Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
Biomed Mater. 2020 Aug 21;15(5):055027. doi: 10.1088/1748-605X/ab998a.
A mini or partial arthroplasty may offer the advantages of reduced pain, shorter hospital stay, and increased range of motion, which are beneficial for the treatment of large-sized focal osteochondral defects. We aimed to evaluate the in vivo histologic response and function of our nonresorbable, composite structure implant, developed using polyetheretherketone (PEEK) and Ti6AI4V alloy, as a treatment for full-thickness osteochondral defects in the femoral head of the hip using a goat model. The gross and imaging appearance and histologic results were compared to those of a similar size cobalt-chromium-molybdenum (CoCrMo) alloy implant placed in a defect in the femoral head and evaluated up to 12 weeks. The X radiographs showed that there was no evidence of loosening of the implants for both the PEEK-Ti6AI4V and CoCrMo groups. Magnetic resonance imaging results showed no inflammatory signal findings in both PEEK-Ti6AI4V and CoCrMo implants. Macroscopically and histologically, there was lesser cartilage degeneration in the PEEK-Ti6AI4V implant than in the CoCrMo implant. The modified macroscopic articular evaluation score was lower in the PEEK-Ti6AI4V group than in the CoCrMo group (p < 0.05), and the histological score of the periprosthetic and acetabular cartilage was lower in the PEEK-Ti6AI4V group than in the CoCrMo group (P < 0.05). The micro-computed tomography results showed that the uncemented PEEK-Ti6AI4V implant has better osseointegration and higher bone-implant contact than the cemented CoCrMo implant. The peri-implant bone mass was higher in the PEEK-Ti6AI4V implant(p < 0.05). Meanwhile, the optical profile analytical results showed that the surface roughness of the cartilage in the acetabulum was higher in the CoCrMo group. In conclusion, the mini-arthroplasty implant based on PEEK-Ti6AI4V was superior to an identical CoCrMo alloy implant as a treatment for local osteochondral defect in the femoral head, owing to its in vivo cartilage protection and better osseointegration.
一种小型或部分关节成形术可能具有减少疼痛、缩短住院时间和增加活动范围的优势,这对治疗大型局灶性骨软骨缺损有益。我们旨在评估我们的不可吸收的复合结构植入物的体内组织学反应和功能,该植入物由聚醚醚酮(PEEK)和 Ti6AI4V 合金制成,作为使用山羊模型治疗股骨头全层骨软骨缺损的一种方法。将大体和影像学表现以及组织学结果与类似大小的钴铬钼(CoCrMo)合金植入物在股骨头缺陷中的表现进行比较,并在 12 周内进行评估。X 射线照片显示,PEEK-Ti6AI4V 和 CoCrMo 两组植入物均无松动迹象。磁共振成像结果显示 PEEK-Ti6AI4V 和 CoCrMo 植入物均无炎症信号发现。大体和组织学上,PEEK-Ti6AI4V 植入物的软骨退变程度小于 CoCrMo 植入物。PEEK-Ti6AI4V 组的改良大体关节评估评分低于 CoCrMo 组(p < 0.05),PEEK-Ti6AI4V 组的假体周围和髋臼软骨的组织学评分也低于 CoCrMo 组(p < 0.05)。微计算机断层扫描结果显示,未固定的 PEEK-Ti6AI4V 植入物具有比固定的 CoCrMo 植入物更好的骨整合和更高的骨-植入物接触。PEEK-Ti6AI4V 植入物的植入物周围骨量较高(p < 0.05)。同时,光学轮廓分析结果表明,CoCrMo 组髋臼软骨的表面粗糙度较高。总之,基于 PEEK-Ti6AI4V 的小型关节成形术植入物优于相同的 CoCrMo 合金植入物,可作为治疗股骨头局部骨软骨缺损的方法,因为它具有体内软骨保护作用和更好的骨整合作用。