Schwarz Markus L R, Kowarsch Markus, Rose Steffen, Becker Kristianna, Lenz Tamara, Jani Lutz
Orthopedic and Trauma Center, University Hospital Mannheim, University of Heidelberg, Germany.
J Biomed Mater Res A. 2009 Jun;89(3):667-78. doi: 10.1002/jbm.a.32000.
The aim of this study was to compare the osseointegration of four different implant surfaces in the Göttingen minipig femur model. They were prepared by glasspearlblasting (A), sandblasting (B) and titaniumplasma spraying (C and D). Surface D received additionally an electrochemically deposited layer of a resorbable calcium phosphate (CaP) layer, made mainly of brushite. Sample size was n = 20 per group. Implants were placed in the intertrochanteric and intercondylar sites of both femora. After 12 weeks, implant anchorage was measured by the pull-out test and histomorphometry measurements were carried out at the bone-implant interface. Implant anchorage was 0.7 +/- 0.3 MPa for surface A, 3.2 +/- 0.6 MPa for surface B, 6.5 +/- 1.5 MPa for surface C and 7.3 +/- 1.9 MPa for surface D. The differences between surfaces were statistically significant, with exception of C and D. The stiffness of the bone-implant interface showed no statistically significant difference between surfaces. After pull-out, surface A and B showed nearly no bone spots, while on surfaces C and D bone remains were found. Bone-implant contact was 1.9 +/- 1.1% for surface A, 10.5 +/- 3.6% for surface B, 22.4 +/- 4.5% for surface C and 48.8 +/- 4.5% for surface D. The differences were statistically significant. Implant location, intertrochanteric and intercondylar, did not affect the data. In this minipig model, rougher surfaces showed better osseointegration. After 12 weeks of healing, the resorbable CaP layer enhanced significantly the bone-implant contact but not the level of anchorage. The findings also suggest that the pull-out test should be critically evaluated to determine the shear strength between bone and porous surfaces.
本研究的目的是比较四种不同种植体表面在哥廷根小型猪股骨模型中的骨整合情况。它们分别通过玻璃微珠喷砂处理(A)、喷砂处理(B)和钛等离子喷涂处理(C和D)制备而成。表面D还额外有一层主要由透钙磷石制成的可吸收磷酸钙(CaP)电化学沉积层。每组样本量为n = 20。种植体植入两侧股骨的转子间和髁间部位。12周后,通过拔出试验测量种植体的锚固力,并在骨-种植体界面进行组织形态计量学测量。表面A的种植体锚固力为0.7±0.3兆帕,表面B为3.2±0.6兆帕,表面C为6.5±1.5兆帕,表面D为7.3±1.9兆帕。除C和D外,各表面之间的差异具有统计学意义。骨-种植体界面的刚度在各表面之间无统计学显著差异。拔出后,表面A和B几乎没有骨附着点,而在表面C和D发现有骨残留。表面A的骨-种植体接触率为1.9±1.1%,表面B为10.5±3.6%,表面C为22.4±4.5%,表面D为48.8±4.5%。差异具有统计学意义。种植体位置(转子间和髁间)不影响数据。在该小型猪模型中,表面越粗糙,骨整合效果越好。愈合12周后,可吸收CaP层显著增强了骨-种植体接触,但未提高锚固力水平。研究结果还表明,对于确定骨与多孔表面之间的剪切强度,应严格评估拔出试验。