1
|
Li X, Zhu L, Che Z, Liu T, Yang C, Huang L. Progress of research on the surface functionalization of tantalum and porous tantalum in bone tissue engineering. Biomed Mater 2024; 19:042009. [PMID: 38838694 DOI: 10.1088/1748-605x/ad5481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/05/2024] [Indexed: 06/07/2024]
Abstract
Tantalum and porous tantalum are ideal materials for making orthopedic implants due to their stable chemical properties and excellent biocompatibility. However, their utilization is still affected by loosening, infection, and peripheral inflammatory reactions, which sometimes ultimately lead to implant removal. An ideal bone implant should have exceptional biological activity, which can improve the surrounding biological microenvironment to enhance bone repair. Recent advances in surface functionalization have produced various strategies for developing compatibility between either of the two materials and their respective microenvironments. This review provides a systematic overview of state-of-the-art strategies for conferring biological functions to tantalum and porous tantalum implants. Furthermore, the review describes methods for preparing active surfaces and different bioactive substances that are used, summarizing their functions. Finally, this review discusses current challenges in the development of optimal bone implant materials.
Collapse
Affiliation(s)
- Xudong Li
- The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| | - Liwei Zhu
- The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| | - Zhenjia Che
- The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| | - Tengyue Liu
- The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| | - Chengzhe Yang
- The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| | - Lanfeng Huang
- The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| |
Collapse
|
2
|
Minku, Mukherjee K, Ghosh R. Assessment of bone ingrowth around beaded coated tibial implant for total ankle replacement using mechanoregulatory algorithm. Comput Biol Med 2024; 175:108551. [PMID: 38703546 DOI: 10.1016/j.compbiomed.2024.108551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024]
Abstract
The long-term performance of porous coated tibial implants for total ankle replacement (TAR) primarily depends on the extent of bone ingrowth at the bone-implant interface. Although attempts were made for primary fixation for immediate post-operative stability, no investigation was conducted on secondary fixation. The aim of this study is to assess bone ingrowth around the porous beaded coated tibial implant for TAR using a mechanoregulatory algorithm. A realistic macroscale finite element (FE) model of the implanted tibia was developed based on computer tomography (CT) data to assess implant-bone micromotions and coupled with microscale FE models of the implant-bone interface to predict bone ingrowth around tibial implant for TAR. The macroscale FE model was subjected to three near physiological loading conditions to evaluate the site-specific implant-bone micromotion, which were then incorporated into the corresponding microscale model to mimic the near physiological loading conditions. Results of the study demonstrated that the implant experienced tangential micromotion ranged from 0 to 71 μm with a mean of 3.871 μm. Tissue differentiation results revealed that bone ingrowth across the implant ranged from 44 to 96 %, with a mean of around 70 %. The average Young's modulus of the inter-bead tissue layer varied from 1444 to 4180 MPa around the different regions of the implant. The analysis postulates that when peak micromotion touches 30 μm around different regions of the implant, it leads to pronounced fibrous tissues on the implant surface. The highest amount of bone ingrowth was observed in the central regions, and poor bone ingrowth was seen in the anterior parts of the implant, which indicate improper osseointegration around this region. This macro-micro mechanical FE framework can be extended to improve the implant design to enhance the bone ingrowth and in future to develop porous lattice-structured implants to predict and enhance osseointegration around the implant.
Collapse
Affiliation(s)
- Minku
- Biomechanics Research Laboratory, School of Mechanical & Materials Engineering, Indian Institute of Technology Mandi, Kamand, Mandi, 175075, Himachal Pradesh, India
| | - Kaushik Mukherjee
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
| | - Rajesh Ghosh
- Biomechanics Research Laboratory, School of Mechanical & Materials Engineering, Indian Institute of Technology Mandi, Kamand, Mandi, 175075, Himachal Pradesh, India.
| |
Collapse
|
3
|
Minku, Ghosh R. A macro-micro FE and ANN framework to assess site-specific bone ingrowth around the porous beaded-coated implant: an example with BOX® tibial implant for total ankle replacement. Med Biol Eng Comput 2024; 62:1639-1654. [PMID: 38321323 DOI: 10.1007/s11517-024-03034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/22/2024] [Indexed: 02/08/2024]
Abstract
The use of mechanoregulatory schemes based on finite element (FE) analysis for the evaluation of bone ingrowth around porous surfaces is a viable approach but requires significant computational time and effort. The aim of this study is to develop a combined macro-micro FE and artificial neural network (ANN) framework for rapid and accurate prediction of the site-specific bone ingrowth around the porous beaded-coated tibial implant for total ankle replacement (TAR). A macroscale FE model of the implanted tibia was developed based on CT data. Subsequently, a microscale FE model of the implant-bone interface was created for performing bone ingrowth simulations using mechanoregulatory algorithms. An ANN was trained for rapid and accurate prediction of bone ingrowth. The results predicted by ANN are well comparable to FE-predicted results. Predicted site-specific bone ingrowth using ANN around the implant ranges from 43.04 to 98.24%, with a mean bone ingrowth of around 74.24%. Results suggested that the central region exhibited the highest bone ingrowth, which is also well corroborated with the recent explanted study on BOX®. The proposed methodology has the potential to simulate bone ingrowth rapidly and effectively at any given site over any implant surface.
Collapse
Affiliation(s)
- Minku
- Biomechanics Research Laboratory, School of Mechanical & Materials Engineering, Indian Institute of Technology Mandi, Kamand, Mandi, 175075, Himachal Pradesh, India
| | - Rajesh Ghosh
- Biomechanics Research Laboratory, School of Mechanical & Materials Engineering, Indian Institute of Technology Mandi, Kamand, Mandi, 175075, Himachal Pradesh, India.
| |
Collapse
|
4
|
Gupta R, Grove K, Wei A, Lee J, Akkouch A. Ankle and Foot Arthroplasty and Prosthesis: A Review on the Current and Upcoming State of Designs and Manufacturing. MICROMACHINES 2023; 14:2081. [PMID: 38004938 PMCID: PMC10673427 DOI: 10.3390/mi14112081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
The foot and ankle serve vital roles in weight bearing, balance, and flexibility but are susceptible to many diverse ailments, making treatment difficult. More commonly, Total Ankle Arthroplasty (TAA) and Total Talus Replacement (TTR) are used for patients with ankle degeneration and avascular necrosis of the talus, respectively. Ankle prosthesis and orthosis are also indicated for use with lower limb extremity amputations or locomotor disability, leading to the development of powered exoskeletons. However, patient outcomes remain suboptimal, commonly due to the misfitting of implants to the patient-specific anatomy. Additive manufacturing (AM) is being used to create customized, patient-specific implants and porous implant cages that provide structural support while allowing for increased bony ingrowth and to develop customized, lightweight exoskeletons with multifunctional actuators. AM implants and devices have shown success in preserving stability and mobility of the joint and achieving fast recovery, as well as significant improvements in gait rehabilitation, gait assistance, and strength for patients. This review of the literature highlights various devices and technologies currently used for foot and ankle prosthesis and orthosis with deep insight into improvements from historical technologies, manufacturing methods, and future developments in the biomedical space.
Collapse
Affiliation(s)
- Richa Gupta
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI 49008, USA; (R.G.); (K.G.); (A.W.); (J.L.)
| | - Kyra Grove
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI 49008, USA; (R.G.); (K.G.); (A.W.); (J.L.)
| | - Alice Wei
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI 49008, USA; (R.G.); (K.G.); (A.W.); (J.L.)
| | - Jennifer Lee
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI 49008, USA; (R.G.); (K.G.); (A.W.); (J.L.)
| | - Adil Akkouch
- Department of Orthopaedic Surgery and Medical Engineering Program, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI 49008, USA
| |
Collapse
|
5
|
HENRICSON A, UNDÉN A, CARLSSON Å, JEHPSSON L, ROSENGREN B. Outcomes of trabecular metal total ankle replacement: a longitudinal observational cohort study of 239 consecutive cases from the Swedish Ankle Registry. Acta Orthop 2022; 93:689-695. [PMID: 35919022 PMCID: PMC9348131 DOI: 10.2340/17453674.2022.4387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE Information on outcomes after some modern total ankle replacement (TAR) designs is scarce. We therefore examined outcomes after trabecular metal (TM) TAR in Sweden by use of data from the national registry. PATIENTS AND METHODS On December 31, 2020, 239 primary TM TARs had been reported to the Swedish Ankle Registry. We analyzed prosthesis survival probability, using exchange or permanent extraction of components as endpoint for 239 protheses with mean follow-up of 2.2 years (0.1-6.6), risk of revision, as well as patient-reported outcome measures (SEFAS/EQ-5D/EQ-VAS) and satisfaction with surgery. RESULTS 7/239 prostheses (3%) had been revised by December 31, 2020. We found an overall prosthesis survival probability of 95% (95% CI 89-98) after 3 years. 2 years after surgery 81% of the answering patients were satisfied or very satisfied with surgery and patients reported median SEFAS 36 (max 48), EQ-5D 0.90 (max 1), and EQ-VAS 80 (max 100). INTERPRETATION We found short- to mid-term outcomes after TM TAR to be at least as good as after other TAR designs regarding prosthesis survival and patient-reported satisfaction.
Collapse
Affiliation(s)
- Anders HENRICSON
- Department of Orthopedics, Falu Central Hospital and Center of Clinical Research Dalecarlia, Falun
| | - Alexandra UNDÉN
- Department of Radiology, Skåne University Hospital, Malmö,Department of Clinical Sciences Malmö (IKVM), Lund University
| | - Åke CARLSSON
- Department of Clinical Sciences Malmö (IKVM), Lund University,Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - Lars JEHPSSON
- Department of Clinical Sciences Malmö (IKVM), Lund University,Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - Björn ROSENGREN
- Department of Clinical Sciences Malmö (IKVM), Lund University,Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
6
|
Fokter SK, Gubeljak N, Punzón-Quijorna E, Pelicon P, Kelemen M, Vavpetič P, Predan J, Ferlič L, Novak I. Total Knee Replacement with an Uncemented Porous Tantalum Tibia Component: A Failure Analysis. MATERIALS 2022; 15:ma15072575. [PMID: 35407908 PMCID: PMC8999729 DOI: 10.3390/ma15072575] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022]
Abstract
Porous tantalum has been extensively used in orthopaedic surgery, including uncemented total knee arthroplasty (TKA). Favourable results were reported with earlier monobloc tibial components and the design evolved to modular implants. We aimed to analyse possible causes for extensive medial tibia bone loss, resulting in modular porous tantalum tibia baseplate fracture after primary TKA. Retrieved tissue samples were scanned with 3 MeV focused proton beam for Proton-Induced X-ray Emission (micro-PIXE) elemental analysis. Fractographic and microstructural analysis were performed by stereomicroscopy. A full 3D finite-element model was made for numerical analysis of stress-strain conditions of the tibial baseplate. Histological examination of tissue underneath the broken part of the tibial baseplate revealed dark-stained metal debris, which was confirmed by micro-PIXE to consist of tantalum and titanium. Fractographic analysis and tensile testing showed that the failure of the tibial baseplate fulfilled the criteria of a typical fatigue fracture. Microstructural analysis of the contact surface revealed signs of bone ingrowth in 22.5% of the surface only and was even less pronounced in the medial half of the tibial baseplate. Further studies are needed to confirm the responsibility of metal debris for an increased bone absorption leading to catastrophic tibial tray failure.
Collapse
Affiliation(s)
- Samo K. Fokter
- Department of Orthopaedics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia;
- Correspondence: ; Tel.: +386-41-772102
| | - Nenad Gubeljak
- Faculty of Mechanical Engineering, University of Maribor, Smetanova 17, 2000 Maribor, Slovenia; (N.G.); (J.P.); (L.F.)
| | - Esther Punzón-Quijorna
- Department of Low and Medium Energy Physics F2, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (E.P.-Q.); (P.P.); (M.K.); (P.V.)
| | - Primož Pelicon
- Department of Low and Medium Energy Physics F2, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (E.P.-Q.); (P.P.); (M.K.); (P.V.)
| | - Mitja Kelemen
- Department of Low and Medium Energy Physics F2, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (E.P.-Q.); (P.P.); (M.K.); (P.V.)
| | - Primož Vavpetič
- Department of Low and Medium Energy Physics F2, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (E.P.-Q.); (P.P.); (M.K.); (P.V.)
| | - Jožef Predan
- Faculty of Mechanical Engineering, University of Maribor, Smetanova 17, 2000 Maribor, Slovenia; (N.G.); (J.P.); (L.F.)
| | - Luka Ferlič
- Faculty of Mechanical Engineering, University of Maribor, Smetanova 17, 2000 Maribor, Slovenia; (N.G.); (J.P.); (L.F.)
| | - Igor Novak
- Department of Orthopaedics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia;
| |
Collapse
|
7
|
Epperson RT, Williams DL, Rogers B, Maxwell J, Stevens P. Assessing the safety of an epiphyseal plate biopsy in a translational lamb model. J Orthop Res 2021; 39:2653-2662. [PMID: 33580528 DOI: 10.1002/jor.25004] [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: 07/17/2020] [Revised: 12/10/2020] [Accepted: 02/10/2021] [Indexed: 02/04/2023]
Abstract
The literature demonstrates that obtaining a biopsy of the physis may be beneficial for diagnostic purposes. A small biopsy of the epiphyseal plate may allow for earlier detection of certain conditions and be used to monitor the healing of diseased and/or damaged physes. However, due to the fear of a growth arrest in a growing child, biopsies are not currently performed. In this study, we investigated the effects of a biopsy of the epiphyseal plate in 3-month-old lambs. A total of 4.2 mm biopsy samples were captured in the proximal tibiae and distal femora physes. The lambs were monitored 12- and 24-week post-biopsy. Computed tomography (CT) and micro-CT scans were obtained to determine if any angular deformities occurred, while scanning electron microscope (SEM) and histological analysis were utilized to assess the bone response due to the biopsy. The contralateral limbs served as unaltered controls for direct comparison within each lamb. The data demonstrated no signs of angular deformities following a 4.2 mm biopsy of the physis. Bone growth/elongation was confirmed by CT, SEM, and fluorochrome analyses and indicated that the lambs were in fact immature and still growing at the time of the biopsy. Clinical Significance: This investigation demonstrated that a small biopsy of the epiphyseal plate can be obtained safely without the cause of growth arrest and angular deformities. The ability to precisely diagnose, treat, and/or monitor at-risk children at an earlier timepoint by way of a biopsy sample could be an important advancement in regard to researching diseased and/or damaged physes.
Collapse
Affiliation(s)
- Richard T Epperson
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.,Department of Veterans Affairs, Bone and Joint Research Laboratory, Salt Lake City, Utah, USA
| | - Dustin L Williams
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.,Department of Veterans Affairs, Bone and Joint Research Laboratory, Salt Lake City, Utah, USA.,Department of Pathology, University of Utah, Salt Lake City, Utah, USA.,Department of Bioengineering, University of Utah, Salt Lake City, Utah, USA.,Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Brady Rogers
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.,Department of Veterans Affairs, Bone and Joint Research Laboratory, Salt Lake City, Utah, USA
| | - John Maxwell
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.,Department of Veterans Affairs, Bone and Joint Research Laboratory, Salt Lake City, Utah, USA
| | - Peter Stevens
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.,Primary Children's Hospital, Salt Lake City, Utah, USA
| |
Collapse
|
8
|
Epperson RT, Isaacson BM, Rothberg DL, Olsen RE, Kawaguchi B, Maxwell JM, Dickerson M, Pasquina PF, Shero J, Williams DL. Developing a combat-relevant translatable large animal model of heterotopic ossification. Bone Rep 2021; 15:101127. [PMID: 34584904 PMCID: PMC8452791 DOI: 10.1016/j.bonr.2021.101127] [Citation(s) in RCA: 3] [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: 07/07/2021] [Revised: 08/25/2021] [Accepted: 09/04/2021] [Indexed: 11/05/2022] Open
Abstract
Heterotopic ossification (HO) refers to ectopic bone formation, typically in residual limbs following trauma and injury. A review of injuries from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) indicated that approximately 70% of war wounds involved the musculoskeletal system, largely in part from the use of improvised explosive devices (IED) and rocket-propelled grenades (RPG). HO is reported to occur in approximately 63%–65% of wounded warriors from OIF and OEF. Symptomatic HO may delay rehabilitation regimens since it often requires modifications to prosthetic limb componentry and socket size. There is limited evidence indicating a mechanism for preventing HO. This may be due to inadequate models, which do not produce HO bone structure that is morphologically similar to HO samples obtained from wounded warfighters injured in theatre. We hypothesized that using a high-power blast of air (shockwave) and simulated battlefield trauma (i.e. bone damage, tourniquet, bacteria, negative pressure wound therapy) in a large animal model, HO would form and have similar morphology to ectopic bone observed in clinical samples. Initial radiographic and micro-computed tomography (CT) data demonstrated ectopic bone growth in sheep 24 weeks post-procedure. Advanced histological and backscatter electron (BSE) analyses showed that 5 out of 8 (63%) sheep produced HO with similar morphology to clinical samples. We conclude that not all ectopic bone observed by radiograph or micro-CT in animal models is HO. Advanced histological and BSE analyses may improve confirmation of HO presence and morphology, which we demonstrated can be produced in a large animal model.
Collapse
Affiliation(s)
- Richard T Epperson
- University of Utah, Bone & Biofilm Research Laboratory, Salt Lake City, UT, United States of America.,University of Utah, Department of Orthopaedics, Salt Lake City, UT, United States of America
| | - Brad M Isaacson
- University of Utah, Department of Orthopaedics, Salt Lake City, UT, United States of America.,The Geneva Foundation, Tacoma, WA, United States of America.,The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD, United States of America
| | - David L Rothberg
- University of Utah, Bone & Biofilm Research Laboratory, Salt Lake City, UT, United States of America.,University of Utah, Department of Orthopaedics, Salt Lake City, UT, United States of America
| | - Raymond E Olsen
- University of Utah, Department of Orthopaedics, Salt Lake City, UT, United States of America
| | - Brooke Kawaguchi
- University of Utah, Bone & Biofilm Research Laboratory, Salt Lake City, UT, United States of America.,University of Utah, Department of Orthopaedics, Salt Lake City, UT, United States of America
| | - John M Maxwell
- University of Utah, Bone & Biofilm Research Laboratory, Salt Lake City, UT, United States of America.,University of Utah, Department of Orthopaedics, Salt Lake City, UT, United States of America
| | - Mary Dickerson
- University of Utah, Office of Comparative Medicine, Salt Lake City, UT, United States of America
| | - Paul F Pasquina
- The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD, United States of America.,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, United States of America
| | - John Shero
- The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD, United States of America.,Extremity Trauma Center of Excellence, Joint Base San Antonio Fort Sam Houston, San Antonio, TX, United States of America
| | - Dustin L Williams
- University of Utah, Bone & Biofilm Research Laboratory, Salt Lake City, UT, United States of America.,University of Utah, Department of Orthopaedics, Salt Lake City, UT, United States of America.,The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD, United States of America.,University of Utah, Department of Pathology, Salt Lake City, UT, United States of America.,University of Utah, Department of Bioengineering, Salt Lake City, UT, United States of America
| |
Collapse
|
9
|
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
|