Objective: The objective of the study was to quantify the effect of cage material (titanium-alloy vs. polyetheretherketone or PEEK) and design (porous vs. solid) on subsidence and osseointegration.
Methods: Three lateral cages (solid PEEK, solid titanium, and 3-dimension-printed porous titanium cages) were evaluated for cage stiffness, subsidence compression stiffness, and dynamic subsidence displacement under simulated postoperative spine loading. Dowel-shaped implants made of grit-blasted solid titanium alloy (solid titanium) and porous titanium were fabricated using commercially available processes. Samples were processed for mechanical push-out testing and polymethylmethacrylate histology following an established ovine bone implantation model.
Results: The solid titanium cage exhibited the greatest stiffness (57.1 ± 0.6 kN/mm), followed by the porous titanium cage (40.4 ± 0.3 kN/mm) and the solid PEEK cage (37.1 ± 1.2 kN/mm). In the clinically relevant dynamic subsidence, the porous titanium cage showed the least amount of subsidence displacement (0.195 ± 0.012 mm), significantly less than that of the solid PEEK cage (0.328 ± 0.020 mm) and the solid titanium cage (0.538 ± 0.027 mm). Bony on-growth was noted histologically on all implant materials; however, only the porous titanium supported bony ingrowth with marked quantities of bone formed within the interconnected pores through 12 weeks. Functional differences in osseointegration were noted between groups during push-out testing. The porous titanium showed the highest maximum shear stress at 12 weeks and was the only group that demonstrated significant improvement (4-12 weeks).
Conclusions: The choice of material and design is critical to cage mechanical and biological performances. A porous titanium cage can reduce subsidence risk and generate biological stability through bone on-growth and ingrowth.
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http://dx.doi.org/10.1016/j.wneu.2022.03.087 | DOI Listing |
J Vet Dent
January 2025
Department of Dentistry, Oral and Maxillo-facial Surgery, Eastcott Veterinary Referrals, Part of Linnaeus Group, Swindon, UK.
Canine acanthomatous ameloblastoma (CAA) is an invasive benign epithelial odontogenic tumour most commonly affecting the mandible of large breed dogs. To the author's knowledge, this report describes the first computer-aided design patient-specific implant (PSI) that has been placed for a critical sized bone defect in mandibular reconstruction of a dog in the UK. The aim was to restore mandibular stability using a regenerative approach combining a titanium locking plate and compression-resistant matrix infused with recombinant human bone morphogenetic protein-2 (rhBMP-2) to bridge the 85 mm mandibular defect created by a segmental mandibulectomy.
View Article and Find Full Text PDFMater Today Bio
February 2025
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China.
Titanium alloys are widely used in the manufacture of orthopedic prosthesis given their excellent mechanical properties and biocompatibility. However, the primary drawbacks of traditional titanium alloy prosthesis are their much higher elastic modulus than cancellous bone and poor interfacial adhesion, which lead to poor osseointegration. 3D-printed porous titanium alloys can partly address these issues, but their bio-inertness still requires modifications to adapt to different physiological and pathological microenvironments.
View Article and Find Full Text PDFInt J Biol Macromol
January 2025
Departamento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, Seville, Spain. Electronic address:
Titanium is widely used for implants however it presents limitations such as infection risk, stress shielding phenomenon, and poor osseointegration. To address these issues, a novel approach was proposed that involves fabricating porous titanium substrates, to reduce implant stiffness, minimizing stress shielding and bone resorption, and applying polymeric coatings to improve bioactivity. Composite coating prepared from chitosan, silver nanoparticles, and nanohydroxyapatite was optimized to enhance antibacterial properties and promote osseointegration.
View Article and Find Full Text PDFThis paper explores the process of forming arrays of vertically oriented carbon nanotubes (CNTs) localized on metal electrodes using thin porous anodic alumina (PAA) on a solid substrate. On a silicon substrate, a titanium film served as the electrode layer, and an aluminium film served as the base layer in the initial film structure. A PAA template was formed from the Al film using two-step electrochemical anodizing.
View Article and Find Full Text PDFJ Spine Surg
December 2024
Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, AUS.
Background: Implant fixation is often the cornerstone of musculoskeletal surgical procedures performed to provide bony fixation and/or fusion. The aim of this study was to evaluate how different design features and manufacturing methods influence implant osseointegration and mechanical properties associated with fixation in a standardized model in cancellous bone of adult sheep.
Methods: We evaluated the performance of three titanium alloy implants: (A) iFuse-TORQ implant; (B) Fenestrated Sacroiliac Device; and (C) Standard Cancellous Bone Screw in the cancellous bone of the distal femur and proximal tibia in 8 sheep.
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