López-Torres Irene I, Sanz-Ruíz Pablo, León-Román Victor E, Navarro-García Federico, Priego-Sánchez Rodrigo, Vaquero-Martín Javier
Gregorio Marañón General Hospital, C/Doctor Esquerdo 46, Madrid, Spain.
Surgery Department, Faculty of Medicine, Complutense University, Madrid, Spain.
Eur J Orthop Surg Traumatol. 2019 Jul;29(5):967-973. doi: 10.1007/s00590-019-02415-5. Epub 2019 Mar 12.
Periprosthetic infection is considered an increasing incidence pathology whose therapeutic strategies can be defined as unsatisfactory. Currently, animal models are employed to study its physiopathology and strategic therapies, but non-species-specific materials are implanted as foreign bodies. The use of these implants implies intrinsic instability, which hinders the development of a biofilm on their surfaces and complicates the post-operative recovery of the animal. The objective of the present study is the design of a species-specific implant for the New Zealand white (NZW) rabbit by means of 3D printing.
A CT scan of the knee of a NZW rabbit was performed, and the tibial surface was reconstructed in order to fabricate a species-specific tibial plateau using Horos and Autodesk Meshmixer™ software. This implant was inserted in fifteen NZW rabbits, and the assessment of its stability was based on the position of the limb at rest and the animal weight-bearing capacity. Biofilm formation on the surface was demonstrated by crystal violet staining.
A 1.81 cm × 1 cm × 1.24 cm stainless steel implant was designed. It consisted of a 4-mm-thick tibial plate with a rough surface and an eccentric metaphyseal anchoring. All of the animals exhibited hyperflexion of the operated limb immediately post-operative, and 100% could apply full weight bearing from day 5 after surgery.
The species-specific design of implants in experimental surgery encourages rapid recovery of the animal and the development of a biofilm on their surfaces, making them ideal for the study of the physiopathology and for establishing possible therapeutic targets for prosthetic infection.
假体周围感染被认为是一种发病率不断上升的病理状况，其治疗策略仍不尽人意。目前，动物模型被用于研究其病理生理学和治疗策略，但非物种特异性材料作为异物被植入。使用这些植入物意味着内在的不稳定性，这阻碍了其表面生物膜的形成，并使动物术后恢复复杂化。本研究的目的是通过3D打印设计一种针对新西兰白兔（NZW）的物种特异性植入物。
对一只NZW兔的膝关节进行CT扫描，并重建胫骨表面，以便使用Horos和Autodesk Meshmixer™软件制作特定物种的胫骨平台。将该植入物植入15只NZW兔体内，并根据肢体在休息时的位置和动物的负重能力来评估其稳定性。通过结晶紫染色证明表面生物膜的形成。
设计了一个1.81厘米×1厘米×1.24厘米的不锈钢植入物。它由一个4毫米厚的胫骨板组成，表面粗糙，有一个偏心的干骺端锚固。所有动物术后立即出现手术肢体过度屈曲，100%的动物在术后第5天能够完全负重。
实验手术中植入物的物种特异性设计促进了动物的快速恢复以及其表面生物膜的形成，使其成为研究病理生理学和确定假体感染可能治疗靶点的理想选择。
