植入物对线在稳定性及假体周围骨溶解中颗粒的作用——植入物失败的兔模型

The role of implant alignment on stability and particles on periprosthetic osteolysis--A rabbit model of implant failure.

作者信息

Fornasier V L, Goodman S B, Protzner K, Kamel M, Song Y, Shojaci A

机构信息

Laboratory of Bone and Joint Pathology, Department of Laboratory Medicine and Pathophysiology, St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.

出版信息

J Biomed Mater Res B Appl Biomater. 2004 Aug 15;70(2):179-86. doi: 10.1002/jbm.b.20038.

Abstract

The study objective was to determine the tissue response to polyethylene and/or titanium particles and the role that these play in peri-prosthetic osteolysis in a rabbit model of implant failure. Twenty-two mature rabbits were used. Unilateral tibial arthroplasty was performed on all of them. The test animals received implants that were intentionally rotationally unstable with reference to the host tibia in order to create a model of failure. The test rabbits were divided into three groups. Group 1 consisted of seven rabbits in which only the carrier was implanted. Group 2 consisted of seven rabbits that received only polyethylene particles suspended in the carrier. Group 3 consisted of eight rabbits that received a mixture of polyethylene and titanium alloy particles suspended in the carrier. The rabbits were sacrificed at 6 months post surgery. The entire knee, together with the immediately surrounding soft tissue, was retrieved. The position of the implant in each rabbit was assessed with reference to its alignment to the tibia. The number of inflammatory, foreign-body reactive cells, the presence of neovascularization, edema, and necrosis in the periprosthetic zones were recorded and assessed in a qualitative and semiquantitative manner. Quantitative histomorphometry was used to determine the proportion of implant surface that interfaced with osseous or fibrous tissue. Also assessed was the thickness and maturity of the fibrous tissue and the endosteal remodeling activity in the peri-implant bone counting both osteoclastic and osteoblastic activity. The results showed that implanted particles and misalignment of the implants combined to produce peri-prosthetic bone resorption. Bone resorption was found to be proportional to the degree of misalignment. The animals that received combined polyethylene/titanium particles had a greater degree of foreign-body and inflammatory response with osteolysis than the other groups. The combination of bio-material particles (polyethylene and titanium alloy) produced a greater degree of bone resorption than the single biomaterial particles (polyethylene). The amount of bone resorption surrounding the implant was directly proportional to the degree of misalignment of the implant.

摘要

本研究的目的是确定聚乙烯和/或钛颗粒的组织反应,以及它们在植入物失败的兔模型中假体周围骨溶解所起的作用。使用了22只成年兔。对所有兔子进行单侧胫骨关节成形术。试验动物接受的植入物相对于宿主胫骨有意旋转不稳定,以创建失败模型。试验兔分为三组。第1组由7只仅植入载体的兔子组成。第2组由7只仅接受悬浮在载体中的聚乙烯颗粒的兔子组成。第3组由8只接受悬浮在载体中的聚乙烯和钛合金颗粒混合物的兔子组成。兔子在术后6个月处死。取出整个膝关节及其紧邻的周围软组织。参照植入物与胫骨的对齐情况评估每只兔子中植入物的位置。记录并以定性和半定量方式评估假体周围区域的炎性、异物反应性细胞数量、新生血管形成、水肿和坏死情况。采用定量组织形态计量学确定与骨组织或纤维组织界面的植入物表面比例。还评估了纤维组织的厚度和成熟度以及植入物周围骨的骨内膜重塑活性,同时计算破骨细胞和成骨细胞活性。结果表明,植入的颗粒与植入物的不对位共同导致假体周围骨吸收。发现骨吸收与不对位程度成正比。接受聚乙烯/钛颗粒组合的动物比其他组具有更大程度的异物和炎症反应以及骨溶解。生物材料颗粒(聚乙烯和钛合金)的组合比单一生物材料颗粒(聚乙烯)产生更大程度的骨吸收。植入物周围的骨吸收量与植入物的不对位程度直接成正比。

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