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Yuan K, Zhang K, Yang Y, Lin Y, Zhou F, Mei J, Li H, Wei J, Yu Z, Zhao J, Tang T. Evaluation of interbody fusion efficacy and biocompatibility of a polyetheretherketone/calcium silicate/porous tantalum cage in a goat model. J Orthop Translat 2022; 36:109-119. [PMID: 36090821 PMCID: PMC9437743 DOI: 10.1016/j.jot.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/11/2022] [Accepted: 06/22/2022] [Indexed: 01/01/2023] Open
Abstract
Objective To evaluate the interbody fusion efficacy and biocompatibility of a graft-free cage made of polyetheretherketone/calcium silicate composite/porous tantalum (PEEK/CS/pTa cage) compared with a PEEK/CS cage with an autogenous bone graft in a goat model. Methods PEEK/CS/pTa and PEEK/CS cages were prepared through an injection-moulding method. The PEEK/CS composites and porous tantalum were characterized by Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive spectroscopy (EDS) mapping. Then, adult goats were chosen for C2/C3 and C3/C4 discectomy via the anterior cervical approach and randomly implanted with PEEK/CS/pTa and PEEK/CS/cages with autogenous bone grafts. The fusion performance and osseointegration of the cages were evaluated by X-ray imaging, magnetic resonance imaging (MRI) scanning, and bone histomorphometry analysis. Moreover, the concentrations of Ca and Si in urine, serum, tissue around the fusion segments and major organs of the goats were determined by inductively coupled plasma–optical emission spectrometry (ICP–OES). Histological observation of major organs of the goats was used to evaluate the biosafety of PEEK/CS/pTa and PEEK/CS cages. Results X-ray and MRI imaging suggested that both PEEK/CS/pTa cages and PEEK/CS cages maintained similar average intervertebral space heights. The tissue volumes in the fusion area were comparable between the two groups of cages at 26 weeks after surgery. Histological morphometric data showed that PEEK/CS/pTa cages and PEEK/CS cages with autogenous bone grafts had similar bone contact and osseointegration at 12 and 26 weeks. Element determination of serum, urine, spinal cord, dura matter, bone and organs showed that the CS/PEEK cages did not cause abnormal systemic metabolism or accumulation of calcium and silicon in local tissues and major organs of goats after implantation. No obvious pathological changes were found in the heart, liver, spleen, liver or kidney tissues. Conclusion Overall, these results suggested that the graft-free PEEK/CS/pTa cage showed similar bony fusion performance to the PEEK/CS cages with autogenous bone grafts. The cages releasing calcium and silicon had good biological safety in vivo. The translational potential of this article: This study provided a new graft-free interbody fusion solution to patients with degenerative disc diseases, which could avert potential donor-site complications. This study also provided a detailed assessment of element excretion and accumulation of Ca and Si in vivo, which validated the biosafety of this new type of bioactive interbody fusion cage.
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Affiliation(s)
- Kai Yuan
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Kai Zhang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yiqi Yang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yixuan Lin
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Feng Zhou
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jingtian Mei
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Hanjun Li
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jie Wei
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, China
| | - Zhifeng Yu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Corresponding author.
| | - Jie Zhao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Corresponding author. Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, 200011, China.
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Corresponding author. Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, 200011, China.
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Lecocq M, Bernard C, Felix MS, Linares JM, Chaves-Jacob J, Decherchi P, Dousset E. Biocompatibility of Four Common Orthopedic Biomaterials Following a High-Salt Diet: An In Vivo Study. Int J Mol Sci 2017; 18:ijms18071489. [PMID: 28696371 PMCID: PMC5535979 DOI: 10.3390/ijms18071489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/03/2017] [Accepted: 07/08/2017] [Indexed: 01/13/2023] Open
Abstract
Nowadays, salt consumption appears to be drastically above the recommended level in industrialized countries. The health consequences of this overconsumption are heavy since high-salt intake induces cardiovascular disease, kidney dysfunction, and stroke. Moreover, harmful interaction may also occur with orthopaedic devices because overconsumption of salt reinforces the corrosive aspect of biological tissues and favors bone resorption process. In the present study, we aimed to assess the in vivo effect of three weeks of a high-salt diet, associated (or not) with two weeks of the neuro-myoelectrostimulation (NMES) rehabilitation program on the biocompatibility of four biomaterials used in the manufacture of arthroplasty implants. Thus, two non-metallic (PEEK and Al2O3) and two metallic (Ti6Al4V and CrCo) compounds were implanted in the rat tibial crest, and the implant-to-bone adhesion and cell viability of two surrounded muscles, the Flexor Digitorum (FD) and Tibialis Anterior (TA), were assessed at the end of the experiment. Results indicated lower adhesion strength for the PEEK implant compared to other biomaterials. An effect of NMES and a high-salt diet was only identified for Al2O3 and Ti6Al4V implants, respectively. Moreover, compared to a normal diet, a high-salt diet induced a higher number of dead cells on both muscles for all biomaterials, which was further increased for PEEK, Al2O3, and CrCo materials with NMES application. Finally, except for Ti6Al4V, NMES induced a higher number of dead cells in the directly stimulated muscle (FD) compared to the indirectly stimulated one (TA). This in vivo experiment highlights the potential harmful effect of a high-salt diet for people who have undergone arthroplasty, and a rehabilitation program based on NMES.
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Affiliation(s)
- Mathieu Lecocq
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288 Marseille CEDEX 09, France.
| | - Cécile Bernard
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288 Marseille CEDEX 09, France.
| | - Marie Solenne Felix
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288 Marseille CEDEX 09, France.
| | - Jean-Marc Linares
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe Conception Bio-Inspirée (CBI), IUT d'Aix-en-Provence 413, avenue Gaston Berger, 13625 Aix-en-Provence CEDEX, France.
| | - Julien Chaves-Jacob
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe Conception Bio-Inspirée (CBI), IUT d'Aix-en-Provence 413, avenue Gaston Berger, 13625 Aix-en-Provence CEDEX, France.
| | - Patrick Decherchi
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288 Marseille CEDEX 09, France.
| | - Erick Dousset
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288 Marseille CEDEX 09, France.
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