Shima Koichiro, Shimizu Takayoshi, Yamaguchi Seiji, Otsuki Bungo, Kawai Toshiyuki, Okuzu Yaichiro, Takaoka Yusuke, Ikeda Norimasa, Matsuda Shuichi
Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, Kasugai, Aichi, Japan.
J Biomed Mater Res A. 2025 Jul;113(7):e37960. doi: 10.1002/jbm.a.37960.
Poor osseointegration of Titanium (Ti) implants in osteoporotic bone can lead to early construct failure in clinical settings. This study investigated whether combining Strontium (Sr) surface loading (modified alkali and heat treatment) with systemic teriparatide administration could enhance implant osseointegration in osteoporotic conditions. Mouse osteoblast-like cells (MC3T3-E1) were cultured on Sr-loaded Ti surfaces with and without teriparatide administration to evaluate cell adhesion, proliferation, differentiation, and mineralization capacity. This in vivo study utilized an osteoporotic rabbit femur through ovariectomy and steroid administration. The combined treatment (Sr-loaded Ti and teriparatide) enhanced osteoblast differentiation and mineralization in vitro, with an increase in alkaline phosphatase activity and alizarin red staining. Six and twelve weeks after in vivo implantation, the combination therapy demonstrated superior outcomes compared to the single treatments (Sr-loaded Ti or teriparatide), including enhanced bone-implant interfacial strength, improved bone morphology parameters, higher mineral apposition rates, and greater bone-implant contact. These findings demonstrate that the synergistic approach of Sr-loaded Ti implants combined with systemic teriparatide administration considerably improves implant osseointegration in osteoporotic bone, suggesting a promising strategy for enhancing implant outcomes in patients with osteoporotic bone quality.
钛（Ti）种植体在骨质疏松性骨中骨整合不良可导致临床环境中早期结构失效。本研究调查了锶（Sr）表面负载（改良碱热处理）与全身给予特立帕肽联合应用是否能增强骨质疏松条件下种植体的骨整合。将小鼠成骨样细胞（MC3T3-E1）培养在负载Sr的Ti表面，分别给予和不给予特立帕肽，以评估细胞粘附、增殖、分化和矿化能力。这项体内研究通过卵巢切除和给予类固醇激素建立了骨质疏松兔股骨模型。联合治疗（负载Sr的Ti和特立帕肽）在体外增强了成骨细胞的分化和矿化，碱性磷酸酶活性和茜素红染色增加。体内植入6周和12周后，联合治疗与单一治疗（负载Sr的Ti或特立帕肽）相比显示出更好的效果，包括增强的骨-种植体界面强度、改善的骨形态参数、更高的矿物质沉积率和更大的骨-种植体接触面积。这些发现表明，负载Sr的Ti种植体与全身给予特立帕肽的协同方法可显著改善骨质疏松性骨中种植体的骨整合，为提高骨质疏松性骨质量患者的种植体效果提供了一种有前景的策略。
