1
|
Pugazhendhi AS, Neal CJ, Ta KM, Molinari M, Kumar U, Wei F, Kolanthai E, Ady A, Drake C, Hughes M, Yooseph S, Seal S, Coathup MJ. A neoteric antibacterial ceria-silver nanozyme for abiotic surfaces. Biomaterials 2024; 307:122527. [PMID: 38518591 DOI: 10.1016/j.biomaterials.2024.122527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/01/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Community-associated and hospital-acquired infections caused by bacteria continue to yield major global challenges to human health. Bacterial contamination on abiotic surfaces is largely spread via high-touch surfaces and contemporary standard disinfection practices show limited efficacy, resulting in unsatisfactory therapeutic outcomes. New strategies that offer non-specific and broad protection are urgently needed. Herein, we report our novel ceria-silver nanozyme engineered at a molar ratio of 5:1 and with a higher trivalent (Ce3+) surface fraction. Our results reveal potent levels of surface catalytic activity on both wet and dry surfaces, with rapid, and complete eradication of Pseudomonas aeruginosa, Staphylococcus aureus, and methicillin resistant S. aureus, in both planktonic and biofilm form. Preferential electrostatic adherence of anionic bacteria to the cationic nanozyme surface leads to a catastrophic loss in both aerobic and anaerobic respiration, DNA damage, osmodysregulation, and finally, programmed bacterial lysis. Our data reveal several unique mechanistic avenues of synergistic ceria-Ag efficacy. Ag potentially increases the presence of Ce3+ sites at the ceria-Ag interface, thereby facilitating the formation of harmful H2O2, followed by likely permeation across the cell wall. Further, a weakened Ag-induced Ce-O bond may drive electron transfer from the Ec band to O2, thereby further facilitating the selective reduction of O2 toward H2O2 formation. Ag destabilizes the surface adsorption of molecular H2O2, potentially leading to higher concentrations of free H2O2 adjacent to bacteria. To this end, our results show that H2O2 and/or NO/NO2-/NO3- are the key liberators of antibacterial activity, with a limited immediate role being offered by nanozyme-induced ROS including O2•- and OH•, and likely other light-activated radicals. A mini-pilot proof-of-concept study performed in a pediatric dental clinic setting confirms residual, and continual nanozyme antibacterial efficacy over a 28-day period. These findings open a new approach to alleviate infections caused by bacteria for use on high-touch hard surfaces.
Collapse
Affiliation(s)
- Abinaya Sindu Pugazhendhi
- Biionix Cluster, College of Medicine, University of Central Florida, Orlando, FL, 32827, United States
| | - Craig J Neal
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), University of Central Florida, Orlando, FL, 32826, United States
| | - Khoa Minh Ta
- Department of Chemical Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, HD1 3DH, United Kingdom
| | - Marco Molinari
- Department of Chemical Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, HD1 3DH, United Kingdom.
| | - Udit Kumar
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), University of Central Florida, Orlando, FL, 32826, United States
| | - Fei Wei
- Biionix Cluster, College of Medicine, University of Central Florida, Orlando, FL, 32827, United States
| | - Elayaraja Kolanthai
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), University of Central Florida, Orlando, FL, 32826, United States
| | - Andrew Ady
- Biionix Cluster, College of Medicine, University of Central Florida, Orlando, FL, 32827, United States
| | - Christina Drake
- Kismet Technologies, 7101 TPC Drive, Suite 130, Orlando, FL, 32822, United States
| | - Megan Hughes
- University of Cardiff, Cardiff, CF10 3AT, Wales, United Kingdom
| | - Shibu Yooseph
- Kravis Department of Integrated Sciences, Claremont McKenna College, Claremont, CA 91711, United States
| | - Sudipta Seal
- Biionix Cluster, College of Medicine, University of Central Florida, Orlando, FL, 32827, United States; Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), University of Central Florida, Orlando, FL, 32826, United States
| | - Melanie J Coathup
- Biionix Cluster, College of Medicine, University of Central Florida, Orlando, FL, 32827, United States.
| |
Collapse
|
2
|
Pugazhendhi AS, Seal A, Hughes M, Kumar U, Kolanthai E, Wei F, Schwartzman JD, Coathup MJ. Extracellular Proteins Isolated from L. acidophilus as an Osteomicrobiological Therapeutic Agent to Reduce Pathogenic Biofilm Formation, Regulate Chronic Inflammation, and Augment Bone Formation In Vitro. Adv Healthc Mater 2024; 13:e2302835. [PMID: 38117082 DOI: 10.1002/adhm.202302835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/31/2023] [Indexed: 12/21/2023]
Abstract
Periprosthetic joint infection (PJI) is a challenging complication that can occur following joint replacement surgery. Efficacious strategies to prevent and treat PJI and its recurrence remain elusive. Commensal bacteria within the gut convey beneficial effects through a defense strategy named "colonization resistance" thereby preventing pathogenic infection along the intestinal surface. This blueprint may be applicable to PJI. The aim is to investigate Lactobacillus acidophilus spp. and their isolated extracellular-derived proteins (LaEPs) on PJI-relevant Staphylococcus aureus, methicillin-resistant S. aureus, and Escherichia coli planktonic growth and biofilm formation in vitro. The effect of LaEPs on cultured macrophages and osteogenic, and adipogenic human bone marrow-derived mesenchymal stem cell differentiation is analyzed. Data show electrostatically-induced probiotic-pathogen species co-aggregation and pathogenic growth inhibition together with LaEP-induced biofilm prevention. LaEPs prime macrophages for enhanced microbial phagocytosis via cathepsin K, reduce lipopolysaccharide-induced DNA damage and receptor activator nuclear factor-kappa B ligand expression, and promote a reparative M2 macrophage morphology under chronic inflammatory conditions. LaEPs also significantly augment bone deposition while abating adipogenesis thus holding promise as a potential multimodal therapeutic strategy. Proteomic analyses highlight high abundance of lysyl endopeptidase, and urocanate reductase. Further, in vivo analyses are warranted to elucidate their role in the prevention and treatment of PJIs.
Collapse
Affiliation(s)
| | - Anouska Seal
- Biionix Cluster, University of Central Florida, Orlando, FL, 32827, USA
| | | | - Udit Kumar
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), University of Central Florida, Orlando, FL, 32826, USA
| | - Elayaraja Kolanthai
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), University of Central Florida, Orlando, FL, 32826, USA
| | - Fei Wei
- Biionix Cluster, University of Central Florida, Orlando, FL, 32827, USA
| | | | - Melanie J Coathup
- Biionix Cluster, University of Central Florida, Orlando, FL, 32827, USA
- College of Medicine, University of Central Florida, Orlando, FL, 32827, USA
| |
Collapse
|
3
|
Seal A, Hughes M, Wei F, Pugazhendhi AS, Ngo C, Ruiz J, Schwartzman JD, Coathup MJ. Sphingolipid-Induced Bone Regulation and Its Emerging Role in Dysfunction Due to Disease and Infection. Int J Mol Sci 2024; 25:3024. [PMID: 38474268 DOI: 10.3390/ijms25053024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
The human skeleton is a metabolically active system that is constantly regenerating via the tightly regulated and highly coordinated processes of bone resorption and formation. Emerging evidence reveals fascinating new insights into the role of sphingolipids, including sphingomyelin, sphingosine, ceramide, and sphingosine-1-phosphate, in bone homeostasis. Sphingolipids are a major class of highly bioactive lipids able to activate distinct protein targets including, lipases, phosphatases, and kinases, thereby conferring distinct cellular functions beyond energy metabolism. Lipids are known to contribute to the progression of chronic inflammation, and notably, an increase in bone marrow adiposity parallel to elevated bone loss is observed in most pathological bone conditions, including aging, rheumatoid arthritis, osteoarthritis, and osteomyelitis. Of the numerous classes of lipids that form, sphingolipids are considered among the most deleterious. This review highlights the important primary role of sphingolipids in bone homeostasis and how dysregulation of these bioactive metabolites appears central to many chronic bone-related diseases. Further, their contribution to the invasion, virulence, and colonization of both viral and bacterial host cell infections is also discussed. Many unmet clinical needs remain, and data to date suggest the future use of sphingolipid-targeted therapy to regulate bone dysfunction due to a variety of diseases or infection are highly promising. However, deciphering the biochemical and molecular mechanisms of this diverse and extremely complex sphingolipidome, both in terms of bone health and disease, is considered the next frontier in the field.
Collapse
Affiliation(s)
- Anouska Seal
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA
| | - Megan Hughes
- School of Biosciences, Cardiff University, Cardiff CF10 3AT, UK
| | - Fei Wei
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | - Abinaya S Pugazhendhi
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | - Christopher Ngo
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | - Jonathan Ruiz
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | | | - Melanie J Coathup
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| |
Collapse
|
4
|
Harb SV, Kolanthai E, Pugazhendhi AS, Beatrice CA, Pinto LA, Neal CJ, Backes EH, Nunes AC, Selistre-de-Araújo HS, Costa LC, Coathup MJ, Seal S, Pessan LA. 3D printed bioabsorbable composite scaffolds of poly (lactic acid)-tricalcium phosphate-ceria with osteogenic property for bone regeneration. Biomater Biosyst 2024; 13:100086. [PMID: 38213985 PMCID: PMC10776431 DOI: 10.1016/j.bbiosy.2023.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/28/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024] Open
Abstract
The fabrication of customized implants by additive manufacturing has allowed continued development of the personalized medicine field. Herein, a 3D-printed bioabsorbable poly (lactic acid) (PLA)- β-tricalcium phosphate (TCP) (10 wt %) composite has been modified with CeO2 nanoparticles (CeNPs) (1, 5 and 10 wt %) for bone repair. The filaments were prepared by melt extrusion and used to print porous scaffolds. The nanocomposite scaffolds possessed precise structure with fine print resolution, a homogenous distribution of TCP and CeNP components, and mechanical properties appropriate for bone tissue engineering applications. Cell proliferation assays using osteoblast cultures confirmed the cytocompatibility of the composites. In addition, the presence of CeNPs enhanced the proliferation and differentiation of mesenchymal stem cells; thereby, increasing alkaline phosphatase (ALP) activity, calcium deposition and bone-related gene expression. Results from this study have shown that the 3D printed PLA-TCP-10%CeO2 composite scaffold could be used as an alternative polymeric implant for bone tissue engineering applications: avoiding additional/revision surgeries and accelerating the regenerative process.
Collapse
Affiliation(s)
- Samarah V. Harb
- Department of Materials Engineering (DEMa), Federal University of Sao Carlos (UFSCar), São Carlos, SP, Brazil
- Advanced Materials Processing and Analysis Center, Department of Materials Science and Engineering, University of Central Florida, Orlando, FL, USA
| | - Elayaraja Kolanthai
- Advanced Materials Processing and Analysis Center, Department of Materials Science and Engineering, University of Central Florida, Orlando, FL, USA
| | | | - Cesar A.G. Beatrice
- Department of Materials Engineering (DEMa), Federal University of Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Leonardo A. Pinto
- Graduate Program in Materials Science and Engineering, Department of Materials Engineering (DEMa), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Craig J. Neal
- Advanced Materials Processing and Analysis Center, Department of Materials Science and Engineering, University of Central Florida, Orlando, FL, USA
| | - Eduardo H. Backes
- Department of Materials Engineering (DEMa), Federal University of Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana C.C. Nunes
- Department of Physiological Sciences, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | | | - Lidiane C. Costa
- Department of Materials Engineering (DEMa), Federal University of Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Melanie J. Coathup
- Biionix Cluster, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Sudipta Seal
- Advanced Materials Processing and Analysis Center, Department of Materials Science and Engineering, University of Central Florida, Orlando, FL, USA
- Biionix Cluster, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Luiz A. Pessan
- Department of Materials Engineering (DEMa), Federal University of Sao Carlos (UFSCar), São Carlos, SP, Brazil
| |
Collapse
|
5
|
Caldwell M, Hughes M, Wei F, Ngo C, Pascua R, Pugazhendhi AS, Coathup MJ. Promising applications of D-amino acids in periprosthetic joint infection. Bone Res 2023; 11:14. [PMID: 36894568 PMCID: PMC9998894 DOI: 10.1038/s41413-023-00254-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 03/11/2023] Open
Abstract
Due to the rise in our aging population, a disproportionate demand for total joint arthroplasty (TJA) in the elderly is forecast. Periprosthetic joint infection (PJI) represents one of the most challenging complications that can occur following TJA, and as the number of primary and revision TJAs continues to rise, an increasing PJI burden is projected. Despite advances in operating room sterility, antiseptic protocols, and surgical techniques, approaches to prevent and treat PJI remain difficult, primarily due to the formation of microbial biofilms. This difficulty motivates researchers to continue searching for an effective antimicrobial strategy. The dextrorotatory-isoforms of amino acids (D-AAs) are essential components of peptidoglycan within the bacterial cell wall, providing strength and structural integrity in a diverse range of species. Among many tasks, D-AAs regulate cell morphology, spore germination, and bacterial survival, evasion, subversion, and adhesion in the host immune system. When administered exogenously, accumulating data have demonstrated that D-AAs play a pivotal role against bacterial adhesion to abiotic surfaces and subsequent biofilm formation; furthermore, D-AAs have substantial efficacy in promoting biofilm disassembly. This presents D-AAs as promising and novel targets for future therapeutic approaches. Despite their emerging antibacterial efficacy, their role in disrupting PJI biofilm formation, the disassembly of established TJA biofilm, and the host bone tissue response remains largely unexplored. This review aims to examine the role of D-AAs in the context of TJAs. Data to date suggest that D-AA bioengineering may serve as a promising future strategy in the prevention and treatment of PJI.
Collapse
Affiliation(s)
- Matthew Caldwell
- Biionix Cluster & College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Megan Hughes
- School of Biosciences, Cardiff University, CF10 3AT, Wales, UK
| | - Fei Wei
- Biionix Cluster & College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Christopher Ngo
- Biionix Cluster & College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Raven Pascua
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Abinaya Sindu Pugazhendhi
- Biionix Cluster & College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Melanie J Coathup
- Biionix Cluster & College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA.
| |
Collapse
|
6
|
Manero A, Crawford KE, Prock‐Gibbs H, Shah N, Gandhi D, Coathup MJ. Improving disease prevention, diagnosis, and treatment using novel bionic technologies. Bioeng Transl Med 2022; 8:e10359. [PMID: 36684104 PMCID: PMC9842045 DOI: 10.1002/btm2.10359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/09/2022] [Accepted: 05/30/2022] [Indexed: 01/25/2023] Open
Abstract
Increased human life expectancy, due in part to improvements in infant and childhood survival, more active lifestyles, in combination with higher patient expectations for better health outcomes, is leading to an extensive change in the number, type and manner in which health conditions are treated. Over the next decades as the global population rapidly progresses toward a super-aging society, meeting the long-term quality of care needs is forecast to present a major healthcare challenge. The goal is to ensure longer periods of good health, a sustained sense of well-being, with extended periods of activity, social engagement, and productivity. To accomplish these goals, multifunctionalized interfaces are an indispensable component of next generation medical technologies. The development of more sophisticated materials and devices as well as an improved understanding of human disease is forecast to revolutionize the diagnosis and treatment of conditions ranging from osteoarthritis to Alzheimer's disease and will impact disease prevention. This review examines emerging cutting-edge bionic materials, devices and technologies developed to advance disease prevention, and medical care and treatment in our elderly population including developments in smart bandages, cochlear implants, and the increasing role of artificial intelligence and nanorobotics in medicine.
Collapse
Affiliation(s)
- Albert Manero
- Limbitless SolutionsUniversity of Central FloridaOrlandoFloridaUSA,Biionix ClusterUniversity of Central FloridaOrlandoFloridaUSA
| | - Kaitlyn E. Crawford
- Biionix ClusterUniversity of Central FloridaOrlandoFloridaUSA,Department of Materials Science and EngineeringUniversity of Central FloridaOrlandoFloridaUSA
| | | | - Neel Shah
- College of MedicineUniversity of Central FloridaOrlandoFloridaUSA
| | - Deep Gandhi
- College of MedicineUniversity of Central FloridaOrlandoFloridaUSA
| | | |
Collapse
|
7
|
Wei F, Neal CJ, Sakthivel TS, Kean T, Seal S, Coathup MJ. Multi-functional cerium oxide nanoparticles regulate inflammation and enhance osteogenesis. Mater Sci Eng C Mater Biol Appl 2021; 124:112041. [PMID: 33947541 DOI: 10.1016/j.msec.2021.112041] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/02/2021] [Accepted: 03/16/2021] [Indexed: 11/24/2022]
Abstract
Oxidative stress increases bone loss and limits repair, in part, through immunoregulation and the formation and maintenance of low-grade chronic inflammation. The aim of this study was to investigate the effect of cerium oxide nanoparticles (CeONPs) on (i) macrophage phenotype and cytokine expression under normal and simulated acute and chronic inflammatory conditions and, (ii) human mesenchymal stem cell (hBMSCs) proliferation, osteoinduction and osteogenic differentiation. Spherical particles composed of 60% Ce3+ with a hydrodynamic size of ~35 nm and surface charge of 25.4 mV were internalized within cells. Under both acute and chronic conditions, inducible nitric oxide synthase (iNOS) activity decreased with a significant reduction seen in the 1 and 10 μg/mL groups (p < 0.001). A dose dependent and significant increase in anti-inflammatory cytokine gene expression was observed in all CeONP groups under chronic inflammatory condition. No increase in alkaline phosphatase (ALP) activity or mineral deposits were measured following hBMSCs cultured without osteogenic media in any of the CeONP groups, however, a significant increase in osteogenic-related gene expression, ALP activity and bone mineral deposits was measured when supplemented with both CeONPs and osteogenic media. CeONP activity was multifaceted and exhibited low toxicity. A therapeutic dose of 1 μg/mL delivered a disparate but protective effect when under both acute and chronic inflammatory conditions while at the same dose, potentiated osteogenesis.
Collapse
Affiliation(s)
- Fei Wei
- Biionix Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Craig J Neal
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), Materials Science and Engineering, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Tamil Selvan Sakthivel
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), Materials Science and Engineering, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Thomas Kean
- Biionix Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Sudipta Seal
- Biionix Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, USA; Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), Materials Science and Engineering, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Melanie J Coathup
- Biionix Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, USA.
| |
Collapse
|
8
|
Jeyanathan A, Ramalhete R, Blunn G, Gibbs H, Pumilia CA, Meckmongkol T, Lovejoy J, Coathup MJ. Lactobacillus cell-free supernatant as a novel bioagent and biosurfactant against Pseudomonas aeruginosa in the prevention and treatment of orthopedic implant infection. J Biomed Mater Res B Appl Biomater 2021; 109:1634-1643. [PMID: 33634961 DOI: 10.1002/jbm.b.34821] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/13/2021] [Accepted: 02/14/2021] [Indexed: 01/09/2023]
Abstract
The hypothesis was that probiotic Lactobacillus species (spp.) or their cell-free supernatant (CFS) are effective in inhibiting (a) planktonic growth of Pseudomonas aeruginosa (PA), (b) its adhesion to a Ti6Al4V-alloy surface, and (c) in dispersing biofilm once formed. (a) A planktonic co-culture containing PA(104 colony-forming unit [CFU]/ml) was combined with either Lactobacillus acidophilus, Lactobacillus plantarum (LP), or Lactobacillus fermentum (LF) at a suspension of 104 (1:1) or 108 CFU/ml (1:2). Lactobacillus and PA CFUs were then quantified. (b) Ti-6Al-4V discs were inoculated with PA followed by supplementation with CFS and adherent PA quantified. (c) Biofilm covered discs were supplemented with Lactobacillus CFS and remaining PA activity quantified. Results showed that whole-cell cultures were ineffective in preventing PA growth; however, the addition of CFS resulted in a 99.99 ± 0.003% reduction in adherent PA in all Lactobacillus groups (p < .05 in all groups) with no viable PA growth measured in the LF and LP groups. Following PA biofilm formation, CFS resulted in a significant reduction in PA activity in all Lactobacillus groups (p ≤ .05 in all groups) with a 29.75 ± 15.98% increase measured in control samples. Supplementation with CFS demonstrated antiadhesive, antibiofilm, and toxic properties to PA.
Collapse
Affiliation(s)
- Augustina Jeyanathan
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, Royal National Orthopaedic Hospital, University College London, Stanmore, UK
| | - Rita Ramalhete
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, Royal National Orthopaedic Hospital, University College London, Stanmore, UK
| | - Gordon Blunn
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, Royal National Orthopaedic Hospital, University College London, Stanmore, UK.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Hannah Gibbs
- Biionix (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Cyrus Anthony Pumilia
- Biionix (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Teerin Meckmongkol
- Biionix (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA.,Department of General Surgery, Nemours Children's Hospital, Orlando, Florida, USA
| | - John Lovejoy
- Biionix (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA.,Department of Orthopaedics, Sports Medicine and Physical Medicine and Rehabilitation, Nemours Children's Hospital, Orlando, Florida, USA
| | - Melanie J Coathup
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, Royal National Orthopaedic Hospital, University College London, Stanmore, UK.,Biionix (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA
| |
Collapse
|
9
|
Martyniak K, Wei F, Ballesteros A, Meckmongkol T, Calder A, Gilbertson T, Orlovskaya N, Coathup MJ. Do polyunsaturated fatty acids protect against bone loss in our aging and osteoporotic population? Bone 2021; 143:115736. [PMID: 33171312 DOI: 10.1016/j.bone.2020.115736] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 02/07/2023]
Abstract
Age-related bone loss is inevitable in both men and women and there will soon be more people of extreme old age than ever before. Osteoporosis is a common chronic disease and as the proportion of older people, rate of obesity and the length of life increases, a rise in age-related degenerating bone diseases, disability, and prolonged dependency is projected. Fragility fractures are one of the most severe complications associated with both primary and secondary osteoporosis and current treatment strategies target weight-bearing exercise and pharmacological intervention, both with limited long-term success. Obesity and osteoporosis are intimately interrelated, and diet is a variable that plays a significant role in bone regeneration and repair. The Western Diet is characterized by its unhealthy components, specifically excess amounts of saturated fat intake. This review examines the impact of saturated and polyunsaturated fatty acid consumption on chronic inflammation, osteogenesis, bone architecture, and strength and explores the hypothesis that dietary polyunsaturated fats have a beneficial effect on osteogenesis, reducing bone loss by decreasing chronic inflammation, and activating bone resorption through key cellular and molecular mechanisms in our aging population. We conclude that aging, obesity and a diet high in saturated fatty acids significantly impairs bone regeneration and repair and that consumption of ω-3 polyunsaturated fatty acids is associated with significantly increased bone regeneration, improved microarchitecture and structural strength. However, ω-6 polyunsaturated fatty acids were typically pro-inflammatory and have been associated with an increased fracture risk. This review suggests a potential role for ω-3 fatty acids as a non-pharmacological dietary method of reducing bone loss in our aging population. We also conclude that contemporary amendments to the formal nutritional recommendations made by the Food and Nutrition Board may be necessary such that our aging population is directly considered.
Collapse
Affiliation(s)
- Kari Martyniak
- Biionix Cluster, University of Central Florida, Orlando, FL, United States; Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Fei Wei
- Biionix Cluster, University of Central Florida, Orlando, FL, United States; Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Amelia Ballesteros
- Biionix Cluster, University of Central Florida, Orlando, FL, United States; Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Teerin Meckmongkol
- Biionix Cluster, University of Central Florida, Orlando, FL, United States; Department of General Surgery, Nemours Children's Hospital, Orlando, FL, United States
| | - Ashley Calder
- Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Timothy Gilbertson
- Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Nina Orlovskaya
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
| | - Melanie J Coathup
- Biionix Cluster, University of Central Florida, Orlando, FL, United States; Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, United States.
| |
Collapse
|
10
|
Cheong VS, Fromme P, Coathup MJ, Mumith A, Blunn GW. Partial Bone Formation in Additive Manufactured Porous Implants Reduces Predicted Stress and Danger of Fatigue Failure. Ann Biomed Eng 2019; 48:502-514. [PMID: 31549330 PMCID: PMC6928091 DOI: 10.1007/s10439-019-02369-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/14/2019] [Indexed: 11/25/2022]
Abstract
New porous implant designs made possible by additive manufacturing allow for increased osseointegration, potentially improving implant performance and longevity for patients that require massive bone implants. The aim of this study was to evaluate how implantation and the strain distribution in the implant affect the pattern of bone ingrowth and how changes in tissue density within the pores alter the stresses in implants. The hypothesis was that porous metal implants are susceptible to fatigue failure, and that this reduces as osteointegration occurs. A phenomenological, finite element analysis (FEA) bone remodelling model was used to predict partial bone formation for two porous (pore sizes of 700 μm and 1500 μm), laser sintered Ti6Al4V implants in an ovine condylar defect model, and was compared and verified against in vivo, histology results. The FEA models predicted partial bone formation within the porous implants, but over-estimated the amount of bone-surface area compared to histology results. The stress and strain in the implant and adjacent tissues were assessed before, during bone remodelling, and at equilibrium. Results showed that partial bone formation improves the stress distribution locally by reducing stress concentrations for both pore sizes, by at least 20%. This improves the long-term fatigue resistance for the larger pore implant, as excessively high stress is reduced to safer levels (86% of fatigue strength) as bone forms. The stress distribution only changed slightly in regions without bone growth. As the extent of bone formation into extensively porous bone implants depends on the level of stress shielding, the design of the implant and stiffness have significant influence on bone integration and need to be considered carefully to ensure the safety of implants with substantial porous regions. To our knowledge this is the first time that the effect of bone formation on stress distribution within a porous implant has been described and characterised.
Collapse
Affiliation(s)
- Vee San Cheong
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
- Department of Mechanical Engineering, University College London, London, WC1E 7JE, UK
| | - Paul Fromme
- Department of Mechanical Engineering, University College London, London, WC1E 7JE, UK.
| | - Melanie J Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
- College of Medicine, University of Central Florida, Orlando, FL, 32827-08, USA
| | - Aadil Mumith
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
| | - Gordon W Blunn
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, UK
| |
Collapse
|
11
|
Blunn GW, Ferro De Godoy R, Meswania J, Briggs TWR, Tyler P, Hargunani R, Wilson H, Khan I, Marriott T, Coathup MJ. A novel ceramic coating for reduced metal ion release in metal-on-metal hip surgery. J Biomed Mater Res B Appl Biomater 2018; 107:1760-1771. [PMID: 30447129 DOI: 10.1002/jbm.b.34268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/12/2018] [Accepted: 09/30/2018] [Indexed: 11/09/2022]
Abstract
An ovine total hip arthroplasty model was developed to evaluate metal ion release, wear, the biological response and adverse tissue reaction to metal-on-metal (MoM) bearing materials. The performance of an advanced superlattice ceramic coating (SLC) was evaluated as a bearing surface and experimental groups divided into; (1) MoM articulating surfaces coated with a SLC coating (SLC-MoM), (2) uncoated MoM surfaces (MoM), and (3) metal on polyethylene (MoP) surfaces. Implants remained in vivo for 13 months and blood chromium (Cr) and cobalt (Co) metal ion levels were measured pre and postoperatively. Synovial tissue was graded using an ALVAL scoring system. When compared with the MoM group, sheep with SLC-MoM implants showed significantly lower levels of chromium and cobalt metal ions within blood over the 13-month period. Evidence of gray tissue staining was observed in the synovium of implants in the MOM group. A significantly lower ALVAL score was measured in the SLC-MoM group (3.88) when compared with MoM components (6.67) (p = 0.010). ALVAL results showed no significant difference when SLC-MOM components were compared to MoP (5.25). This model was able to distinguish wear and the effect of released debris between different bearing combinations and demonstrated the effect of a SLC coating when applied onto the bearing surface. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1760-1771, 2019.
Collapse
Affiliation(s)
- Gordon W Blunn
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
| | - Roberta Ferro De Godoy
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
| | - Jayantilal Meswania
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
| | - Tim W R Briggs
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
| | - Philippa Tyler
- Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Rikin Hargunani
- Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Hannah Wilson
- Zimmer Biomet, Dorcan Industrial Estate, Swindon, Wiltshire, UK
| | - Imran Khan
- Zimmer Biomet, Dorcan Industrial Estate, Swindon, Wiltshire, UK
| | - Tim Marriott
- Zimmer Biomet, Dorcan Industrial Estate, Swindon, Wiltshire, UK
| | - Melanie J Coathup
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
| |
Collapse
|
12
|
Cheong VS, Fromme P, Mumith A, Coathup MJ, Blunn GW. Novel adaptive finite element algorithms to predict bone ingrowth in additive manufactured porous implants. J Mech Behav Biomed Mater 2018; 87:230-239. [PMID: 30086415 DOI: 10.1016/j.jmbbm.2018.07.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 06/04/2018] [Accepted: 07/10/2018] [Indexed: 11/30/2022]
Abstract
Bone loss caused by stress shielding of metallic implants is a concern, as it can potentially lead to long-term implant failure. Surface coating and reducing structural stiffness of implants are two ways to improve bone ingrowth and osteointegration. Additive manufacturing, through selective laser sintering (SLS) or electron beam melting (EBM) of metallic alloys, can produce porous implants with bone ingrowth regions that enhance osteointegration and improve clinical outcomes. Histology of porous Ti6Al4V plugs of two pore sizes with and without electrochemically deposited hydroxyapatite coating, implanted in ovine condyles, showed that bone formation did not penetrate deep into the porous structure, whilst significantly increased bone growth along coated pore surfaces (osteointegration) was observed. Finite Element simulations, combining new algorithms to model bone ingrowth and the effect of surface modification on osteoconduction, were verified with the histology results. The results showed stress shielding of porous implants made from conventional titanium alloy due to material stiffness and implant geometry, limiting ingrowth and osteointegration. Simulations for reduced implant material stiffness predicted increased bone ingrowth. For low modulus Titanium-tantalum alloy (Ti-70%Ta), reduced stress shielding and enhanced bone ingrowth into the porous implant was found, leading to improved mechanical interlock. Algorithms predicted osteoconductive coating to promote both osteointegration and bone ingrowth into the inner pores when they were coated. These new Finite Element algorithms show that using implant materials with lower elastic modulus, osteoconductive coatings or improved implant design could lead to increased bone remodelling that optimises tissue regeneration, fulfilling the potential of enhanced porosity and complex implant designs made possible by additive layer manufacturing techniques.
Collapse
Affiliation(s)
- Vee San Cheong
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedics Hospital, Stanmore HA7 4LP, UK; Department of Mechanical Engineering, University College London, London WC1E 7JE, UK.
| | - Paul Fromme
- Department of Mechanical Engineering, University College London, London WC1E 7JE, UK
| | - Aadil Mumith
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedics Hospital, Stanmore HA7 4LP, UK
| | - Melanie J Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedics Hospital, Stanmore HA7 4LP, UK
| | - Gordon W Blunn
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedics Hospital, Stanmore HA7 4LP, UK; School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth PO1 2DT, UK
| |
Collapse
|
13
|
Cheong VS, Blunn GW, Coathup MJ, Fromme P. A novel adaptive algorithm for 3D finite element analysis to model extracortical bone growth. Comput Methods Biomech Biomed Engin 2018; 21:129-138. [DOI: 10.1080/10255842.2018.1425997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Vee San Cheong
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedics Hospital, Stanmore, UK
| | - Gordon W. Blunn
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedics Hospital, Stanmore, UK
| | - Melanie J. Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedics Hospital, Stanmore, UK
| | - Paul Fromme
- Department of Mechanical Engineering, University College London, London, UK
| |
Collapse
|
14
|
Coathup MJ, Blunn GW, Mirhosseini N, Erskine K, Liu Z, Garrod DR, Li L. Controlled laser texturing of titanium results in reliable osteointegration. J Orthop Res 2017; 35:820-828. [PMID: 27306746 DOI: 10.1002/jor.23340] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
We have developed a laser-textured superhydrophilic Ti-6Al-4V surface with unique surface chemistry and topography that substantially promotes osteoblast adhesion in culture. Here we investigate the osteointegration of laser-textured implants in an ovine model. Our hypothesis was that laser-textured implants, without any surface coating (LT), would encourage comparable amounts of bone-implant contact and interfacial strength when compared with widely accepted hydroxyapatite (HA) coated implants. Additionally, we hypothesized that LT would significantly increase bony integration compared with machine-finished (MF) and grit-blasted (GB) implants. Forty-eight tapered transcortical pins were implanted into six sheep. Four experimental groups (LT, HA, MF, and GB) were investigated (n = 12) and implants remained in vivo for 6 weeks. Bone apposition rates, interfacial shear strength, and bone-implant contact (BIC) were quantified. The interfacial strength of LT and HA implants were found to be significantly greater than GB (p = 0.032 and p = 0.004) and MF (p = 0.004 and p = 0.004, respectively), but no significant difference between LT and HA implants was observed. Significantly increased BIC was measured adjacent to HA implants when compared with both LT and GB implant surfaces (p = 0.022 and p = 0.006, respectively). No significant difference was found when LT and GB implants were compared. However, all surface finishes encouraged significantly increased BIC when compared with the MF surface. Maximizing implant fixation to host bone is vital for its long-term success. The production of an LT surface is a simple and cheap manufacturing process and this study demonstrated that laser-textured implants are a very promising technical development that warrants further research. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:820-828, 2017.
Collapse
Affiliation(s)
- Melanie J Coathup
- Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
| | - Gordon W Blunn
- Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
| | - Nazanin Mirhosseini
- Laser Processing Research Center, School of Mechanical, Aerospace, and Civil Engineering, University of Manchester, Manchester, United Kingdom
| | - Karen Erskine
- Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
| | - Zhu Liu
- School of Materials, University of Manchester, Manchester, United Kingdom
| | - David R Garrod
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - Lin Li
- Laser Processing Research Center, School of Mechanical, Aerospace, and Civil Engineering, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
15
|
Fromme P, Blunn GW, Aston WJ, Abdoola T, Koris J, Coathup MJ. The effect of bone growth onto massive prostheses collars in protecting the implant from fracture. Med Eng Phys 2017; 41:19-25. [DOI: 10.1016/j.medengphy.2016.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 12/14/2016] [Accepted: 12/21/2016] [Indexed: 12/23/2022]
|
16
|
Ajami S, Coathup MJ, Khoury J, Blunn GW. Augmenting the bioactivity of polyetheretherketone using a novel accelerated neutral atom beam technique. J Biomed Mater Res B Appl Biomater 2016; 105:1438-1446. [PMID: 27086858 DOI: 10.1002/jbm.b.33681] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/22/2016] [Accepted: 03/29/2016] [Indexed: 01/27/2023]
Abstract
Polyetheretherketone (PEEK) is an alternative to metallic implants in orthopedic applications; however, PEEK is bioinert and does not osteointegrate. In this study, an accelerated neutral atom beam technique (ANAB) was employed to improve the bioactivity of PEEK. The aim was to investigate the growth of human mesenchymal stem cells (hMSCs), human osteoblasts (hOB), and skin fibroblasts (BR3G) on PEEK and ANAB PEEK. METHODS The surface roughness and contact angle of PEEK and ANAB PEEK was measured. Cell metabolic activity, proliferation and alkaline phosphatase (ALP) was measured and cell attachment was determined by quantifying adhesion plaques with cells. RESULTS ANAB treatment increased the surface hydrophilicity [91.74 ± 4.80° (PEEK) vs. 74.82 ± 2.70° (ANAB PEEK), p < 0.001] but did not alter the surface roughness. Metabolic activity and proliferation for all cell types significantly increased on ANAB PEEK compared to PEEK (p < 0.05). Significantly increased cell attachment was measured on ANAB PEEK surfaces. MSCs seeded on ANAB PEEK in the presence of osteogenic media, expressed increased levels of ALP compared to untreated PEEK (p < 0.05) CONCLUSION: Our results demonstrated that ANAB treatment increased the cell attachment, metabolic activity, and proliferation on PEEK. ANAB treatment may improve the osteointegration of PEEK implants. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1438-1446, 2017.
Collapse
Affiliation(s)
- S Ajami
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics, Division of Surgery, University College London, London, UK
| | - M J Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics, Division of Surgery, University College London, London, UK
| | - J Khoury
- Exogenesis Corp., Billerica, Massachusetts, 01821
| | - G W Blunn
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics, Division of Surgery, University College London, London, UK
| |
Collapse
|
17
|
Godoy RF, Coathup MJ, Blunn GW, Alves AL, Robotti P, Goodship AE. Fast plasma sintering delivers functional graded materials components with macroporous structures and osseointegration properties. Eur Cell Mater 2016; 31:250-63. [PMID: 27071735 DOI: 10.22203/ecm.v031a17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
We explored the osseointegration potential of two macroporous titanium surfaces obtained using fast plasma sintering (FPS): Ti macroporous structures with 400-600 µmØ pores (TiMac400) and 850-1000 µmØ pores (TiMac850). They were compared against two surfaces currently in clinical use: Ti-Growth® and air plasma spray (Ti-Y367). Each surface was tested, once placed over a Ti-alloy and once onto a CoCr bulk substrate. Implants were placed in medial femoral condyles in 24 sheep. Samples were explanted at four and eight weeks after surgery. Push-out loads were measured using a material-testing system. Bone contact and ingrowth were assessed by histomorphometry and SEM and EDX analyses. Histology showed early osseointegration for all the surfaces tested. At 8 weeks, TiMac400, TiMac850 and Ti-Growth® showed deep bone ingrowth and extended colonisation with newly formed bone. The mechanical push-out force was equal in all tested surfaces. Plasma spray surfaces showed greater bone-implant contact and higher level of pores colonisation with new bone than FPS produced surfaces. However, the void pore area in FPS specimens was significantly higher, yet the FPS porous surfaces allowed a deeper osseointegration of bone to implant. FPS manufactured specimens showed similar osseointegration potential to the plasma spray surfaces for orthopaedic implants. FPS is a useful technology for manufacturing macroporous titanium surfaces. Furthermore, its capability to combine two implantable materials, using bulk CoCr with macroporous titanium surfaces, could be of interest as it enables designers to conceive and manufacture innovative components. FPS delivers functional graded materials components with macroporous structures optimised for osseointegration.
Collapse
Affiliation(s)
- R F Godoy
- Institute of Orthopaedics and Musculoskeletal Science, Brockley Hill, HA7 4LP, Middlesex,
| | | | | | | | | | | |
Collapse
|
18
|
Ajami S, Blunn GW, Lambert S, Alexander S, Foxall Smith M, Coathup MJ. Histological evaluation of two designs of shoulder surface replacement implants. Bone Joint J 2016; 98-B:504-11. [PMID: 27037433 DOI: 10.1302/0301-620x.98b4.36600] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 11/20/2015] [Indexed: 11/05/2022]
Abstract
AIMS To assess the extent of osteointegration in two designs of shoulder resurfacing implants. Bony integration to the Copeland cylindrical central stem design and the Epoca RH conical-crown design were compared. PATIENTS AND METHODS Implants retrieved from six patients in each group were pair-matched. Mean time to revision surgery of Copeland implants was 37 months (standard deviation (sd) 23; 14 to 72) and Epoca RH 38 months (sd 28; 12 to 84). The mean age of patients investigated was 66 years (sd 4; 59 to 71) and 58 years (sd 17; 31 to 73) in the Copeland and Epoca RH groups respectively. None of these implants were revised for loosening. RESULTS Increased osteointegration was measured under the cup in the Copeland implant group with limited bone seen in direct contact with the central stem. Bone adjacent to the Epoca RH implants was more uniform. CONCLUSION This difference in the distribution of bone-implant contact and bone formation was attributed to the Epoca implant's conical crown, which is positioned in more dense peripheral bone. The use of a central stem may not be necessary provided there is adequate peripheral fixation within good quality humeral bone. TAKE HOME MESSAGE Poor osteointegration of cementless surface replacement shoulder prosthesis may be improved by implant design.
Collapse
Affiliation(s)
- S Ajami
- University College London, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - G W Blunn
- University College London, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - S Lambert
- University College London, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - S Alexander
- University College London, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - M Foxall Smith
- University College London, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - M J Coathup
- University College London, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| |
Collapse
|
19
|
Vanhegan IS, Coathup MJ, McCarthy I, Meswania J, Blunn GW, Haddad FS. An In Vitro Comparison of the Primary Stability of 2 Tapered Fluted Femoral Stem Designs. J Arthroplasty 2016; 31:517-23. [PMID: 26601631 DOI: 10.1016/j.arth.2015.09.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 09/12/2015] [Accepted: 09/15/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Proximal bony deficiencies present a biomechanical challenge to achieving primary stability in revision hip arthroplasty. Long tapered fluted stems have been engineered to span these defects but concerns of early subsidence are well documented. This work aimed primarily to investigate the issue of subsidence with this design using a cadaveric model. A secondary aim was to compare the stability of 2 versions of this design. METHODS Seven pairs of cadaveric femora were obtained, dual emission x-ray absorpitometry scanned, with calibration radiographs taken for digital templating. Each bone was potted according to the ISO standard for fatigue testing and a Paprosky type 3 defect was simulated. The established cone-conical Restoration Modular (Stryker) system and a novel design with a chamfered tip and flute configuration (Redapt, Smith & Nephew) were examined. Movement at the stem-bone interface was measured using radiostereometric analysis and micromotion transducers. RESULTS All restoration stems and 85% of the Redapt stems achieved stability by recognized criteria, micromotion < 150 μm and migration less than 2 mm. A Fisher exact test comparing the proportion of stems which were stable or unstable was not significant, P = .055. Mean axial subsidence (SD) was 0.17 mm (0.32) and 0.1 mm (0.131) for the Restoration and Redapt stems respectively. CONCLUSION This study has demonstrated minimal subsidence in the immediate post-operative period using tapered fluted stems. Both designs achieved excellent stability despite simulation of Paprosky type 3 bony defects in the cadaveric model. This geometry appears satisfactory for use in revision surgery in the presence of significant proximal bony deficiencies.
Collapse
Affiliation(s)
- Ivor S Vanhegan
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College and Royal Free Medical School, Stanmore, Middlesex; Orthopaedic Surgery Department, University College London Hospital NHS Trust, London
| | - Melanie J Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College and Royal Free Medical School, Stanmore, Middlesex
| | - Ian McCarthy
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College and Royal Free Medical School, Stanmore, Middlesex
| | - Jay Meswania
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College and Royal Free Medical School, Stanmore, Middlesex
| | - Gordon W Blunn
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College and Royal Free Medical School, Stanmore, Middlesex
| | - Fares S Haddad
- Orthopaedic Surgery Department, University College London Hospital NHS Trust, London
| |
Collapse
|
20
|
Abstract
This review assesses the current knowledge on treatments, pathogenesis and the prevention of infections associated with orthopaedic implants, with a focus on total hip arthroplasty.
Collapse
Affiliation(s)
| | - Christopher Davidson
- John Scales Centre for Biomedical Engineering
- Institute of Orthopaedics and Musculoskeletal Science
- Division of Surgery and Interventional Science
- University College London
- Royal National Orthopaedic Hospital
| | - Alexandra Levin
- RAFT Institute of Plastic Surgery
- Mount Vernon Hospital
- Northwood HA6 2RN
- UK
| | - Melanie J. Coathup
- John Scales Centre for Biomedical Engineering
- Institute of Orthopaedics and Musculoskeletal Science
- Division of Surgery and Interventional Science
- University College London
- Royal National Orthopaedic Hospital
| | - Gordon W. Blunn
- John Scales Centre for Biomedical Engineering
- Institute of Orthopaedics and Musculoskeletal Science
- Division of Surgery and Interventional Science
- University College London
- Royal National Orthopaedic Hospital
| |
Collapse
|
21
|
García-Gareta E, Coathup MJ, Blunn GW. Osteoinduction of bone grafting materials for bone repair and regeneration. Bone 2015; 81:112-121. [PMID: 26163110 DOI: 10.1016/j.bone.2015.07.007] [Citation(s) in RCA: 346] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 07/03/2015] [Accepted: 07/06/2015] [Indexed: 01/01/2023]
Abstract
Regeneration of bone defects caused by trauma, infection, tumours or inherent genetic disorders is a clinical challenge that usually necessitates bone grafting materials. Autologous bone or autograft is still considered the clinical "gold standard" and the most effective method for bone regeneration. However, limited bone supply and donor site morbidity are the most important disadvantages of autografting. Improved biomaterials are needed to match the performance of autograft as this is still superior to that of synthetic bone grafts. Osteoinductive materials would be the perfect candidates for achieving this task. The aim of this article is to review the different groups of bone substitutes in terms of their most recently reported osteoinductive properties. The different factors influencing osteoinductivity by biomaterials as well as the mechanisms behind this phenomenon are also presented, showing that it is very limited compared to osteoinductivity shown by bone morphogenetic proteins (BMPs). Therefore, a new term to describe osteoinductivity by biomaterials is proposed. Different strategies for adding osteoinductivity (BMPs, stem cells) to bone substitutes are also discussed. The overall objective of this paper is to gather the current knowledge on osteoinductivity of bone grafting materials for the effective development of new graft substitutes that enhance bone regeneration.
Collapse
Affiliation(s)
- Elena García-Gareta
- RAFT Institute of Plastic Surgery, Mount Vernon Hospital, Northwood HA6 2RN, UK.
| | - Melanie J Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
| | - Gordon W Blunn
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
| |
Collapse
|
22
|
Coathup MJ, Edwards TC, Samizadeh S, Lo WJ, Blunn GW. The effect of an alginate carrier on bone formation in a hydroxyapatite scaffold. J Biomed Mater Res B Appl Biomater 2015; 104:1328-35. [PMID: 26118665 DOI: 10.1002/jbm.b.33395] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/12/2015] [Accepted: 02/08/2015] [Indexed: 12/23/2022]
Abstract
This study investigated the osteoconductive properties of a porous hydroxyapatite (HA) scaffold manufactured using a novel technique similar to the bread-making process, alone and in combination with an alginate polysaccharide fiber gel (HA/APFG putty) and autologous bone marrow aspirate (BMA). The hypothesis was that the HA/APFG putty would be as osteoconductive as granular HA and that the presence of BMA would further enhance bone formation in an ovine femoral condyle critical defect model. Thirty-six defects were created and either (1) porous HA granules, (2) HA/APFG putty, or (3) HA/APFG putty + BMA were implanted. After retrieval at 6 and 12 weeks, image analysis techniques were used to quantify bone apposition rates, new bone area, bone-HA scaffold contact, and implant resorption. At 6 weeks postsurgery, significantly lower bone apposition rates were observed in the HA/APFG putty group when compared to the HA (p = 0.014) and HA/APFG putty + BMA (p = 0.014) groups. At 12 weeks, significantly increased amounts of new bone formation were measured within the HA scaffold (33.56 ± 3.53%) when compared to both the HA/APFG putty (16.69 ± 2.7%; p = 0.043) and the defects containing HA/APFG putty + BMA (19.31 ± 3.8%; p = 0.043). The use of an APFG gel as a carrier for injectable CaP bone substitute materials delayed bone formation in this model compared to HA granules alone which enhanced bone formation especially within the interconnected smaller pores. Our results also showed that the addition of autologous BMA did not further enhance its osteoconductive properties. Further study is required to optimize the degradation rate of this APFG binding agent before using as a directly injectable material for repair of bone defect. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1328-1335, 2016.
Collapse
Affiliation(s)
- Melanie J Coathup
- Division of Surgery and Interventional Science, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7, 4LP, UK.
| | - Thomas C Edwards
- Division of Surgery and Interventional Science, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7, 4LP, UK
| | - Sorousheh Samizadeh
- Division of Surgery and Interventional Science, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7, 4LP, UK
| | - Wei-Jen Lo
- Department of Research and Development, Wollaton Medical Consultancy Ltd., Nottingham, NG8, 2RN, UK
| | - Gordon W Blunn
- Division of Surgery and Interventional Science, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7, 4LP, UK
| |
Collapse
|
23
|
Coathup MJ, Sanghrajka A, Aston WJ, Gikas PD, Pollock RC, Cannon SR, Skinner JA, Briggs TWR, Blunn GW. Hydroxyapatite-coated collars reduce radiolucent line progression in cemented distal femoral bone tumor implants. Clin Orthop Relat Res 2015; 473:1505-14. [PMID: 25634027 PMCID: PMC4353558 DOI: 10.1007/s11999-014-4116-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/12/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Aseptic loosening of massive bone tumor implants is a major cause of prosthesis failure. Evidence suggests that an osteointegrated hydroxyapatite (HA)-coated collar would reduce the incidence of aseptic loosening around the cemented intramedullary stem in distal femoral bone tumor prostheses. Because these implants often are used in young patients with a tumor, such treatment might extend the longevity of tumor implants. Questions/purposes We asked whether (1) HA-coated collars were more likely to osteointegrate; (2) HA collars were associated with fewer progressive radiolucent lines around the stem-cement interface; and (3) HA-coated collars were associated with less bone loss at the bone-shoulder implant junction? METHODS Twenty-two patients were pair-matched to one of two groups--either (1) implants with a HA-coated ingrowth collar (HA Collar Group); or (2) implants without an ingrowth collar (Noncollar Group). Age, sex, and length of followup were similar in both groups. HA-coated collars were developed and used at our institution from 1992 to address the high failure rate attributable to aseptic loosening in patients with massive bone tumor implants. Before this, smooth titanium shafts were used routinely adjacent to bone at the transection site. The minimum followup was 2 years (mean, 7 years; range, 2-12 years). Radiographs obtained throughout the followup period were analyzed and osteointegration at the shaft of the implant quantified. Radiolucent line progression around the cemented stem was semi-quantitatively assessed and cortical bone loss at the bone-shoulder implant junction was measured during the followup period. RESULTS Comparison of the most recent radiographs showed nine of 11 patients had osteointegrated HA collars, whereas only one patient in the Noncollar Group had osteointegration (p > 0.001). The radiolucent line score quantified around the cemented stem was lower in the HA Collar Group when compared with the Noncollar Group (p = 0.001). Results showed an increase in cortical bone loss at the bone-shoulder implant junction in the Noncollar Group when compared with the HA Collar Group (p < 0.001). CONCLUSIONS Osteointegration at the implant collar resulted in fewer radiolucent lines adjacent to the intramedullary cemented stem and decreased cortical bone loss immediately adjacent to the transection site. These results suggest that the HA collar may help reduce the risk of aseptic loosening in patients with this type of implant, but longer followup and a larger prospective comparison series are necessary to prove this more definitively.
Collapse
Affiliation(s)
- Melanie J. Coathup
- />John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, London, UK , />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| | | | - William J. Aston
- />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| | - Panagiotis D. Gikas
- />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| | - Robin C. Pollock
- />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| | - Stephen R. Cannon
- />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| | - John A. Skinner
- />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| | - Timothy W. R. Briggs
- />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| | - Gordon W. Blunn
- />John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, London, UK , />The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP UK
| |
Collapse
|
24
|
Batta V, Coathup MJ, Parratt MT, Pollock RC, Aston WJ, Cannon SR, Skinner JA, Briggs TW, Blunn GW. Uncemented, custom-made, hydroxyapatite-coated collared distal femoral endoprostheses: up to 18 years' follow-up. Bone Joint J 2014; 96-B:263-9. [PMID: 24493195 DOI: 10.1302/0301-620x.96b2.32091] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We reviewed the outcome of 69 uncemented, custom-made, distal femoral endoprosthetic replacements performed in 69 patients between 1994 and 2006. There were 31 women and 38 men with a mean age at implantation of 16.5 years (5 to 37). All procedures were performed for primary malignant bone tumours of the distal femur. At a mean follow-up of 124.2 months (4 to 212), 53 patients were alive, with one patient lost to follow-up. All nine implants (13.0%) were revised due to aseptic loosening at a mean of 52 months (8 to 91); three implants (4.3%) were revised due to fracture of the shaft of the prosthesis and three patients (4.3%) had a peri-prosthetic fracture. Bone remodelling associated with periosteal cortical thinning adjacent to the uncemented intramedullary stem was seen in 24 patients but this did not predispose to failure. All aseptically loose implants in this series were diagnosed to be loose within the first five years. The results from this study suggest that custom-made uncemented distal femur replacements have a higher rate of aseptic loosening compared to published results for this design when used with cemented fixation. Loosening of uncemented replacements occurs early indicating that initial fixation of the implant is crucial.
Collapse
Affiliation(s)
- V Batta
- University College London, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Ghani Y, Coathup MJ, Hing KA, Blunn GW. Antibacterial effect of incorporating silver ions in electrochemically deposited hydroxyapatite coating: An experimental study. JRSM Short Rep 2013; 4:2042533313481212. [PMID: 24040499 PMCID: PMC3767068 DOI: 10.1177/2042533313481212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yaser Ghani
- The John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, The Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK; Department of Materials and IRC in Biomedical Materials, School of Engineering and Materials, Queen Mary University of London, Mile End Road, London E1 4NS, UK
| | | | | | | |
Collapse
|
26
|
Coathup MJ, Cai Q, Campion C, Buckland T, Blunn GW. The effect of particle size on the osteointegration of injectable silicate-substituted calcium phosphate bone substitute materials. J Biomed Mater Res B Appl Biomater 2013; 101:902-10. [PMID: 23362131 PMCID: PMC4166705 DOI: 10.1002/jbm.b.32895] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 11/20/2012] [Accepted: 12/20/2012] [Indexed: 12/12/2022]
Abstract
Calcium phosphate (CaP) particles as a carrier in an injectable bone filler allows less invasive treatment of bony defects. The effect of changing granule size within a poloxamer filler on the osteointegration of silicate-substituted calcium phosphate (SiCaP) bone substitute materials was investigated in an ovine critical-sized femoral condyle defect model. Treatment group (TG) 1 consisted of SiCaP granules sized 1000–2000 μm in diameter (100 vol %). TG2 investigated a granule size of 250–500 μm (75 vol %), TG3 a granule size of 90–125 μm (75 vol %) and TG4 a granule size of 90–125 μm (50 vol %). Following a 4 and 8 week in vivo period, bone area, bone-implant contact, and remaining implant area were quantified within each defect. At 4 weeks, significantly increased bone formation was measured in TG2 (13.32% ± 1.38%) when compared with all other groups (p = 0.021 in all cases). Bone in contact with the bone substitute surface was also significantly higher in TG2. At 8 weeks most new bone was associated within defects containing the smallest granule size investigated (at the lower volume) (TG4) (42.78 ± 3.36%) however this group was also associated with higher amounts of fragmented SiCaP. These smaller particles were phagocytosed by macrophages and did not appear to have a negative influence on healing. In conclusion, SiCaP granules of 250–500 μm in size may be a more suitable scaffold when used as an injectable bone filler and may be a convenient method for treating bony defects. © 2013 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 101B: 902–910, 2013
Collapse
Affiliation(s)
- Melanie J Coathup
- Division of Surgery and Interventional Science, John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore Middlesex, HA7 4LP, UK.
| | | | | | | | | |
Collapse
|
27
|
Coathup MJ, Kalia P, Konan S, Mirza K, Blunn GW. A comparison of allogeneic and autologous mesenchymal stromal cells and osteoprogenitor cells in augmenting bone formation around massive bone tumor prostheses. J Biomed Mater Res A 2012; 101:2210-8. [DOI: 10.1002/jbm.a.34536] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 10/10/2012] [Accepted: 11/19/2012] [Indexed: 11/08/2022]
|
28
|
Chan O, Coathup MJ, Nesbitt A, Ho CY, Hing KA, Buckland T, Campion C, Blunn GW. The effects of microporosity on osteoinduction of calcium phosphate bone graft substitute biomaterials. Acta Biomater 2012; 8:2788-94. [PMID: 22475784 DOI: 10.1016/j.actbio.2012.03.038] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/23/2012] [Accepted: 03/26/2012] [Indexed: 11/17/2022]
Abstract
The effect of increasing strut porosity on the osteoinductive ability of silicate substituted calcium phosphate (SiCaP) biomaterials was investigated in an ectopic ovine model. Implants with strut porosities of 22.5%, 32.0% and 46.0% were inserted into the parapsinalis muscle. At 8, 12 and 24 weeks histological sections were prepared. Sections were examined using backscattered scanning electron microscopy and un-decalcified histology. Bone area, implant area and bone-implant contact were quantified. At 8 weeks there was no significant difference between the groups in terms of bone area and implant area. However at 12 weeks, the amount of bone formation observed was significantly greater in SiCaP-46 (6.17 ± 1.51%) when compared with SiCaP-22.5 (1.33 ± 0.84%) p=0.035. Results also showed significantly increased amounts of bone-implant contact to the SiCaP-46 scaffold (3.30 ± 1.17%) compared with SiCaP-22.5 (0.67 ± 0.52%, p=0.043) at 8 weeks and 12 weeks; (SiCaP-46 (21.82 ± 5.59%) vs SiCaP-22.5 (3.06 ± 1.89%), p=0.012). At 24 weeks, bone formation and graft resorption had significantly increased in all groups so that the level of bone formation in the SiCaP-46 group had increased 75-fold to 30.05 ± 8.38%. Bone formation was observed in pores <10 μm. Results suggest that bone graft substitute materials with greater strut porosity are more osteoinductive.
Collapse
Affiliation(s)
- O Chan
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Coathup MJ, Hing KA, Samizadeh S, Chan O, Fang YS, Campion C, Buckland T, Blunn GW. Effect of increased strut porosity of calcium phosphate bone graft substitute biomaterials on osteoinduction. J Biomed Mater Res A 2012; 100:1550-5. [DOI: 10.1002/jbm.a.34094] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 01/12/2012] [Accepted: 01/17/2012] [Indexed: 11/12/2022]
|
30
|
Ghani Y, Coathup MJ, Hing KA, Blunn GW. Development of a hydroxyapatite coating containing silver for the prevention of peri-prosthetic infection. J Orthop Res 2012; 30:356-63. [PMID: 21901753 DOI: 10.1002/jor.21543] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 08/11/2011] [Indexed: 02/04/2023]
Abstract
We hypothesized that the electrochemical deposition of hydroxyapatite (EHA) can be used to incorporate silver (Ag), providing a controlled and sustained release of Ag ions at a bactericidal concentration. Six groups were investigated: electrochemical co-precipitation of HA and Ag (EHA/Ag); EHA pre-coated discs treated in AgN0(3) (EHA/AgN0(3)); plasma sprayed HA (PHA) pre-coated discs treated in AgN0(3) (PHA/AgN0(3)); EHA with 2 "layers" of Ag (EHA/Ag/2 layers); EHA coating only; and PHA coating only. Scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) and X-ray diffraction (XRD) analyses quantified coating thickness, calcium/phosphorous ratio, and % atomic silver content, respectively. Inductively coupled plasma-mass spectrometry quantified the amount of Ag released in phosphate-buffered saline, and zone of inhibition tests on agar plates using a lawn of Staph aureus were quantified in each group. XRD and EDX analysis confirmed the presence of Ag in all coatings. EHA coated discs with two layers of Ag and the EHA discs soaked in AgN0(3) showed significantly higher zones of inhibition at all time points when compared with all other groups (except PHA/AgN0(3) on day 0). This study demonstrated that Ag ions can be incorporated into a HA coating using an electrochemical technique.
Collapse
Affiliation(s)
- Yaser Ghani
- The John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, The Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | | | | | | |
Collapse
|
31
|
Abstract
BACKGROUND The osteoinductivity of silicate-substituted calcium phosphate and stoichiometric calcium phosphate was investigated with use of ectopic implantation. Implants with a macroporosity of 80% and a strut porosity of 30% were inserted into sites located in the left and right paraspinal muscles of six female sheep. METHODS After twelve weeks in vivo, a longitudinal thin section was prepared through the center of each implant. Bone formation within the implant, bone formation in contact with the implant surface, and implant resorption were quantified with use of a line intersection method. The specimens were also analyzed with use of backscattered scanning electron microscopy and energy-dispersive x-ray analysis. RESULTS Silicate substitution had a significant effect on the formation of bone both within the implant and on the implant surface during the twelve-week period. Bone area within the implant was greater in the silicate-substituted calcium phosphate group (mean, 7.65% ± 3.2%) than in the stoichiometric calcium phosphate group (0.99% ± 0.9%, p = 0.01). The amount of bone formed at the surface of the implant was also significantly greater in the silicate-substituted calcium phosphate group (mean, 26.00% ± 7.8%) than in the stoichiometric calcium phosphate group (2.2% ± 2.0%, p = 0.01). Scanning electron microscopy demonstrated bone formation within pores that were <5 μm in size, and energy-dispersive x-ray analysis confirmed the presence of silicon within the new bone in the silicate-substituted calcium phosphate group. CONCLUSIONS The formation of bone within muscle during the twelve-week period showed both silicate-substituted calcium phosphate and stoichiometric calcium phosphate to be osteoinductive in an ovine model. Silicate substitution significantly increased the amount of bone that formed and the amount of bone attached to the implant surface. New bone formation occurred through an intramembranous process within the implant structure.
Collapse
Affiliation(s)
- Melanie J Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, United Kingdom.
| | | | | | | | | | | |
Collapse
|
32
|
Goodship AE, Blunn GW, Green J, Coathup MJ. Prevention of strain-related osteopenia in aseptic loosening of hip prostheses using perioperative bisphosphonate. J Orthop Res 2008; 26:693-703. [PMID: 18050308 DOI: 10.1002/jor.20533] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The hypothesis tested in this study was that perioperative administration of the bisphosphonate zoledronate will reduce strain protection-related calcar osteopenia and maintain functional integration of the femoral component in an ovine hemiarthroplasty model. Twelve sheep received a unilateral cemented hemiarthroplasty where six animals were given nine intravenous infusions of zoledronate (10 microg/kg) pre-, peri-, and postsurgery over 8 months. Control animals received physiological saline only. Implants remained in vivo for 9 months. Ground reaction force (GRF) was used to assess functional loading of the implanted limb, bone mineral density (BMD) was quantified using dual energy X-ray absorptiometry (DEXA). Cortical bone area, thickness, and viable osteocytes were assessed histologically. No significant differences in GRF data between groups was identified. Results demonstrated a significant drop in BMD values in the control group (9.7%) when compared with the bisphosphonate-treated group (3.2%) (p = 0.0159). Histological results showed that cortical area, thickness, and the percentage of lacunae with viable osteocytes was significantly greater in the bisphosphonate-treated group when compared with control (p = 0.002, p = 0.001, p = 0.003, respectively). The administration of zoledronate reduced cortical osteopenia in the calcar region of the proximal femur and this therapy could be used as a preventive measure to combat strain protection osteopenia and its contribution to associated aseptic loosening in total hip replacement surgery.
Collapse
Affiliation(s)
- Allen E Goodship
- The Institute of Orthopaedics and Musculoskeletal Science, University College London, The Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | | | | | | |
Collapse
|
33
|
Kalia P, Blunn GW, Miller J, Bhalla A, Wiseman M, Coathup MJ. Do Autologous Mesenchymal Stem Cells Augment Bone Growth and Contact to Massive Bone Tumor Implants? ACTA ACUST UNITED AC 2006; 12:1617-26. [PMID: 16846357 DOI: 10.1089/ten.2006.12.1617] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study investigated the hypothesis that spraying autologous mesenchymal stem cells (MSCs) onto grooved hydroxyapatite (HA) coated collars of segmental bone tumor implants would increase bone growth and contact to the implant surface in an ovine model. Autologous MSCs were isolated from bone marrow, grown in culture and during surgery implants in group 1 were sprayed with MSCs, suspended within fibrin glue. Implants in group 2 received no MSC therapy and acted as control. Implants remained in vivo for 6 months. New bone area and contact to the implant was quantified on radiographs and histologically. Radiographic analysis demonstrated greater total bone area in the MSC treated group in both ML (MSC = 79.738 mm2 +/- 22.964; control = 30.135 mm2 +/- 6.717) (p = 0.018) and AP (MSC = 90.338 +/- 19.361 mm2; control = 57.384 +/- 9.035 mm2 (p = 0.074) radiographs at 6 months. Results demonstrated significantly increased bone growth in the MSC group at 2 (p = 0.03) and 3 months (p < 0.05). Histological analysis demonstrated significantly greater bone area adjacent to the collars in the treated group (53.994 +/- 10.641 mm2) when compared with the control group 21.069 +/- 7.339 mm2 (p = 0.020). Increased bone contact in the MSC group (19.833 +/- 8.729 %) was observed when compared with controls (8.667 +/- 8.667%). This novel application of spraying MSCs onto the implant surface has significant implications for the future of successful implant fixation.
Collapse
Affiliation(s)
- Priya Kalia
- The Centre for Biomedical Engineering, Institute of Orthopaedics and Musculo-Skeletal Science, University College London, The Royal National Orthopaedic Hospital Trust, Middlesex, UK
| | | | | | | | | | | |
Collapse
|
34
|
Lee OK, Coathup MJ, Goodship AE, Blunn GW. Use of Mesenchymal Stem Cells to Facilitate Bone Regeneration in Normal and Chemotherapy-Treated Rats. ACTA ACUST UNITED AC 2005; 11:1727-35. [PMID: 16411818 DOI: 10.1089/ten.2005.11.1727] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Reconstructing segmental bone defects after resection of malignant bone tumors is a long-standing clinical problem. Treatment of bone tumors such as osteosarcoma involves chemotherapy. These chemotherapeutic agents are potent inhibitors of cell division and these drugs may affect regeneration of bone from osteoprogenitor cells. It may be possible to reconstruct segmental bone defects by a tissue-engineering approach. The aim of this study was to investigate the use of mesenchymal stem cells (MSCs) in a fibrin glue carrier to enhance bone regeneration after chemotherapy. Bone marrow was harvested from young adult male rats of the Wistar strain; stem cells were isolated and expanded. Bone regeneration in normal and chemotherapy-treated rats was investigated in 1.5-mm rat femoral defects created by osteotomizing the femur and stabilizing the femoral fragments by external fixation. The osteotomy gap was left either unfilled, filled with fibrin glue alone, or filled with glue containing stem cells. Bone formation within the gap was determined by radiography, dual-energy X-ray absorptiometry, and histology. It was shown that MSCs encapsulated within fibrin glue could remain viable for up to 96 h in tissue culture. Chemotherapy significantly reduced bone formation in unfilled defects and defects filled only with fibrin glue. When MSCs were used in conjunction with fibrin glue, even in non-chemotherapy-treated rats bone formation in the gap was significantly increased. Using stem cells, the effects of chemotherapy on bone formation could be alleviated by bone formation in the gap similar to that seen in non-chemotherapy-treated animals with MSCs. These studies demonstrated that a tissue-engineering approach in patients undergoing chemotherapy may be beneficial for treating segmental bone defects after tumor resection.
Collapse
Affiliation(s)
- O K Lee
- Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei and School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | | | | |
Collapse
|
35
|
Porter AE, Taak P, Hobbs LW, Coathup MJ, Blunn GW, Spector M. Bone bonding to hydroxyapatite and titanium surfaces on femoral stems retrieved from human subjects at autopsy. Biomaterials 2004; 25:5199-208. [PMID: 15109844 DOI: 10.1016/j.biomaterials.2003.12.018] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2003] [Accepted: 12/07/2003] [Indexed: 11/19/2022]
Abstract
The success of clinical results obtained with many hydroxyapatite (HA)-coated prosthetic designs has deflected attention from the need to extend the life of the HA coating on the device. In the current study the percentages of HA and titanium surfaces to which bone was bonded, on HA-coated and non-coated titanium femoral stems retrieved from human subjects, were evaluated. Plasma-sprayed hydroxyapatite (PSHA)-coated devices demonstrated wide variability in the percentage of the PSHA coating remaining on the stems. The coating was missing from a substantial portion of a stem after only about 6 months of implantation. The percentage of revealed metal to which bone was bonded was significantly less than the percentage of the HA coating demonstrating such bonding. The revealed metal to which bone was bonded was comparable to the same value for a separate group of non-PSHA-coated titanium stems. If HA-coatings degrade over time precipitous decline in performance may occur even after several functional years. Many ultrastructural features of the bone bonded to the HA coatings on these implants from human subjects were comparable to those found on HA-coated devices implanted in a canine model.
Collapse
Affiliation(s)
- Alexandra E Porter
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge MA 02139, USA.
| | | | | | | | | | | |
Collapse
|
36
|
Coathup MJ, Blunn GW, Flynn N, Williams C, Thomas NP. A comparison of bone remodelling around hydroxyapatite-coated, porous-coated and grit-blasted hip replacements retrieved at post-mortem. J Bone Joint Surg Br 2001; 83:118-23. [PMID: 11245519 DOI: 10.1302/0301-620x.83b1.10062] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We investigated the implant-bone interface around one design of femoral stem, proximally coated with either a plasma-sprayed porous coating (plain porous) or a hydroxyapatite porous coating (porous HA), or which had been grit-blasted (Interlok). Of 165 patients implanted with a Bimetric hip hemiarthroplasty (Biomet, Bridgend, UK) specimens were retrieved from 58 at post-mortem. We estimated ingrowth and attachment of bone to the surface of the implant in 21 of these, eight plain porous, seven porous HA and six Interlok, using image analysis and light morphometric techniques. The amount of HA coating was also quantified. There was significantly more ingrowth (p = 0.012) and attachment of bone (p < 0.05) to the porous HA surface (mean bone ingrowth 29.093 +/- 2.019%; mean bone attachment 37.287 +/- 2.489%) than to the plain porous surface (mean bone ingrowth 21.762 +/- 2.068%; mean bone attachment 18.9411 +/- 1.971%). There was no significant difference in attachment between the plain porous and Interlok surfaces. Bone grew more evenly over the surface of the HA coating whereas on the porous surface, bone ingrowth and attachment occurred more on the distal and medial parts of the coated surface. No significant differences in the volume of HA were found with the passage of time. This study shows that HA coating increases the amount of ingrowth and attachment of bone and leads to a more even distribution of bone over the surface of the implant. This may have implications in reducing stress shielding and limiting osteolysis induced by wear particles.
Collapse
Affiliation(s)
- M J Coathup
- Centre for Biomedical Engineering, University College of London, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | | | | | | | | |
Collapse
|
37
|
Abstract
This study investigated the concept of using plates to attach endoprostheses to bone after segmental resection for bone tumours in an animal model. Titanium alloy plates integrated with the prosthesis and coated with hydroxyapatite were attached to bone by screws. This type of uncemented fixation relied on the induction of periosteal bone formation into and around the plates to secure the implant to bone. Two, three, and six-slotted plate designs were investigated. On retrieval, each plate was securely fixed by new bone. Bone apposition on the external surface of the plates occurred through a combination of periosteal bone production, invasion of bone through slots in the plate, and bone growth over the ends of the plates. Most plates became incorporated into a remodelled cortex. Higher bone turnover rates (microm day(-1)) were seen in bone in the slots of the plate compared with normal cortical bone turnover (p < 0.05). Significantly higher rates of turnover were measured beneath slotted parts of the plates compared with regions below the unslotted parts (p < 0.05). The cross-sectional area of bone surrounding the six-plate implant design was significantly higher than that of the three-plate (p < 0.05) and two-plate (p < 0.05) designs. In addition, significantly more bone formed adjacent to the six-plated implant design compared with that in the contralateral limb (p = 0.002). However, no significant difference was found when the total cortical area around the three-plated design was compared with that of the contralateral limb (p = 0.63). In contrast, significantly less bone was measured adjacent to the two-plate design than in the untreated limb (p = 0.001). Image analysis also demonstrated increased cortical porosity adjacent to the six-plate design compared with the three-plate (p = 0.004) and two-plate (p < 0.05) designs. Finite element analysis demonstrated that the six and three-plate designs increased the second moment of area compared with that in the left tibia (p = 0.003 and 0.066, respectively). However, the attachment of the more flexible two-plate design did not significantly increase the second moment of area compared with that in the contralateral limb (p = 0.235). It was concluded that due to both mechanical and biological effects, the hydroxyapatite-coated plate designs generated new bone that enhanced fixation and encouraged plate integration into the load-bearing structure of the cortex. This method of fixation may be an alternative to the use of intramedullary cemented stems in patients requiring bone tumour implants and may be the only way to preserve the joint in difficult cases where only short segments of bone remain.
Collapse
Affiliation(s)
- M J Coathup
- Centre for Biomedical Engineering, University College London, The Royal National Orthopaedic Hospital Trust, Stanmore, England
| | | | | | | |
Collapse
|
38
|
Coathup MJ, Bates P, Cool P, Walker PS, Blumenthal N, Cobb JP, Blunn GW. Osseo-mechanical induction of extra-cortical plates with reference to their surface properties and geometric designs. Biomaterials 1999; 20:793-800. [PMID: 10353662 DOI: 10.1016/s0142-9612(98)00239-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this investigation was to determine which geometric and surface properties encouraged optimal ingrowth and bonding of bone to an extra-cortical plate. Forty-eight titanium extra-cortical plates were attached onto the left and right femora of adult rabbits. The plates were of six different designs and the osseoconductive effects of four surfaces were examined. A roughened titanium surface, a plasma sprayed HA coating of low crystallinity (57%) and a solution precipitated calcium phosphate coating were compared with a plasma sprayed crystalline hydroxyapatite coating (crystallinity 85%). Thin sections were prepared by grinding and polishing. Bone formation and the interface around the plates were investigated histologically and computer and morphometric analyses were used to quantify new bone formation, bone apposition onto the plate, bone porosity and the condition of the HA coating. The study found that a hydroxyapatite coating (with the exception of the solution precipitated coating) had significantly greater interfacial contact with bone when compared to a roughened titanium surface, and that significantly more bone attached to a crystalline HA coating compared with the HA coating of lower crystallinity although significantly more bone formed in the vicinity of the lower crystalline HA coating. Differences in the bony reaction induced by the various geometric designs were evident and the optimal plate design requires either holes or slots along its length as this encouraged bone ingrowth into the plate.
Collapse
Affiliation(s)
- M J Coathup
- Centre for Biomedical Engineering, University College London, Royal National Orthopaedic Hospital Trust, Stanmore, UK
| | | | | | | | | | | | | |
Collapse
|