The Technology of Osseointegration—ODT Forum Panel Highlights

At the recent ODT Forum, which was held at the University of Memphis in April, a number of sessions put a spotlight on leading issues impacting the orthopedic device manufacturing space. Topics ranged from regulatory shifts to the transition of procedures to the ASC environment to deciding whether to make or buy. The single-day conference and networking event takes place every other year and offers a fantastic opportunity for those in the second most important orthopedic manufacturing region to gather, discuss, be informed, and network.

One session at this year’s event—Osseointegration in Modern Orthopedics—centered on technologies involved with the critical action of joining the implant to bone. A panel consisting of three industry experts, along with a knowledgeable moderator, had a conversation about this process and the innovations today that help facilitate it. This group consisted of Chuck Hansford, industry consultant; Mark Morrison, research director at Smith+Nephew; Trey Rodgers, research principal engineer in Zimmer Biomet’s Advanced Technology Research group; and Brian McLaughlin, co-founder and CTO at ALM Ortho Inc.

As all sessions were captured on video, I was able to revisit this session and call-out some comments shared that I found interesting. To start, Morrison offered a statement on the use of cementless technology. While adoption is growing, it varies significantly based on region. For example, with hip stems, the U.S. has seen almost 10x growth recently (approximately 2% use to 22%); other countries are a bit more behind the curve, still embracing a more conservative approach. 

Continuing this portion of the discussion, Hansford (speaking as the contract manufacturing representative of the group) mentioned that 24% of all cups are additively manufactured. Morrison followed this up with a comment that all additively manufactured products produced in the last 10 years had a porous structure. This seems to be a clear response to the importance of osseointegration for orthopedic implants. 

Moving on to the concerns of infection, Rodgers shared a rather sobering comment about the matter. He stated there are five cancers that are more likely to be survived than an infection in a primary joint. I found that to be rather eye-opening on the seriousness of joint infection. He noted the lack of blood, the presence of a biofilm, and the protection around that area all contribute to the challenge. 

Morrison was asked about regulatory guidance with regard to osseointegration and whether or not it was too restrictive. He felt the regulations were appropriate, stating, “if you look at the FDA guidance document, for example, or the regulations around porous structures, they essentially say anything with greater than 30% porosity pore size from 100 to 1,000 microns. It’s a huge range.” 

He did, however, note the more pressing concern with regulatory standards is the pace of changes. He explained that many of the standards being used today were developed 20-plus years ago for beaded coatings, which don’t fit with the needs of today. Having the ability to update those standards more rapidly would be a step in the right direction, but he was also upfront about recognizing that’s not always how it works. Changing standards is traditionally a slow process. 

Circling back to additive manufacturing and the advantages around it, especially with the fabrication of a porous structure for orthopedic implants, Rodgers offered some insights. “I do think there’s a significant outcome improvement that comes with a fully interconnected porous structure that allows bone in-growth more so than just on-growth.” He added, “But I think some of the reasons why additive might have more value [are] more like tissue sparing designs where you can get a thinner construct or new design features where you can’t do that in any other way.”

Hansford also offered an important point regarding the use of additive versus other technologies. “Using additive manufacturing today versus the standard ways of doing fixation in the past is you get repeatable geometry on every part every time…So when you generate a porous structure on a shell or on a tip base or on a shoulder, and you validate that part, and you grow that part, every part you run after that, it’s the same geometry…the same place, the same pore structure, the same strut size, same pore size repeatably.”

This summary only offers a smattering of insights from this panel. Further, the other six sessions from the ODT Forum are not even highlighted here. Fortunately, you don’t have to rely on this less-than-comprehensive overview of the discussion. Register for free to view all sessions on demand and enjoy content from the 2026 event. Visit tinyurl.com/odtforum26 for access.

Sean Fenske, Editor-in-Chief
[email protected]