Department of Orthopaedics and Rehabilitation, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Department of Orthopaedics and Traumatology, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
PLoS One. 2023 Sep 8;18(9):e0282457. doi: 10.1371/journal.pone.0282457. eCollection 2023.
Previous studies have demonstrated the ability of osseointegration of porous titanium implants in cancellous bone. Our study was designed to (i) investigate the ability of bone ingrowth into 3D-printed porous titanium alloy implant on the cortical bone of rabbits using CT-scan and histology, and (ii) to identify the consistency of the radiology information between clinical Cone Beam Computed Tomography (CBCT) and Micro Computed Tomography (μCT) in the evaluation of bone ingrowth. The porous titanium alloy implants were 3D-printed employing the Electron Beam Melting (EBM) technology with an intended pore size of 600 μm and porosity of approximately 50 percent. Each implant was inserted into tibial diaphysis in one rabbit and its pores were classified as contacting bone or non-contacting bone. Depending on the time of explantation, the rabbits were divided into two groups: group 1 consisting of 6 rabbits between 13 and 20 weeks and group 2 consisting of 6 rabbits between 26 and 32 weeks. Tissue ingrowth into the non-bone contacting pores were evaluated by CBCT and histology. μCT was used to further investigate the bone ingrowth into four implants (two from each group were randomly chosen). The CBCT detected the present of tissue with bone-like density in both bone-contacting pores and non-bone-contacting pores of all implants. The μCT analysis also supported this result. All the bone-like tissues were then histologically confirmed to be mature bone. The analysis of CBCT data to assess bone ingrowth in porous implants had the sensitivity, specificity, positive and negative predictive values of 85, 84, 93 and 70 percent, respectively, when considering μCT assessment as the gold standard. Fully porous titanium alloy implant has great potential to reconstruct diaphyseal bone defect due to its good ability of osseointegration. CBCT is a promising method for evaluation of bone ingrowth into porous implants.
先前的研究已经证明了多孔钛植入物在松质骨中骨整合的能力。我们的研究旨在：（i）使用 CT 扫描和组织学来研究 3D 打印多孔钛合金植入物在兔皮质骨中的骨内生长能力，以及（ii）确定临床锥形束 CT（CBCT）和微计算机断层扫描（μCT）在评估骨内生长中的放射学信息的一致性。多孔钛合金植入物采用电子束熔化（EBM）技术 3D 打印，预期孔径为 600μm，孔隙率约为 50%。每个植入物都插入一只兔子的胫骨骨干中，其孔隙分为接触骨或非接触骨。根据取出的时间，兔子被分为两组：第 1 组由 6 只兔子组成，时间为 13 到 20 周，第 2 组由 6 只兔子组成，时间为 26 到 32 周。通过 CBCT 和组织学评估组织向内生长到非骨接触的孔隙中。μCT 用于进一步研究四个植入物（每组各两个随机选择）中的骨内生长。CBCT 检测到所有植入物的骨接触和非骨接触孔隙中都存在具有骨密度的组织。μCT 分析也支持了这一结果。所有的骨样组织随后都通过组织学确认为成熟骨。当将 μCT 评估作为金标准时，使用 CBCT 数据分析来评估多孔植入物中的骨内生长的方法具有 85%、84%、93%和 70%的敏感性、特异性、阳性和阴性预测值。完全多孔钛合金植入物由于其良好的骨整合能力，具有重建骨干骨缺损的巨大潜力。CBCT 是评估多孔植入物骨内生长的一种很有前途的方法。
