Simmons C A, Valiquette N, Pilliar R M
Institute of Biomaterials and Biomedical Engineering, University of Toronto, 170 College Street, Toronto, Ontario M5S 3E3, Canada.
J Biomed Mater Res. 1999 Nov;47(2):127-38. doi: 10.1002/(sici)1097-4636(199911)47:2<127::aid-jbm3>3.0.co;2-c.
The osseointegration and long-term success of bone-interfacing implants are dependent on mechanical stability of the implant relative to host bone during the early healing period. The geometric design of an implant surface may play an important role in affecting early implant stabilization, possibly by influencing tissue healing dynamics. In this study, we compared the early tissue healing response and resulting implant stability for two surface designs by characterizing the histological and mechanical properties of the healing tissue around Ti6Al4V sintered porous-surfaced and Ti plasma-sprayed implants. The implants were inserted transversely in rabbit femoral condyles and evaluated at 0, 4, 8, and 16 days postimplantation. At 4 and 8 days after implantation, the early healing tissue (fibrin and collagenous matrix) was more extensively integrated with the three-dimensional interconnected structure of the sintered porous surface than with the irregular geometry of the plasma-sprayed coating. In addition, histological examination indicated that initial matrix mineralization leading to osseointegration occurred more rapidly with the porous-surfaced implants. The more extensive tissue integration and more rapid matrix mineralization with the porous-surfaced implants were reflected in the mechanical test data, which demonstrated greater attachment strength and interfacial stiffness for the porous-surfaced implants 4 and 8 days postimplantation (p <.05). Sixteen days after implantation, both implant designs were osseointegrated and had comparable attachment characteristics. These data demonstrate that appropriate surface design selection can improve early implant stability and induce an accelerated healing response, thereby improving the potential for implant osseointegration.
骨植入物的骨整合及长期成功依赖于植入物在早期愈合阶段相对于宿主骨的机械稳定性。植入物表面的几何设计可能在影响植入物早期稳定性方面发挥重要作用,这可能是通过影响组织愈合动力学来实现的。在本研究中,我们通过表征钛合金(Ti6Al4V)烧结多孔表面和钛等离子喷涂植入物周围愈合组织的组织学和力学性能,比较了两种表面设计的早期组织愈合反应及由此产生的植入物稳定性。将植入物横向插入兔股骨髁,并在植入后0、4、8和16天进行评估。在植入后4天和8天,早期愈合组织(纤维蛋白和胶原基质)与烧结多孔表面的三维互连结构的整合程度比与等离子喷涂涂层的不规则几何结构的整合程度更高。此外,组织学检查表明,多孔表面植入物导致骨整合的初始基质矿化发生得更快。多孔表面植入物更广泛的组织整合和更快的基质矿化反映在力学测试数据中,该数据表明多孔表面植入物在植入后4天和8天具有更大的附着强度和界面刚度(p <.05)。植入后16天,两种植入物设计均实现了骨整合,且具有相当的附着特性。这些数据表明,选择合适的表面设计可以提高植入物早期稳定性并诱导加速愈合反应,从而提高植入物骨整合的潜力。