Low elastic modulus contributes to the osteointegration of titanium alloy plug.

Resurfacing of cartilage defect with mini titanium plug is considered a promising alternative for the treatment of focal chondral defects. Elastic modulus of the metal implant plays a significant role in force transmission which influences the stability of plug. This study assessed the effects of two kinds of titanium alloy plug with different elastic modulus, that is, titanium 2448 (Ti2448) plug and titanium-6 aluminum-4 vanadium (TAV) plug on osteointegration. The full-thickness chondral defects were created in bilateral knees of dogs and then TAV and Ti2448 plugs were implanted, respectively. After 12 weeks, radiographic evaluation did not reveal any signs of disassembly, subsidence, or periprosthetic radiolucency in both groups. Microcomputed tomography analysis revealed that bone histomorphometric parameters in Ti2448 group were all significantly better than those of TAV group. Furthermore, the value of pullout force in Ti2448 group was also significantly higher. Histology showed that the screw threads of Ti2448 plug were well integrated into the newly formed bone. In contrast, the trabecular bone was sparsely distributed around TAV plug. In conclusion, Ti2448 plug with low elastic modulus showed more favorable characteristics in osteointegration. Ti2448 may be a promising biomaterial for fabricating mini plug applied for cartilage resurfacing.