Musculoskeletal injuries and diseases affect hundreds of millions of people around the world, and this figure is projected to escalate in the next 10-20 years due to the aging population and sedentary lifestyles (American Academy of Orthopaedic Surgeons 2008). In the United States, musculoskeletal injuries and diseases are the

Department of Bioengineering, University of California Riverside, 900 University Avenue, Riverside, CA 92521, USA e-mail: [email protected]

T.J. Webster (ed.), Nanotechnology Enabled In situ Sensors for Monitoring Health, 115

DOI 10.1007/978-1-4419-7291-0_6, © Springer Science+Business Media, LLC 2011

leading causes of disability and visits to physicians' offices accounting for more than three million hospitalizations annually, according to the National Health Interview Survey (Weinstein 2000; Praemer et al. 1995a, b). More than 1 in 4 Americans have a musculoskeletal condition requiring medical attention. Sprains, dislocations, and fractures accounted for almost one half (46%) of all musculoskeletal injuries (Praemer et al. 1995a). The economic impact of these conditions is continuously rising. In 2004, the sum of the direct expenditures in musculoskeletal-related health care and the indirect expenditures in lost wages was estimated to be $849 billion, or 7.7% of the national gross domestic product (GDP) (American Academy of Orthopaedic Surgeons 2008). In contrast, expenditures for research in these areas currently take less than 2% of the total National Institute of Health (NIH) budget of 32 billion (Weinstein 2000). More research is urgently needed if health and economic burdens are to be contained or reduced. On January 13, 2000, the World Health Organization (WHO) formally launched 2000-2010 as the Bone and Joint Decade, a global campaign to improve the quality of life for people who have musculoskeletal conditions and to advance the understanding and treatment of these conditions through research, prevention, and education. The aims of the campaign are to raise awareness of the increasing societal impact of musculoskel-etal injuries and disorders, to empower patients to participate in decisions about their care, to increase funding for prevention activities and research, and to promote cost-effective prevention and treatment (Weinstein 2000).

The development of effective treatments and associated technologies for muscu-loskeletal injuries and diseases is one of the most important long-term goals of health care and research. There are enormous needs to develop safer, more effective methods and therapies to stimulate the healing and regeneration of musculoskeletal tissues, including bone, cartilage, ligaments, and tendons. Bioengineers, biologists, and clinicians need to work together closely as a multidisciplinary team to develop novel tissue-like biomaterials and design innovative devices to adequately address the clinical problems. This chapter will first introduce hard and soft tissues in the human musculoskeletal system. The physiochemical and mechanical properties of natural bone and ligaments will be discussed so as to closely mimic or match their composition, microstructure, nanostructure, and properties using novel biomaterials. Biomaterials, including synthetic and natural materials, for the repair and regeneration of bone and ligament tissues will be reviewed. Recent research efforts and renewed interests in developing resorbable metallic biomaterials such as magnesium (Mg) alloys for orthopedic and craniofacial applications will be highlighted. Lastly, growing clinical interests in the development of responsive biosensors for orthopedic/craniofacial applications will also be discussed.

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