1
|
Liu W, Wang D, He G, Li T, Zhang X. A novel porous titanium with engineered surface for bone defect repair in load-bearing position. J Biomed Mater Res A 2024; 112:1083-1092. [PMID: 38411355 DOI: 10.1002/jbm.a.37689] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/28/2024]
Abstract
Porous titanium exhibits low elastic modulus and porous structure is thought to be a promising implant in bone defect repair. However, the bioinert and low mechanical strength of porous titanium have limited its clinical application, especially in load-bearing bone defect repair. Our previous study has reported an infiltration casting and acid corrosion (IC-AC) method to fabricate a novel porous titanium (pTi) with 40% porosity and 0.4 mm pore diameter, which exerts mechanical property matching with cortical bone and interconnected channels. In this study, we introduced a nanoporous coating and incorporated an osteogenic element strontium (Sr) on the surface of porous titanium (named as Sr-micro arch oxidation [MAO]) to improve the osteogenic ability of the pTi by MAO. Better biocompatibility of Sr-MAO was verified by cell adhesion experiment and cell counting kit-8 (CCK-8) test. The in vitro osteogenic-related tests such as immunofluorescence staining, alkaline phosphatase staining and real-time polymerase chain reaction (RT-PCR) demonstrated better osteogenic ability of Sr-MAO. Femoral bone defect repair model was employed to evaluate the osseointegration of samples in vivo. Results of micro-CT scanning, sequential fluorochrome labeling and Van Gieson staining suggested that Sr-MAO showed better in vivo osteogenic ability than other groups. Taking results of both in vitro and in vivo experiment together, this study indicated the Sr-MAO porous titanium could be a promising implant load-bearing bone defect.
Collapse
Affiliation(s)
- Wei Liu
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Wang
- School of Mechanical and Electrical Engineering, Henan University of Technology, Zhengzhou, China
| | - Guo He
- State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Tingting Li
- Department of Infection Disease, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xianlong Zhang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
2
|
Civantos A, Mesa-Restrepo A, Torres Y, Shetty AR, Cheng MK, Jaramillo-Correa C, Aditya T, Allain JP. Nanotextured porous titanium scaffolds by argon ion irradiation: Toward conformal nanopatterning and improved implant osseointegration. J Biomed Mater Res A 2023; 111:1850-1865. [PMID: 37334879 DOI: 10.1002/jbm.a.37582] [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: 12/03/2022] [Revised: 04/29/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
Stress shielding and osseointegration are two main challenges in bone regeneration, which have been targeted successfully by chemical and physical surface modification methods. Direct irradiation synthesis (DIS) is an energetic ion irradiation method that generates self-organized nanopatterns conformal to the surface of materials with complex geometries (e.g., pores on a material surface). This work exposes porous titanium samples to energetic argon ions generating nanopatterning between and inside pores. The unique porous architected titanium (Ti) structure is achieved by mixing Ti powder with given amounts of spacer NaCl particles (vol % equal to 30%, 40%, 50%, 60%, and 70%), compacted and sintered, and combined with DIS to generate a porous Ti with bone-like mechanical properties and hierarchical topography to enhance Ti osseointegration. The porosity percentages range between 25% and 30% using 30 vol % NaCl space-holder (SH) volume percentages to porosity rates of 63%-68% with SH volume of 70 vol % NaCl. Stable and reproducible nanopatterning on the flat surface between pores, inside pits, and along the internal pore walls are achieved, for the first time on any porous biomaterial. Nanoscale features were observed in the form of nanowalls and nanopeaks of lengths between 100 and 500 nm, thicknesses of 35-nm and heights between 100 and 200 nm on average. Bulk mechanical properties that mimic bone-like structures were observed along with increased wettability (by reducing contact values). Nano features were cell biocompatible and enhanced in vitro pre-osteoblast differentiation and mineralization. Higher alkaline phosphatase levels and increased calcium deposits were observed on irradiated 50 vol % NaCl samples at 7 and 14 days. After 24 h, nanopatterned porous samples decreased the number of attached macrophages and the formation of foreign body giant cells, confirming nanoscale tunability of M1-M2 immuno-activation with enhanced osseointegration.
Collapse
Affiliation(s)
- Ana Civantos
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Nick Holonyak, Jr., Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Andrea Mesa-Restrepo
- Department of Biomedical Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | - Yadir Torres
- Department of Engineering and Materials Science and Transport, University of Seville, Seville, Spain
| | - Akshath R Shetty
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ming Kit Cheng
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Camilo Jaramillo-Correa
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- The Ken and Mary Alice Lindquist Department of Nuclear Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | - Teresa Aditya
- The Ken and Mary Alice Lindquist Department of Nuclear Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | - Jean Paul Allain
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Nick Holonyak, Jr., Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Department of Biomedical Engineering, Pennsylvania State University, State College, Pennsylvania, USA
- The Ken and Mary Alice Lindquist Department of Nuclear Engineering, Pennsylvania State University, State College, Pennsylvania, USA
- Department of Materials Science and Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| |
Collapse
|
3
|
Tan L, Li Y, Hu X, Lu M, Zhang Y, Gan Y, Tu C, Min L. Clinical evaluation of the three-dimensional printed strut-type prosthesis combined with autograft reconstruction for giant cell tumor of the distal femur. Front Oncol 2023; 13:1206765. [PMID: 37675226 PMCID: PMC10479807 DOI: 10.3389/fonc.2023.1206765] [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: 04/16/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023] Open
Abstract
Propose This study aimed to describe the design and surgical techniques of a three-dimensional (3D) printed strut-type prosthesis with a porous titanium surface for distal femur giant cell tumors of bone (GCTB) and evaluate the short-term clinical outcomes. Methods From June 2018 to January 2021, 9 consecutive patients with grade I or II GCTB in the distal femur underwent extended intralesional curettage followed by 3D-printed strut-type prosthesis combined with autograft reconstruction were retrospectively reviewed to assess their clinical and radiographic outcomes. Results All patients were followed up for 30.8 ± 7.5 months (18-42 months) after surgery. The mean affected subchondral bone percentage and the mean subchondral bone thickness before surgery was 31.8% ± 9.6% (range, 18.2% ~50.2%) and 2.2 ± 0.8 mm (range, 1.2-4.0 mm), respectively. At the final follow-up, all the patients were alive without local recurrence; no postoperative complications were observed. Patients had significant improvements in postoperative MSTS-93 score [(26.7 ± 2.4) vs. (18.8 ± 3.7), P < 0.05], and ROM [(122.8° ± 9.1°) vs. (108.3° ± 6.1°), P < 0.05] compared with their preoperative statuses. Furthermore, the mean subchondral bone thickness has increased to 10.9 ± 1.3 mm (range, 9.1-12.1 mm). Conclusion 3D-printed strut-type prosthesis combined with autograft reconstruction provides acceptable early functional and radiographic outcomes in patients with grade I or II GCTB in distal femur due to the advantages of the prosthesis such as good biocompatibility, osseointegration capacity, and subchondral bone protection. If our early outcomes can be further validated in studies with more patients and sufficient follow-up, this method may be evaluated as an alternative for the treatment of grade I or II GCTB in the distal femur.
Collapse
Affiliation(s)
- Linyun Tan
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
- Department of Model Worker and Innovative Craftsman, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Li
- Department of Orthopedics, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xin Hu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
- Department of Model Worker and Innovative Craftsman, West China Hospital, Sichuan University, Chengdu, China
| | - Minxun Lu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
- Department of Model Worker and Innovative Craftsman, West China Hospital, Sichuan University, Chengdu, China
| | - Yuqi Zhang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
- Department of Model Worker and Innovative Craftsman, West China Hospital, Sichuan University, Chengdu, China
| | - Yuxiong Gan
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
| | - Chongqi Tu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
- Department of Model Worker and Innovative Craftsman, West China Hospital, Sichuan University, Chengdu, China
| | - Li Min
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
- Department of Model Worker and Innovative Craftsman, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
4
|
Vautrin A, Aw J, Attenborough E, Varga P. Fatigue life of 3D-printed porous titanium dental implants predicted by validated finite element simulations. Front Bioeng Biotechnol 2023; 11:1240125. [PMID: 37636001 PMCID: PMC10449641 DOI: 10.3389/fbioe.2023.1240125] [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: 06/14/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction: Porous dental implants represent a promising strategy to reduce failure rate by favoring osseointegration or delivering drugs locally. Incorporating porous features weakens the mechanical capacity of an implant, but sufficient fatigue strength must be ensured as regulated in the ISO 14801 standard. Experimental fatigue testing is a costly and time-intensive part of the implant development process that could be accelerated with validated computer simulations. This study aimed at developing, calibrating, and validating a numerical workflow to predict fatigue strength on six porous configurations of a simplified implant geometry. Methods: Mechanical testing was performed on 3D-printed titanium samples to establish a direct link between endurance limit (i.e., infinite fatigue life) and monotonic load to failure, and a finite element model was developed and calibrated to predict the latter. The tool was then validated by predicting the fatigue life of a given porous configuration. Results: The normalized endurance limit (10% of the ultimate load) was the same for all six porous designs, indicating that monotonic testing was a good surrogate for endurance limit. The geometry input of the simulations influenced greatly their accuracy. Utilizing the as-designed model resulted in the highest prediction error (23%) and low correlation between the estimated and experimental loads to failure (R2 = 0.65). The prediction error was smaller when utilizing specimen geometry based on micro computed tomography scans (14%) or design models adjusted to match the printed porosity (8%). Discussion: The validated numerical workflow presented in this study could therefore be used to quantitatively predict the fatigue life of a porous implant, provided that the effect of manufacturing on implant geometry is accounted for.
Collapse
Affiliation(s)
- Antoine Vautrin
- AO Research Institute Davos, Davos, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Jensen Aw
- Attenborough Dental Laboratories Ltd, Nottingham, United Kingdom
| | - Ed Attenborough
- Attenborough Dental Laboratories Ltd, Nottingham, United Kingdom
| | - Peter Varga
- AO Research Institute Davos, Davos, Switzerland
| |
Collapse
|
5
|
Markovsky PE, Janiszewski J, Stasiuk OO, Savvakin DG, Oryshych DV, Dziewit P. Mechanical Energy Absorption Ability of Titanium-Based Porous Structures Produced by Various Powder Metallurgy Approaches. Materials (Basel) 2023; 16:ma16093530. [PMID: 37176411 PMCID: PMC10180269 DOI: 10.3390/ma16093530] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
Porous materials are very efficient in absorbing mechanical energy, for instance, in combined armor, in order to improve the anti-ballistic protection characteristics. In the present study, porous titanium-based structures were manufactured via three different powder metallurgy methods using titanium hydride (TiH2) powder, which provided activated sintering, owing to dehydrogenation. The emission of hydrogen and shrinkage of powder particles on dehydrogenation also added an additional potential to control the sintering process and create desirable porosities. TiH2 powder was sintered with additions of NaCl or ammonium carbide as pore holding removable agents, while highly porous Ti-Al structures were formed via liquid phase reactive sintering of TiH2 and Al powders. The microstructures and porosities of sintered dehydrogenated titanium and Ti-Al structures were comparatively studied. Mechanical characteristics were evaluated using compression testing with strain rates varying from quasi-static to high levels. The resonant frequency method was also employed to determine damping parameters and elastic modulus of these materials. All testing methods were aimed at characterizing the energy-absorbing ability of the obtained porous structures. The desired strength, plasticity and energy-absorbing characteristics of porous titanium-based structures were assessed, and the possibilities of their application were also discussed. Based on the obtained results, it was found that porous titanium materials produced with the use of ammonium carbonate showed promising energy absorption properties.
Collapse
Affiliation(s)
- Pavlo E Markovsky
- G.V. Kurdyumov Institute for Metal Physics of N.A.S. of Ukraine, 36, Academician Vernadsky Boulevard, 03142 Kyiv, Ukraine
- Faculty of Mechatronics, Armament and Aerospace, Jarosław Dąbrowski Military University of Technology, 2, Gen. Sylwester Kaliski Str., 00-908 Warsaw, Poland
| | - Jacek Janiszewski
- Faculty of Mechatronics, Armament and Aerospace, Jarosław Dąbrowski Military University of Technology, 2, Gen. Sylwester Kaliski Str., 00-908 Warsaw, Poland
| | - Oleksandr O Stasiuk
- G.V. Kurdyumov Institute for Metal Physics of N.A.S. of Ukraine, 36, Academician Vernadsky Boulevard, 03142 Kyiv, Ukraine
| | - Dmytro G Savvakin
- G.V. Kurdyumov Institute for Metal Physics of N.A.S. of Ukraine, 36, Academician Vernadsky Boulevard, 03142 Kyiv, Ukraine
| | - Denys V Oryshych
- G.V. Kurdyumov Institute for Metal Physics of N.A.S. of Ukraine, 36, Academician Vernadsky Boulevard, 03142 Kyiv, Ukraine
| | - Piotr Dziewit
- Faculty of Mechatronics, Armament and Aerospace, Jarosław Dąbrowski Military University of Technology, 2, Gen. Sylwester Kaliski Str., 00-908 Warsaw, Poland
| |
Collapse
|
6
|
Liao TY, King PC, Zhu D, Crawford RJ, Ivanova EP, Thissen H, Kingshott P. Surface Characteristics and Bone Biocompatibility of Cold-Sprayed Porous Titanium on Polydimethylsiloxane Substrates. ACS Biomater Sci Eng 2023; 9:1402-1421. [PMID: 36813258 DOI: 10.1021/acsbiomaterials.2c01506] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 02/24/2023]
Abstract
A variant of the cold spray (CS) technique was applied for the functionalization of polymer-based materials such as polydimethylsiloxane (PDMS) to improve the extent of mammalian cell interactions with these substrates. This was demonstrated by the embedment of porous titanium (pTi) into PDMS substrates using a single-step CS technique. CS processing parameters such as gas pressure and temperature were optimized to achieve the mechanical interlocking of pTi in the compressed PDMS to fabricate a unique hierarchical morphology possessing micro-roughness. As evidenced by the preserved porous structure, the pTi particles did not undergo any significant plastic deformation upon impact with the polymer substrate. The thickness of the particle embedment layer was determined, by cross-sectional analysis, ranging from 120 μm to over 200 μm. The behavior of osteoblast-like cells MG63 coming into contact with the pTi-embedded PDMS was examined. The results showed that the pTi-embedded PDMS samples promoted 80-96% of cell adhesion and proliferation during the early stages of incubation. The low cytotoxicity of the pTi-embedded PDMS was confirmed, with cell viability of the MG63 cells being above 90%. Furthermore, the pTi-embedded PDMS facilitated the production of alkaline phosphatase and calcium deposition in the MG63 cells, as demonstrated by the higher amount of alkaline phosphatase (2.6 times) and calcium (10.6 times) on the pTi-embedded PDMS sample fabricated at 250 °C, 3 MPa. Overall, the work demonstrated that the CS process provided flexibility in the parameters used for the production of the modified PDMS substrates and is highly efficient for the fabrication of coated polymer products. The results obtained in this study suggest that a tailorable porous and rough architecture could be achieved that promoted osteoblast function, indicating that the method has promise in the design of titanium-polymer composite materials applied to biomaterials used in musculoskeletal applications.
Collapse
Affiliation(s)
- Tzu-Ying Liao
- School of Science, Computing & Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- Australian Research Council (ARC) Training Centre in Surface Engineering for Advanced Materials (SEAM), Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- CSIRO Manufacturing, Clayton, Victoria 3168, Australia
| | - Peter C King
- Australian Research Council (ARC) Training Centre in Surface Engineering for Advanced Materials (SEAM), Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- CSIRO Manufacturing, Clayton, Victoria 3168, Australia
| | - Deming Zhu
- School of Science, Computing & Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
| | - Russell J Crawford
- Australian Research Council (ARC) Training Centre in Surface Engineering for Advanced Materials (SEAM), Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- College of STEM, School of Science, RMIT University, Melbourne, Victoria 3000, Australia
| | - Elena P Ivanova
- Australian Research Council (ARC) Training Centre in Surface Engineering for Advanced Materials (SEAM), Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- College of STEM, School of Science, RMIT University, Melbourne, Victoria 3000, Australia
| | - Helmut Thissen
- Australian Research Council (ARC) Training Centre in Surface Engineering for Advanced Materials (SEAM), Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- CSIRO Manufacturing, Clayton, Victoria 3168, Australia
| | - Peter Kingshott
- School of Science, Computing & Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- Australian Research Council (ARC) Training Centre in Surface Engineering for Advanced Materials (SEAM), Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
| |
Collapse
|
7
|
Helvie PF, Deckard ER, Meneghini RM. Cementless Total Knee Arthroplasty Over the Past Decade: Excellent Survivorship in Contemporary Designs. J Arthroplasty 2023; 38:S145-S150. [PMID: 36791890 DOI: 10.1016/j.arth.2023.02.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Cementless fixation in total knee arthroplasty (TKA) is re-emerging due to improvements in biomaterials, surgical technique, and implant design. Albeit rare, failure of osseointegration typically occurs within the first 2 years, and limited data exist on survivorship of the modern cementless TKA designs. This study evaluated clinical survivorship of 2 contemporary cementless TKA designs at minimum 2-year follow-up. METHODS A total of 627 cementless TKAs were performed up to July 2022. Three hundred thirty-nine cases were eligible for 2-year follow-up. Indications centered around bone quality and involved predominantly younger patients. The 2 designs consisted of tibial components with a highly porous titanium ingrowth surface, a central keel, and peripheral cruciform pegs with a porous cobalt-chromium femur. Survivorship estimates were calculated using right-censored non-parametric Kaplan-Meier methodologies. A total of 226 TKAs obtained minimum 2-year follow-up with a mean of 3.6 years (range, 2 to 10). RESULTS The all-cause revision rate was 2.4% (8 of 339). The revision rate due to aseptic loosening was 0.6% (2 of 339) consisting of 2 femoral components. No tibial components were revised for aseptic loosening. Kaplan-Meier survivorship free from aseptic loosening was 99% (95% confidence interval 98 to 100) at a maximum of 10 years. CONCLUSION These results demonstrate encouraging survivorship of cementless fixation in primary TKA with use of contemporary ingrowth biomaterials and modern implant designs. This particular tibial implant design with a highly porous titanium fixation surface, central keel, and peripheral cruciform pegs demonstrated excellent clinical survivorship without failure which may portend superior fixation. LEVEL OF EVIDENCE IV-case series, no control group/historical control group.
Collapse
Affiliation(s)
- Peter F Helvie
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Evan R Deckard
- Indiana Joint Replacement Institute, Indianapolis, Indiana
| | - R Michael Meneghini
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana; Indiana Joint Replacement Institute, Indianapolis, Indiana
| |
Collapse
|
8
|
Xiao C, Zhang S, Gao Z, Tu C. Custom-made 3D-printed porous metal acetabular composite component in revision hip arthroplasty with Paprosky type III acetabular defects: A case report. Technol Health Care 2023; 31:283-291. [PMID: 35964214 DOI: 10.3233/thc-212984] [Citation(s) in RCA: 1] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND Increases in the numbers of surgical procedures for primary total hip arthroplasty (THA) inevitably lead to increases in the requirements for revision THA. The achievement of long-term stability is difficult or impossible by conventional implants in patients with severe destruction of the acetabulum. OBJECTIVE This case report presents a successful treatment using a specific three-dimensional (3D)-printed porous titanium acetabular composite component without a flange in the management of Paprosky type IIIB acetabular defects. METHOD A 65-year-old female diagnosed with right hip prosthetic loosening with a huge acetabular defect presented to our hospital. We designed the 3D model of the pelvis and created an individualized 3D-printed porous titanium acetabular composite component for revision THA. The procedure was performed through a posterolateral approach, and the component was implanted in the defect and fixed with cup screws using the drill guides. RESULTS At the last follow-up at 2 years, the patient had a satisfactory hip joint function and no signs of loosening or other complications were found. CONCLUSIONS The 3D-printed porous titanium acetabular composite component without a flange is showing promising clinical and radiological outcomes in the management of Paprosky type III acetabular defects.
Collapse
Affiliation(s)
- Cong Xiao
- Department of Orthopedics, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China.,Department of Orthopedics, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China
| | - Shaoyun Zhang
- Department of Orthopedics, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China.,Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Department of Orthopedics, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China
| | - Zhixiang Gao
- Department of Orthopedics, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
9
|
Mehdi-Sefiani H, Perez-Puyana V, Ostos FJ, Sepúlveda R, Romero A, Rafii-El-Idrissi Benhnia M, Chicardi E. Type-A Gelatin-Based Hydrogel Infiltration and Degradation in Titanium Foams as a Potential Method for Localised Drug Delivery. Polymers (Basel) 2023; 15. [PMID: 36679157 DOI: 10.3390/polym15020275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 12/31/2022] [Accepted: 01/01/2023] [Indexed: 01/06/2023] Open
Abstract
A gelatin-based hydrogel was infiltrated and degraded-released in two different titanium foams with porosities of 30 and 60 vol.% (Ti30 and Ti60 foams) and fabricated by the space holder technique to evaluate its potential to act as an innovative, alternative, and localised method to introduce both active pharmaceutical ingredients, such as antibiotics and non-steroidal anti-inflammatory drugs, and growth factors, such as morphogens, required after bone-tissue replacement surgeries. In addition, the kinetic behaviour was studied for both infiltration and degradation-release processes. A higher infiltration rate was observed in the Ti60 foam. The maximum infiltration hydrogel was achieved for the Ti30 and Ti60 foams after 120 min and 75 min, respectively. Further, both processes followed a Lucas-Washburn theoretical behaviour, typical for the infiltration of a fluid by capillarity in porous channels. Regarding the subsequent degradation-release process, both systems showed similar exponential degradation performance, with the full release from Ti60 foam (80 min), versus 45 min for Ti30, due to the greater interconnected porosity open to the surface of the Ti60 foam in comparison with the Ti30 foam. In addition, the optimal biocompatibility of the hydrogel was confirmed, with the total absence of cytotoxicity and the promotion of cell growth in the fibroblast cells evaluated.
Collapse
|
10
|
Accioni F, Rassu G, Begines B, Rodríguez-Albelo LM, Torres Y, Alcudia A, Gavini E. Novel Utilization of Therapeutic Coatings Based on Infiltrated Encapsulated Rose Bengal Microspheres in Porous Titanium for Implant Applications. Pharmaceutics 2022; 14:pharmaceutics14061244. [PMID: 35745816 PMCID: PMC9230760 DOI: 10.3390/pharmaceutics14061244] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 05/21/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023] Open
Abstract
Despite the increasing progress achieved in the last 20 years in both the fabrication of porous dental implants and the development of new biopolymers for targeting drug therapy, there are important issues such as bone resorption, poor osseointegration, and bacterial infections that remain as critical challenges to avoid clinical failure problems. In this work, we present a novel microtechnology based on polycaprolactone microspheres that can adhere to porous titanium implant models obtained by the spacer holder technique to allow a custom biomechanical and biofunctional balance. For this purpose, a double emulsion solvent evaporation technique was successfully employed for the fabrication of the microparticles properly loaded with the antibacterial therapeutic agent, rose bengal. The resulting microspheres were infiltrated into porous titanium substrate and sintered at 60 °C for 1 h, obtaining a convenient prophylactic network. In fact, the sintered polymeric microparticles were demonstrated to be key to controlling the drug dissolution rate and favoring the early healing process as consequence of a better wettability of the porous titanium substrate to promote calcium phosphate nucleation. Thus, this joint technology proposes a suitable prophylactic tool to prevent both early-stage infection and late-stage osseointegration problems.
Collapse
Affiliation(s)
- Francesca Accioni
- Departmento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (F.A.); (B.B.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giovanna Rassu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
- Correspondence: (G.R.); (A.A.)
| | - Belén Begines
- Departmento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (F.A.); (B.B.)
| | - Luisa Marleny Rodríguez-Albelo
- Departmento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41004 Sevilla, Spain; (L.M.R.-A.); (Y.T.)
| | - Yadir Torres
- Departmento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41004 Sevilla, Spain; (L.M.R.-A.); (Y.T.)
| | - Ana Alcudia
- Departmento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (F.A.); (B.B.)
- Correspondence: (G.R.); (A.A.)
| | - Elisabetta Gavini
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| |
Collapse
|
11
|
Malone H, Mundis GM, Collier M, Kidwell RL, Rios F, Jelousi M, Galli S, Shahidi B, Akbarnia BA, Eastlack RK. Can a bioactive interbody device reduce the cost burden of achieving lateral lumbar fusion? J Neurosurg Spine 2022; 37:1-8. [PMID: 36303478 DOI: 10.3171/2022.4.spine211070] [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: 08/11/2021] [Accepted: 04/05/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Intervertebral devices are increasingly utilized for fusion in the lumbar spine, along with a variety of bone graft materials. These various grafting materials often have substantial cost burdens for the surgical procedure, although they are necessary to overcome the limitations in healing capacity for many traditional interbody devices. The use of bioactive interbody fusion devices, which have demonstrable stimulatory capacity for the surrounding osteoblasts and osteoprogenitor cells and allow for osseointegration, may reduce this heavy reliance on osteobiologics for achieving interbody fusion. The objective of this study was to evaluate the rate of successful interbody fusion with a bioactive lateral lumbar interbody titanium implant with limited volume and low-cost graft material. METHODS The authors conducted a retrospective study (May 2017 to October 2018) of consecutively performed lateral lumbar interbody fusions with a bioactive 3D-printed porous titanium interbody device. Each interbody device was filled with 2-3 cm3/cage of a commercially available ceramic bone extender (β-tricalcium phosphate-hydroxyapatite) and combined with posterior pedicle screw fixation. No other biological agents or grafts were utilized. Demographic, clinical, and radiographic variables were captured. Fusion success was the primary endpoint of the study, with graft subsidence, fixation failure, and patient-reported outcomes (Oswestry Disability Index [ODI] and visual analog scale [VAS]-back and -leg pain scores) collected as secondary endpoints. The authors utilized a CT-based fusion classification system that accounted for both intervertebral through-growth (bone bridging) and ingrowth (integration of bone at the endplate-implant interface). RESULTS In total, 136 lumbar levels were treated in 90 patients. The mean age was 69 years, and 63% of the included patients were female. Half (50.0%) had undergone previous spinal surgery, and a third (33.7%) had undergone prior lumbar fusion. A third (33.7%) were treated at multiple levels (mean levels per patient 1.51). One year after surgery, the mean improvements in patient-reported outcomes (vs preoperative scores) were -17.8 for ODI (p < 0.0001), -3.1 for VAS-back pain (p < 0.0001), and -2.9 for VAS-leg pain (p < 0.0001). Bone bridging and/or appositional integrity was achieved in 99.3% of patients, including 97.8% who had complete bone bridging. No fixation loosening or implant failure was observed at any segment. Low-grade graft subsidence (Marchi grade ≤ I) occurred in 3 levels (2.2%), and intraoperative endplate violation occurred twice (1.5%). High-grade subsidence was not found. No implant failure or revision surgery for pseudarthrosis/subsidence was necessary. CONCLUSIONS The use of bioactive titanium interbody devices with a large surface footprint appears to result in a very high rate of effective fusion, despite the use of a small volume of low-cost biological material. This potential change in the osteobiologics required to achieve high fusion rates may have a substantially beneficial impact on the economic burden inherent to spinal fusion.
Collapse
Affiliation(s)
- Hani Malone
- 1Department of Neurosurgery, Scripps Clinic, San Diego
- 5San Diego Spine Foundation, San Diego, California
| | - Gregory M Mundis
- 2Department of Orthopedic Surgery, Scripps Clinic, San Diego
- 5San Diego Spine Foundation, San Diego, California
| | - Martin Collier
- 3Department of Orthopedic Surgery, Naval Medical Center, San Diego
- 5San Diego Spine Foundation, San Diego, California
| | - Reilly L Kidwell
- 1Department of Neurosurgery, Scripps Clinic, San Diego
- 5San Diego Spine Foundation, San Diego, California
| | - Fernando Rios
- 2Department of Orthopedic Surgery, Scripps Clinic, San Diego
- 5San Diego Spine Foundation, San Diego, California
| | - Michael Jelousi
- 2Department of Orthopedic Surgery, Scripps Clinic, San Diego
- 5San Diego Spine Foundation, San Diego, California
| | - Shae Galli
- 2Department of Orthopedic Surgery, Scripps Clinic, San Diego
- 5San Diego Spine Foundation, San Diego, California
| | - Bahar Shahidi
- 4Department of Orthopedic Surgery, University of California, San Diego; and
- 5San Diego Spine Foundation, San Diego, California
| | | | - Robert K Eastlack
- 2Department of Orthopedic Surgery, Scripps Clinic, San Diego
- 5San Diego Spine Foundation, San Diego, California
| |
Collapse
|
12
|
Knudsen MB, Thillemann JK, Jørgensen PB, Jakobsen SS, Daugaard H, Søballe K, Stilling M. Electrochemically applied hydroxyapatite on the cementless porous surface of Bi-Metric stems reduces early migration and has a lasting effect : an efficacy trial of a randomized five-year follow-up radiostereometric study. Bone Joint J 2022; 104-B:647-656. [PMID: 35638207 DOI: 10.1302/0301-620x.104b6.bjj-2021-1545.r1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS BoneMaster is a thin electrochemically applied hydroxyapatite (HA) coating for orthopaedic implants that is quickly resorbed during osseointegration. Early stabilization is a surrogacy marker of good survival of femoral stems. The hypothesis of this study was that a BoneMaster coating yields a fast early and lasting fixation of stems. METHODS A total of 53 patients were randomized to be treated using Bi-Metric cementless femoral stems with either only a porous titanium plasma-sprayed coating (P group) or a porous titanium plasma-sprayed coating with an additional BoneMaster coating (PBM group). The patients were examined with radiostereometry until five years after surgery. RESULTS At three months, the mean total translation (TT) was 0.95 mm (95% confidence interval (CI) 0.68 to 1.22) in the P group and 0.57 mm (95% CI 0.31 to 0.83) in the PBM group (p = 0.047). From two to five years, the TT increased by a mean of 0.14 mm (95% CI 0.03 to 0.25) more in the P group than in the PBM group (p = 0.021). In osteopenic patients (n = 20), the mean TT after three months was 1.61 mm (95% CI 1.03 to 2.20) in the P group and 0.73 mm (95% CI 0.25 to 1.21) in the PBM group (p = 0.023). After 60 months, the mean TT in osteopenic patients was 1.87 mm (95% CI 1.24 to 2.50) in the P group and 0.82 mm (95% CI 0.30 to 1.33) in the PBM group (p = 0.011). CONCLUSION There was less early and midterm migration of cementless stems with BoneMaster coating compared with those with only a porous titanium plasma-sprayed coating. Although a BoneMaster coating seems to be important for stem fixation, especially in osteopenic patients, further research is warranted. Cite this article: Bone Joint J 2022;104-B(6):647-656.
Collapse
Affiliation(s)
- Martin B Knudsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Janni K Thillemann
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.,Department of Orthopaedics, University Clinic for Hand, Hip and Knee Surgery, Gødstrup Hospital, Herning, Denmark
| | - Peter B Jørgensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Stig S Jakobsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Daugaard
- Department of Orthopaedics, Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark
| | - Kjeld Søballe
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Maiken Stilling
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.,Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
13
|
Wu MH, Lee MH, Wu C, Tsai PI, Hsu WB, Huang SI, Lin TH, Yang KY, Chen CY, Chen SH, Lee CY, Huang TJ, Tsau FH, Li YY. In Vitro and In Vivo Comparison of Bone Growth Characteristics in Additive-Manufactured Porous Titanium, Nonporous Titanium, and Porous Tantalum Interbody Cages. Materials (Basel) 2022; 15:ma15103670. [PMID: 35629694 PMCID: PMC9147460 DOI: 10.3390/ma15103670] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/04/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023]
Abstract
Autogenous bone grafts are the gold standard for interbody fusion implant materials; however, they have several disadvantages. Tantalum (Ta) and titanium (Ti) are ideal materials for interbody cages because of their biocompatibility, particularly when they are incorporated into a three-dimensional (3D) porous structure. We conducted an in vitro investigation of the cell attachment and osteogenic markers of self-fabricated uniform porous Ti (20%, 40%, 60%, and 80%), nonporous Ti, and porous Ta cages (n = 6) in each group. Cell attachment, osteogenic markers, and alkaline phosphatase (ALP) were measured. An in vivo study was performed using a pig-posterior-instrumented anterior interbody fusion model to compare the porous Ti (60%), nonporous Ti, and porous Ta interbody cages in 12 pigs. Implant migration and subsidence, determined using plain radiographs, were recorded before surgery, immediately after surgery, and at 1, 3, and 6 months after surgery. Harvested implants were assessed for bone ingrowth and attachment. Relative to the 20% and 40% porous Ti cages, the 60% and 80% cages achieved superior cellular migration into cage pores. Among the cages, osteogenic marker and ALP activity levels were the highest in the 60% porous Ti cage, osteocalcin expression was the highest in the nonporous Ti cage, and the 60% porous Ti cage exhibited the lowest subsidence. In conclusion, the designed porous Ti cage is biocompatible and suitable for lumbar interbody fusion surgery and exhibits faster fusion with less subsidence compared with porous Ta and nonporous Ti cages.
Collapse
Affiliation(s)
- Meng-Huang Wu
- Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan; (M.-H.W.); (C.-Y.C.); (C.-Y.L.); (T.-J.H.)
- Department of Orthopedics, Taipei Medical University Hospital, Taipei 110301, Taiwan
- TMU Biodesign Center, Taipei Medical University, Taipei 110301, Taiwan
| | - Ming-Hsueh Lee
- Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi 613016, Taiwan
| | - Christopher Wu
- College of Medicine, Taipei Medical University, Taipei 110301, Taiwan;
| | - Pei-I Tsai
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu County 310401, Taiwan; (P.-I.T.); (S.-I.H.); (K.-Y.Y.)
| | - Wei-Bin Hsu
- Sports Medicine Center, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
| | - Shin-I Huang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu County 310401, Taiwan; (P.-I.T.); (S.-I.H.); (K.-Y.Y.)
| | - Tzu-Hung Lin
- Material and Chemical Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu County 310401, Taiwan;
| | - Kuo-Yi Yang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu County 310401, Taiwan; (P.-I.T.); (S.-I.H.); (K.-Y.Y.)
| | - Chih-Yu Chen
- Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan; (M.-H.W.); (C.-Y.C.); (C.-Y.L.); (T.-J.H.)
- TMU Biodesign Center, Taipei Medical University, Taipei 110301, Taiwan
- Department of Orthopedics, Shuang-Ho Hospital, Taipei Medical University, Taipei 235041, Taiwan
| | - Shih-Hao Chen
- Department of Orthopedic Surgery, Buddhist Tzu-Chi General Hospital, Taichung Branch, Taichung 427213, Taiwan;
- Department of Orthopedic Surgery, Tzu-Chi University, Hualien 970374, Taiwan
| | - Ching-Yu Lee
- Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan; (M.-H.W.); (C.-Y.C.); (C.-Y.L.); (T.-J.H.)
- Department of Orthopedics, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Tsung-Jen Huang
- Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan; (M.-H.W.); (C.-Y.C.); (C.-Y.L.); (T.-J.H.)
- Department of Orthopedics, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Fang-Hei Tsau
- Laser and Additive Manufacturing Technology Center, Southern Region Campus, Industrial Technology Research Institute, Tainan 734045, Taiwan;
| | - Yen-Yao Li
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Correspondence: ; Tel.: +88653621000 (ext. 2855)
| |
Collapse
|
14
|
Beltrán AM, Giner M, Rodríguez Á, Trueba P, Rodríguez-Albelo LM, Vázquez-Gámez MA, Godinho V, Alcudia A, Amado JM, López-Santos C, Torres Y. Influence of Femtosecond Laser Modification on Biomechanical and Biofunctional Behavior of Porous Titanium Substrates. Materials (Basel) 2022; 15:2969. [PMID: 35591307 DOI: 10.3390/ma15092969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022]
Abstract
Bone resorption and inadequate osseointegration are considered the main problems of titanium implants. In this investigation, the texture and surface roughness of porous titanium samples obtained by the space holder technique were modified with a femtosecond Yb-doped fiber laser. Different percentages of porosity (30, 40, 50, and 60 vol.%) and particle range size (100–200 and 355–500 μm) were compared with fully-dense samples obtained by conventional powder metallurgy. After femtosecond laser treatment the formation of a rough surface with micro-columns and micro-holes occurred for all the studied substrates. The surface was covered by ripples over the micro-metric structures. This work evaluates both the influence of the macro-pores inherent to the spacer particles, as well as the micro-columns and the texture generated with the laser, on the wettability of the surface, the cell behavior (adhesion and proliferation of osteoblasts), micro-hardness (instrumented micro-indentation test, P–h curves) and scratch resistance. The titanium sample with 30 vol.% and a pore range size of 100–200 μm was the best candidate for the replacement of small damaged cortical bone tissues, based on its better biomechanical (stiffness and yield strength) and biofunctional balance (bone in-growth and in vitro osseointegration).
Collapse
|
15
|
Begines B, Arevalo C, Romero C, Hadzhieva Z, Boccaccini AR, Torres Y. Fabrication and Characterization of Bioactive Gelatin-Alginate-Bioactive Glass Composite Coatings on Porous Titanium Substrates. ACS Appl Mater Interfaces 2022; 14:15008-15020. [PMID: 35316017 PMCID: PMC8990524 DOI: 10.1021/acsami.2c01241] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
In this research work, the fabrication of biphasic composite implants has been investigated. Porous, commercially available pure Ti (50 vol % porosity and pore distributions of 100-200, 250-355, and 355-500 μm) has been used as a cortical bone replacement, while different composites based on a polymer blend (gelatin and alginate) and bioactive glass (BG) 45S5 have been applied as a soft layer for cartilage tissues. The microstructure, degradation rates, biofunctionality, and wear behavior of the different composites were analyzed to find the best possible coating. Experiments demonstrated the best micromechanical balance for the substrate containing 200-355 μm size range distribution. In addition, although the coating prepared from alginate presented a lower mass loss, the composite containing 50% alginate and 50% gelatin showed a higher elastic recovery, which entails that this type of coating could replicate the functions of the soft tissue in areas of the joints. Therefore, results revealed that the combinations of porous commercially pure Ti and composites prepared from alginate/gelatin/45S5 BG are candidates for the fabrication of biphasic implants not only for the treatment of osteochondral defects but also potentially for any other diseases affecting simultaneously hard and soft tissues.
Collapse
Affiliation(s)
- Belen Begines
- Departamento
de Química Orgánica y Farmacéutica, Facultad
de Farmacia, Universidad de Sevilla, c/ Profesor García González
2, Seville 41012, Spain
| | - Cristina Arevalo
- Departamento
de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, c/ Virgen de África 7, Seville 41011, Spain
| | - Carlos Romero
- Departamento
de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, c/ Virgen de África 7, Seville 41011, Spain
- Department
of Materials Science and Engineering and Chemical Engineering, Universidad Carlos III de Madrid, Av. de la Universidad 30, Leganés, Madrid 28911, Spain
| | - Zoya Hadzhieva
- Institute
of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauerstraße 6, Erlangen 91058, Germany
| | - Aldo R. Boccaccini
- Institute
of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauerstraße 6, Erlangen 91058, Germany
| | - Yadir Torres
- Departamento
de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, c/ Virgen de África 7, Seville 41011, Spain
| |
Collapse
|
16
|
Navarro P, Olmo A, Giner M, Rodríguez-Albelo M, Rodríguez Á, Torres Y. Electrical Impedance of Surface Modified Porous Titanium Implants with Femtosecond Laser. Materials (Basel) 2022; 15:ma15020461. [PMID: 35057181 PMCID: PMC8779557 DOI: 10.3390/ma15020461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 01/25/2023]
Abstract
The chemical composition and surface topography of titanium implants are essential to improve implant osseointegration. The present work studies a non-invasive alternative of electrical impedance spectroscopy for the characterization of the macroporosity inherent to the manufacturing process and the effect of the surface treatment with femtosecond laser of titanium discs. Osteoblasts cell culture growths on the titanium surfaces of the laser-treated discs were also studied with this method. The measurements obtained showed that the femtosecond laser treatment of the samples and cell culture produced a significant increase (around 50%) in the absolute value of the electrical impedance module, which could be characterized in a wide range of frequencies (being more relevant at 500 MHz). Results have revealed the potential of this measurement technique, in terms of advantages, in comparison to tiresome and expensive techniques, allowing semi-quantitatively relating impedance measurements to porosity content, as well as detecting the effect of surface modification, generated by laser treatment and cell culture.
Collapse
Affiliation(s)
- Paula Navarro
- Departamento de Tecnología Electrónica, Escuela Técnica Superior de Ingeniería Informática, Universidad de Sevilla, Av. Reina Mercedes s/n, 41012 Sevilla, Spain;
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (M.R.-A.); (Y.T.)
| | - Alberto Olmo
- Departamento de Tecnología Electrónica, Escuela Técnica Superior de Ingeniería Informática, Universidad de Sevilla, Av. Reina Mercedes s/n, 41012 Sevilla, Spain;
- Instituto de Microelectrónica de Sevilla, IMSE-CNM (CSIC, Universidad de Sevilla), Av. Américo Vespucio s/n, 41092 Sevilla, Spain
- Correspondence: ; Tel.: +34-954556835
| | - Mercè Giner
- Departamento de Citología e Histología Normal y Patológica, Universidad de Sevilla, Av. Doctor Fedriani s/n, 41009 Sevilla, Spain;
| | - Marleny Rodríguez-Albelo
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (M.R.-A.); (Y.T.)
| | - Ángel Rodríguez
- Escuela Politécnica Superior, Universidad da Coruña, Calle Mendizábal s/n, 15403 Ferrol, Spain;
| | - Yadir Torres
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (M.R.-A.); (Y.T.)
| |
Collapse
|
17
|
Chávez-Vásconez R, Lascano S, Sauceda S, Reyes-Valenzuela M, Salvo C, Mangalaraja RV, Gotor FJ, Arévalo C, Torres Y. Effect of the Processing Parameters on the Porosity and Mechanical Behavior of Titanium Samples with Bimodal Microstructure Produced via Hot Pressing. Materials (Basel) 2021; 15:136. [PMID: 35009282 PMCID: PMC8746005 DOI: 10.3390/ma15010136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/18/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Commercially pure (c.p.) titanium grade IV with a bimodal microstructure is a promising material for biomedical implants. The influence of the processing parameters on the physical, microstructural, and mechanical properties was investigated. The bimodal microstructure was achieved from the blends of powder particles with different sizes, while the porous structure was obtained using the space-holder technique (50 vol.% of ammonium bicarbonate). Mechanically milled powders (10 and 20 h) were mixed in 50 wt.% or 75 wt.% with c.p. titanium. Four different mixtures of powders were precompacted via uniaxial cold pressing at 400 MPa. Then, the specimens were sintered at 750 °C via hot pressing in an argon gas atmosphere. The presence of a bimodal microstructure, comprised of small-grain regions separated by coarse-grain ones, was confirmed by optical and scanning electron microscopies. The samples with a bimodal microstructure exhibited an increase in the porosity compared with the commercially available pure Ti. In addition, the hardness was increased while the Young's modulus was decreased in the specimens with 75 wt.% of the milled powders (20 h).
Collapse
Affiliation(s)
- Ricardo Chávez-Vásconez
- Departamento de Ingeniería Mecánica, Universidad Técnica Federico Santa María, Avenida Vicuña Mackenna 3939, Santiago 8940572, Chile; (R.C.-V.); (S.S.); (M.R.-V.)
| | - Sheila Lascano
- Departamento de Ingeniería Mecánica, Universidad Técnica Federico Santa María, Avenida Vicuña Mackenna 3939, Santiago 8940572, Chile; (R.C.-V.); (S.S.); (M.R.-V.)
| | - Sergio Sauceda
- Departamento de Ingeniería Mecánica, Universidad Técnica Federico Santa María, Avenida Vicuña Mackenna 3939, Santiago 8940572, Chile; (R.C.-V.); (S.S.); (M.R.-V.)
| | - Mauricio Reyes-Valenzuela
- Departamento de Ingeniería Mecánica, Universidad Técnica Federico Santa María, Avenida Vicuña Mackenna 3939, Santiago 8940572, Chile; (R.C.-V.); (S.S.); (M.R.-V.)
| | - Christopher Salvo
- Departamento de Ingeniería Mecánica, Facultad de Ingeniería, Universidad del Bío-Bío, Avda. Collao 1202, Casilla 5-C, Concepción 4081112, Chile;
| | | | - Francisco José Gotor
- Instituto de Ciencia de Materiales de Sevilla (CSIC-US), Américo Vespucio 49, 41092 Sevilla, Spain;
| | - Cristina Arévalo
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Poliécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (C.A.); (Y.T.)
| | - Yadir Torres
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Poliécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (C.A.); (Y.T.)
| |
Collapse
|
18
|
Piolanti N, Neri E, Bonicoli E, Parchi PD, Marchetti S, Manca M, Bonini L, Banci L, Scaglione M. Use of a Plasma-Sprayed Titanium-Hydroxyapatite Femoral Stem in Hip Arthroplasty in Patients Older than 70 Years. Is Cementless Fixation a Reliable Option in the Elderly? J Clin Med 2021; 10:4735. [PMID: 34682858 DOI: 10.3390/jcm10204735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Although cementless implants are increasing in popularity, the use of cementless femoral stems for total hip arthroplasty (THA) and hip hemiarthroplasty (HH) in elderly patients remains controversial. The aim of this study was to report the outcomes of a cementless stem used in a large multicentric cohort of elderly patients receiving elective THA and HH for displaced femoral neck fracture. Methods: A total of 293 patients (301 hips) aged 70 years or older (mean age, 78 years; range, 70–93) who received the same cementless plasma-sprayed porous titanium–hydroxyapatite stem were retrospectively evaluated after primary THA and HH to investigate stem survival, complications, and clinical and radiographic results. Results: Cumulative stem survival was 98.5% (95% CI, 96.4–99.4%; 91 hips at risks) with revision due to any reason as the end-point at 10-year follow-up (mean 8.6 years, range 4–12). No stem was revised due to aseptic loosening. The mean Forgotten Joint Score was 98.7. Radiographically, the implants showed complete osseointegration, with slight stress-shieling signs in less than 10% of the hips. Conclusion: The use of cementless stems was proven to be a reliable and versatile option even in elderly patients for elective THA and HH for femoral neck fracture.
Collapse
|
19
|
Olmo A, Hernández M, Chicardi E, Torres Y. Characterization and Monitoring of Titanium Bone Implants with Impedance Spectroscopy. Sensors (Basel) 2020; 20:s20164358. [PMID: 32764276 PMCID: PMC7472105 DOI: 10.3390/s20164358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 12/30/2022]
Abstract
Porous titanium is a metallic biomaterial with good properties for the clinical repair of cortical bone tissue, although the presence of pores can compromise its mechanical behavior and clinical use. It is therefore necessary to characterize the implant pore size and distribution in a suitable way. In this work, we explore the new use of electrical impedance spectroscopy for the characterization and monitoring of titanium bone implants. Electrical impedance spectroscopy has been used as a non-invasive route to characterize the volumetric porosity percentage (30%, 40%, 50% and 60%) and the range of pore size (100–200 and 355–500 mm) of porous titanium samples obtained with the space-holder technique. Impedance spectroscopy is proved to be an appropriate technique to characterize the level of porosity of the titanium samples and pore size, in an affordable and non-invasive way. The technique could also be used in smart implants to detect changes in the service life of the material, such as the appearance of fractures, the adhesion of osteoblasts and bacteria, or the formation of bone tissue.
Collapse
Affiliation(s)
- Alberto Olmo
- Instituto de Microelectrónica de Sevilla, IMSE-CNM (CSIC, Universidad de Sevilla), Av. Américo Vespucio, sn, 41092 Sevilla, Spain;
- Escuela Técnica Superior de Ingeniería Informática, Departamento de Tecnología Electrónica, Universidad de Sevilla, Av. Reina Mercedes sn, 41012 Sevilla, Spain
- Correspondence: ; Tel.: +34-09-5455-4325
| | - Miguel Hernández
- Instituto de Microelectrónica de Sevilla, IMSE-CNM (CSIC, Universidad de Sevilla), Av. Américo Vespucio, sn, 41092 Sevilla, Spain;
- Escuela Técnica Superior de Ingeniería Informática, Departamento de Tecnología Electrónica, Universidad de Sevilla, Av. Reina Mercedes sn, 41012 Sevilla, Spain
| | - Ernesto Chicardi
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Superior de Ingenieros, Universidad de Sevilla, 41092 Sevilla, Spain;
| | - Yadir Torres
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Calle Virgen de África, 7, 41011 Sevilla, Spain;
| |
Collapse
|
20
|
Fu X, Zhou X, Liu P, Chen H, Xiao Z, Yuan B, Yang X, Zhu X, Zhang K, Zhang X. The optimized preparation of HA/L-TiO 2/D-TiO 2 composite coating on porous titanium and its effect on the behavior osteoblasts. Regen Biomater 2020; 7:505-514. [PMID: 33149939 PMCID: PMC7597800 DOI: 10.1093/rb/rbaa013] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/24/2020] [Accepted: 03/07/2020] [Indexed: 02/07/2023] Open
Abstract
Various surface bioactivation technology has been confirmed to improve the osteogenic ability of porous titanium (pTi) implants effectively. In this study, a three-layered composite coating, i.e. outer layer of hydroxyapatite (HA), middle layer of loose titanium dioxide (L-TiO2) and inner layer of dense TiO2 (D-TiO2), was fabricated on pTi by a combined processing procedure of pickling, alkali heat (AH), anodic oxidation (AO), electrochemical deposition (ED) and hydrothermal treatment (HT). After soaking in simulated body fluid for 48 h, the surface of the AHAOEDHT-treated pTi was completely covered by a homogeneous apatite layer. Using MC3T3-E1 pro-osteoblasts as cell model, the cell culture revealed that both the pTi without surface treatment and the AHAOEDHT sample could support the attachment, growth and proliferation of the cells. Compared to the pTi sample, the AHAOEDHT one induced higher expressions of osteogenesis-related genes in the cells, including alkaline phosphatase, Type I collagen, osteopontin, osteoclast inhibitor, osteocalcin and zinc finger structure transcription factor. As thus, besides the good corrosion resistance, the HA/L-TiO2/D-TiO2-coated pTi had good osteogenic activity, showing good potential in practical application for bone defect repair.
Collapse
Affiliation(s)
- Xi Fu
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Xingyu Zhou
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Pin Liu
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Hewei Chen
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Zhanwen Xiao
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Bo Yuan
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Xiao Yang
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Xiangdong Zhu
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Kai Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, No. 29, Wangjiang Road, Chengdu 610064, China
| |
Collapse
|
21
|
Koolen M, Amin Yavari S, Lietaert K, Wauthle R, Zadpoor AA, Weinans H. Bone Regeneration in Critical-Sized Bone Defects Treated with Additively Manufactured Porous Metallic Biomaterials: The Effects of Inelastic Mechanical Properties. Materials (Basel) 2020; 13:ma13081992. [PMID: 32344664 PMCID: PMC7215733 DOI: 10.3390/ma13081992] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 02/05/2023]
Abstract
Additively manufactured (AM) porous metallic biomaterials, in general, and AM porous titanium, in particular, have recently emerged as promising candidates for bone substitution. The porous design of such materials allows for mimicking the elastic mechanical properties of native bone tissue and showed to be effective in improving bone regeneration. It is, however, not clear what role the other mechanical properties of the bulk material such as ductility play in the performance of such biomaterials. In this study, we compared the bone tissue regeneration performance of AM porous biomaterials made from the commonly used titanium alloy Ti6Al4V-ELI with that of commercially pure titanium (CP-Ti). CP-Ti was selected because of its high ductility as compared to Ti6Al4V-ELI. Critical-sized (6 mm diameter) femoral defects in rats were treated with implants made from both Ti6Al4V-ELI and CP-Ti. Bone regeneration was assessed up to 11 weeks using micro-CT scanning. The regenerated bone volume was assessed ex vivo followed by histology and biomechanical testing to assess osseointegration of the implants. The bony defects treated with AM CP-Ti implants generally showed higher volumes of regenerated bone as compared to those treated with AM Ti6Al4V-ELI. The torsional strength of the two titanium groups were similar however, and both considerably lower than those measured for intact bony tissue. These findings show the importance of material type and ductility of the bulk material in the ability for bone tissue regeneration of AM porous biomaterials.
Collapse
Affiliation(s)
- Marianne Koolen
- Department of Orthopaedics, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands
| | - Saber Amin Yavari
- Department of Orthopaedics, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands
| | - Karel Lietaert
- 3D Systems Healthcare, 3D Systems Leuven, 3001 Leuven, Belgium
| | - Ruben Wauthle
- 3D Systems Healthcare, 3D Systems Leuven, 3001 Leuven, Belgium
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, 2628 CN Delft, The Netherlands
| | - Harrie Weinans
- Department of Orthopaedics, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, 2628 CN Delft, The Netherlands
| |
Collapse
|
22
|
Wang D, He G, Tian Y, Ren N, Liu W, Zhang X. Dual effects of acid etching on cell responses and mechanical properties of porous titanium with controllable open-porous structure. J Biomed Mater Res B Appl Biomater 2020; 108:2386-2395. [PMID: 32017357 DOI: 10.1002/jbm.b.34571] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 11/12/2019] [Accepted: 01/11/2020] [Indexed: 11/06/2022]
Abstract
This study was focused on dual effects of 20 wt % hydrochloric acid etching treatment on cell responses and mechanical properties of a porous titanium with controllable open-porous structure. The results show that the acid etching induced the formation of a rough surface on the porous titanium, resulting in a remarkable improvement of the MG-63 osteoblasts adhesion and proliferation on the porous titanium. The surface roughness is found to be mainly dependent on the etching time. As increasing etching time, the surface roughness exhibited a noticeable rise. After etching for 90 min, the best cell response was achieved on the rough surface with a roughness value of 3.7 mm. However, the acid etching treatment displayed a negative effect on the porous titanium strength, and the yield strength was reduced down to 106 MPa as the etching time increased to 150 min. Taking both the cell responses and strength into account, an optimal etching time was determined as 60 min by experiments.
Collapse
Affiliation(s)
- Dong Wang
- School of Mechanical and Electrical Engineering, Henan University of Technology, Zhengzhou, China
| | - Guo He
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Ye Tian
- School of Mechanical and Electrical Engineering, Henan University of Technology, Zhengzhou, China
| | - Ning Ren
- School of Mechanical and Electrical Engineering, Henan University of Technology, Zhengzhou, China
| | - Wei Liu
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xianlong Zhang
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
23
|
Alshehri F, Alshehri M, Sumague T, Niazy A, Jansen J, van den Beucken J, Alghamdi H. Evaluation of Peri-Implant Bone Grafting Around Surface-Porous Dental Implants: An In Vivo Study in a Goat Model. Materials (Basel) 2019; 12:ma12213606. [PMID: 31684138 PMCID: PMC6862611 DOI: 10.3390/ma12213606] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/22/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022]
Abstract
Dental implants with surface-porous designs have been recently developed. Clinically, peri-implant bone grafting is expected to promote early osseointegration and bone ingrowth when applied with surface-porous dental implants in challenging conditions. The aim of this study was to comparatively analyze peri-implant bone healing around solid implants and surface-porous implants with and without peri-implant bone grafting, using biomechanical and histomorphometrical assessment in a goat iliac bone model. A total of 36 implants (4.1 mm wide, 11.5 mm long) divided into three groups, solid titanium implant (STI; n = 12), porous titanium implants (PTI; n = 12) and PTI with peri-implant bone grafting using biphasic calcium phosphate granules (PTI + BCP; n = 12), were placed bilaterally in the iliac crests of six goats. The goats were sacrificed seven weeks post-operatively and then subjected to biomechanical (n = 6 per group) and histomorphometrical (n = 6 per group) assessment. The biomechanical assessment revealed no significant differences between the three types of implants. Although the peri-implant bone-area (PIBA%) measured by histomorphometry (STI: 8.63 ± 3.93%, PTI: 9.89 ± 3.69%, PTI + BCP: 9.28 ± 2.61%) was similar for the three experimental groups, the percentage of new bone growth area (BGA%) inside the porous implant portion was significantly higher (p < 0.05) in the PTI group (10.67 ± 4.61%) compared to the PTI + BCP group (6.50 ± 6.53%). These data demonstrate that peri-implant bone grafting around surface-porous dental implants does not significantly accelerate early osseointegration and bone ingrowth.
Collapse
Affiliation(s)
- Fahad Alshehri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
| | - Mohammed Alshehri
- Dental Department, King Khalid University Hospital, King Saud University, Riyadh 11545, Saudi Arabia.
| | - Terrence Sumague
- Molecular and Cell Biology Laboratory, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
| | - Abdurahman Niazy
- Molecular and Cell Biology Laboratory, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
| | - John Jansen
- Department of Regenerative Biomaterials, Radboudumc, 6525EX Nijmegen, The Netherlands.
| | | | - Hamdan Alghamdi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
- Molecular and Cell Biology Laboratory, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
| |
Collapse
|
24
|
Vilardell AM, Cinca N, Barriuso E, Frigola J, Dosta S, Cano IG, Guilemany JM. X-ray microtomographic characterization of highly rough titanium cold gas sprayed coating for identification of effective surfaces for osseointegration. Microscopy (Oxf) 2019; 68:413-416. [PMID: 31282956 DOI: 10.1093/jmicro/dfz025] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/02/2019] [Accepted: 05/12/2019] [Indexed: 11/15/2022] Open
Abstract
A highly rough titanium coating obtained by Cold Gas Spray (CGS) has been characterized by means of high-resolution 3D microtomography (micro-CT) with the aim to evaluate its open and close porosity for possible use in orthopaedic implants to promote osseointegration. Micro-CT allowed a qualitative and quantitative description of the main features, morphology of the pores and surface roughness of the coating. Several numerical values were obtained to describe size, form and distribution of the closed/inner and open/outer pores. Additionally, surface roughness and open porosity were image-analyzed to find the effective surface for osseointegration.
Collapse
Affiliation(s)
- A M Vilardell
- Centre de Projecció Tèrmica (CPT). Dpt. Ciència dels Materials i Enginyeria Metal.lúrgica, Universitat de Barcelona, Martí i Franquès 1, 08028 Barcelona, Spain
| | - N Cinca
- Centre de Projecció Tèrmica (CPT). Dpt. Ciència dels Materials i Enginyeria Metal.lúrgica, Universitat de Barcelona, Martí i Franquès 1, 08028 Barcelona, Spain
| | - E Barriuso
- GRC Geociències Marines, Dpt. Ciències de la Terra i de l'Oceà, Facultat de Ciències de la Terra, Universitat de Barcelona, Martí i Franquès s/n, 08028, Barcelona, Spain
| | - J Frigola
- GRC Geociències Marines, Dpt. Ciències de la Terra i de l'Oceà, Facultat de Ciències de la Terra, Universitat de Barcelona, Martí i Franquès s/n, 08028, Barcelona, Spain
| | - S Dosta
- Centre de Projecció Tèrmica (CPT). Dpt. Ciència dels Materials i Enginyeria Metal.lúrgica, Universitat de Barcelona, Martí i Franquès 1, 08028 Barcelona, Spain
| | - I G Cano
- Centre de Projecció Tèrmica (CPT). Dpt. Ciència dels Materials i Enginyeria Metal.lúrgica, Universitat de Barcelona, Martí i Franquès 1, 08028 Barcelona, Spain
| | - J M Guilemany
- Centre de Projecció Tèrmica (CPT). Dpt. Ciència dels Materials i Enginyeria Metal.lúrgica, Universitat de Barcelona, Martí i Franquès 1, 08028 Barcelona, Spain
| |
Collapse
|
25
|
Chang JZC, Tsai PI, Kuo MYP, Sun JS, Chen SY, Shen HH. Augmentation of DMLS Biomimetic Dental Implants with Weight-Bearing Strut to Balance of Biologic and Mechanical Demands: From Bench to Animal. Materials (Basel) 2019; 12:ma12010164. [PMID: 30621012 PMCID: PMC6337105 DOI: 10.3390/ma12010164] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/24/2018] [Accepted: 12/27/2018] [Indexed: 12/16/2022]
Abstract
A mismatch of elastic modulus values could result in undesirable bone resorption around the dental implant. The objective of this study was to optimize direct metal laser sintering (DMLS)-manufactured Ti₆Al₄V dental implants' design, minimize elastic mismatch, allow for maximal bone ingrowth, and improve long-term fixation of the implant. In this study, DMLS dental implants with different morphological characteristics were fabricated. Three-point bending, torsional, and stability tests were performed to compare the mechanical properties of different designs. Improvement of the weaker design was attempted by augmentation with a longitudinal 3D-printed strut. The osseointegrative properties were evaluated. The results showed that the increase in porosity decreased the mechanical properties, while augmentation with a longitudinal weight-bearing strut can improve mechanical strength. Maximal alkaline phosphatase gene expression of MG63 cells attained on 60% porosity Ti₆Al₄V discs. In vivo experiments showed good incorporation of bone into the porous scaffolds of the DMLS dental implant, resulting in a higher pull-out strength. In summary, we introduced a new design concept by augmenting the implant with a longitudinal weight-bearing strut to achieve the ideal combination of high strength and low elastic modulus; our results showed that there is a chance to reach the balance of both biologic and mechanical demands.
Collapse
Affiliation(s)
| | - Pei-I Tsai
- Department of Materials Science and Engineering, National Chiao-Tung University, Hsinchu 30010, Taiwan.
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31040, Taiwan.
| | - Mark Yen-Ping Kuo
- School of Dentistry, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
| | - Jui-Sheng Sun
- Department of Orthopedic Surgery, College of Medicine, National Taiwan University, Taipei 10002, Taiwan.
| | - San-Yuan Chen
- Department of Materials Science and Engineering, National Chiao-Tung University, Hsinchu 30010, Taiwan.
| | - Hsin-Hsin Shen
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31040, Taiwan.
| |
Collapse
|
26
|
Shi M, Liu S, Wang Q, Yang X, Zhang G. Preparation and Properties of Titanium Obtained by Spark Plasma Sintering of a Ti Powder⁻Fiber Mixture. Materials (Basel) 2018; 11:E2510. [PMID: 30544733 PMCID: PMC6316922 DOI: 10.3390/ma11122510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 11/30/2018] [Accepted: 12/06/2018] [Indexed: 12/04/2022]
Abstract
Porous titanium is a functional structural material with certain porosity, which is prepared from titanium powder and titanium fiber. In order to study the porosity, phase structure, microstructure, sintering mechanism and mechanical properties of porous titanium obtained by spark plasma sintering of a Ti powder⁻fiber mixture at different sintering temperatures, a spherical titanium powder (D50 of 160 μm) was prepared via plasma rotating electrode processing, and titanium fiber (average wire diameter of fiber of 110 μm) was prepared by drawing, and they were mixed as raw materials according to different mass ratios. Porous titanium with a fiber⁻powder composite porous structure was prepared by spark plasma sintering at sintering temperatures of 800 °C, 900 °C and 1000 °C under a sintering pressure of 20 MPa. The results showed that there were no new phases occurring in porous titanium with porosity of 1.24⁻24.6% after sintering. Titanium fiber and titanium powder were sintered using powder/powder, powder/fiber and fiber/fiber regimes to form composite pore structures. The mass transfer mechanism of the sintered neck was a diffusion-dominated material migration mechanism during sintering. At higher sintering temperatures, the grain size was larger, and the fiber (800 °C; 10⁻20 μm) was finer than the powder (800 °C; 10⁻92 μm). The stress⁻strain curve of porous titanium showed no obvious yield point, and the compressive strength was higher at higher sintering temperatures. The results of this paper can provide data reference for the preparation of porous titanium obtained by spark plasma sintering of a Ti powder⁻fiber mixture.
Collapse
Affiliation(s)
- Mingjun Shi
- School of Metallurgical Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China.
| | - Shifeng Liu
- School of Metallurgical Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China.
| | - Qingge Wang
- School of Metallurgical Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China.
| | - Xin Yang
- College of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, China.
| | - Guangxi Zhang
- School of Metallurgical Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China.
| |
Collapse
|
27
|
Cheng BC, Koduri S, Wing CA, Woolery N, Cook DJ, Spiro RC. Porous titanium-coated polyetheretherketone implants exhibit an improved bone-implant interface: an in vitro and in vivo biochemical, biomechanical, and histological study. Med Devices (Auckl) 2018; 11:391-402. [PMID: 30464653 PMCID: PMC6211303 DOI: 10.2147/mder.s180482] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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] [Indexed: 11/26/2022] Open
Abstract
Purpose Spinal interbody fusion cages are designed to provide immediate stabilization for adjoining vertebrae and ideally enable bony ingrowth to achieve successful integration. For such an implant, cells must be able to attach, move, grow, and differentiate on its surface. These cellular interactions are dependent on how the implant surface enables the coating and binding of blood and tissue fluid proteins that support cell adhesion. The purpose of this study was to evaluate the in vitro and in vivo osteoblast cell–implant surface interactions that result in osseointegration onto a surface composed of plasma-sprayed titanium on a polyetheretherketone (PEEK) substrate or titanium-coated PEEK (Ti-PEEK) (PlasmaporeXP®) as compared to uncoated PEEK implants. Materials and methods The influence of the Ti-PEEK surface modification on the biochemical, biomechanical, and histological properties at the bone–implant interface is demonstrated both in vitro using simulated bone-forming cell culture experiments and in vivo using a 12- and 24-week ovine implant model. Results Osteoblast-like cells attached to the Ti-PEEK surface upregulated early bone-forming activity as measured by an increase in transcription and translation of ALP and BMP-2 when compared to cells on PEEK. Similarly, a significant increase in new bone formation, bony apposition, and pullout strength was demonstrated on Ti-PEEK implants when compared to PEEK implants at 12 and 24 weeks in an ovine implant in vivo model. Conclusion The study shows that the Ti-PEEK surface demonstrated enhanced osseointegrative properties compared to PEEK both in vitro and in vivo.
Collapse
Affiliation(s)
- Boyle C Cheng
- Neuroscience Institute, Allegheny Health Network, Pittsburgh, PA 15212, USA
| | - Sravanthi Koduri
- Neuroscience Institute, Allegheny Health Network, Pittsburgh, PA 15212, USA
| | - Charles A Wing
- Research and Development, Aesculap Implant Systems, LLC, Breinigsville, PA 18031, USA,
| | - Natalie Woolery
- Research and Development, Aesculap Biologics, LLC, Breinigsville, PA 18031, USA
| | - Daniel J Cook
- Neuroscience Institute, Allegheny Health Network, Pittsburgh, PA 15212, USA
| | - Robert C Spiro
- Research and Development, Aesculap Implant Systems, LLC, Breinigsville, PA 18031, USA, .,Research and Development, Aesculap Biologics, LLC, Breinigsville, PA 18031, USA
| |
Collapse
|
28
|
Yang H, Zhu Q, Qi H, Liu X, Ma M, Chen Q. A Facile Flow-Casting Production of Bioactive Glass Coatings on Porous Titanium for Bone Tissue Engineering. Materials (Basel) 2018; 11:E1540. [PMID: 30150523 PMCID: PMC6163300 DOI: 10.3390/ma11091540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/17/2018] [Accepted: 08/22/2018] [Indexed: 11/16/2022]
Abstract
Additive manufacturing enabled the fabrication of porous titanium (PT) with customized porosity and mechanical properties. However, functionalization of PT surfaces with bioactive coatings is being challenged due to sophisticated geometry and highly porous structure. In this study, a facile flow-casting technique was developed to produce homogeneous 45S5 bioactive glass (BG) coatings on the entire surface of PT. The coating weight as a function of BG concentration in a BG-PVA slurry was investigated to achieve controllable coating yield without blocking macropore structure. The annealing-treated BG coating not only exhibited compact adhesion confirmed by qualitative sonication treatment, but also enhanced the mechanical properties of PT scaffolds. Moreover, in-vitro assessments of BG-coated PT cultured with MC3T3-E1 cells was carried out having in mind their potential as bioactive bone implants. The experimental results in this study offer a simple and versatile approach for the bio-functionalization of PT and other porous biomedical devices.
Collapse
Affiliation(s)
- Haiou Yang
- State Key Laboratory of Solidification Processing, Northwestern Polytechnical University, Xi'an 710072, China.
| | - Qijie Zhu
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China.
| | - Hongfei Qi
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China.
| | - Xianhu Liu
- National Engineering Research Center for Advanced Polymer Processing Technology, Zhengzhou University, Zhengzhou 450002, China.
| | - Meixia Ma
- State Key Laboratory of Solidification Processing, Northwestern Polytechnical University, Xi'an 710072, China.
| | - Qiang Chen
- State Key Laboratory of Solidification Processing, Northwestern Polytechnical University, Xi'an 710072, China.
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China.
| |
Collapse
|
29
|
Lee H, Liao JD, Sivashanmugan K, Liu BH, Su YH, Yao CK, Juang YD. Hydrothermal Fabrication of Highly Porous Titanium Bio-Scaffold with a Load-Bearable Property. Materials (Basel) 2017; 10:E726. [PMID: 28773090 DOI: 10.3390/ma10070726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 06/12/2017] [Accepted: 06/28/2017] [Indexed: 11/17/2022]
Abstract
Porous titanium (P_Ti) is considered as an effective material for bone scaffold to achieve a stiffness reduction. Herein, biomimetic (bio-)scaffolds were made of sintered P_Ti, which used NaCl as the space holder and had it removed via the hydrothermal method. X-ray diffraction results showed that the subsequent sintering temperature of 1000 °C was the optimized temperature for preparing P_Ti. The compressive strength of P_Ti was measured using a compression test, which revealed an excellent load-bearing ability of above 70 MPa for that with an addition of 50 wt % NaCl (P_Ti_50). The nano-hardness of P_Ti, tested upon their solid surface, was presumably consistent with the density of pores vis-à-vis the addition of NaCl. Overall, a load-bearable P_Ti with a highly porous structure (e.g., P_Ti_50 with a porosity of 43.91% and a pore size around 340 μm) and considerable compressive strength could be obtained through the current process. Cell proliferation (MTS) and lactate dehydrogenase (LDH) assays showed that all P_Ti samples exhibited high cell affinity and low cell mortality, indicating good biocompatibility. Among them, P_Ti_50 showed relatively good in-cell morphology and viability, and is thus promising as a load-bearable bio-scaffold.
Collapse
|
30
|
Faizan A, Bhowmik-Stoker M, Alipit V, Kirk AE, Krebs VE, Harwin SF, Meneghini RM. Development and Verification of Novel Porous Titanium Metaphyseal Cones for Revision Total Knee Arthroplasty. J Arthroplasty 2017; 32:1946-53. [PMID: 28196619 DOI: 10.1016/j.arth.2017.01.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 12/09/2016] [Accepted: 01/10/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Porous metaphyseal cones are widely used in revision knee arthroplasty. A new system of porous titanium metaphyseal cones has been designed based on the femoral and tibial morphology derived from a computed tomography-based anatomical database. The purpose of this study is to evaluate the initial mechanical stability of the new porous titanium revision cone system by measuring the micromotion under physiologic loading compared with a widely-used existing porous tantalum metaphyseal cone system. METHODS The new cones were designed to precisely fit the femoral and tibial anatomy, and 3D printing technology was used to manufacture these porous titanium cones. The stability of the new titanium cones and the widely-used tantalum cones were compared under physiologic loading conditions in bench top test model. RESULTS The stability of the new titanium cones was either equivalent or better than the tantalum cones. The new titanium femoral cone construct had significantly less micromotion compared with the traditional femoral cone construct in 5 of the 12 directions measured (P < .05), whereas no statistical difference was found in 7 directions. The new porous titanium metaphyseal tibial cones demonstrated less micromotion in medial varus/valgus (P = .004) and posterior compressive micromotion (P = .002) compared with the traditional porous tantalum system. CONCLUSION The findings of this biomechanical study demonstrate satisfactory mechanical stability of an anatomical-based porous titanium metaphyseal cone system for femoral and tibial bone loss as measured by micromotion under physiologic loading. The new cone design, in combination with instrumentation that facilitates surgical efficiency, is encouraging. Long-term clinical follow-up is warranted.
Collapse
|
31
|
Jia Z, Xiu P, Xiong P, Zhou W, Cheng Y, Wei S, Zheng Y, Xi T, Cai H, Liu Z, Wang C, Zhang W, Li Z. Additively Manufactured Macro porous Titanium with Silver-Releasing Micro-/Nanoporous Surface for Multipurpose Infection Control and Bone Repair - A Proof of Concept. ACS Appl Mater Interfaces 2016; 8:28495-28510. [PMID: 27704758 DOI: 10.1021/acsami.6b10473] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Restoring large-scale bone defects, where osteogenesis is slow while infections lurk, with biomaterials represents a formidable challenge in orthopedic clinics. Here, we propose a scaffold-based multipurpose anti-infection and bone repairing strategy to meet such restorative needs. To do this, personalized multifunctional titanium meshes were produced through an advanced additive manufacturing process and dual "TiO2-poly(dopamine)/Ag (nano)" post modifications, yielding macroporous constructs with micro-/nanoporous walls and nanosilver bullets immobilized/embedded therein. Ultrahigh loading capacity and durable release of Ag+ were accomplished. The scaffolds were active against planktonic/adherent bacteria (Gram-negative and positive) for up to 12 weeks. Additionally, they not only defended themselves from biofilm colonization but also helped destroy existing biofilms, especially in combination with antibiotics. Further, the osteoblasts/bacteria coculture study displayed that the engineered surfaces aided MG-63 cells to combat bacterial invasion. Meanwhile, the scaffolds elicited generally acceptable biocompatibility (cell adhesion, proliferation, and viability) and hastened osteoblast differentiation and maturation (alkaline phosphatase production, matrix secretion, and calcification), by synergy of micro-/nanoscale topological cues and bioactive catecholamine chemistry. Although done ex vivo, these studies reveal that our three-in-one strategy (infection prophylaxis, infection fighting, and bone repair) has great potential to simultaneously prevent/combat infections and bridge defected bone. This work provides new thoughts to the use of enabling technologies to design biomaterials that resolve unmet clinical needs.
Collapse
Affiliation(s)
| | - Peng Xiu
- Department of Orthopedics, Peking University Third Hospital , Beijing 100191, China
| | | | | | | | | | | | | | - Hong Cai
- Department of Orthopedics, Peking University Third Hospital , Beijing 100191, China
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital , Beijing 100191, China
| | - Caimei Wang
- Beijing AKEC Medical Company Ltd. , Beijing 102200, China
| | - Weiping Zhang
- Beijing AKEC Medical Company Ltd. , Beijing 102200, China
| | - Zhijiang Li
- Beijing AKEC Medical Company Ltd. , Beijing 102200, China
| |
Collapse
|
32
|
Yin B, Ma P, Chen J, Wang H, Wu G, Li B, Li Q, Huang Z, Qiu G, Wu Z. Hybrid Macro- Porous Titanium Ornamented by Degradable 3D Gel/nHA Micro-Scaffolds for Bone Tissue Regeneration. Int J Mol Sci 2016; 17:575. [PMID: 27092492 PMCID: PMC4849031 DOI: 10.3390/ijms17040575] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 03/17/2016] [Revised: 04/05/2016] [Accepted: 04/11/2016] [Indexed: 12/23/2022] Open
Abstract
Porous titanium is a kind of promising material for bone substitution, while its bio-inert property results in demand of modifications to improve the osteointegration capacity. In this study, gelatin (Gel) and nano-hydroxyapatite (nHA) were used to construct 3D micro-scaffolds in the pores of porous titanium in the ratios of Gel:nHA = 1:0, Gel:nHA = 1:1, and Gel:nHA = 1:3, respectively. Cell attachment and proliferation, and gene and protein expression levels of osteogenic markers were evaluated in MC3T3-E1 cells, followed by bone regeneration assessment in a rabbit radius defect model. All hybrid scaffolds with different composition ratio were found to have significant promotional effects in cell adhesion, proliferation and differentiation, in which the group with Gel:nHA = 1:1 showed the best performance in vitro, as well as the most bone regeneration volume in vivo. This 3D micro-scaffolds modification may be an innovative method for porous titanium ornamentation and shows potential application values in clinic.
Collapse
Affiliation(s)
- Bo Yin
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Pei Ma
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
- Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
| | - Jun Chen
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Hai Wang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Gui Wu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Bo Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Qiang Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Zhifeng Huang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Guixing Qiu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
| | - Zhihong Wu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
- Central Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
- Beijing Key Laboratory for Genetic Research of Bone and Joint Disease, No. 1 Shuaifuyuan, Beijing 100730, China.
| |
Collapse
|
33
|
Abstract
BACKGROUND Lateral column lengthening (LCL) is commonly utilized in treating stage II posterior tibialis tendon dysfunction. This study aimed to analyze the outcomes of LCL with porous titanium wedges compared to historic controls of iliac crest autograft and allograft. We hypothesized that the use of a porous titanium wedge would have radiographic improvement and union rates similar to those with the use of autograft and allograft in LCL. METHODS Between May 2009 and May 2014, 28 feet in 26 patients were treated with LCL using a porous titanium wedge. Of the 26 patients, 9 were males (34.6%). The average age for males was 43 years (range, 17.9-58.7), 48.7 years (range, 21-72.3) for females. Mean follow-up was 14.6 months. Radiographs were examined for correction of the flatfoot deformity and forefoot abduction. All complications were noted. RESULTS Radiographically, the patients had a significant deformity correction in the anteroposterior talo-first metatarsal angle, talonavicular coverage angle, lateral talo-first metatarsal angle, and calcaneal pitch. All but 1 patient (96%) had bony incorporation of the porous titanium wedge. The average preoperative visual analog scale pain score was 5; all patients but 3 (12%) had improvements in their pain score, with a mean change of 3.4. CONCLUSION LCL with porous titanium had low nonunion rates, improved radiographic correction, and pain relief. LEVEL OF EVIDENCE Level IV, case series.
Collapse
Affiliation(s)
| | | | - Joni Gray
- Duke University Medical Center, Durham, NC, USA
| | | | | |
Collapse
|
34
|
Bsat S, Yavari SA, Munsch M, Valstar ER, Zadpoor AA. Effect of Alkali-Acid-Heat Chemical Surface Treatment on Electron Beam Melted Porous Titanium and Its Apatite Forming Ability. Materials (Basel) 2015; 8:1612-1625. [PMID: 28788021 PMCID: PMC5507016 DOI: 10.3390/ma8041612] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/23/2015] [Accepted: 03/30/2015] [Indexed: 11/16/2022]
Abstract
Advanced additive manufacturing techniques such as electron beam melting (EBM), can produce highly porous structures that resemble the mechanical properties and structure of native bone. However, for orthopaedic applications, such as joint prostheses or bone substitution, the surface must also be bio-functionalized to promote bone growth. In the current work, EBM porous Ti6Al4V alloy was exposed to an alkali acid heat (AlAcH) treatment to bio-functionalize the surface of the porous structure. Various molar concentrations (3, 5, 10M) and immersion times (6, 24 h) of the alkali treatment were used to determine optimal parameters. The apatite forming ability of the samples was evaluated using simulated body fluid (SBF) immersion testing. The micro-topography and surface chemistry of AlAcH treated samples were evaluated before and after SBF testing using scanning electron microscopy and energy dispersive X-ray spectroscopy. The AlAcH treatment successfully modified the topographical and chemical characteristics of EBM porous titanium surface creating nano-topographical features ranging from 200–300 nm in size with a titania layer ideal for apatite formation. After 1 and 3 week immersion in SBF, there was no Ca or P present on the surface of as manufactured porous titanium while both elements were present on all AlAcH treated samples except those exposed to 3M, 6 h alkali treatment. An increase in molar concentration and/or immersion time of alkali treatment resulted in an increase in the number of nano-topographical features per unit area as well as the amount of titania on the surface.
Collapse
Affiliation(s)
- Suzan Bsat
- Department of Mechanical and Aerospace Engineering, Carleton University, 1125 Colonel by Drive, Ottawa, ON K1S 5B6, Canada.
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands.
| | - Saber Amin Yavari
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands.
| | - Maximilian Munsch
- Implantcast GmbH, Lueneburger Schanze 26, D-21614 Buxtehude, Germany.
| | - Edward R Valstar
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands.
- Department of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Amir A Zadpoor
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands.
| |
Collapse
|
35
|
Li Y, Yang W, Li X, Zhang X, Wang C, Meng X, Pei Y, Fan X, Lan P, Wang C, Li X, Guo Z. Improving osteointegration and osteogenesis of three-dimensional porous Ti6Al4V scaffolds by polydopamine-assisted biomimetic hydroxyapatite coating. ACS Appl Mater Interfaces 2015; 7:5715-24. [PMID: 25711714 DOI: 10.1021/acsami.5b00331] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Titanium alloys with various porous structures can be fabricated by advanced additive manufacturing techniques, which are attractive for use as scaffolds for bone defect repair. However, modification of the scaffold surfaces, particularly inner surfaces, is critical to improve the osteointegration of these scaffolds. In this study, a biomimetic approach was employed to construct polydopamine-assisted hydroxyapatite coating (HA/pDA) onto porous Ti6Al4V scaffolds fabricated by the electron beam melting method. The surface modification was characterized with the field emission scanning electron microscopy, energy dispersive spectroscopy, water contact angle measurement, and confocal laser scanning microscopy. Attachment and proliferation of MC3T3-E1 cells on the scaffold surface were significantly enhanced by the HA/pDA coating compared to the unmodified surfaces. Additionally, MC3T3-E1 cells grown on the HA/pDA-coated Ti6Al4V scaffolds displayed significantly higher expression of runt-related transcription factor-2, alkaline phosphatase, osteocalcin, osteopontin, and collagen type-1 compared with bare Ti6Al4V scaffolds after culture for 14 days. Moreover, microcomputed tomography analysis and Van-Gieson staining of histological sections showed that HA/pDA coating on surfaces of porous Ti6Al4V scaffolds enhanced osteointegration and significantly promoted bone regeneration after implantation in rabbit femoral condylar defects for 4 and 12 weeks. Therefore, this study provides an alternative to biofunctionalized porous Ti6Al4V scaffolds with improved osteointegration and osteogenesis functions for orthopedic applications.
Collapse
Affiliation(s)
- Yong Li
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Wei Yang
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Xiaokang Li
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Xing Zhang
- ‡Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning 110016, People's Republic of China
| | - Cairu Wang
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Xiangfei Meng
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Yifeng Pei
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Xiangli Fan
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Pingheng Lan
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Chunhui Wang
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Xiaojie Li
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Zheng Guo
- †Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| |
Collapse
|
36
|
Abstract
Custom implants for the reconstruction of craniofacial defects have gained importance due to better performance over their generic counterparts. This is due to the precise adaptation to the region of implantation, reduced surgical times and better cosmesis. Application of 3D modeling in craniofacial surgery is changing the way surgeons are planning surgeries and graphic designers are designing custom implants. Advances in manufacturing processes and ushering of additive manufacturing for direct production of implants has eliminated the constraints of shape, size and internal structure and mechanical properties making it possible for the fabrication of implants that conform to the physical and mechanical requirements of the region of implantation. This article will review recent trends in 3D modeling and custom implants in craniofacial reconstruction.
Collapse
|
37
|
Reig L, Tojal C, Busquets DJ, Amigó V. Microstructure and Mechanical Behavior of Porous Ti-6Al-4V Processed by Spherical Powder Sintering. Materials (Basel) 2013; 6:4868-78. [PMID: 28788365 DOI: 10.3390/ma6104868] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 08/29/2013] [Accepted: 10/21/2013] [Indexed: 11/17/2022]
Abstract
Reducing the stiffness of titanium is an important issue to improve the behavior of this material when working together with bone, which can be achieved by generating a porous structure. The aim of this research was to analyze the porosity and mechanical behavior of Ti-6Al-4V porous samples developed by spherical powder sintering. Four different microsphere sizes were sintered at temperatures ranging from 1300 to 1400 °C for 2, 4 and 8 h. An open, interconnected porosity was obtained, with mean pore sizes ranging from 54.6 to 140 µm. The stiffness of the samples diminished by as much as 40% when compared to that of solid material and the mechanical properties were affected mainly by powder particles size. Bending strengths ranging from 48 to 320 MPa and compressive strengths from 51 to 255 MPa were obtained.
Collapse
|
38
|
Farrell BJ, Prilutsky BI, Ritter JM, Kelley S, Popat K, Pitkin M. Effects of pore size, implantation time, and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants. J Biomed Mater Res A 2013; 102:1305-15. [PMID: 23703928 DOI: 10.1002/jbm.a.34807] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [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: 04/15/2013] [Revised: 05/13/2013] [Accepted: 05/15/2013] [Indexed: 11/10/2022]
Abstract
The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40-100 μm and Large, 100-160 μm), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to seven groups. Implant extrusion rate was measured weekly and skin ingrowth into implants was determined histologically after harvesting implants. It was found that all three types of implants demonstrated skin tissue ingrowth of over 30% (at week 3) and 50% (at weeks 4-6) of total implant porous area under the skin; longer implantation resulted in greater skin ingrowth (p < 0.05). Only one case of infection was observed (infection rate 2.9%). Small and Nano groups showed the same implant extrusion rate which was lower than the Large group rate (0.06 ± 0.01 vs. 0.16 ± 0.02 cm/week; p < 0.05). Ingrowth area was comparable in the Small, Large, and Nano implants. However, qualitatively, the Nano implants showed greatest cellular inhabitation within first 3 weeks. We concluded that percutaneous porous titanium implants allow for skin integration with the potential for a safe seal.
Collapse
Affiliation(s)
- Brad J Farrell
- School of Applied Physiology, Center for Human Movement Studies, Georgia Institute of Technology, Atlanta, Georgia
| | | | | | | | | | | |
Collapse
|