Have you ever heard of using Gore-Tex to fill in the gap left when a bone in the wrist is removed? I'm asking because I'm going to have this procedure done and it strikes me that Gore-tex is used for lots of different things. Why not this?
You aren't the first to think of this idea! Gore-Tex is a porous form of a chemical known as polytetrafluoroethylene (a member of the Teflon family). It has a micro-structure characterized by nodes interconnected by fibrils, which makes it ideal as an intervention device such as a bone spacer. In fact, since its first patent in 1976, Gore-Tex has been developed into many industrial and medical products. One of those products was called a "Regenerative Membrane" used as an aid in tissue engineering. This particular product had some problems and has been taken off the market. Gore-Tex was actually used in the mid-1990s to fill in the gap left when the trapezium bone was removed for 34 patients (a procedure referred to as a trapeziectomy). In 80 per cent of those patients, bone destruction occurred. As a result of this study, the use of Gore-Tex for thumb interposition was recommended against. Gore-Tex continues to be used in other medical products as synthetic vascular grafts, stent-grafts, surgical meshes for hernia repair, and sutures for use in surgery. Further research may be able to improve on the use of Gore-Tex grafts for thumb trapeziectomy. However, it is possible that inserting something into the void left by removing the trapezium just isn't necessary. If this is the case, it would be a cost savings with no risk of foreign body reaction. This conclusion was made by surgeons comparing the use of interspacers versus removal of the bone without filling in the gap. They made the surprising discovery that results were just as good (and often even better) if they just left the gap unfilled. There was less risk of infection, inflammation, and no risk of graft material moving out of the space or spreading disease to the patient. Further studies are needed to take a closer look at this phenomenon. Studies comparing different types of grafts would be helpful along with efforts to compare filling the gap with no interspace filling.