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Koguchi M, Mori Y, Kamimura M, Ito K, Tanaka H, Kurishima H, Koyama T, Mori N, Masahashi N, Aizawa T. Low Young's Modulus TiNbSn Alloy Locking Plates Accelerate Osteosynthesis in Rabbit Tibiae. TOHOKU J EXP MED 2023; 261:199-209. [PMID: 37704419 DOI: 10.1620/tjem.2023.j075] [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] [Indexed: 09/15/2023]
Abstract
A new beta TiNbSn alloy with a low Young's modulus of approximately 40 GPa has been developed to resolve the stress shielding by Young's modulus divergence. In this study, the efficacy of TiNbSn alloy locking plates on bone repair is compared to that of commercially pure titanium (CP-Ti). The TiNbSn alloy and CP-Ti, which have Young's moduli of 49.1 GPa and 107 GPa, respectively, were compared. Male Japanese white rabbits were anesthetized, and osteotomy and osteosynthesis with locking plates were performed on the right tibia. The bone repair was assessed using micro-computed tomography (CT), histomorphometry, immunohistochemistry, and mechanical testing. Micro-CT, histomorphometry, immunohistochemistry, and mechanical testing were performed four weeks after osteotomy. Six weeks after surgery, micro-CT and mechanical testing were performed. Micro-CT analysis at four weeks after surgery showed that the intramedullary fracture callus in the TiNbSn alloy group had more bone volume and numerous bridging structures compared to the CP-Ti group (CP-Ti vs. TiNbSn alloy, 34.3 ± 13.1 mm3 vs. 61.3 ± 19.6 mm3, p = 0.02; mean ± standard deviation). At four weeks post-osteotomy, the healed tibia showed significantly higher strength in the TiNbSn alloy group compared with CP-Ti (CP-Ti vs. TiNbSn alloy, 81.3 ± 31.2 N vs. 133.7 ± 46.6 N, p = 0.04). TiNbSn alloy locking plates had a more positive impact on bone formation and bone strength restoration than the CP-Ti locking plates during the early phase of bone healing.
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Affiliation(s)
- Masashi Koguchi
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Yu Mori
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Masayuki Kamimura
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Kentaro Ito
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Hidetatsu Tanaka
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Hiroaki Kurishima
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Tomoki Koyama
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Naoko Mori
- Department of Radiology, Akita University Graduate School of Medicine
| | | | - Toshimi Aizawa
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
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Baba K, Mori Y, Chiba D, Kuwahara Y, Kurishima H, Tanaka H, Kogure A, Kamimura M, Yamada N, Ohtsu S, Oyama M, Masahashi N, Hanada S, Itoi E, Aizawa T. TiNbSn stems with gradient changes of Young's modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems. Eur J Med Res 2023; 28:214. [PMID: 37400903 DOI: 10.1186/s40001-023-01199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 06/26/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The difference between Young's moduli of the femur and the stem causes stress shielding (SS). TiNbSn (TNS) stem has a low Young's modulus and strength with gradient functional properties during the change in elastic modulus with heat treatment. The aim of this study was to investigate the inhibitory effect of TNS stems on SS and their clinical outcomes compared to conventional stems. METHODS This study was a clinical trial. Primary THA was performed using a TNS stem from April 2016 to September 2017 for patients in the TNS group. Unilateral THA was performed using a Ti6Al4V alloy stem from January 2007 to February 2011 for patients in the control group. The TNS and Ti6Al4V stems were matched in shape. Radiographs were obtained at the 1- and 3-year follow-ups. Two surgeons independently checked the SS grade and appearance of cortical hypertrophy (CH). The Japanese Orthopaedic Association (JOA) scores before and 1 year after surgery were assessed as clinical scores. RESULTS None of the patients in the TNS group had grade 3 or 4 SS. In contrast, in the control group, 24% and 40% of patients had grade 3 and 4 SS at the 1- and 3-year follow-ups, respectively. The SS grade was lower in the TNS group than in the control group at the 1- and 3-year follow-ups (p < 0.001). The frequencies of CH in both groups were no significant difference at the 1- and 3-year follow-ups. The JOA scores of the TNS group significantly improved at 1 year after surgery and were comparable to control group. CONCLUSION The TNS stem reduced SS at 1 and 3 years after THA compared to the proximal-engaging cementless stem, although the shapes of the stems matched. The TNS stem could reduce SS, stem loosening, and periprosthetic fractures. TRIAL REGISTRATION Current Controlled Trials. ISRCTN21241251. https://www.isrctn.com/search?q=21241251 . The date of registration was October 26, 2021. Retrospectively registered.
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Affiliation(s)
- Kazuyoshi Baba
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yu Mori
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Daisuke Chiba
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yoshiyuki Kuwahara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroaki Kurishima
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hidetatsu Tanaka
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Atsushi Kogure
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Masayuki Kamimura
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Norikazu Yamada
- Department of Orthopaedic Surgery, Sendai Red Cross Hospital, 2‑43‑3 Yagiyamahoncho, Taihaku‑ku, Sendai, Miyagi, 982-8501, Japan
| | - Susumu Ohtsu
- Department of Orthopaedic Surgery, Osaki Citizen Hospital, 3-8-1 Furukawahonami, Osaki, Miyagi, 989-6183, Japan
| | - Masamizu Oyama
- Department of Orthopaedic Surgery, Sendai Red Cross Hospital, 2‑43‑3 Yagiyamahoncho, Taihaku‑ku, Sendai, Miyagi, 982-8501, Japan
| | - Naoya Masahashi
- Institute for Materials Research, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi, 980-8577, Japan
| | - Shuji Hanada
- Institute for Materials Research, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi, 980-8577, Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku Rosai Hospital, 4-3-21 Dainohara, Aoba-ku, Sendai, Miyagi, 981-0911, Japan
| | - Toshimi Aizawa
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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Mori Y, Fujimori S, Kurishima H, Inoue H, Ishii K, Kubota M, Kawakami K, Mori N, Aizawa T, Masahashi N. Antimicrobial Properties of TiNbSn Alloys Anodized in a Sulfuric Acid Electrolyte. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1487. [PMID: 36837117 PMCID: PMC9968052 DOI: 10.3390/ma16041487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
TiNbSn alloy is a high-performance titanium alloy which is biosafe, strong, and has a low Young's modulus. TiNbSn alloy has been clinically applied as a material for orthopedic prosthesis. Anodized TiNbSn alloys with acetic and sulfuric acid electrolytes have excellent biocompatibility for osseointegration. Herein, TiNbSn alloy was anodized in a sulfuric acid electrolyte to determine the antimicrobial activity. The photocatalytic activities of the anodic oxide alloys were investigated based on their electronic band structure and crystallinity. In addition, the cytotoxicity of the anodized TiNbSn alloy was evaluated using cell lines of the osteoblast and fibroblast lineages. The antimicrobial activity of the anodic oxide alloy was assessed according to the ISO 27447 using methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and Escherichia coli. The anodic oxide comprised rutile and anatase titanium dioxide (TiO2) and exhibited a porous microstructure. A well-crystallized rutile TiO2 phase was observed in the anodized TiNbSn alloy. The methylene blue degradation tests under ultraviolet illumination exhibited photocatalytic activity. In antimicrobial tests, the anodized TiNbSn alloy exhibited robust antimicrobial activities under ultraviolet illumination for all bacterial species, regardless of drug resistance. Therefore, the anodized TiNbSn alloy can be used as a functional biomaterial with low Young's modulus and excellent antimicrobial activity.
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Affiliation(s)
- Yu Mori
- Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Satoko Fujimori
- Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Hiroaki Kurishima
- Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Hiroyuki Inoue
- Department of Materials Science, Graduate School of Engineering, Osaka Metropolitan University, 1-1 Gakuen-machi, Naka-ku, Sakai 599-8531, Japan
| | - Keiko Ishii
- Department of Medical Microbiology, Mycology, and Immunology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Maya Kubota
- Graduate School of Engineering, Institute for Materials Research, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai 980-8577, Japan
| | - Kazuyoshi Kawakami
- Department of Medical Microbiology, Mycology, and Immunology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Naoko Mori
- Department of Radiology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Toshimi Aizawa
- Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Naoya Masahashi
- Institute for Materials Research, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai 980-8577, Japan
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