1
|
Cheers GM, Weimer LP, Neuerburg C, Arnholdt J, Gilbert F, Thorwächter C, Holzapfel BM, Mayer-Wagner S, Laubach M. Advances in implants and bone graft types for lumbar spinal fusion surgery. Biomater Sci 2024. [PMID: 39190323 DOI: 10.1039/d4bm00848k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
The increasing prevalence of spinal disorders worldwide necessitates advanced treatments, particularly interbody fusion for severe cases that are unresponsive to non-surgical interventions. This procedure, especially 360° lumbar interbody fusion, employs an interbody cage, pedicle screw-and-rod instrumentation, and autologous bone graft (ABG) to enhance spinal stability and promote fusion. Despite significant advancements, a persistent 10% incidence of non-union continues to result in compromised patient outcomes and escalated healthcare costs. Innovations in lumbar stabilisation seek to mimic the properties of natural bone, with evolving implant materials like titanium (Ti) and polyetheretherketone (PEEK) and their composites offering new prospects. Additionally, biomimetic cages featuring precisely engineered porosities and interconnectivity have gained traction, as they enhance osteogenic differentiation, support osteogenesis, and alleviate stress-shielding. However, the limitations of ABG, such as harvesting morbidities and limited fusion capacity, have spurred the exploration of sophisticated solutions involving advanced bone graft substitutes. Currently, demineralised bone matrix and ceramics are in clinical use, forming the basis for future investigations into novel bone graft substitutes. Bioglass, a promising newcomer, is under investigation despite its observed rapid absorption and the potential for foreign body reactions in preclinical studies. Its clinical applicability remains under scrutiny, with ongoing research addressing challenges related to burst release and appropriate dosing. Conversely, the well-documented favourable osteogenic potential of growth factors remains encouraging, with current efforts focused on modulating their release dynamics to minimise complications. In this evidence-based narrative review, we provide a comprehensive overview of the evolving landscape of non-degradable spinal implants and bone graft substitutes, emphasising their applications in lumbar spinal fusion surgery. We highlight the necessity for continued research to improve clinical outcomes and enhance patient well-being.
Collapse
Affiliation(s)
- Giles Michael Cheers
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Lucas Philipp Weimer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Carl Neuerburg
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Jörg Arnholdt
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Fabian Gilbert
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Christoph Thorwächter
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Boris Michael Holzapfel
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Susanne Mayer-Wagner
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Markus Laubach
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
| |
Collapse
|
2
|
Chahidi E, Martinov S, Simion F, Mercier C, Sabot L, Kyriakydis T, Callewier A, Hernigou J. Survivorship and complications of cementless compared to cemented posterior-stabilized total knee arthroplasties: A systematic review and meta-analysis. SICOT J 2024; 10:22. [PMID: 38819292 PMCID: PMC11141522 DOI: 10.1051/sicotj/2024017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/23/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE Controversy exists on the best fixation for total knee arthroplasty (TKA). Non-cemented fixation has been theorized to improve patient outcomes and longevity of implantation but no study has focused on comparison between cemented or cementless posterior-stabilized implants despite being the most commonly or second most frequently utilized implant in most total knee replacement registries. METHODS Inclusion criteria with observational and interventional papers, and review articles that focused on patients with cementless and cemented PS TKAs were used to analyze outcomes such as implant survivorship, complication, or revision rates. Using a combination of keywords, a systematic search was performed on Medline (PubMed), Embase, and Cochrane Library for Meta-Analysis. RESULTS When using the specified criteria, only 8 studies were selected for full-text analysis and meta-analysis after eliminating screening duplicates, titles, and abstracts without full-text access. These eight studies contain 1652 patients, 693 in the non-cemented Group, and 959 in the cemented total knee prosthesis Group. The meta-analysis revealed the advantage of cementless fixation over cemented fixation in implant survivorship, with 0.6% and 2.6% of aseptic loosening in each Group. The cumulative survival at 12 years was 97.4% for the cementless Group and 89.2% for the cemented Group. The subgroup with a stem showed a positive outcome for cementless fixation over cemented fixation regarding implant survivorship. No differences between the cemented and cementless TKAs were observed in patient-reported outcomes, revision rates, or radiolucent line development. CONCLUSION We observed comparable rates for cemented and cementless posterior-stabilized TKAs over a medium-term follow-up period.
Collapse
Affiliation(s)
- Esfandiar Chahidi
- Université Libre de Bruxelles Av. Franklin Roosevelt 50 1050 Brussels Belgium
| | - Sagi Martinov
- Orthopaedic Department, EpiCURA Baudour, Hornu, Ath Hospitals Rue Louis Caty 136 7331 Saint-Ghislain Hainaut Belgium
| | - Filip Simion
- Orthopaedic Department, EpiCURA Baudour, Hornu, Ath Hospitals Rue Louis Caty 136 7331 Saint-Ghislain Hainaut Belgium
| | - Camille Mercier
- Université Libre de Bruxelles Av. Franklin Roosevelt 50 1050 Brussels Belgium
| | - Liam Sabot
- Université Libre de Bruxelles Av. Franklin Roosevelt 50 1050 Brussels Belgium
| | - Theofylaktos Kyriakydis
- 2nd Department of Orthopaedic Surgery and Traumatology, Aristotle University of Thessaloniki, “G. Gennimatas” General Hospital Thessaloniki Hellas Greece
| | - Antoine Callewier
- Orthopaedic Department, EpiCURA Baudour, Hornu, Ath Hospitals Rue Louis Caty 136 7331 Saint-Ghislain Hainaut Belgium
| | - Jacques Hernigou
- Orthopaedic Department, EpiCURA Baudour, Hornu, Ath Hospitals Rue Louis Caty 136 7331 Saint-Ghislain Hainaut Belgium
- Laboratoire de Biochimie Osseuse et Métabolique ULB, Bone and Metabolic Biochemistry Research Laboratory, Université Libre de Bruxelles Lenniksebaan 808 1070 Brussels Belgium
| |
Collapse
|
3
|
Wojtowicz R, Otten V, Henricson A, Crnalic S, Nilsson KG. Uncemented trabecular metal high-flex posterior-stabilized monoblock total knee arthroplasty in patients aged 60 years or younger. Knee 2024; 46:99-107. [PMID: 38070382 DOI: 10.1016/j.knee.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Uncemented trabecular metal (TM) monoblock tibial components in total knee arthroplasty (TKA) have shown excellent clinical results for up to 10 years. However, these studies were performed in highly specialized units, with few surgeons and often excluding knees with secondary osteoarthritis (OA), severe malalignments and previous surgery. The purpose of this study was to investigate implant survivorship and clinical and radiological outcome of the uncemented TM high-flex posterior stabilized (PS) monoblock tibial component in routine clinical practice. METHODS A retrospective study of 339 knees (282 patients) operated with the implant in routine clinical practice at two hospitals on patients aged 60 years or younger between 2007 and 2015. The operations were performed by 12 surgeons and there were no specific contraindications for use of the implant. Follow up ended in 2020. The status of the implant of deceased patients at death and those not attending follow up was checked with the Swedish Knee Arthroplasty Register. Clinical follow up consisted of clinical investigation, PROMs, and knee X-ray. RESULTS Follow up was mean (range) 8.5 (5-13.8) years, and the 8-year survival rate was 0.98 (standard error 0.007). Five patients five knees) were deceased, five knees were revised (none due to aseptic loosening), and 16 patients did not attend the clinical follow up. Forty-four percent of the knees had secondary OA and 45% had had previous operations. 93% were satisfied or very satisfied with the operation and forgotten joint score (FJS) was median (interquartile range) 81 (44-94). Radiographic analysis revealed bone in close contact with the tibial tray and pegs in most cases, and in only 2% of the knees were potential radiolucent lines found. CONCLUSION The results indicate that this uncemented implant performs excellently in routine clinical practice and also in younger patients with secondary OA or previous knee operations.
Collapse
Affiliation(s)
- Radoslaw Wojtowicz
- Department of Surgical and Perioperative Sciences - Orthopedics, Umeå University, Umeå, Sweden.
| | - Volker Otten
- Department of Surgical and Perioperative Sciences - Orthopedics, Umeå University, Umeå, Sweden
| | - Anders Henricson
- Department of Orthopedics, Falun General Hospital, Falun, Sweden
| | - Sead Crnalic
- Department of Surgical and Perioperative Sciences - Orthopedics, Umeå University, Umeå, Sweden
| | - Kjell G Nilsson
- Department of Surgical and Perioperative Sciences - Orthopedics, Umeå University, Umeå, Sweden
| |
Collapse
|
4
|
Ferraro M, Puglia F, Della Valle A, Cerbone V, Cicatelli A, Peroni DR, Cecconi D, Misaggi B, La Maida GA. Transforaminal lumbar interbody fusion with a tantalum cage: lumbar lordosis redistribution and sacral slope restoration with a modified posterior technique. J Orthop Traumatol 2023; 24:62. [PMID: 38091159 PMCID: PMC10719190 DOI: 10.1186/s10195-023-00741-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/19/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Transforaminal lumbar interbody fusion (TLIF), a commonly used procedure in spine surgery, has the advantage of a lower incidence of nerve lesions compared to the posterior lumbar interbody fusion (PLIF) technique. The intersomatic arthrodesis has always been carried out with a single tantalum cage normally used for PLIF. Tantalum is a metal that is particularly used in orthopedic surgery. It has a modulus of elasticity similar to marrow and leads to high primary stability of the implant. MATERIALS AND METHODS Our study was a retrospective monocentric observational study evaluating clinical and radiological outcomes of tantalum cages in a modified TLIF technique with posterior instrumentation and autologous and/or homologous posterolateral bone grafting. The aim of the study was to evaluate clinical outcomes and the increase in or redistribution of lumbar lordosis. The intersomatic arthrodesis was always carried out with a single tantalum cage normally used for PLIF to reduce the neurological risk. We retrospectively studied 105 patients who were treated with a modified unilateral TLIF approach by two surgeons between 2013 and 2018. We evaluated the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for back pain, global lumbar lordosis, lordosis of L4-sacrum, segmental lordosis of functional motion units that underwent arthrodesis, pelvic tilt, pelvic incidence, and the sacral slope in 77 patients. All patients were suffering from grade III or IV Pfirrmann, instability, or foraminal post-laminectomy stenosis and/or grade I-II degenerative spondylolisthesis or low-grade isthmic spondylolisthesis. They had no significant sagittal imbalance, with a sagittal vertical axis (SVA) of < 5 mm. The average follow-up duration was 30 months. RESULTS We achieved excellent clinical results, with only four cases of failure (5.2%). Moreover, we noticed a statistically significant redistribution of lumbar lordosis, with an average percentage increase in L4-S1 lordosis equal to 19.9% (P < 0.001), an average increase in the L4-S1/Lumbar lordosis (LL) ratio from 0.53 to 0.63 (P < 0.001), and a mean percentage increase in sacral slope equal to 7.6% (P < 0.001). CONCLUSION Thanks to the properties of tantalum, our modified single-portal TLIF technique is a valid surgical solution to obtain a solid arthrodesis and restore the correct lumbar lordosis distribution while reducing neurological complications and the number of failures. LEVEL OF EVIDENCE 4 Trial registration statement: retrospective observational study, no trial registration.
Collapse
Affiliation(s)
- Marcello Ferraro
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
| | - Francesco Puglia
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy.
- University of Milan, Milan, Italy.
| | - Andrea Della Valle
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
| | - Vincenzo Cerbone
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
- University of Milan, Milan, Italy
| | - Alfonso Cicatelli
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
- University of Milan, Milan, Italy
| | - Donata Rita Peroni
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
| | - Davide Cecconi
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
| | - Bernardo Misaggi
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
| | - Giovanni Andrea La Maida
- Spine Surgery Department, Orthopaedic Institute Gaetano Pini, Via Gaetano Pini, 1, 20121, Milan, Italy
| |
Collapse
|
5
|
Zhang B, Feng J, Chen S, Liao R, Zhang C, Luo X, Yang Z, Xiao D, He K, Duan K. Cell response and bone ingrowth to 3D printed Ti6Al4V scaffolds with Mg-incorporating sol-gel Ta 2O 5 coating. RSC Adv 2023; 13:33053-33060. [PMID: 37954425 PMCID: PMC10632765 DOI: 10.1039/d3ra05814j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023] Open
Abstract
In recent years, additive manufacturing techniques have been used to fabricate 3D titanium (Ti)-based scaffolds for production of desirable complex shapes. However, insufficient osteointegration of porous Ti-based scaffolds can elicit long-term complications (e.g., aseptic loosening) and need further revision surgery. In this study, a magnesium (Mg)-incorporating tantalum (Ta) coating was deposited on a 3D Ti6Al4V scaffold using a sol-gel method for enhancing its osteogenic properties. To evaluate the biofunction of this surface, bone mesenchymal stem cells and rabbit femoral condyle were used to assess the cell response and bone ingrowth, respectively. Ta2O5 coatings and Mg-incorporating Ta2O5 coatings were both homogeneously deposited on porous scaffolds. In vitro studies revealed that both coatings exhibit enhanced cell proliferation, ALP activity, osteogenic gene expression and mineralization compared with the uncoated Ti6Al4V scaffold. Especially for Mg-incorporating Ta2O5 coatings, great improvements were observed. In vivo studies, including radiographic examination, fluorochrome labeling and histological evaluation also followed similar trends. Also, bone ingrowth to scaffolds with Mg-incorporating Ta2O5 coatings exhibited the most significant increase compared with uncoated and Ta2O5 coated scaffolds. All the above results indicate that Mg-doped Ta2O5 coatings are an effective tool for facilitating osteointegration of conventional porous Ti6Al4V scaffolds.
Collapse
Affiliation(s)
- Bo Zhang
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
| | - Jun Feng
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
| | - Shuo Chen
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
| | - Ruohan Liao
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
| | - Chengdong Zhang
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
- Key Laboratory of Advanced Technologies of Materials (MOE), School of Materials Science and Engineering, Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Xuwei Luo
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
| | - Zelong Yang
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
| | - Dongqin Xiao
- Research Institute of Tissue Engineering and Stem Cells, Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan 637000 China
| | - Kui He
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Department of Orthopaedics, Affiliated Hospital of Southwest Medical University Luzhou Sichuan 646000 China
| | - Ke Duan
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Department of Orthopaedics, Affiliated Hospital of Southwest Medical University Luzhou Sichuan 646000 China
| |
Collapse
|
6
|
Ge X, Li T, Yu M, Zhu H, Wang Q, Bi X, Xi T, Wu X, Gao Y. A review: strategies to reduce infection in tantalum and its derivative applied to implants. BIOMED ENG-BIOMED TE 2023:bmt-2022-0211. [PMID: 36587948 DOI: 10.1515/bmt-2022-0211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023]
Abstract
Implant-associated infection is the main reasons for implant failure. Titanium and titanium alloy are currently the most widely used implant materials. However, they have limited antibacterial performance. Therefore, enhancing the antibacterial ability of implants by surface modification technology has become a trend of research. Tantalum is a potential implant coating material with good biological properties. With the development of surface modification technology, tantalum coating becomes more functional through improvement. In addition to improving osseointegration, its antibacterial performance has also become the focus of attention. In this review, we provide an overview of the latest strategies to improve tantalum antibacterial properties. We demonstrate the potential of the clinical application of tantalum in reducing implant infections by stressing its advantageous properties.
Collapse
Affiliation(s)
- Xiao Ge
- School of Stomatology, Weifang Medical University, Weifang, China
| | - Ti Li
- Department of Stomatology, Weifang People's Hospital, Weifang, China
| | - Miao Yu
- Department of Stomatology, Weifang People's Hospital, Weifang, China
| | - Hongguang Zhu
- Department of Stomatology, Weifang People's Hospital, Weifang, China
| | - Qing Wang
- Department of Stomatology, Weifang People's Hospital, Weifang, China
| | - Xiuting Bi
- Department of Stomatology, Weifang People's Hospital, Weifang, China
| | - Tiantian Xi
- School of Stomatology, Weifang Medical University, Weifang, China
| | - Xiaoyan Wu
- School of Stomatology, Weifang Medical University, Weifang, China
| | - Yubin Gao
- School of Stomatology, Weifang Medical University, Weifang, China
| |
Collapse
|
7
|
Kaneko T, Nakamura S, Hayakawa K, Tokimura F, Miyazaki T. Clinical and radiological outcomes of total hip arthroplasty in octogenarian patients using a three-dimensional porous titanium cup: a retrospective analysis in Japanese patients. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2022:10.1007/s00590-022-03439-0. [PMID: 36414875 DOI: 10.1007/s00590-022-03439-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Osteointegration of a three-dimensional (3D) porous titanium material has been experimentally proven, but only a few studies have shown the clinical outcomes of a 3D porous titanium cup in the Japanese elderly population. The purpose of this study was to compare the short-and-medium term clinical and radiographic results of total hip arthroplasty (THA) using a 3D porous titanium cup in patients aged ≥ 80 (octogenarians) versus those aged < 80 (younger controls). METHODS A total of 104 hips that underwent THA using a 3D porous titanium cup (SQRUM TT, Kyocera Medical) were enrolled in the study and were divided into two groups according to age: the octogenarian group (≥ 80, n = 42) and the younger control group (< 80, n = 62). Furthermore, we evaluated patient characteristics, clinical outcomes determined by the Japanese Orthopedic Association score, cup alignment, and incidence of radiolucent lines around the cup. RESULTS The mean follow-up period was 4.2 and 4.0 years (p = 0.29) for octogenarians and younger controls, respectively. The clinical outcomes were excellent, and no revision surgery occurred until the last follow-up in both groups. The number of patients with radiolucent lines at the final evaluation was 21 of 62 (33.9%) in younger controls and 16 of 42 (38.1%) in octogenarians. CONCLUSION THA with 3D porous titanium cup for octogenarians had similar clinical outcomes and incidence of radiolucent lines as those of younger controls, suggesting that the 3D porous titanium cup may be useful in THA for octogenarians. Further investigations will confirm its long-term outcomes.
Collapse
Affiliation(s)
- Taizo Kaneko
- Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Sakae-cho 35- 2, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Shinya Nakamura
- Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Sakae-cho 35- 2, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Kentaro Hayakawa
- Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Sakae-cho 35- 2, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Fumiaki Tokimura
- Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Sakae-cho 35- 2, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Tsuyoshi Miyazaki
- Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Sakae-cho 35- 2, Itabashi-ku, Tokyo, 173-0015, Japan.
| |
Collapse
|
8
|
Xue N, Ding X, Huang R, Jiang R, Huang H, Pan X, Min W, Chen J, Duan JA, Liu P, Wang Y. Bone Tissue Engineering in the Treatment of Bone Defects. Pharmaceuticals (Basel) 2022; 15:879. [PMID: 35890177 PMCID: PMC9324138 DOI: 10.3390/ph15070879] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 02/05/2023] Open
Abstract
Bones play an important role in maintaining exercise and protecting organs. Bone defect, as a common orthopedic disease in clinics, can cause tremendous damage with long treatment cycles. Therefore, the treatment of bone defect remains as one of the main challenges in clinical practice. Today, with increased incidence of bone disease in the aging population, demand for bone repair material is high. At present, the method of clinical treatment for bone defects including non-invasive therapy and invasive therapy. Surgical treatment is the most effective way to treat bone defects, such as using bone grafts, Masquelet technique, Ilizarov technique etc. In recent years, the rapid development of tissue engineering technology provides a new treatment strategy for bone repair. This review paper introduces the current situation and challenges of clinical treatment of bone defect repair in detail. The advantages and disadvantages of bone tissue engineering scaffolds are comprehensively discussed from the aspect of material, preparation technology, and function of bone tissue engineering scaffolds. This paper also summarizes the 3D printing technology based on computer technology, aiming at designing personalized artificial scaffolds that can accurately fit bone defects.
Collapse
Affiliation(s)
- Nannan Xue
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing 210023, China; (X.P.); (J.-A.D.)
| | - Xiaofeng Ding
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
| | - Rizhong Huang
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
| | - Ruihan Jiang
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
| | - Heyan Huang
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
| | - Xin Pan
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing 210023, China; (X.P.); (J.-A.D.)
| | - Wen Min
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
| | - Jun Chen
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
| | - Jin-Ao Duan
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing 210023, China; (X.P.); (J.-A.D.)
| | - Pei Liu
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing 210023, China; (X.P.); (J.-A.D.)
| | - Yiwei Wang
- Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, China; (N.X.); (X.D.); (R.H.); (R.J.); (H.H.); (W.M.); (J.C.)
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing 210023, China; (X.P.); (J.-A.D.)
- Burns Injury and Reconstructive Surgery Research, ANZAC Research Institute, University of Sydney, Concord Repatriation General Hospital, Concord 2137, Australia
| |
Collapse
|
9
|
Mesenchymal stem cell-seeded porous tantalum-based biomaterial: A promising choice for promoting bone regeneration. Colloids Surf B Biointerfaces 2022; 215:112491. [PMID: 35405535 DOI: 10.1016/j.colsurfb.2022.112491] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/29/2022] [Accepted: 04/03/2022] [Indexed: 12/17/2022]
Abstract
Porous tantalum-based biomaterial is a novel tissue engineering material widely used in repairing bone defects due to its corrosion resistance, low elastic modulus, high friction coefficient, and excellent biocompatibility. Bone marrow-derived mesenchymal stem cells (BMSCs), a type of pluripotent stem cell, can travel from their original ecological niche to bone injury sites, where they differentiate into osteoblasts and osteocytes. Multiple factors regulate the proliferation, migration, and differentiation of BMSCs. In recent years, the regulatory effects of porous tantalum on BMSCs have been widely studied. Hence, in this study, we reviewed the characteristics of porous tantalum-based biomaterials and the mechanism of action of their regulatory effects on BMSCs. Further, we discuss the feasibility of seeding BMSCs in porous tantalum-based biomaterials for use in tissue repair.
Collapse
|
10
|
Batinica B, Bolam SM, D'Arcy M, Zhu M, Monk AP, Munro JT. Tibial metaphyseal cones combined with short stems perform as well as long stems in revision total knee arthroplasty. ANZ J Surg 2022; 92:2254-2260. [PMID: 35754371 PMCID: PMC9539956 DOI: 10.1111/ans.17864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/11/2022] [Accepted: 06/07/2022] [Indexed: 12/02/2022]
Abstract
Backgrounds There is uncertainty around optimal tibial stem length in revision total knee arthroplasty (rTKA) utilizing a tibial trabecular metal (TM) cone. The purpose of this study was to compare: (1) functional outcomes, (2) radiographic outcomes and (3) implant survivorship in rTKA utilizing TM cones combined with either short stems (SS) or long stems (LS) at minimum 2 years follow‐up. Methods In this retrospective, multi‐centre study, patients undergoing rTKA utilizing a TM cone between 2008 and 2019 were included. Patients were divided into: SS group (no diaphyseal engagement), and LS group (diaphyseal engagement). All relevant clinical charts and post‐operative radiographs were examined. Oxford Knee Score (OKS) and EuroQol‐5D (EQ‐5D‐5L) data were collected at most recent follow‐up. Results In total, 44 patients were included: 18 in the SS group and 26 in the LS group. The mean time of follow‐up was 4.0 years. Failure free survival was 94.4% for the SS group and 92.3% for the LS group. All failures were for prosthetic joint infections managed with debridement, antibiotics, and implant retention. At most recent follow‐up, 3 patients demonstrated radiographic signs of lucency (1 SS 2 LS, P = 1) and the mean OKS were 37 ± 4 and 36 ± 6 (P = 0.73) in the SS and LS groups, respectively. Conclusion Tibial SS combined with TM cones performed as well as LS in rTKA at minimum 2 years follow‐up. A tibial SS in combination with a TM cone is a reliable technique to achieve stable and durable fixation in rTKA.
Collapse
Affiliation(s)
- Bruno Batinica
- Department of Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
| | - Scott M. Bolam
- Department of Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
- Department of Orthopaedics Auckland City Hospital Auckland New Zealand
| | - Matt D'Arcy
- Department of Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
- Department of Orthopaedics Auckland City Hospital Auckland New Zealand
| | - Mark Zhu
- Department of Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
- Department of Orthopaedics Auckland City Hospital Auckland New Zealand
| | - A. Paul Monk
- Department of Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
- Department of Orthopaedics Auckland City Hospital Auckland New Zealand
- Auckland Bioengineering Institute University of Auckland Auckland New Zealand
| | - Jacob T. Munro
- Department of Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
- Department of Orthopaedics Auckland City Hospital Auckland New Zealand
| |
Collapse
|
11
|
Robo I, Heta S, Papakozma D, Ostreni V. Modification of implant surfaces to stimulate mesenchymal cell activation. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:52. [PMID: 35261541 PMCID: PMC8894561 DOI: 10.1186/s42269-022-00743-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The process of osteointegration, as key point has the activation of mesenchymal cells at implant-bone interspace, their differentiation into osteoblasts and connection between the implant surface and the surrounding bone. MAIN TEXT Implant surfaces composed by biocompatible, organism-friendly materials require changes in content and surface morphology; changes that may further stimulate mesenchymal cell activation. The way the implant surfaces are affected with advantages and disadvantages, that typically bring each methodology, is also the purpose of this study. The study is of review type, based on finding articles about implant surface modification, with the aim of promoting the mesenchymal cell activation, utilizing keyword combination. CONCLUSIONS Implant success beyond the human element of the practicioner and the protocol element of implant treatment, also relies on the application of the right type of implant, at the right implant site, in accordance with oral and individual health status of the patient. Implant success does not depend on type of "coating" material of the implants. Based at this physiological process, the success or implant failure is not a process depending on the type of selected implant, because types of synthetic or natural materials that promote osteointegration are relatively in large number.
Collapse
Affiliation(s)
- Ilma Robo
- Faculty of Dental Medicine, University of Medicine, Tiranë, Albania
| | - Saimir Heta
- Pediatric Surgery, Pediatric Surgeon, University Hospital, QSUT, Tiranë, Albania
| | | | - Vera Ostreni
- Pediatric Surgery, Pediatric Surgeon, University Hospital, QSUT, Tiranë, Albania
- Department of Morphology, University of Medicine, Tiranë, Albania
| |
Collapse
|
12
|
Motomura G, Mashima N, Imai H, Sudo A, Hasegawa M, Yamada H, Morita M, Mitsugi N, Nakanishi R, Nakashima Y. Effects of porous tantalum on periprosthetic bone remodeling around metaphyseal filling femoral stem: a multicenter, prospective, randomized controlled study. Sci Rep 2022; 12:914. [PMID: 35042918 PMCID: PMC8766592 DOI: 10.1038/s41598-022-04936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/23/2021] [Indexed: 11/09/2022] Open
Abstract
Periprosthetic bone loss due to adaptive bone remodeling is an important unresolved issue in cementless total hip arthroplasty (THA). The use of porous tantalum on the proximal surface of the femoral stem is expected to decrease postoperative bone loss around the prosthesis through early fixation. We conducted a multicenter randomized controlled study to determine if porous tantalum could reduce periprosthetic bone loss after THA. From October 2012 to September 2014, 118 patients (mean age, 61.5 years; 107 females and 11 males) were prospectively enrolled and were randomly allocated at a ratio of 1:1 to either a metaphyseal filling stem with a proximal porous tantalum coating (Trabecular Metal) or a conventional metaphyseal filling stem with fiber mesh coating (VerSys). Patients underwent dual-energy x-ray absorptiometry scans within 1 week after surgery (baseline) and at 6, 12, and 24 months after surgery to assess periprosthetic bone mineral density (BMD) in the 7 Gruen zones. In addition, the Japanese Orthopaedic Association hip score was assessed before surgery and at 6, 12, and 24 months after surgery. In the proximal periprosthetic region (zones 1 and 7), the Trabecular Metal group had significantly smaller reductions in BMD than the VerSys group throughout the study period. In the VerSys group, significant reductions in BMD compared to baseline were seen at each measurement point in all regions, except in zone 6 at 24 months. In the Trabecular Metal group, no significant reductions in BMD relative to baseline were seen in zones 1, 5, or 6 throughout the study period. Both groups demonstrated similar improvement in Japanese Orthopaedic Association hip scores over the study period. This study demonstrated that a proximally coated stem with porous tantalum has superior results over a conventional stem with titanium fiber mesh in terms of periprosthetic bone remodeling.
Collapse
Affiliation(s)
- Goro Motomura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Naohiko Mashima
- Department of Regeneration of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Hiroshi Imai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, 791-0295, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Masahiro Hasegawa
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Harumoto Yamada
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Aichi, 470-1192, Japan
- Department of Orthopedic Surgery, Nisshin Orido Hospital, 110, Nishidamen, Orido-cho, Nisshin, Aichi, 470-0115, Japan
| | - Mitsuhiro Morita
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Aichi, 470-1192, Japan
| | - Naoto Mitsugi
- Department of Orthopedic Surgery, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami, Yokohama, Kanagawa, 232-0024, Japan
- Department of Orthopedic Surgery, Osada Hospital, 2-10, Maruyamadai, Minatominami-ku, Yokohama, Kanagawa, 233-0013, Japan
| | - Ryosuke Nakanishi
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, Showa University School of Medicine, 1-30 Fujigaoka Aobaku, Yokohama, 227-8501, Japan
- Department of Orthopedic Surgery, Shizuoka Medical Center, 762-1, Nagasawa, Shimizu-cho, Sunto District, Shizuoka, 411-8611, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| |
Collapse
|
13
|
Wang X, Ning B, Pei X. Tantalum and its derivatives in orthopedic and dental implants: Osteogenesis and antibacterial properties. Colloids Surf B Biointerfaces 2021; 208:112055. [PMID: 34438295 DOI: 10.1016/j.colsurfb.2021.112055] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/11/2021] [Accepted: 08/16/2021] [Indexed: 02/08/2023]
Abstract
Implant-associated infections and aseptic loosening are some of the main reasons for implant failure. Therefore, there is an urgent need to improve the osseointegration and antibacterial capabilities of implant materials. In recent years, a large number of breakthroughs in the biological application of tantalum and its derivatives have been achieved. Owing to their corrosion resistance, biocompatibility, osseointegration ability, and antibacterial properties, they have shown considerable potential in orthopedic and dental implant applications. In this review, we provide the latest progress and achievements in the research on osseointegration and antibacterial properties of tantalum as well as its derivatives, and summarize the surface modification methods to enhance their osseointegration and antibacterial properties.
Collapse
Affiliation(s)
- Xu Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Boyu Ning
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xibo Pei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| |
Collapse
|
14
|
Hasandoost L, Marx D, Zalzal P, Safir O, Hurtig M, Mehrvar C, Waldman SD, Papini M, Towler MR. Comparative Evaluation of Two Glass Polyalkenoate Cements: An In Vivo Pilot Study Using a Sheep Model. J Funct Biomater 2021; 12:jfb12030044. [PMID: 34449631 PMCID: PMC8395762 DOI: 10.3390/jfb12030044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022] Open
Abstract
Poly(methyl methacrylate) (PMMA) is used to manage bone loss in revision total knee arthroplasty (rTKA). However, the application of PMMA has been associated with complications such as volumetric shrinkage, necrosis, wear debris, and loosening. Glass polyalkenoate cements (GPCs) have potential bone cementation applications. Unlike PMMA, GPC does not undergo volumetric shrinkage, adheres chemically to bone, and does not undergo an exothermic setting reaction. In this study, two different compositions of GPCs (GPCA and GPCB), based on the patented glass system SiO2-CaO-SrO-P2O5-Ta2O5, were investigated. Working and setting times, pH, ion release, compressive strength, and cytotoxicity of each composition were assessed, and based on the results of these tests, three sets of samples from GPCA were implanted into the distal femur and proximal tibia of three sheep (alongside PMMA as control). Clinical CT scans and micro-CT images obtained at 0, 6, and 12 weeks revealed the varied radiological responses of sheep bone to GPCA. One GPCA sample (implanted in the sheep for 12 weeks) was characterized with no bone resorption. Furthermore, a continuous bone-cement interface was observed in the CT images of this sample. The other implanted GPCA showed a thin radiolucent border at six weeks, indicating some bone resorption occurred. The third sample showed extensive bone resorption at both six and 12 weeks. Possible speculative factors that might be involved in the varied response can be: excessive Zn2+ ion release, low pH, mixing variability, and difficulty in inserting the samples into different parts of the sheep bone.
Collapse
Affiliation(s)
- Leyla Hasandoost
- Faculty of Engineering and Architectural Science, Biomedical Engineering Program, Ryerson University, Toronto, ON M5B 2K3, Canada; (L.H.); (D.M.); (S.D.W.); (M.P.)
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Daniella Marx
- Faculty of Engineering and Architectural Science, Biomedical Engineering Program, Ryerson University, Toronto, ON M5B 2K3, Canada; (L.H.); (D.M.); (S.D.W.); (M.P.)
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Paul Zalzal
- Faculty of Medicine, Department of Surgery, McMaster University, Hamilton, ON L8S 4L8, Canada;
- Oakville Trafalgar Memorial Hospital, Oakville, ON L6J 3L7, Canada
| | - Oleg Safir
- Division of Orthopedic Surgery, Mount Sinai Hospital, 600 University Ave, Toronto, ON M5G 1X5, Canada;
| | - Mark Hurtig
- Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1, Canada;
| | - Cina Mehrvar
- Department of Mechanical & Industrial Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada;
| | - Stephen D. Waldman
- Faculty of Engineering and Architectural Science, Biomedical Engineering Program, Ryerson University, Toronto, ON M5B 2K3, Canada; (L.H.); (D.M.); (S.D.W.); (M.P.)
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Department of Chemical Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Marcello Papini
- Faculty of Engineering and Architectural Science, Biomedical Engineering Program, Ryerson University, Toronto, ON M5B 2K3, Canada; (L.H.); (D.M.); (S.D.W.); (M.P.)
- Department of Mechanical & Industrial Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada;
| | - Mark R. Towler
- Faculty of Engineering and Architectural Science, Biomedical Engineering Program, Ryerson University, Toronto, ON M5B 2K3, Canada; (L.H.); (D.M.); (S.D.W.); (M.P.)
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Department of Mechanical & Industrial Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada;
- Correspondence:
| |
Collapse
|
15
|
Fiani B, Jarrah R, Shields J, Sekhon M. Enhanced biomaterials: systematic review of alternatives to supplement spine fusion including silicon nitride, bioactive glass, amino peptide bone graft, and tantalum. Neurosurg Focus 2021; 50:E10. [PMID: 34062502 DOI: 10.3171/2021.3.focus201044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/22/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Spinal fusions are among the most common and effective spinal surgical practices; however, the current model presents some cost and safety concerns within the patient population. Therefore, enhanced biomaterials have been presented to be an innovative yet underutilized tool to supplement the success of spinal fusion surgery. Herein, the authors discuss these biomaterials, their compositions, clinical outcomes, and cost analysis through a systematic review of the literature to date. METHODS This systematic review was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria and guidelines. Article selection was performed using the PubMed electronic bibliographic databases. The search yielded 1168 articles that were assessed and filtered for relevance by the four authors. Following the screening of titles and abstracts, 62 articles were deemed significant enough for final selection. RESULTS To date, silicon nitride, bioactive glass, amino peptide bone grafts, and tantalum are all biomaterials that could have significant roles in supporting spinal fusion. Their unique compositions allow them to be biocompatible in the spine, and their mechanisms of action stimulate osteoblast formation and support fusion success. Moreover, these biomaterials also present positive clinical and cost outcomes that support their application in spinal procedures. However, further studies with longer follow-ups are necessary to fully understand these biomaterials prior to their incorporation in mainstream spinal practice. CONCLUSIONS The combination of their positive clinical outcomes, biocompatibility, and cost-effectiveness makes these biomaterials valuable, innovative, and effective treatment modalities that could revolutionize the current model of spinal fusion.
Collapse
Affiliation(s)
- Brian Fiani
- 1Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, California
| | - Ryan Jarrah
- 2College of Arts and Sciences, University of Michigan-Flint
| | - Jennifer Shields
- 3College of Human Medicine, Michigan State University, East Lansing; and
| | - Manraj Sekhon
- 4William Beaumont School of Medicine, Oakland University, Rochester, Michigan
| |
Collapse
|
16
|
Huang G, Pan ST, Qiu JX. The Clinical Application of Porous Tantalum and Its New Development for Bone Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2647. [PMID: 34070153 PMCID: PMC8158527 DOI: 10.3390/ma14102647] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
Porous tantalum (Ta) is a promising biomaterial and has been applied in orthopedics and dentistry for nearly two decades. The high porosity and interconnected pore structure of porous Ta promise fine bone ingrowth and new bone formation within the inner space, which further guarantee rapid osteointegration and bone-implant stability in the long term. Porous Ta has high wettability and surface energy that can facilitate adherence, proliferation and mineralization of osteoblasts. Meanwhile, the low elastic modulus and high friction coefficient of porous Ta allow it to effectively avoid the stress shield effect, minimize marginal bone loss and ensure primary stability. Accordingly, the satisfactory clinical application of porous Ta-based implants or prostheses is mainly derived from its excellent biological and mechanical properties. With the advent of additive manufacturing, personalized porous Ta-based implants or prostheses have shown their clinical value in the treatment of individual patients who need specially designed implants or prosthesis. In addition, many modification methods have been introduced to enhance the bioactivity and antibacterial property of porous Ta with promising in vitro and in vivo research results. In any case, choosing suitable patients is of great importance to guarantee surgical success after porous Ta insertion.
Collapse
Affiliation(s)
| | | | - Jia-Xuan Qiu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China; (G.H.); (S.-T.P.)
| |
Collapse
|
17
|
Sasaki M, Umegaki M, Fukunaga T, Hijikata Y, Banba Y, Matsumoto K, Miyao Y. Vertebral Endplate Cyst Formation in Relation to Properties of Interbody Cages. Neurospine 2021; 18:170-176. [PMID: 33819943 PMCID: PMC8021841 DOI: 10.14245/ns.2040498.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/13/2020] [Indexed: 11/19/2022] Open
Abstract
Objective This retrospective study aimed to compare vertebral endplate cyst formation (VECF), an early predictor for pseudoarthrosis, in different types of interbody cages.
Methods We reviewed 84 cases treated with single-level posterior/transforaminal lumbar interbody fusion. We utilized a polyetheretherketone cage in 20 cases (group P), a titanium cage in 16 cases (group Ti), a titanium-coating polyetheretherketone cage in 13 cases (group TiP) and a porous tantalum cage in 35 cases (group Tn). VECF was evaluated comparing the computed tomography scans taken at day 0 and 6-month postoperation. We defined VECF (+) as enlargement of a pre-existing cyst or de novo formation of a cyst with the diameter over 2 mm. We calculated the adjusted odds ratio (OR) and 95% confidence intervals (CIs) as an indicator of association between different types of cages and VECF using a logistic regression model.
Results VECF was observed in 13 (65%), 7 (44%), 9 (69%), and 8 (23%) cases in groups P, Ti, TiP and Tn, respectively. VECF correlated with the type of cage (p = 0.04). In comparison with group P, the proportion of VECF (+) cases was lower in group Tn (OR, 0.16; 95% CI, 0.04–0.60) but not different in group Ti (OR, 0.47; 95% CI, 0.10–2.20) and group TiP (OR, 1.06; 95% CI, 0.21–5.28). No patient underwent additional surgery for the fused spinal level during the follow-up periods (average, 37.9 months; range, 6–76 months).
Conclusion VECF was the least in the porous Tn cage, suggesting its potential superiority for initial stability.
Collapse
Affiliation(s)
- Manabu Sasaki
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Japan
| | - Masao Umegaki
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Japan
| | - Takanori Fukunaga
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Japan
| | - Yasukazu Hijikata
- Department of Spine and Lumbago Center, Kitasuma Hospital, Hyogo, Japan
| | - Yohei Banba
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Japan
| | - Katsumi Matsumoto
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Japan
| | - Yasuyoshi Miyao
- Department of Neurosurgery, Suita Municipal Hospital, Suita, Japan
| |
Collapse
|
18
|
Brodie EG, Robinson KJ, Sigston E, Molotnikov A, Frith JE. Osteogenic Potential of Additively Manufactured TiTa Alloys. ACS APPLIED BIO MATERIALS 2021. [DOI: 10.1021/acsabm.0c01450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Erin G. Brodie
- Department of Materials Science and Engineering, Monash University, Clayton, Victoria 3800, Australia
- Monash Centre for Additive Manufacturing (MCAM), 11 Normanby Road, Nottinghill, Victoria 3168, Australia
| | - Kye J. Robinson
- Department of Inorganic and Analytical Chemistry, University of Geneva, Quai Ernest-Ansermet 30, CH-1211 Geneva, Switzerland
| | - Elizabeth Sigston
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria 3800, Australia
- Department of Otolaryngology, Head and Neck Surgery, Monash Health, Clayton, Victoria 3168, Australia
| | - Andrey Molotnikov
- Department of Materials Science and Engineering, Monash University, Clayton, Victoria 3800, Australia
- Monash Centre for Additive Manufacturing (MCAM), 11 Normanby Road, Nottinghill, Victoria 3168, Australia
- RMIT Centre for Additive Manufacturing, School of Engineering, RMIT University, 3001 Melbourne, Australia
| | - Jessica E. Frith
- Department of Materials Science and Engineering, Monash University, Clayton, Victoria 3800, Australia
| |
Collapse
|
19
|
Managing bone defects in primary total knee arthroplasty: options and current trends. Musculoskelet Surg 2020; 105:31-38. [PMID: 33058073 DOI: 10.1007/s12306-020-00683-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/03/2020] [Indexed: 12/31/2022]
Abstract
While tackling with bone deficiencies in the context of total knee arthroplasty, it is imperative for the arthroplasty surgeon to arm himself with an in-depth knowledge on the various management options available and to use the right option for the right type of defect in the right patient. Aim of this review paper is to focus on the various options available and discuss the evolving concepts and recent trends with regard to the implications and treatment of bone deficiencies, in primary total knee arthroplasty. Relevant literature is evaluated with specific focus on the modality used for managing a defect, their clinical and radiological outcomes and failure rates. Out of various classifications described, Anderson Orthopaedic Research Institute (AORI) system is universally employed to classify the bone defects. The currently available management options include more tibial resection, the use of bone cement to fill the defect, with or without augmentation with screws, bone grafting which may be autograft or allograft, metal augments, metaphyseal cones and sleeves. There is no single option which can be applied universally; each has its own advantages, disadvantages and specific indications with regard to application in specific types of defects, in specific patients as outlined in this article.
Collapse
|
20
|
Park PJ, Lehman RA. Optimizing the Spinal Interbody Implant: Current Advances in Material Modification and Surface Treatment Technologies. Curr Rev Musculoskelet Med 2020; 13:688-695. [PMID: 32816234 DOI: 10.1007/s12178-020-09673-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Interbody implants allow for fusion of the anterior column of the spine between vertebral body endplates. As rates of spinal fusion surgery have increased over the past several years, significant research has been devoted to optimizing both the mechanical and biologic properties of the interbody implant in order to promote bony fusion. The first interbody implants used decades ago were fashioned from cortical autograft. Currently, titanium alloy and polyetheretherketone (PEEK) are the most widely used and studied materials for this purpose. This review focuses on recent innovations in material modification and surface treatment techniques for both titanium and PEEK implants to maximize fusion rates in spinal surgery. RECENT FINDINGS Titanium has an elastic modulus much higher than native bone and however has better osseointegrative properties than PEEK. PEEK, however, has an elastic modulus closer to that of bone without any of the advantageous biologic properties that titanium has. Increasing porosity and surface roughness of titanium implants have been shown to improve the mechanical properties of titanium implants, while the biologic properties of PEEK have been enhanced using surface coating technology, either with titanium or with hydroxyapatite (HA). Techniques such as increasing porosity, surface roughening, and surface coating are just some of the recent innovations aimed at optimizing both mechanical and biologic properties of interbody implants to promote spinal fusion. The future of interbody implant design will rely on continued improvements of PEEK and titanium implants as well as exploring new implant materials altogether.
Collapse
Affiliation(s)
- Paul J Park
- The Spine Hospital, NewYork-Presbyterian/Columbia University Irving Medical Center, 5141 Broadway, 3 Field West-022, New York, NY, 10034, USA.
| | - Ronald A Lehman
- The Spine Hospital, NewYork-Presbyterian/Columbia University Irving Medical Center, 5141 Broadway, 3 Field West-022, New York, NY, 10034, USA
| |
Collapse
|
21
|
Patel MS, McCormick JR, Ghasem A, Huntley SR, Gjolaj JP. Tantalum: the next biomaterial in spine surgery? JOURNAL OF SPINE SURGERY 2020; 6:72-86. [PMID: 32309647 DOI: 10.21037/jss.2020.01.01] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Tantalum is a porous metal, whose elastic modulus, high frictional properties and biocompatibility make it an ideal construct to facilitate adequate bony fusion in spine surgery. Since 2015, the published literature on clinical outcomes of tantalum in spine surgery has more than doubled. A review of the literature was performed on the PubMed (MEDLINE) database on January 27, 2019, for papers pertinent to the use of tantalum metal in spine surgery. Thirteen studies were included in this review. For cervical spine, we found increased fusion rates in autograft alone compared to tantalum standalone (92.8% vs. 89.0%, P=0.001) and tantalum cages plus autograft (92.8% vs. 64.8%, P<0.0001). Complication rates in cervical fusion were lower in patients treated with tantalum standalone versus those treated with autograft (7.4% vs. 13.7%, P<0.0001), and autograft and anterior plate (7.4% vs. 33%, P=0.001). Autograft patients had higher rates of revision surgery compared to tantalum standalone (12.8% vs. 2.8%, P<0.0001) and tantalum ring with autograft (12.8% vs. 7.7%, P<0.001). For lumbar spine, we found autograft had lower fusion rate compared to tantalum standalone (80.0% vs. 93.4%, P<0.0001). Use of tantalum metal in spine fusion surgery shows promising results in fusion, complication and revision rates, and clinical outcomes compared to autograft. Although, fusion rates in short-term studies evaluating tantalum in the cervical spine are conflicting, long-term series beyond 2 years show excellent results. This early finding may be related difficulties in radiographic evaluation of fusion in the setting of tantalum cage use. Further studies are needed to further delineate the timing of fusion with the implementation of tantalum in the cervical and lumbar spine.
Collapse
Affiliation(s)
- Manan Sunil Patel
- The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | | | - Alexander Ghasem
- Department of Orthopedic Surgery, University of Miami Hospital, Miami, FL, USA
| | - Samuel R Huntley
- The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.,Department of Orthopedic Surgery, University of Miami Hospital, Miami, FL, USA
| | - Joseph P Gjolaj
- Department of Orthopedic Surgery, University of Miami Hospital, Miami, FL, USA
| |
Collapse
|
22
|
Li R, Liu G, Yang L, Qing Y, Tang X, Guo D, Zhang K, Qin Y. Tantalum boride as a biocompatible coating to improve osteogenesis of the bionano interface. J Biomed Mater Res A 2020; 108:1726-1735. [PMID: 32223058 DOI: 10.1002/jbm.a.36940] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 12/30/2022]
Abstract
A proper biological microenvironment conducive to tissue repair and regeneration, while the bioimplant interface directly affects the local microenvironment. In this study, to improve the biological microenvironment, a nanosized tantalum boride (Ta-B) was coated on a titanium alloy substrate (Ti6Al4V, TC4) using magnetron cosputtering. The sample surface was characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM). To investigate the effects of tantalum boride coating on the microenvironment, rabbit bone marrow stromal cells (BMSCs), and RAW 264.7 cells were respectively seeded on the sample surface and relevant experiments were conducted in vitro. The pure tantalum coating (Ta) and naked TC4 were prepared as controls. Our results showed that the Ta-B coating enhanced cell proliferation and adhesion and inhibited the inflammatory response. Findings of alkaline phosphatase (ALP) staining, alizarin red staining and real-time PCR for osteoblastic gene expression indicated that Ta-B and Ta coating improve the osteogenesis, in which Ta-B coating showed higher osteogenesis than Ta coating. Thus, this study suggests that Ta-B coating with excellent biocompatibility could have new applications for wound healing in bone tissue engineering.
Collapse
Affiliation(s)
- Ruiyan Li
- Department of Orthopedics, The Second Hospital of Jilin University, Jilin University, Changchun, PR China
| | - Guancong Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Jilin University, Changchun, PR China.,Department of Orthopedics, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Lina Yang
- State Key Laboratory of Superhard Materials, Department of Materials Science, and Key Laboratory of Automobile Materials, MOE, Jilin University, Changchun, PR China
| | - Yun'an Qing
- Department of Orthopedics, The Second Hospital of Jilin University, Jilin University, Changchun, PR China
| | - Xiongfeng Tang
- Department of Orthopedics, The Second Hospital of Jilin University, Jilin University, Changchun, PR China
| | - Deming Guo
- Department of Orthopedics, The Second Hospital of Jilin University, Jilin University, Changchun, PR China
| | - Kan Zhang
- State Key Laboratory of Superhard Materials, Department of Materials Science, and Key Laboratory of Automobile Materials, MOE, Jilin University, Changchun, PR China
| | - Yanguo Qin
- Department of Orthopedics, The Second Hospital of Jilin University, Jilin University, Changchun, PR China
| |
Collapse
|
23
|
Tantalum Fusion Device in Anterior Cervical Discectomy and Fusion For Treatment of Cervical Degeneration Disease: A Systematic Review and Meta-Analysis. Clin Spine Surg 2020; 33:111-119. [PMID: 31634174 DOI: 10.1097/bsd.0000000000000875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN This is a systematic review and meta-analysis study. OBJECTIVE The purpose of this systematic review and meta-analysis study is to evaluate the outcomes of a tantalum fusion device in anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degeneration disease. SUMMARY OF BACKGROUND DATA A great interest has raised for porous tantalum in cervical fusion, but several studies reported the divergent clinical outcome and fusion rate. No systematic review and meta-analysis has been conducted up to present to evaluate the outcomes of the tantalum fusion device. METHODS We comprehensively searched multiple databases for studies that investigated the tantalum fusion device in ACDF. The retrieved results were last updated on February 15, 2018. Outcomes of interest comprised of operative parameters, fusion rate, the incidence of adverse events as well as patient-reported outcomes, including the Neck Disability Index (NDI) score, Visual Analog Scale (VAS) score, Short Form-36 Physical Component Scores and complications. RESULTS Ten studies included were included in this review and 6 randomized controlled trial studies included. All studies were pooled to evaluate the outcome of fusion rate, NDI, and VAS after tantalum fusion treatment. The results of the meta-analysis showed that implantation of the tantalum fusion device is associated with significantly shorter operative and fewer adverse events when compared with autologous iliac crest bone graft. However, no difference was found with regards to the fusion rate, NDI, VAS, and global assessment. CONCLUSIONS Through this systemic review and meta-analysis, no significant difference was found with regards to fusion rate, postoperative NDI, and VAS between tantalum fusion and iliac crest bone graft in ACDF. More longer-term and randomized studies with large samples are warranted to validate any association found in this study. LEVEL OF EVIDENCE Level II.
Collapse
|
24
|
Abstract
Patients with symptomatic instability of the spine may be treated surgically with interbody fusion. Cost and complexity in this procedure arises owing to the implanted materials involved with facilitating fusion such as titanium or polyetheretherketone. Surface modifications have been developed to augment these base materials such as plasma-spraying polyetheretherketone with titanium or coating implants with hydroxyapatite. Although some evidence has been gathered on these novel materials, additional study is needed to establish the true efficacy of surface modifications for interbody fusion devices in improving long-term patient outcomes.
Collapse
Affiliation(s)
- Jacob J Enders
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Daniel Coughlin
- Center for Spine Health, Cleveland Clinic, Desk S40, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Thomas E Mroz
- Center for Spine Health, Cleveland Clinic, Desk S40, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Shaleen Vira
- Center for Spine Health, Cleveland Clinic, Desk S40, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| |
Collapse
|
25
|
Gee ECA, Eleotério R, Bowker LM, Saithna A, Hunt JA. The influence of tantalum on human cell lineages important for healing in soft-tissue reattachment surgery: an in-vitro analysis. J Exp Orthop 2019; 6:40. [PMID: 31659540 PMCID: PMC6816656 DOI: 10.1186/s40634-019-0210-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 10/17/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Porous tantalum is currently used in orthopaedic surgery for a variety of indications including soft tissue re-attachment. However, the clinical results have been variable and a previous laboratory study has suggested that tantalum may actually inhibit chick tendon fibroblasts. The influence of tantalum on human cell-types involved in soft tissue re-attachment has not been defined. METHODS Human fibroblasts, human osteoblasts and human mesenchymal stem cells were plated on glass cover slips, half of which were coated with tantalum. Cell numbers were assessed at 1, 2, 7 and 14 days using Cyquant® assay. Cell adhesion and morphology were assessed using light microscopy at 7, 14 and 28 days. To reduce the effect of an expected rate of error, n = 4 was utilised for each cell type and the experiment was repeated twice. RESULTS Statistically similar numbers of human osteoblasts and human mesenchymal stem cells were present at 14 days on tantalum-coated and uncoated glass cover slips, revealing no inhibitory effect on cell proliferation. More than double the number of human fibroblasts was seen on tantalum-coated cover slips at that time point (compared to controls), which was statistically significant (p < 0.0001). Morphological assessment revealed normal cell spreading and adhesion on both substrates at all time points. CONCLUSIONS In vitro study demonstrates that Tantalum causes a significant increase in the proliferation of human fibroblasts with no quantifiable negative effects seen on fibroblast behaviour after 28 days culture. Furthermore, tantalum does not exert any inhibitory effects on the proliferation or behaviour of human osteoblasts or human mesenchymal stem cells. Tantalum could be an appropriate biomaterial for use in situations where soft tissue requires direct reattachment to implants and may stimulate soft tissue healing.
Collapse
Affiliation(s)
| | - Renato Eleotério
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
| | - Laura M. Bowker
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
| | - Adnan Saithna
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
- Sano Orthopedic Clinic, Kansas City, Kansas USA
- Kansas City University of Medicine and Biosciences, Kansas City, MO USA
| | - John A. Hunt
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
| |
Collapse
|
26
|
Wojtowicz R, Henricson A, Nilsson KG, Crnalic S. Uncemented monoblock trabecular metal posterior stabilized high-flex total knee arthroplasty: similar pattern of migration to the cruciate-retaining design - a prospective radiostereometric analysis (RSA) and clinical evaluation of 40 patients (49 knees) 60 years or younger with 9 years' follow-up. Acta Orthop 2019; 90:460-466. [PMID: 31210081 PMCID: PMC6746276 DOI: 10.1080/17453674.2019.1626097] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Uncemented monoblock cruciate retaining (CR) trabecular metal (TM) tibial components in total knee arthroplasty (TKA) work well in the long-term perspective in patients ≤ 60 years. Younger persons expect nearly normal knee flexion after TKA, but CR implants generally achieve less knee flexion compared with posterior stabilized (PS) implants. Cemented PS implants have higher revision rate than CR implants. Can an uncemented monoblock PS TM implant be used safely in younger patients? Patients and methods - 40 patients (49 knees) age ≤ 60 years with primary (20 knees) or posttraumatic osteoarthritis (OA) were operated with a high-flex TKA using an uncemented monoblock PS TM tibial component. Knees were evaluated with radiostereometric analysis (RSA) a mean 3 days (1-5) postoperatively, and thereafter at 6 weeks, 3 months, 1, 2, 5, and 9 years. Clinical outcome was measured with patient-related outcome measures (PROMs). Results - The implants showed a pattern of migration with initial large migration followed by early stabilization lasting up to 9 years, a pattern known to be compatible with good long-term results. Clinical and radiological outcome was excellent with 38 of the 40 patients being satisfied or very satisfied with the procedure and bone apposition to the entire implant surface in 46 of 49 knees. Mean knee flexion was 130°. 1 knee was revised at 3 months due to medial tibial condyle collapse. Interpretation - The uncemented monoblock PS TM implant works well in younger persons operated with TKA due to primary or secondary OA.
Collapse
Affiliation(s)
- Radoslaw Wojtowicz
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden;
| | | | - Kjell G Nilsson
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden; ,Correspondence:
| | - Sead Crnalic
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden;
| |
Collapse
|
27
|
Bandyopadhyay A, Mitra I, Shivaram A, Dasgupta N, Bose S. Direct comparison of additively manufactured porous titanium and tantalum implants towards in vivo osseointegration. ADDITIVE MANUFACTURING 2019; 28:259-266. [PMID: 31406683 PMCID: PMC6690615 DOI: 10.1016/j.addma.2019.04.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Material properties of implants such as volume porosity and nanoscale surface modification have been shown to enhance cell-material interactions in vitro and osseointegration in vivo. Porous tantalum (Ta) and titanium (Ti) coatings are widely used for non-cemented implants, which are fabricated using different processing routes. In recent years, some of those implants are being manufactured using additive manufacturing. However, limited knowledge is available on direct comparison of additively manufactured porous Ta and Ti structures towards early stage osseointegration. In this study, we have fabricated porous Ta and Ti6Al4V (Ti64) implants using laser engineered net shaping (LENS™) with similar volume fraction porosity to compare the influence of surface characteristics and material chemistry on in vivo response using a rat distal femur model for 5 and 12 weeks. We have also assessed whether surface modification on Ti64 can elicit similar in vivo response as porous Ta in a rat distal femur model for 5 and 12 weeks. The harvested implants were histologically analyzed for osteoid surface per bone surface. Field emission scanning electron microscopy (FESEM) was done to assess the bone-implant interface. The results presented here indicate comparable performance of porous Ta and surface modified porous Ti64 implants towards early stage osseointegration at 5 weeks post implantation through seamless bone-material interlocking. However, a continued and extended efficacy of porous Ta is found in terms of higher osteoid formation at 12 weeks post-surgery.
Collapse
Affiliation(s)
- Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Indranath Mitra
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Anish Shivaram
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Nairanjana Dasgupta
- Department of Mathematics and Statistics, Washington State University, Pullman, WA, 99164, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| |
Collapse
|
28
|
Application of a novel porous tantalum implant in rabbit anterior lumbar spine fusion model: in vitro and in vivo experiments. Chin Med J (Engl) 2019; 132:51-62. [PMID: 30628959 PMCID: PMC6629310 DOI: 10.1097/cm9.0000000000000030] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Some porous materials have been developed to enhance biologic fusion of the implants to bone in spine fusion surgeries. However, there are several inherent limitations. In this study, a novel biomedical porous tantalum was applied to in vitro and in vivo experiments to test its biocompatibility and osteocompatibility. METHODS Bone marrow-derived mesenchymal stem cells (BMSCs) were cultured on porous tantalum implant. Scanning electron microscope (SEM) and Cell Counting Kit-8 assay were used to evaluate the cell toxicity and biocompatibility. Twenty-four rabbits were performed discectomy only (control group), discectomy with autologous bone implanted (autograft group), and discectomy with porous tantalum implanted (tantalum group) at 3 levels: L3-L4, L4-L5, and L5-L6 in random order. All the 24 rabbits were randomly sacrificed at the different post-operative times (2, 4, 6, and 12 months; n = 6 at each time point). Histologic examination and micro-computed tomography scans were done to evaluate the fusion process. Comparison of fusion index scores between groups was analyzed using one-way analysis of variance. Other comparisons of numerical variables between groups were made by Student t test. RESULTS All rabbits survived and recovered without any symptoms of nerve injury. Radiographic fusion index scores at 12 months post-operatively between autograft and tantalum groups showed no significant difference (2.89 ± 0.32 vs. 2.83 ± 0.38, F = 244.60, P = 0.709). Cell Counting Kit-8 assay showed no significant difference of absorbance values between the leaching liquor group and control group (1.25 ± 0.06 vs. 1.23 ± 0.04, t = -0.644, P = 0.545), which indicated the BMSC proliferation without toxicity. SEM images showed that these cells had irregular shapes with long spindles adhered to the surface of tantalum implant. No implant degradation, wear debris, or osteolysis was observed. Histologic results showed solid fusion in the porous tantalum and autologous bone implanted intervertebral spaces. CONCLUSION This novel porous tantalum implant showed a good biocompatibility and osteocompatibility, which could be a valid biomaterial for interbody fusion cages.
Collapse
|
29
|
Ding X, Liu X, Chen J, Chen S. [Research progress of porous tantalum in bone tissue engineering]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2019; 32:753-757. [PMID: 29905056 DOI: 10.7507/1002-1892.201711040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To review the basical research progress of porous tantalum in bone tissue engineering. Methods The related basical research in fabrication, cytobiology, and surface modification of porous tantalum was reviewed and analyzed. Results The outstanding physiochemical properties of porous tantalum granted its excellent performance in biocompatibility and osteointegration, as well as promoting cartilage and tendon tissue restoration. However, the clinical utilization of porous tantalum is somehow greatly limited by the complex and rigid commercial fabrication methods and extraordinary high cost. Along with the publication of novel fabrication and surface modification technology, the application of porous tantalum will be more extensive, the promotion in bone tissue regeneration will be more prominent. Conclusion Porous tantalum has advantage in bone defect restoration, and significant breakthrough technology is needed in fabrication methods and surface modification.
Collapse
Affiliation(s)
- Xiaoquan Ding
- Department of Sports Medicine and Arthroscopy, Huashan Hospital, Fudan University, Shanghai, 200040, P.R.China
| | - Xingwang Liu
- Department of Sports Medicine and Arthroscopy, Huashan Hospital, Fudan University, Shanghai, 200040, P.R.China
| | - Jun Chen
- Department of Sports Medicine and Arthroscopy, Huashan Hospital, Fudan University, Shanghai, 200040, P.R.China
| | - Shiyi Chen
- Department of Sports Medicine and Arthroscopy, Huashan Hospital, Fudan University, Shanghai, 200040,
| |
Collapse
|
30
|
Bencharit S, Morelli T, Barros S, Seagroves JT, Kim S, Yu N, Byrd K, Brenes C, Offenbacher S. Comparing Initial Wound Healing and Osteogenesis of Porous Tantalum Trabecular Metal and Titanium Alloy Materials. J ORAL IMPLANTOL 2019; 45:173-180. [PMID: 30663941 DOI: 10.1563/aaid-joi-d-17-00258] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Porous tantalum trabecular metal (PTTM) has long been used in orthopedics to enhance neovascularization, wound healing, and osteogenesis; recently, it has been incorporated into titanium alloy dental implants. However, little is known about the biological responses to PTTM in the human oral cavity. We have hypothesized that, compared with conventional titanium alloy, PTTM has a greater expression of genes specific to neovascularization, wound healing, and osteogenesis during the initial healing period. Twelve subjects requiring at least 4 implants in the mandible were enrolled. Four 3 × 5mm devices, including 2 titanium alloy tapered screws and 2 PTTM cylinders, were placed in the edentulous mandibular areas using a split-mouth design. One device in each group was trephined for analysis at 2 and 4 weeks after placement. RNA microarray analysis and ingenuity pathway analysis were used to analyze osteogenesis gene expression and relevant signaling pathways. Compared to titanium alloy, PTTM samples exhibited significantly higher expressions of genes specific to cell neovascularization, wound healing, and osteogenesis. Several genes-including bone morphogenic proteins, collagens, and growth factors-were upregulated in the PTTM group compared to the titanium alloy control. PTTM materials may enhance the initial healing of dental implants by modifying gene expression profiles.
Collapse
Affiliation(s)
- Sompop Bencharit
- 1 Departments of General Practice and Oral and Maxillofacial Surgery, School of Dentistry and Department of Biomedical Engineering, School of Engineering, Virginia Commonwealth University, Richmond, Va
| | - Thiago Morelli
- 2 Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Silvana Barros
- 2 Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Jackson T Seagroves
- 3 Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Steven Kim
- 4 Curriculum in Oral Biology, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Ning Yu
- 4 Curriculum in Oral Biology, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Kevin Byrd
- 4 Curriculum in Oral Biology, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Christian Brenes
- 5 Department of General Dentistry, Dental College of Georgia, Augusta University, Augusta, Ga
| | - Steven Offenbacher
- 2 Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC
| |
Collapse
|
31
|
Addressing large tibial osseous defects in primary total knee arthroplasty using porous tantalum cones. Knee 2019; 26:228-239. [PMID: 30554910 DOI: 10.1016/j.knee.2018.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/22/2018] [Accepted: 11/01/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Tibial osseous defects can present a serious challenge in primary total knee arthroplasty. We describe a technique of using porous tantalum cones along with primary arthroplasty implants to address large tibial osseous defects in primary total knee arthroplasty and present the short-term results. METHODS We present 17 cases (15 patients) in which primary total knee implants and porous tantalum cones were used to address large tibial bony defects. Clinical results were evaluated using Knee Society Scores, pre- and postoperative knee range of motion, and serial radiographs. RESULTS At an average of 3.5 years of follow-up, all 17 knees had functioning implants with stable metaphyseal cones demonstrating radiographic evidence of osteointegration. At a minimum follow-up of two years, no patient had signs of osteolysis, instability, infection, or systemic complications. All 15 patients had excellent results with an average post-operative Knee Society Score of 94.6. Knee flexion improved by an average of 12.0° and knee extension improved to neutral in all patients. CONCLUSION Primary total knee arthroplasty with porous tantalum cone augmentation produced excellent short-term results and should be considered an effective method for addressing large tibial osseous defects in primary total knee arthroplasty.
Collapse
|
32
|
Guo Y, Xie K, Jiang W, Wang L, Li G, Zhao S, Wu W, Hao Y. In Vitro and in Vivo Study of 3D-Printed Porous Tantalum Scaffolds for Repairing Bone Defects. ACS Biomater Sci Eng 2018; 5:1123-1133. [PMID: 33405802 DOI: 10.1021/acsbiomaterials.8b01094] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yu Guo
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Kai Xie
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Wenbo Jiang
- Clinical and Translational Research Center for 3D Printing Technology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Lei Wang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Guoyuan Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital of USTC, Department of Orthopaedic Surgery, Division of Life Sciences and Medicine, University of Science and Technology of China, 230001 Hefei, China
| | - Shuang Zhao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Wen Wu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Yongqiang Hao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
- Clinical and Translational Research Center for 3D Printing Technology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| |
Collapse
|
33
|
Rahman SU, Nagrath M, Ponnusamy S, Arany PR. Nanoscale and Macroscale Scaffolds with Controlled-Release Polymeric Systems for Dental Craniomaxillofacial Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2018; 11:E1478. [PMID: 30127246 PMCID: PMC6120038 DOI: 10.3390/ma11081478] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/03/2018] [Accepted: 08/10/2018] [Indexed: 12/11/2022]
Abstract
Tremendous progress in stem cell biology has resulted in a major current focus on effective modalities to promote directed cellular behavior for clinical therapy. The fundamental principles of tissue engineering are aimed at providing soluble and insoluble biological cues to promote these directed biological responses. Better understanding of extracellular matrix functions is ensuring optimal adhesive substrates to promote cell mobility and a suitable physical niche to direct stem cell responses. Further, appreciation of the roles of matrix constituents as morphogen cues, termed matrikines or matricryptins, are also now being directly exploited in biomaterial design. These insoluble topological cues can be presented at both micro- and nanoscales with specific fabrication techniques. Progress in development and molecular biology has described key roles for a range of biological molecules, such as proteins, lipids, and nucleic acids, to serve as morphogens promoting directed behavior in stem cells. Controlled-release systems involving encapsulation of bioactive agents within polymeric carriers are enabling utilization of soluble cues. Using our efforts at dental craniofacial tissue engineering, this narrative review focuses on outlining specific biomaterial fabrication techniques, such as electrospinning, gas foaming, and 3D printing used in combination with polymeric nano- or microspheres. These avenues are providing unprecedented therapeutic opportunities for precision bioengineering for regenerative applications.
Collapse
Affiliation(s)
- Saeed Ur Rahman
- Departments of Oral Biology and Biomedical Engineering, School of Dentistry, University at Buffalo, Buffalo, NY 14214, USA.
- Interdisciplinary Research Centre in Biomedical Materials, COMSATS University Islamabad, Lahore Campus, Lahore 54000, Pakistan.
| | - Malvika Nagrath
- Departments of Oral Biology and Biomedical Engineering, School of Dentistry, University at Buffalo, Buffalo, NY 14214, USA.
- Department of Biomedical Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada.
| | - Sasikumar Ponnusamy
- Departments of Oral Biology and Biomedical Engineering, School of Dentistry, University at Buffalo, Buffalo, NY 14214, USA.
| | - Praveen R Arany
- Departments of Oral Biology and Biomedical Engineering, School of Dentistry, University at Buffalo, Buffalo, NY 14214, USA.
| |
Collapse
|
34
|
Huang Q, Li X, Elkhooly TA, Xu S, Liu X, Feng Q, Wu H, Liu Y. The osteogenic, inflammatory and osteo-immunomodulatory performances of biomedical Ti-Ta metal-metal composite with Ca- and Si-containing bioceramic coatings. Colloids Surf B Biointerfaces 2018; 169:49-59. [PMID: 29747030 DOI: 10.1016/j.colsurfb.2018.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 02/01/2023]
Abstract
It is known that good mechanical properties, low modulus to reduce stress-shielding effect, favorable osteogenic activity and limited inflammatory response are critical factors for orthopedic implants to induce excellent osteointegration. In this study, Ti-20% Ta metal-metal composite (referred as Ti-Ta) which consisted of Ti- and Ta-rich phases was fabricated via the strategy of powder metallurgy. Micro-arc oxidation (MAO) was employed to modify the surface of Ti-Ta composite. The surfaces of Ti-Ta composite after MAO treatment at an applied voltage of 250 (referred as MAO-250 V) or 300 V (referred as MAO-300 V) exhibited three distinct zones with significantly different morphological features and surface chemistry. Osteoblast-like SaOS-2 cells were found to be preferential to attach on the Ta-rich phase and its surrounding areas, exhibiting an area-dependent adhesion tendency. However, the attachment of Raw 264.7 macrophages was found to be insensitive to the surface characteristics. The proliferation and differentiation of SaOS-2 cells cultured on various surfaces basically followed the trend: MAO-modified surfaces > Ti-Ta surface > Ti surface. The Ti-Ta and MAO-modified surfaces were found to inhibit the inflammatory response and polarize macrophages to anti-inflammatory M2 phenotype compared to Ti surface. Moreover, the microenvironments created by Ti-Ta, MAO-250 V and MAO-300 V/macrophage interactions promoted the proliferation and differentiation of SaOS-2 cells compared to that created by Ti/macrophage interactions. MAO-300 V surface exhibited further enhanced positive osteo-immunomodulatory effects compared to Ti-Ta surface. Together, the Ti-20% Ta metal-metal composite modified by MAO at an applied voltage of 300 V is considered as a promising implant material for orthopedic applications.
Collapse
Affiliation(s)
- Qianli Huang
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, PR China
| | - Xuezhong Li
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, PR China
| | - Tarek A Elkhooly
- Department of ceramics, Inorganic Chemical Industries Division, National Research Centre, Dokki, 12622, Cairo, Egypt
| | - Shenghang Xu
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, PR China
| | - Xujie Liu
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, PR China
| | - Qingling Feng
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, PR China
| | - Hong Wu
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, PR China.
| | - Yong Liu
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, PR China.
| |
Collapse
|
35
|
Mutsuzaki H, Watanabe A, Kinugasa T, Ikeda K. Radiolucent lines are decreased at 3 years following total knee arthroplasty using trabecular metal tibial components. J Int Med Res 2018; 46:1919-1927. [PMID: 29557268 PMCID: PMC5991252 DOI: 10.1177/0300060518757927] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To analyse location and frequency, and change over time, of radiolucent lines (RLLs) around trabecular metal tibial components in total knee arthroplasty (TKA). Methods Osteoarthritic knees in patients who had undergone TKA were retrospectively evaluated via analysis of RLLs on anteroposterior and lateral X-rays obtained at 2 and 6 months, and 1, 2 and 3 years following TKA. Results In 125 osteoarthritic knees from 90 patients (mean age, 75.0 ± 6.2; 21 male/69 female), frequency of RLLs around trabecular metal tibial components was generally highest at 2 and 6 months, and 1 year following TKA, then gradually decreased over the 3-year follow-up. Frequency of RLLs around trabecular metal tibial components was greater at the tip of the two pegs, particularly the medial peg, and around the pegs, versus other zones. No postoperative revisions were performed for loosening. Conclusions Over 3 years following TKA, RLLs were most frequently observed up to 1 year, then gradually decreased. RLLs were significantly more frequent in the medial peg zone and zones close to the medial peg than in other zones.
Collapse
Affiliation(s)
- Hirotaka Mutsuzaki
- 1 Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, Ami, Inashiki, Ibaraki, Japan.,2 Department of Orthopaedic Surgery, Ichihara Hospital, Ozone, Tsukuba, Ibaraki, Japan
| | - Arata Watanabe
- 2 Department of Orthopaedic Surgery, Ichihara Hospital, Ozone, Tsukuba, Ibaraki, Japan
| | - Tomonori Kinugasa
- 2 Department of Orthopaedic Surgery, Ichihara Hospital, Ozone, Tsukuba, Ibaraki, Japan
| | - Kotaro Ikeda
- 2 Department of Orthopaedic Surgery, Ichihara Hospital, Ozone, Tsukuba, Ibaraki, Japan
| |
Collapse
|
36
|
Rodríguez-Méndez I, Fernández-Gutiérrez M, Rodríguez-Navarrete A, Rosales-Ibáñez R, Benito-Garzón L, Vázquez-Lasa B, San Román J. Bioactive Sr(II)/Chitosan/Poly(ε-caprolactone) Scaffolds for Craniofacial Tissue Regeneration. In Vitro and In Vivo Behavior. Polymers (Basel) 2018; 10:E279. [PMID: 30966314 PMCID: PMC6415099 DOI: 10.3390/polym10030279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/23/2018] [Accepted: 03/02/2018] [Indexed: 01/16/2023] Open
Abstract
In craniofacial tissue regeneration, the current gold standard treatment is autologous bone grafting, however, it presents some disadvantages. Although new alternatives have emerged there is still an urgent demand of biodegradable scaffolds to act as extracellular matrix in the regeneration process. A potentially useful element in bone regeneration is strontium. It is known to promote stimulation of osteoblasts while inhibiting osteoclasts resorption, leading to neoformed bone. The present paper reports the preparation and characterization of strontium (Sr) containing hybrid scaffolds formed by a matrix of ionically cross-linked chitosan and microparticles of poly(ε-caprolactone) (PCL). These scaffolds of relatively facile fabrication were seeded with osteoblast-like cells (MG-63) and human bone marrow mesenchymal stem cells (hBMSCs) for application in craniofacial tissue regeneration. Membrane scaffolds were prepared using chitosan:PCL ratios of 1:2 and 1:1 and 5 wt % Sr salts. Characterization was performed addressing physico-chemical properties, swelling behavior, in vitro biological performance and in vivo biocompatibility. Overall, the composition, microstructure and swelling degree (≈245%) of scaffolds combine with the adequate dimensional stability, lack of toxicity, osteogenic activity in MG-63 cells and hBMSCs, along with the in vivo biocompatibility in rats allow considering this system as a promising biomaterial for the treatment of craniofacial tissue regeneration.
Collapse
Affiliation(s)
- Itzia Rodríguez-Méndez
- Faculty of Chemistry, Autonomous University of San Luis Potosi, San Luis Potosi 6, Salvador Nava Martínez, 78210 San Luis, S.L.P., Mexico.
| | - Mar Fernández-Gutiérrez
- Institute of Polymer Science and Technology, ICTP-CSIC, C/Juan de la Cierva 3, 28006 Madrid, Spain.
- CIBER, Carlos III Health Institute, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
| | - Amairany Rodríguez-Navarrete
- Faculty of Higher Studies, National Autonomous University of Mexico, Av. Chalma s/n Col. La Pastora, Cuautepec Barrio Bajo. Delegación Gustavo A. Madero, Ciudad de México 07160, Mexico.
| | - Raúl Rosales-Ibáñez
- Faculty of Higher Studies, National Autonomous University of Mexico, Av. Chalma s/n Col. La Pastora, Cuautepec Barrio Bajo. Delegación Gustavo A. Madero, Ciudad de México 07160, Mexico.
| | - Lorena Benito-Garzón
- Faculty of Medicine, University of Salamanca, C/Alfonso X el Sabio, s/n, 37007 Salamanca, Spain.
| | - Blanca Vázquez-Lasa
- Institute of Polymer Science and Technology, ICTP-CSIC, C/Juan de la Cierva 3, 28006 Madrid, Spain.
- CIBER, Carlos III Health Institute, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
| | - Julio San Román
- Institute of Polymer Science and Technology, ICTP-CSIC, C/Juan de la Cierva 3, 28006 Madrid, Spain.
- CIBER, Carlos III Health Institute, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
| |
Collapse
|
37
|
Zeng YJ, Twan SC, Wang KW, Huang HH, Hsu YB, Wang CY, Lan MY, Lee SW. Enhanced Biocompatibility in Anodic TaO x Nanotube Arrays. NANOSCALE RESEARCH LETTERS 2017; 12:557. [PMID: 28975550 PMCID: PMC5626673 DOI: 10.1186/s11671-017-2325-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
This study first investigates the biocompatibility of self-organized TaO x nanotube arrays with different nanotube diameters fabricated by electrochemical anodization. All as-anodized TaO x nanotubes were identified to be an amorphous phase. The transition in surface wettability with TaO x nanotube diameters can be explained based on Wenzel's model in terms of geometric roughness. In vitro biocompatibility evaluation further indicates that fibroblast cells exhibit an obvious wettability-dependent behavior on the TaO x nanotubes. The 35-nm-diameter TaO x nanotube arrays reveal the highest biocompatibility among all samples. This enhancement could be attributed to highly dense focal points provided by TaO x nanotubes due to higher surface hydrophilicity. This work demonstrates that the biocompatibility in Ta can be improved by forming TaO x nanotube arrays on the surface with appropriate nanotube diameter and geometric roughness.
Collapse
Affiliation(s)
- Yu-Jin Zeng
- Institute of Materials Science and Engineering, National Central University, Taoyuan, 320 Taiwan Republic of China
| | - Sheng-Chen Twan
- Institute of Materials Science and Engineering, National Central University, Taoyuan, 320 Taiwan Republic of China
| | - Kuan-Wen Wang
- Institute of Materials Science and Engineering, National Central University, Taoyuan, 320 Taiwan Republic of China
| | - Her-Hsiung Huang
- Department of Dentistry, National Yang-Ming University, Taipei, 11221 Taiwan Republic of China
| | - Yen-Bin Hsu
- Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, 112 Taiwan Republic of China
- School of Medicine, National Yang-Ming University, Taipei, 112 Taiwan Republic of China
| | - Chien-Ying Wang
- Department of Emergency, Taipei Veterans General Hospital, Taipei, 112 Taiwan Republic of China
| | - Ming-Ying Lan
- Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, 112 Taiwan Republic of China
- School of Medicine, National Yang-Ming University, Taipei, 112 Taiwan Republic of China
| | - Sheng-Wei Lee
- Institute of Materials Science and Engineering, National Central University, Taoyuan, 320 Taiwan Republic of China
| |
Collapse
|
38
|
Huang J, Wang D, Chen J, Liu W, Duan L, You W, Zhu W, Xiong J, Wang D. Osteogenic differentiation of bone marrow mesenchymal stem cells by magnetic nanoparticle composite scaffolds under a pulsed electromagnetic field. Saudi Pharm J 2017; 25:575-579. [PMID: 28579894 PMCID: PMC5447436 DOI: 10.1016/j.jsps.2017.04.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This study was conducted to investigate the effect of magnetic nanoparticle composite scaffold under a pulsed electromagnetic field on bone marrow mesenchymal stem cells (BMSCs), which was achieved by examining the biological behaviors of cell adhesion, proliferation and differentiation on the surface of the scaffolds. This may provide some experimental evidence for the use of magnetic nanoparticles in medical application. The magnetic nanoparticle composite scaffolds were evaluated and characterized by the following indexes: the cell proliferation was detected by the CCK-8 method, the alkaline phosphatase (ALP) activity was examined by a detection kit, and the expression of type I collagen and osteocalcin gene were evaluated by RT-PCR. The CCK-8 test showed that there was no significant difference in Group A (BMSCs-seeded magnetic scaffolds under the electromagnetic field), B (BMSCs-seeded magnetic scaffolds) and C (BMSCs cultured alone) (P > 0.05). The value for the ALP activity in Group A was higher than the other two groups. In addition, the RT-PCR results showed that the expression of type I collagen gene in Group A was enhanced (P < 0.05), suggesting that the magnetic nanoparticles combined with the pulsed electromagnetic field had a positive effect on the osteogenic differentiation of BMSCs. However, the expression of osteocalcin was not significantly different in three groups (P > 0.05). To conclude, magnetic nanoparticles may induce the osteogenic differentiation with the action of the pulsed electromagnetic field.
Collapse
Affiliation(s)
- Jianghong Huang
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Daming Wang
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Software Town of Shenzhen Universiade, Shenzhen Longer3d Technology, Shenzhen 518116, China
| | - Jielin Chen
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Wei Liu
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Li Duan
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Wei You
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Weimin Zhu
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Jianyi Xiong
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Daping Wang
- Shenzhen National Key Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China.,Shenzhen Laboratory of Digital Orthopedic Engineering, Shenzhen Second People's Hospital, Shenzhen 518035, China
| |
Collapse
|
39
|
A novel tantalum-containing bioglass. Part II. Development of a bioadhesive for sternal fixation and repair. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 71:401-411. [DOI: 10.1016/j.msec.2016.10.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/02/2016] [Accepted: 10/16/2016] [Indexed: 11/21/2022]
|
40
|
Shi J, Zhang X, Qiao S, Ni J, Mo J, Gu Y, Lai H. Enhanced osteointegration of tantalum-modified titanium implants with micro/nano-topography. RSC Adv 2017. [DOI: 10.1039/c7ra08036k] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Ta modification enhanced the osteointegration of an SLA surface with micro/nano topography and the possible mechanism might be activation of the Wnt pathway.
Collapse
Affiliation(s)
- Junyu Shi
- Department of Oral and Maxillo-facial Implantology
- Shanghai Ninth People's Hospital
- School of Medicine
- Shanghai Jiaotong University
- Shanghai 200011
| | - Xiaomeng Zhang
- Department of Oral and Maxillo-facial Implantology
- Shanghai Ninth People's Hospital
- School of Medicine
- Shanghai Jiaotong University
- Shanghai 200011
| | - Shichong Qiao
- Department of Oral and Maxillo-facial Implantology
- Shanghai Ninth People's Hospital
- School of Medicine
- Shanghai Jiaotong University
- Shanghai 200011
| | - Jie Ni
- Department of Oral and Maxillo-facial Implantology
- Shanghai Ninth People's Hospital
- School of Medicine
- Shanghai Jiaotong University
- Shanghai 200011
| | - Jiaji Mo
- Department of Oral and Maxillo-facial Implantology
- Shanghai Ninth People's Hospital
- School of Medicine
- Shanghai Jiaotong University
- Shanghai 200011
| | - Yingxin Gu
- Department of Oral and Maxillo-facial Implantology
- Shanghai Ninth People's Hospital
- School of Medicine
- Shanghai Jiaotong University
- Shanghai 200011
| | - Hongchang Lai
- Department of Oral and Maxillo-facial Implantology
- Shanghai Ninth People's Hospital
- School of Medicine
- Shanghai Jiaotong University
- Shanghai 200011
| |
Collapse
|
41
|
Kang C, Wei L, Song B, Chen L, Liu J, Deng B, Pan X, Shao L. Involvement of autophagy in tantalum nanoparticle-induced osteoblast proliferation. Int J Nanomedicine 2017; 12:4323-4333. [PMID: 28652735 PMCID: PMC5473603 DOI: 10.2147/ijn.s136281] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Porous tantalum (Ta) implants are highly corrosion resistant and biocompatible, and they possess significantly better initial stability than that of conventional titanium (Ti) implants. During loading wear, Ta nanoparticles (Ta-NPs) that were deposited on the surface of a porous Ta implant are inevitably released and come into direct contact with peri-implant osteoblasts. The wear debris may influence cell behavior and implant stabilization. However, the interaction of Ta-NPs with osteoblasts has not been clearly investigated. This study aimed to investigate the effect of Ta-NPs on cell proliferation and their underlying mechanism. The Cell Counting Kit-8 (CCK-8) assay was used to measure the cell viability of MC3T3-E1 mouse osteoblasts and showed that Ta-NP treatment could increase cell viability. Then, confocal microscopy, Western blotting, and transmission electron microscopy were used to confirm the autophagy induced by Ta-NPs, and evidence of autophagy induction was observed as positive LC3 puncta, high-LC3-II expression, and autophagic vesicle ultrastructures. The CCK-8 assay revealed that the cell viability was further increased and decreased by the application of an autophagy inducer and inhibitor, respectively. In addition, pre-treatment with autophagy inhibitor 3-methyladenine (3-MA) inhibited the Ta-NP-induced autophagy. These results indicate that the Ta-NPs can promote cell proliferation, that an autophagy inducer can further strengthen this effect and that an autophagy inhibitor can weaken this effect. In conclusion, autophagy was involved in Ta-NP-induced cell proliferation and had a promoting effect.
Collapse
Affiliation(s)
- Chengrong Kang
- Department of Stomatology, Nanfang Hospital, Southern Medical University
- Department of Stomatology, The First Affiliated Hospital of Guangdong Pharmaceutical University
| | - Limin Wei
- Department of Stomatology, Nanfang Hospital, Southern Medical University
| | - Bin Song
- Department of Stomatology, Nanfang Hospital, Southern Medical University
| | - Liangjiao Chen
- Department of Orthodontics, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou
| | - Jia Liu
- Department of Stomatology, Nanfang Hospital, Southern Medical University
| | - Bin Deng
- Department of Stomatology, The General Hospital of People’s Liberation Army, Beijing, China
| | - Xuan Pan
- Department of Stomatology, The First Affiliated Hospital of Guangdong Pharmaceutical University
- Xuan Pan, Department of Stomatology, The First Affiliated Hospital of Guangdong Pharmaceutical University, 19 Nonglinxialu, Guangzhou 510080, China, Tel/fax +86 20 6132 5457, Email
| | - Longquan Shao
- Department of Stomatology, Nanfang Hospital, Southern Medical University
- Correspondence: Longquan Shao, Department of Stomatology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Road, Guangzhou 510515, China, Tel +86 20 6278 7153, Fax +86 20 6164 1101, Email
| |
Collapse
|
42
|
Zhu Y, Gu Y, Qiao S, Zhou L, Shi J, Lai H. Bacterial and mammalian cells adhesion to tantalum-decorated micro-/nano-structured titanium. J Biomed Mater Res A 2016; 105:871-878. [PMID: 27784134 DOI: 10.1002/jbm.a.35953] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 10/18/2016] [Accepted: 10/25/2016] [Indexed: 11/09/2022]
Abstract
Microorganisms are frequently introduced to dental implants during surgery and start the race for the surface with host cells before osseointegration occurs. The aim of the study was to endow implant surfaces with biological functions that reliably select cells over microbes. Nano-structured tantalum (Ta) has exhibited excellent compatibility. Thus, nano-structured Ta films were deposited on the sand-blasted, large grit, and acid-etched (SLA) titanium by the magnetron sputtering method, thus forming hierarchical micro-/nano-structured surfaces. No obvious Ta release confirmed the robustness of the deposited layer probably arising from the stable Ta2 O5 . Moreover, Ta-modified surfaces not only improved the initial adhesion and spreading of rat bone mesenchymal stem cells (rBMSCs), but also exhibited good antibacterial activities towards Streptococcus mutans and Porphyromonas gingivalis. The satisfactory cell-surface interactions on Ta-modified surfaces depended largely on the up-regulation of adhesion-related genes and activation of focal adhesion kinase (FAK), as confirmed by real-time PCR and Western blot. Here, the coculture model was also forwarded to mimic the perioperative bacterial contamination. We found that the adherent cell number and the cell-surface coverage were hampered by bacteria presence on both surfaces. Yet, rBMSCs still attached and spread more readily on Ta-modified surfaces than on SLA titanium surfaces even in coculture with adhering oral pathogens. Our results revealed that Ta-modified micro-/nano-structured surfaces would selectively promote cell-surface rather than bacteria-surface interactions, boding well for the applications for dental implants in possibly infected environments. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 871-878, 2017.
Collapse
Affiliation(s)
- Yu Zhu
- Department of Oral Implantology, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yingxin Gu
- Department of Oral Implantology, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Shichong Qiao
- Department of Oral Implantology, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Linyi Zhou
- Department of Oral Implantology, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Junyu Shi
- Department of Oral Implantology, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Hongchang Lai
- Department of Oral Implantology, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| |
Collapse
|
43
|
Alhalawani AM, Towler MR. A novel tantalum-containing bioglass. Part I. Structure and solubility. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 72:202-211. [PMID: 28024578 DOI: 10.1016/j.msec.2016.11.066] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/02/2016] [Accepted: 11/17/2016] [Indexed: 11/26/2022]
Abstract
Bioglasses are employed for surgical augmentation in a range of hard tissue applications. Tantalum is a bioactive and biocompatible transition metal that has been used as an orthopedic medical device. It has a range of biological and physical properties that make its incorporation into ionic form into bioactive glass systems promising for various clinical applications. The work herein reports the characterization and properties of novel tantalum-containing glasses. A series of glasses based on the system 48SiO2-(36-X)ZnO-6CaO-8SrO-2P2O5-XTa2O5 with X varying from 0mol% (TA0) to 0.5mol% (TA2) were synthesized. The addition of small amounts of Ta2O5 did not cause crystallization of the glasses but increasing Ta2O5 content at the expense of ZnO was found to result in an increased number of bridging oxygens (BOs). This, along with the data recorded by differential thermal analysis (DTA) and magic angle spinning-nuclear magnetic resonance (MAS-NMR), confirms that Ta acts as a glass former in this series. Solubility experiments showed that minor changes in the glass structure caused by Ta incorporation (0.5mol%) exhibited greater cumulative % weight loss, pH values and cumulative Zn2+ and Sr2+ ion concentration over a period of 30days of maturation, when compared to Ta2O5-free glasses. The results presented in this article confirm that replacing ZnO with Ta2O5 in silicate glasses results in the formation of stronger bonds within the glass network without any adverse effects on the solubility of the glasses prepared from them.
Collapse
Affiliation(s)
- Adel Mf Alhalawani
- Department of Mechanical & Industrial Engineering, Ryerson University, Toronto, Ontario, Canada
| | - Mark R Towler
- Department of Mechanical & Industrial Engineering, Ryerson University, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
| |
Collapse
|
44
|
Liu X, Song X, Zhang P, Zhu Z, Xu X. Effects of nano tantalum implants on inducing osteoblast proliferation and differentiation. Exp Ther Med 2016; 12:3541-3544. [PMID: 28101149 PMCID: PMC5228204 DOI: 10.3892/etm.2016.3801] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/20/2016] [Indexed: 12/11/2022] Open
Abstract
In the present study, we examined the effects of nano tantalum (Ta) dental implants on inducing osteoblast proliferation and differentiation. The MG-63 osteoblasts were divided into 3 groups after recovery, passage and storage: i) Osteoblast culturing group (control group); ii) osteoblast and titanium (Ti) implant co-culturing group (Ti group); and iii) osteoblast and Ta implant co-culturing group (Ta group). After 7 days, a scanning electron microscope was used to observe the growth status, number and morphological changes of the cells on the surfaces of the materials. An MTT assay was used to detect cell proliferation after culturing for 1, 3 and 7 days. ELISA assay was used to detect the levels of alkaline phosphatase (ALP) after 1, 3 and 7 days. Western blot analysis was used to detect the expression levels of collagen type I (Col-1) and osteocalcin after 1, 3 and 7 days. There was significant cell spreading on the surfaces of Ti and of Ta after 7 days, flat and with many pseudopodia. Additionally, there were more cell components in the Ta group. Concurrently, cell proliferation in the Ti and Ta groups increased. There was also an increase in the level of ALP and the expression level of Col-1 over time. The indexes of the Ta group were more apparent than those of the Ti group at each time-point, and the differences were statistically significant (p<0.05). In conclusion, compared with Ti implants, Ta implants induced more osteoblast proliferation and differentiation.
Collapse
Affiliation(s)
- Xinyu Liu
- Stomatological College of Shandong University, Jinan, Shandong 250012, P.R. China; Shandong Province Key Laboratory of Oral Biology Medicine, Jinan, Shandong 250012, P.R. China; Department of Stomatology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Xiaobin Song
- Department of Stomatology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Peng Zhang
- Department of Orthopedics, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250012, P.R. China
| | - Zhenkun Zhu
- Stomatological College of Shandong University, Jinan, Shandong 250012, P.R. China; Shandong Province Key Laboratory of Oral Biology Medicine, Jinan, Shandong 250012, P.R. China
| | - Xin Xu
- Stomatological College of Shandong University, Jinan, Shandong 250012, P.R. China; Shandong Province Key Laboratory of Oral Biology Medicine, Jinan, Shandong 250012, P.R. China
| |
Collapse
|
45
|
Abstract
Background and purpose - Total knee replacement (TKR) in younger patients using cemented components has shown inferior results, mainly due to aseptic loosening. Excellent clinical results have been reported with components made of trabecular metal (TM). In a previous report, we have shown stabilization of the TM tibial implants for up to 5 years. In this study, we compared the clinical and RSA results of these uncemented implants with those of cemented implants. Patients and methods - 41 patients (47 knees) aged ≤ 60 years underwent TKR. 22 patients (26 knees) received an uncemented monoblock cruciate-retaining (CR) tibial component (TM) and 19 patients (21 knees) received a cemented NexGen Option CR tibial component. Follow-up examination was done at 10 years, and 16 patients (19 knees) with TM tibial components and 17 patients (18 knees) with cemented tibial components remained for analysis. Results - 1 of 19 TM implants was revised for infection, 2 of 18 cemented components were revised for knee instability, and no revisions were done for loosening. Both types of tibial components migrated in the first 3 months, the TM group to a greater extent than the cemented group. After 3 months, both groups were stable during the next 10 years. Interpretation - The patterns of migration for uncemented TM implants and cemented tibial implants over the first 10 years indicate that they have a good long-term prognosis regarding fixation.
Collapse
Affiliation(s)
- Anders Henricson
- Department of Orthopaedics and Center for Clinical Research, Falu General Hospital, Falun;,Correspondence:
| | - Kjell G Nilsson
- Institution of Surgical and Perioperative Sciences, Department of Orthopaedics, Umeå University, Umeå, Sweden
| |
Collapse
|
46
|
Lewallen EA, Jones DL, Dudakovic A, Thaler R, Paradise CR, Kremers HM, Abdel MP, Kakar S, Dietz AB, Cohen RC, Lewallen DG, van Wijnen AJ. Osteogenic potential of human adipose-tissue-derived mesenchymal stromal cells cultured on 3D-printed porous structured titanium. Gene 2016; 581:95-106. [PMID: 26774799 PMCID: PMC5054723 DOI: 10.1016/j.gene.2016.01.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/12/2016] [Indexed: 01/08/2023]
Abstract
Integration of porous metal prosthetics, which restore form and function of irreversibly damaged joints, into remaining healthy bone is critical for implant success. We investigated the biological properties of adipose-tissue-derived mesenchymal stromal/stem cells (AMSCs) and addressed their potential to alter the in vitro microenvironment of implants. We employed human AMSCs as a practical source for musculoskeletal applications because these cells can be obtained in large quantities, are multipotent, and have trophic paracrine functions. AMSCs were cultured on surgical-grade porous titanium disks as a model for orthopedic implants. We monitored cell/substrate attachment, cell proliferation, multipotency, and differentiation phenotypes of AMSCs upon osteogenic induction. High-resolution scanning electron microscopy and histology revealed that AMSCs adhere to the porous metallic surface. Compared to standard tissue culture plastic, AMSCs grown in the porous titanium microenvironment showed differences in temporal expression for genes involved in cell cycle progression (CCNB2, HIST2H4), extracellular matrix production (COL1A1, COL3A1), mesenchymal lineage identity (ACTA2, CD248, CD44), osteoblastic transcription factors (DLX3, DLX5, ID3), and epigenetic regulators (EZH1, EZH2). We conclude that metal orthopedic implants can be effectively seeded with clinical-grade stem/stromal cells to create a pre-conditioned implant.
Collapse
Affiliation(s)
- Eric A Lewallen
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Dakota L Jones
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; Department of Biomedical Engineering and Physiology, Mayo Graduate School, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Amel Dudakovic
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Roman Thaler
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Christopher R Paradise
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Hilal M Kremers
- Department of Health Sciences Research, College of Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Matthew P Abdel
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Allan B Dietz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St. SW Rochester, MN 55905, USA
| | - Robert C Cohen
- Stryker Orthopedics, 325 Corporate Drive, Mahwah, NJ 07430, USA
| | - David G Lewallen
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
| | - Andre J van Wijnen
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; Department of Biomedical Engineering and Physiology, Mayo Graduate School, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; Department of Biochemistry and Molecular Biology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
| |
Collapse
|
47
|
8: Scientific studies and medical trials. Per Med 2016. [DOI: 10.1201/b19687-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
48
|
Wei X, Zhao D, Wang B, Wang W, Kang K, Xie H, Liu B, Zhang X, Zhang J, Yang Z. Tantalum coating of porous carbon scaffold supplemented with autologous bone marrow stromal stem cells for bone regeneration in vitro and in vivo. Exp Biol Med (Maywood) 2016; 241:592-602. [PMID: 26843518 DOI: 10.1177/1535370216629578] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 01/04/2016] [Indexed: 01/23/2023] Open
Abstract
Porous tantalum metal with low elastic modulus is similar to cancellous bone. Reticulated vitreous carbon (RVC) can provide three-dimensional pore structure and serves as the ideal scaffold of tantalum coating. In this study, the biocompatibility of domestic porous tantalum was first successfully tested with bone marrow stromal stem cells (BMSCs) in vitro and for bone tissue repair in vivo. We evaluated cytotoxicity of RVC scaffold and tantalum coating using BMSCs. The morphology, adhesion, and proliferation of BMSCs were observed via laser scanning confocal microscope and scanning electron microscopy. In addition, porous tantalum rods with or without autologous BMSCs were implanted on hind legs in dogs, respectively. The osteogenic potential was observed by hard tissue slice examination. At three weeks and six weeks following implantation, new osteoblasts and new bone were observed at the tantalum-host bone interface and pores. At 12 weeks postporous tantalum with autologous BMSCs implantation, regenerated trabecular equivalent to mature bone was found in the pore of tantalum rods. Our results suggested that domestic porous tantalum had excellent biocompatibility and could promote new bone formation in vivo. Meanwhile, the osteogenesis of porous tantalum associated with autologous BMSCs was more excellent than only tantalum implantation. Future clinical studies are warranted to verify the clinical efficacy of combined implantation of this domestic porous tantalum associated with autologous BMSCs implantation and compare their efficacy with conventional autologous bone grafting carrying blood vessel in patients needing bone repairing.
Collapse
Affiliation(s)
- Xiaowei Wei
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Dewei Zhao
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Benjie Wang
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Wei Wang
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Kai Kang
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Hui Xie
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Baoyi Liu
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Xiuzhi Zhang
- Department of Orthopaedic Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Jinsong Zhang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Zhenming Yang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| |
Collapse
|
49
|
Gee ECA, Jordan R, Hunt JA, Saithna A. Current evidence and future directions for research into the use of tantalum in soft tissue re-attachment surgery. J Mater Chem B 2016; 4:1020-1034. [DOI: 10.1039/c5tb01786f] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The use of tantalum is well established in orthopaedic surgery.
Collapse
Affiliation(s)
- Edward C. A. Gee
- Southport and Ormskirk Hospitals
- Orthopaedics
- Southport
- United Kingdom of Great Britain and Northern Ireland
| | - Robert Jordan
- Southport and Ormskirk Hospitals
- Orthopaedics
- Southport
- United Kingdom of Great Britain and Northern Ireland
| | - John A. Hunt
- University of Liverpool
- Clinical Engineering
- Duncan Building
- Daulby Street
- Liverpool
| | - Adnan Saithna
- Southport and Ormskirk Hospitals
- Orthopaedics
- Southport
- United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
50
|
Sarraf M, Abdul Razak B, Dabbagh A, Nasiri-Tabrizi B, Abu Kasim NH, Basirun WJ. Optimizing PVD conditions for electrochemical anodization growth of well-adherent Ta2O5 nanotubes on Ti–6Al–4V alloy. RSC Adv 2016. [DOI: 10.1039/c6ra11290k] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The proposed approach could be considered for the design of various nanostructured titanium implant surfaces.
Collapse
Affiliation(s)
- Masoud Sarraf
- Center of Advanced Manufacturing and Material Processing
- Department of Engineering
- University of Malaya
- Kuala Lumpur 50603
- Malaysia
| | - Bushroa Abdul Razak
- Center of Advanced Manufacturing and Material Processing
- Department of Engineering
- University of Malaya
- Kuala Lumpur 50603
- Malaysia
| | - Ali Dabbagh
- Center of Advanced Manufacturing and Material Processing
- Department of Engineering
- University of Malaya
- Kuala Lumpur 50603
- Malaysia
| | - Bahman Nasiri-Tabrizi
- Advanced Materials Research Center
- Materials Engineering Department
- Najafabad Branch
- Islamic Azad University
- Najafabad
| | - Noor Hayaty Abu Kasim
- Department of Restorative Dentistry
- Faculty of Dentistry
- University of Malaya
- Kuala Lumpur
- Malaysia
| | - Wan Jefrey Basirun
- Department of Chemistry
- Faculty of Science
- University of Malaya
- 50603 Kuala Lumpur
- Malaysia
| |
Collapse
|