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Zhang Y, Chen Z, Zhao H, Zhao D, Zhang X, Ma X, Jin Z. Comparison of joint load, motions and contact stress and bone-implant interface micromotion of three implant designs for total ankle arthroplasty. Comput Methods Programs Biomed 2022; 223:106976. [PMID: 35785557 DOI: 10.1016/j.cmpb.2022.106976] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Loosening and wear are still the main problems for the failure of total ankle arthroplasty, which are closely related to the micromotion at the bone-implant interface and the contact stress and joint motions at the articular surfaces. Implant design is a key factor to influence the ankle force, motions, contact stress, and bone-implant interface micromotion. The purpose of this study is to evaluate the differences in these parameters of INBONE II, INFINITY, and a new anatomic ankle implant under the physiological walking gait of three patients. METHODS This was achieved by using an in-silico simulation framework combining patient-specific musculoskeletal multibody dynamics and finite element analysis. Each implant was implanted into the musculoskeletal multibody dynamics model, respectively, which was driven by the gait data to calculate ankle forces and motions. These were then used as the boundary conditions for the finite element model, and the contact stress and the bone-implant interface micromotions were calculated. RESULTS The total ankle contact forces were not significantly affected by articular surface geometries of ankle implants. The range of motion of the ankle joint implanted with INFINITY was a little larger than that with INBONE II. The anatomic ankle implant design produced a greater range of motion than INBONE II, especially the internal-external rotation. The fixation design of INFINITY achieved lower bone-implant interface micromotion compared with INBONE II. The anatomic ankle implant design produced smaller contact stress with no evident edge contact and a smaller tibia-implant interface micromotion. In addition, significant differences in the magnitudes and tendencies of total ankle contact forces and motions among different patients were found. CONCLUSIONS The articular surface geometry of ankle implants not only affected the ankle motions and contact stress distribution but also affected the bone-implant interface micromotions. The anatomic ankle implant had good performance in recovering ankle joint motion, equalizing contact stress, and reducing bone-implant interface micromotion. INFINITY's fixation design could achieve smaller bone-implant interface micromotion than INBONE II.
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Affiliation(s)
- Yanwei Zhang
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
| | - Zhenxian Chen
- Key Laboratory of Road Construction Technology and Equipment (Ministry of Education), School of Mechanical Engineering, Chang'an University, Xi'an, Shaanxi, China.
| | - Hongmou Zhao
- Foot and Ankle Surgery Department, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
| | - Dahang Zhao
- Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Xuan Zhang
- Key Laboratory of Road Construction Technology and Equipment (Ministry of Education), School of Mechanical Engineering, Chang'an University, Xi'an, Shaanxi, China
| | - Xin Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongmin Jin
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China; Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China; Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK.
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Huang YM, Huang CC, Tsai PI, Yang KY, Huang SI, Shen HH, Lai HJ, Huang SW, Chen SY, Lin FH, Chen CY. Three-Dimensional Printed Porous Titanium Screw with Bioactive Surface Modification for Bone-Tendon Healing: A Rabbit Animal Model. Int J Mol Sci 2020; 21:ijms21103628. [PMID: 32455543 PMCID: PMC7279243 DOI: 10.3390/ijms21103628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 11/16/2022] Open
Abstract
The interference screw fixation method is used to secure a graft in the tibial tunnel during anterior cruciate ligament reconstruction surgery. However, several complications have been reported, such as biodegradable screw breakage, inflammatory or foreign body reaction, tunnel enlargement, and delayed graft healing. Using additive manufacturing (AM) technology, we developed a titanium alloy (Ti6Al4V) interference screw with chemically calcium phosphate surface modification technology to improve bone integration in the tibial tunnel. After chemical and heat treatment, the titanium screw formed a dense apatite layer on the metal surface in simulated body fluid. Twenty-seven New Zealand white rabbits were randomly divided into control and additive manufactured (AMD) screw groups. The long digital extensor tendon was detached and translated into a tibial plateau tunnel (diameter: 2.0 mm) and transfixed with an interference screw while the paw was in dorsiflexion. Biomechanical analyses, histological analyses, and an imaging study were performed at 1, 3, and 6 months. The biomechanical test showed that the ultimate pull-out load failure was significantly higher in the AMD screw group in all tested periods. Micro-computed tomography analyses revealed early woven bone formation in the AMD screw group at 1 and 3 months. In conclusion, AMD screws with bioactive surface modification improved bone ingrowth and enhanced biomechanical performance in a rabbit model.
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Affiliation(s)
- Yu-Min Huang
- Department of Biomedical Engineering, National Taiwan University, Taipei 106, Taiwan; (Y.-M.H.); (S.-W.H.); (F.-H.L.)
- Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei 100, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 100, Taiwan
| | - Chih-Chieh Huang
- Department of Materials Science and Engineering, National Chiao-Tung University, Hsinchu 300, Taiwan; (C.-C.H.); (S.-Y.C.)
| | - Pei-I Tsai
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 310, Taiwan; (P.-IT.); (K.-Y.Y.); (S.-IH.); (H.-H.S.)
| | - Kuo-Yi Yang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 310, Taiwan; (P.-IT.); (K.-Y.Y.); (S.-IH.); (H.-H.S.)
| | - Shin-I Huang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 310, Taiwan; (P.-IT.); (K.-Y.Y.); (S.-IH.); (H.-H.S.)
| | - Hsin-Hsin Shen
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 310, Taiwan; (P.-IT.); (K.-Y.Y.); (S.-IH.); (H.-H.S.)
| | - Hong-Jen Lai
- Material and Chemical Research Laboratories, Industrial Technology Research Institute, Hsinchu 310, Taiwan;
| | - Shu-Wei Huang
- Department of Biomedical Engineering, National Taiwan University, Taipei 106, Taiwan; (Y.-M.H.); (S.-W.H.); (F.-H.L.)
| | - San-Yuan Chen
- Department of Materials Science and Engineering, National Chiao-Tung University, Hsinchu 300, Taiwan; (C.-C.H.); (S.-Y.C.)
| | - Feng-Huei Lin
- Department of Biomedical Engineering, National Taiwan University, Taipei 106, Taiwan; (Y.-M.H.); (S.-W.H.); (F.-H.L.)
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli County 360, Taiwan
| | - Chih-Yu Chen
- Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei 100, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-970-747767
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Vandeweghe S, De Bruyn H. Oral Implantology: Myths Exposed in Recent Research. Compend Contin Educ Dent 2018; 39:6-11. [PMID: 30188143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Today, a variety of surgical and prosthetic protocols, implant designs, and prosthetic devices are used for implant dentistry, employing many different dental technologies. With a plethora of options available, choosing an implant system has become highly challenging for practitioners. Having an understanding of the role of different implant design properties may help clinicians make informed decisions. This article provides an overview of factors affecting osseointegration and preservation of bone and discusses the importance of surgical and prosthetic treatments that respect the biologic width and avoid interventions, such as cementation, that may disturb the surrounding soft and hard tissues.
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Affiliation(s)
- Stefan Vandeweghe
- Faculty of Medicine and Health Sciences, Dental School, Ghent University, Gent, Belgium
| | - Hugo De Bruyn
- Faculty of Medicine and Health Sciences, Dental School, Ghent University, Gent, Belgium; Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
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Oliveira PGFPD, Bergamo ETP, Neiva R, Bonfante EA, Witek L, Tovar N, Coelho PG. Osseodensification outperforms conventional implant subtractive instrumentation: A study in sheep. Mater Sci Eng C Mater Biol Appl 2018; 90:300-307. [PMID: 29853095 DOI: 10.1016/j.msec.2018.04.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/12/2017] [Accepted: 04/17/2018] [Indexed: 01/02/2023]
Affiliation(s)
| | - Edmara T P Bergamo
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA.
| | - Rodrigo Neiva
- Department of Periodontology, University of Florida, 1395 Center Drive, D1-11, Gainesville, FL 32610, USA.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Al. Otávio Pinheiro Brisola 9-75, Bauru, SP 17.012-901, Brazil.
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA.
| | - Nick Tovar
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA.
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, 550 First Avenue, New York 10016, NY, USA; Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, 6 MetroTech Center, New York, NY 11201, USA.
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Pura JA, Bobyn JD, Tanzer M. Implant-delivered Alendronate Causes a Dose-dependent Response on Net Bone Formation Around Porous Titanium Implants in Canines. Clin Orthop Relat Res 2016; 474:1224-33. [PMID: 26831478 PMCID: PMC4814409 DOI: 10.1007/s11999-016-4714-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/14/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Bony fixation of cementless orthopaedic implants is not always achieved, particularly in challenging scenarios such as revision surgery, trauma, and tumor reconstruction. An adjunct therapy for improving porous implant fixation could improve the reliability and durability of these reconstructive procedures. QUESTIONS/PURPOSES In this study, we asked whether there is a positive and dose-dependent effect of the local release of the bisphosphonate alendronate from (1) alendronate/hydroxyapatite (HA) porous-coated titanium implants compared with bare metal porous controls; and (2) alendronate/HA on porous-coated titanium implants compared with HA-coated porous controls with respect to extent of bone ingrowth, bone apposition, and periimplant bone formation in a canine model? METHODS Three-dimensional printed porous-coated cylindrical implants coated with three different doses (0.02, 0.06, and 0.18 mg/cm(2)) of alendronate were inserted bilaterally in the intramedullary canal of the proximal femora of 15 adult mongrel dogs (age range, 3-9 years; mean, 5 years) weighing between 36 kg and 60 kg (mean, 43 kg). In each dog, an implant coated with HA and one of three different doses of alendronate was inserted on one side while the contralateral femur had a bare metal porous control implant and an identical control implant with a coating of HA. The dose effect of locally released alendronate on the extent of bone ingrowth, bone apposition, and periimplant bone was assessed by backscattered electron microscopy of three pairs of cross-sections taken from each implant at 12 weeks after surgery. A linear mixed model was used to perform the statistical analyses to account for the correlation in the data resulting from the multiple measures performed on each dog. RESULTS Compared with paired bare metal controls, periimplant bone increased by 92% (p = 0.007), and 114% (p < 0.001) in the femora with the alendronate implants with a dose of 0.06 mg/cm(2), or 0.18 mg/cm(2), respectively. At a dose of 0.02 mg/cm(2), there was no difference (46% change; p = 0.184, with the numbers available). The comparison of the alendronate-dosed implants with their HA-coated controls showed that the intermediate dose of 0.06 mg/cm(2) alendronate had the greatest effect on net bone formation. Bone apposition was enhanced with the 0.06-mg/cm(2) alendronate femoral implants (82%; p = 0.008), although there was no change in bone ingrowth (37% change; p = 0.902, with the numbers available). When compared with the HA-coated control implants, the greatest effect of the alendronate-dosed implants was the increased amount of periimplant bone at the intermediate dose of 0.06-mg/cm(2) (108%, p = 0.009). There was no effect of the low (0.02-mg/cm(2)) and high (0.18-mg/cm(2)) alendronate-dosed implants (4%, and 6%, respectively; p = 0.321, p = 0.502). Overall, all three alendronate-dosed implants revealed little to no effect on bone ingrowth compared with the HA-coated control implants. CONCLUSIONS The local release of alendronate from a three-dimensional printed porous-coated implant from the three doses studied showed an overall improvement in bone apposition and periimplant bone at the intermediate dose compared with bare metal or with HA-coated controls, although the effect was more pronounced compared with bare metal. Long-term studies to show the effects of localized alendronate delivery and mechanical fixation would be the next step for future studies. CLINICAL RELEVANCE Local release of alendronate from a three-dimensional printed porous-coated implant may improve the reliability of cementless fixation of currently available porous-coated bare metal implants.
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Affiliation(s)
- Jenny Ann Pura
- Jo Miller Orthopaedic Research Laboratory, Montreal General Hospital, Montreal, QC, Canada.
- Montreal General Hospital, 1650 Cedar Avenue, Room C9-136, Montreal, QC, H3G1A4, Canada.
| | - J Dennis Bobyn
- Jo Miller Orthopaedic Research Laboratory, Montreal General Hospital, Montreal, QC, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McGill University, Montreal, QC, Canada
| | - Michael Tanzer
- Jo Miller Orthopaedic Research Laboratory, Montreal General Hospital, Montreal, QC, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McGill University, Montreal, QC, Canada
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Prochor P, Piszczatowski S, Sajewicz E. Biomechanical evaluation of a novel Limb Prosthesis Osseointegrated Fixation System designed to combine the advantages of interference-fit and threaded solutions. Acta Bioeng Biomech 2016; 18:21-31. [PMID: 28133377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE The study was aimed at biomechanical evaluation of a novel Limb Prosthesis Osseointegrated Fixation System (LPOFS) designed to combine the advantages of interference-fit and threaded solutions. METHODS Three cases, the LPOFS (designed), the OPRA (threaded) and the ITAP (interference-fit) implants were studied. Von-Mises stresses in bone patterns and maximal values generated while axial loading on an implant placed in bone and the force reaction values in contact elements while extracting an implant were analysed. Primary and fully osteointegrated connections were considered. RESULTS The results obtained for primary connection indicate more effective anchoring of the OPRA, however the LPOFS provides more appropriate stress distribution (lower stress-shielding, no overloading) in bone. In the case of fully osteointegrated connection the LPOFSs kept the most favourable stress distribution in cortical bone which is the most important long-term feature of the implant usage and bone remodelling. Moreover, in fully bound connection its anchoring elements resist extracting attempts more than the ITAP and the OPRA. CONCLUSIONS The results obtained allow us to conclude that in the case of features under study the LPOFS is a more functional solution to direct skeletal attachment of limb prosthesis than the referential implants during short and long-term use.
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Affiliation(s)
- Piotr Prochor
- Department of Biocybernetics and Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, Białystok, Poland
| | - Szczepan Piszczatowski
- Department of Biocybernetics and Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, Białystok, Poland
| | - Eugeniusz Sajewicz
- Department of Biocybernetics and Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, Białystok, Poland
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