we are still very much at the beginning and that the general level of knowledge had to be increased before any more definite statements can be made. The lively discussion between panelists and the audience, masterfully chaired by Branemark, indicated clearly that biomaterials research is in a very interesting state at the present time. We should, at the same time, work on improve- ments of existing materials and techniques, and improve the follow-up studies both from the clinical and the materials standpoint, but we should also give a very high priority to studies on the consequences of the implantation of biomaterials (both local and systemic). Finally, we should design new materials and procedures, and carry out basic studies on the tissue-materials interface events. Unfortunately, this very exciting prospect for biomaterials research and clinical application of biomaterials is some- what reduced by economical considerations on both the clinical and research side.

The Conference demonstrated the value of multi- disciplinary research. In my opinion, the most exciting projects were presented by teams of scientists combining expertise in the physical and in the biological sciences,

Sadly, it has to be reported that two past presidents of the European Society for Biomaterials died in the Spring of 1981, Dr. Jean Leray disappeared in an avalanche in the French Alps and Dr. G.D. Winter passed away. The book of abstracts opens with necrologues describing the contributions of the deceased and expressing the sorrow of the Society for the loss of two friends.

salter fingg

A further report will appear in April.

B&materials t982, Vof 3 January 63