Chen Chih-Hwa, Chang Wen-Jen, Chen Yu-San, Chen Kuan Hao, Huang Shao-Fu, Hsueh Hsin-Ru, Li Cun-Bin, Lin Chun-Li
School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.
Department of Orthopedics, Taipei Medical University - Shuang Ho Hospital, New Taipei City, Taiwan.
Int J Bioprint. 2022 Aug 26;8(4):608. doi: 10.18063/ijb.v8i4.608. eCollection 2022.
The aim of this study is to develop a titanium three-dimensional (3D) printing novel hybrid suture anchor (HSA) with wing structure mechanism which can be opened to provide better holding power for surrounding osteoporotic bone. A screw-type anchor (5.5-mm diameter and 16-mm length) was designed with wing mechanism as well as micro dual-thread in the outer cortex bone contact area and macro single-thread in the anchor body. Both side wings can be opened by an internal screw to provide better bone holding power. The suture anchor and internal screw were manufactured using Ti6Al4V 3D printing and traditional machining, respectively. Static pullout and after dynamic 300-cyclic load (150 N) pullout tests for HSA with or without the wing open and commercial solid anchor (CSA) were performed ( = 5) in severely osteoporotic bone and osteoporotic bone to evaluate failure strengths. Comparison of histomorphometrical evaluation was performed through pig implantation of HSAs with the wing open and CSAs. The failure strengths of HSA with or without the wing open were 2.50/1.95- and 2.46/2.17-fold higher than those of CSA for static and after dynamic load pullout tests in severely osteoporotic bone, respectively. Corresponding values for static and after dynamic load pullout tests were 1.81/1.54- and 1.77/1.62-fold in osteoporotic bone, respectively. Histomorphometrical evaluation revealed that the effects of new bone ingrowth along the anchor contour for CSA and HSA were both approximately 20% with no significant difference. A novel HSA with wing mechanism was developed using 3D printing and the opened wing mechanism can be used to increase bone holding power for osteoporosis when necessary. Better failure strength of HSA than CSA under static and after dynamic load pullout tests and equivalence of bone ingrowth along the anchor contours confirmed the feasibility of the novel HSA.
本研究的目的是开发一种具有翼状结构机制的钛三维（3D）打印新型混合缝合锚钉（HSA），其可以打开以对周围骨质疏松骨提供更好的握持力。设计了一种螺钉型锚钉（直径5.5毫米，长度16毫米），其具有翼状机制，在骨皮质外层接触区域有微双螺纹，在锚钉主体中有宏观单螺纹。两侧的翼可通过内螺钉打开，以提供更好的骨握持力。缝合锚钉和内螺钉分别采用Ti6Al4V 3D打印和传统加工制造。对有或没有打开翼的HSA以及商用实心锚钉（CSA）进行了静态拔出试验和动态300次循环加载（150 N）后的拔出试验（ = 5），试验在严重骨质疏松骨和骨质疏松骨中进行，以评估破坏强度。通过对打开翼的HSA和CSA进行猪植入，进行了组织形态计量学评估比较。在严重骨质疏松骨中，有或没有打开翼的HSA在静态和动态加载后拔出试验中的破坏强度分别比CSA高2.50/1.95倍和2.46/2.17倍。在骨质疏松骨中，静态和动态加载后拔出试验的相应值分别为1.81/1.54倍和1.77/1.62倍。组织形态计量学评估显示，CSA和HSA沿锚钉轮廓的新骨长入效果均约为20%，无显著差异。利用3D打印开发了一种具有翼状机制的新型HSA，必要时打开的翼状机制可用于增加骨质疏松症的骨握持力。在静态和动态加载后拔出试验中，HSA的破坏强度优于CSA，且沿锚钉轮廓的骨长入等效性证实了新型HSA的可行性。
