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Uklejewski R, Winiecki M, Dąbrowski M, Rogala P. Towards the First Generation of Biomimetic Fixation for Resurfacing Arthroplasty Endoprostheses. Biomimetics (Basel) 2024; 9:99. [PMID: 38392145 PMCID: PMC10887084 DOI: 10.3390/biomimetics9020099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/21/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
This paper presents advances in designs of resurfacing arthroplasty endoprostheses that occurred through their historical generations. The critical characteristics of contemporary generation hip resurfacing arthroplasty endoprostheses are given and the failures resulting from the specific generation cemented and short stem fixation of the femoral component are reviewed. On the background of these failures, the critical need arises for an alternative approach to the fixation of components of resurfacing arthroplasty leading towards the first generation of biomimetic fixation for resurfacing arthroplasty endoprostheses. The state of the art of the completed bioengineering research on the first biomimetic fixation for resurfacing arthroplasty endoprostheses is presented. This new design type of completely cementless and stemless resurfacing arthroplasty endoprostheses of the hip joint (and other joints), where endoprosthesis components are embedded in the surrounding bone via the prototype biomimetic multi-spiked connecting scaffold (MSC-Scaffold), initiates the first at all generations of biomimetic endoprostheses of diarthrodial joints.
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Affiliation(s)
- Ryszard Uklejewski
- Department of Constructional Materials and Biomaterials, Faculty of Materials Engineering, Kazimierz Wielki University, Jan Karol Chodkiewicz Street 30, 85-064 Bydgoszcz, Poland
| | - Mariusz Winiecki
- Department of Constructional Materials and Biomaterials, Faculty of Materials Engineering, Kazimierz Wielki University, Jan Karol Chodkiewicz Street 30, 85-064 Bydgoszcz, Poland
| | - Mikołaj Dąbrowski
- Adult Spine Orthopaedics Department, Wiktor Dega Orthopaedic and Rehabilitation Clinical Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland
| | - Piotr Rogala
- Institute of Health Sciences, Hipolit Cegielski State College of Higher Education, Card. Stefan Wyszyński Street 38, 62-200 Gniezno, Poland
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Subchondral Bone Relative Area and Density in Human Osteoarthritic Femoral Heads Assessed with Micro-CT before and after Mechanical Embedding of the Innovative Multi-Spiked Connecting Scaffold for Resurfacing THA Endoprostheses: A Pilot Study. J Clin Med 2021; 10:jcm10132937. [PMID: 34208953 PMCID: PMC8268800 DOI: 10.3390/jcm10132937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022] Open
Abstract
The multi-spiked connecting scaffold (MSC-Scaffold) prototype is the essential innovation in the fixation of components of resurfacing total hip arthroplasty (THRA) endoprostheses in the subchondral trabecular bone. We conducted the computed micro-tomography (micro-CT) assessment of the subchondral trabecular bone microarchitecture before and after the MSC-Scaffold embedding in femoral heads removed during long-stem endoprosthesis total hip arthroplasty (THA) of different bone densities from 4 patients with hip osteoarthritis (OA). The embedding of the MSC-Scaffold in subchondral trabecular bone causes the change in its relative area (BA/TA, bone area/total area ratio) ranged from 18.2% to 24.7% (translating to the calculated density ρB relative change 11.1–14.4%, and the compressive strength S relative change 75.3–122.7%) regardless of its initial density (before the MSC-Scaffold embedding). The densification of the trabecular microarchitecture of subchondral trabecular bone due to the MSC-Scaffold initial embedding gradually decreases with the increasing distance from the apexes of the MSC-Scaffold’s spikes while the spatial extent of this subchondral trabecular bone densification ranged from 1.5 to 2.5 mm (which is about half the height of the MSC-Scaffold’s spikes). It may be suggested, despite the limited number of examined femoral heads, that: (1) the magnitude of the effect of the MSC-Scaffold embedding on subchondral trabecular bone densification may be a factor contributing to the maintenance of the MSC-Scaffold also for decreased initial bone density values, (2) the deeper this effect of the subchondral trabecular bone densification, the better strength of subchondral trabecular bone, and as consequence, the better post-operative embedding of the MSC-Scaffold in the bone should be expected.
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Bone Density Micro-CT Assessment during Embedding of the Innovative Multi-Spiked Connecting Scaffold in Periarticular Bone to Elaborate a Validated Numerical Model for Designing Biomimetic Fixation of Resurfacing Endoprostheses. MATERIALS 2021; 14:ma14061384. [PMID: 33809176 PMCID: PMC8000753 DOI: 10.3390/ma14061384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/21/2022]
Abstract
Our team has been working for some time on designing a new kind of biomimetic fixation of resurfacing endoprostheses, in which the innovative multi-spiked connecting scaffold (MSC-Scaffold) that mimics the natural interface between articular cartilage and periarticular trabecular bone in human joints is the crucial element. This work aimed to develop a numerical model enabling the design of the considered joint replacement implant that would reflect the mechanics of interacting biomaterials. Thus, quantitative micro-CT analysis of density distribution in bone material during the embedding of MSC-Scaffold in periarticular bone was applied. The performed numerical studies and corresponding mechanical tests revealed, under the embedded MSC-Scaffold, the bone material densification affecting its mechanical properties. On the basis of these findings, the built numerical model was modified by applying a simulated insert of densified bone material. This modification led to a strong correlation between the re-simulation and experimental results (FVU = 0.02). The biomimetism of the MSC-Scaffold prototype that provided physiological load transfer from implant to bone was confirmed based on the Huber–von Mises–Hencky (HMH) stress maps obtained with the validated finite element (FE) model of the problem. The micro-CT bone density assessment performed during the embedding of the MSC-Scaffold prototype in periarticular bone provides insight into the mechanical behaviour of the investigated implant-bone system and validates the numerical model that can be used for the design of material and geometric features of a new kind of resurfacing endoprostheses fixation.
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Native Osseous CaP Biomineral Coating on a Biomimetic Multi-Spiked Connecting Scaffold Prototype for Cementless Resurfacing Arthroplasty Achieved by Combined Electrochemical Deposition. MATERIALS 2019; 12:ma12233994. [PMID: 31810185 PMCID: PMC6927003 DOI: 10.3390/ma12233994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 11/29/2022]
Abstract
The multi-spiked connecting scaffold (MSC-Scaffold) prototype with spikes mimicking the interdigitations of articular subchondral bone is an essential innovation in surgically initiated fixation of resurfacing arthroplasty (RA) endoprosthesis components. This paper aimed to present a determination of the suitable range of conditions for the calcium phosphate (CaP) potentiostatic electrochemical deposition (ECDV=const) on the MSC-Scaffold prototype spikes to achieve a biomineral coating with a native Ca/P ratio. The CaP ECDV=const process on the MSC-Scaffold Ti4Al6V pre-prototypes was investigated for potential VECDfrom −9 to −3 V, and followed by 48 h immersion in a simulated body fluid. An acid–alkaline pretreatment (AAT) was applied for a portion of the pre-prototypes. Scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD) studies of deposited coatings together with coatings weight measurements were performed. Themost suitable VECD range, from −5.25 to −4.75 V, was determined as the native biomineral Ca/P ratio of coatings was achieved. AAT increases the weight of deposited coatings (44% for VECD = −5.25 V, 9% for VECD = −5.00 V and 15% for VECD = −4.75 V) and the coverage degree of the lateral spike surfaces (40% for VECD = −5.25 V, 14% for VECD = −5.00 V and 100% for VECD = −4.75 V). XRD confirmed that the multiphasic CaP coating containing crystalline octacalcium phosphate is produced on the lateral surface of the spikes of the MSC-Scaffold. ECDV=const preceded by AAT prevents micro-cracks on the bone-contacting surfaces of the MSC-Scaffold prototype, increases its spikes’ lateral surface coverage, and results in the best modification effect at VECD = −5.00 V. To conclude, the biomimetic MSC-Scaffold prototype with desired biomineral coating of native Ca/P ratio was obtained for cementless RA endoprostheses.
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Rogala P, Uklejewski R, Winiecki M, Dąbrowski M, Gołańczyk J, Patalas A. First Biomimetic Fixation for Resurfacing Arthroplasty: Investigation in Swine of a Prototype Partial Knee Endoprosthesis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6952649. [PMID: 31355275 PMCID: PMC6634287 DOI: 10.1155/2019/6952649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/10/2019] [Accepted: 05/21/2019] [Indexed: 02/05/2023]
Abstract
Resurfacing hip and knee endoprostheses are generally embedded in shallow, prepared areas in the bone and secured with cement. Massive cement penetration into periarticular bone, although it provides sufficient primary fixation, leads to the progressive weakening of peri-implant bone and results in failures. The aim of this paper was to investigate in an animal model the first biomimetic fixation of components of resurfacing arthroplasty endoprostheses by means of the innovative multispiked connecting scaffold (MSC-Scaffold). The partial resurfacing knee arthroplasty (RKA) endoprosthesis working prototype with the MSC-Scaffold was designed for biomimetic fixation investigations using reverse engineering methods and manufactured by selective laser melting. After Ca-P surface modification of bone contacting surfaces of the MSC-Scaffold, the working prototypes were implanted in 10 swines. Radiological, histopathological, and micro-CT examinations were performed on retrieved bone-implant specimens. Clinical examination confirmed very good stability (4 in 5-point Likert scale) of the operated knee joints. Radiological examinations showed good implant fixation (radiolucency less than 2 mm) without any signs of migration. Spaces between the MSC-Scaffold spikes were penetrated by bone tissue. The histological sections showed newly formed trabecular bone tissue between the spikes, and the trabeculae of periscaffold bone were seen in contact with the spikes. The micro-CT results showed the highest percentage of bone tissue ingrowths into the MSC-Scaffold at a distance of 2.5÷3.0 mm from the spikes bases. The first biomimetic fixation for resurfacing arthroplasty was successfully verified in 10 swines investigations using RKA endoprosthesis working prototypes. The performed research shows that the MSC-Scaffold allows for cementless and biomimetic fixation of resurfacing endoprosthesis components in periarticular cancellous bone.
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Affiliation(s)
- Piotr Rogala
- Department of Orthopaedics and Traumatology, W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland
- Institute of Health Sciences, Hipolit Cegielski State College of Higher Education, Card. Stefan Wyszyński Street 38, 62-200 Gniezno, Poland
- Veterinary Surgery Department, Naramowicka Street 68, 61-619 Poznań, Poland
| | - Ryszard Uklejewski
- Institute of Health Sciences, Hipolit Cegielski State College of Higher Education, Card. Stefan Wyszyński Street 38, 62-200 Gniezno, Poland
- Department of Medical Bioengineering Fundamentals, Institute of Technology, Kazimierz Wielki University, Karol Chodkiewicz Street 30, 85-064 Bydgoszcz, Poland
- Department of Technology Design/Laboratory of Bone Implants Research and Design, Institute of Mechanical Technology, Poznan University of Technology, Piotrowo Street 3, 60-965 Poznan, Poland
| | - Mariusz Winiecki
- Department of Medical Bioengineering Fundamentals, Institute of Technology, Kazimierz Wielki University, Karol Chodkiewicz Street 30, 85-064 Bydgoszcz, Poland
- Department of Technology Design/Laboratory of Bone Implants Research and Design, Institute of Mechanical Technology, Poznan University of Technology, Piotrowo Street 3, 60-965 Poznan, Poland
| | - Mikołaj Dąbrowski
- Department of Orthopaedics and Traumatology, W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland
- Department of Spondyloorthopaedics and Biomechanics, W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland
| | - Jacek Gołańczyk
- Veterinary Surgery Department, Naramowicka Street 68, 61-619 Poznań, Poland
| | - Adam Patalas
- Department of Technology Design/Laboratory of Bone Implants Research and Design, Institute of Mechanical Technology, Poznan University of Technology, Piotrowo Street 3, 60-965 Poznan, Poland
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