Our study showed that the evaluated implants have good BIC features. Furthermore, based on histomorthometry and histology, Porous tantalum Trabecular Metal (A) and Trabecular Titanium (B) implants exhibit higher BIC with bone tissue.
Background: To compare structural features of the femoral bone of ovariectomized and non-ovariectomized rats after implantation of porous materials (TANTALUM, CONCELOC, TTM, ATLANT). Methods: Experiments were carried out on 56 white laboratory female rats aged 6 months. Rats were randomly assigned into groups: sham-operated control group (SH) or ovariectomy group (OVX). Four different commercial implant materials (TTM, CONCELOC, TANTALUM, ATLANT) were placed into the defects (diameter 2.5 mm, depth 3.0 mm) in the distal metaphysis of femurs. Rats were sacrificed 45 days after surgery. Histological study was performed and the percentage of the bone area (BA%) around the implant at a distance of 500 μm in the cancellous area was measured. Results: Formation of mature bone tissue of varying degrees around all of the implants was detected. In OVX rats cancellous bone defect zone was characterized by a high density of osteocytes on the surface. In the SH group, no differences in BA% among implant materials were found. In OVX rats, the BA% around ATLANT implants was 1.5time less (p = 0.002) than around TANTALUM. The BA% around the rest of the materials was not statistically different. Conclusions: Bone formation around the studied porous titanium and tantalum materials in the osteoporosis model was lower than in normal bone. There were differences in bone formation around the different materials in the osteoporosis model, while in the normal bone model, these differences were absent.
Objective. Basing on the analysis of the scientific literature to study the prevalence of osteoporosis and osteopenia among patients with hip osteoarthritis undergoing THA and to establish the influence of osteoporosis/osteopenia on the choice of implants and on the restoration of the joint function after the surgery. Osteoporosis and osteopenia are manifested in 21-32 % patients undergoing hip arthroplasty. Low bone mass may be a cause of intraoperative (periprosthetic hip fractures) and postoperative complications. In patients with low bone mass bone remodeling with an increased resorption and inhibition of bone formation around hip components can lead to increasing of its micro-movements, the formation of fibrous tissues, and diminution of implants survivorship. In patients with normal bone mineral density (BMD) also the loss of bone tissue around the acetabular cup can occur; it can occur up to 20-60 % in the first three years post operation, which can lead to the cup instability. But the dynamics of changes in bone tissue around the acetabular component in patients with osteoporosis/osteopenia is nowadays poorly understood. We suppose that porous acetabular components have advantages in patients with low BMD. Due to the elastic modulus which is closely similar to cancellous bone, as well as the corresponding porosity, which facilitates osteointegration and gives a reliable secondary biological fixation of the acetabulum. Rehabilitation and restoration of kinematic and support function of the hip joint after arthroplasty is an important issue for patients with low BMD. Gait disturbance can persist 12 months after surgery. One of the reasons is the weakness of the muscles of the femur. Rehabilitation after total hip arthroplasty leads to faster recovery, but particularities of rehabilitation in patients with low bone mass are not fully studied.
Background To compare structural features of femoral bone of ovariectomized and non-ovariectomized rats after implantation of porous materials (TANTALUM, CONCELOC, TTM, ATLANT). Methods Experiments were carried out on 56 white laboratory female rats aged 6-months. Rats were randomly assigned into groups: Sham control group (SH) or ovariectomy group (OVX). Four different commercial implant materials (TTM, CONCELOC, TANTALUM, ATLANT) were placed into the defects (diameter 2.5mm, depth 3.0mm) in the distal metaphysis of femurs. Rats were sacrificed 45-days after surgery. Histological study was performed and the percentage of bone area (BA%) around the implant at a distance of 500μm in the cancellous area was measured. Results Formation of mature bone tissue of varying degrees around all of the implants was detected. In OVX rats cancellous bone defect zone was characterized by a high density of osteocytes on the surface. In the SH group, no differences in BA% among implant materials were found. In OVX rats the BA% around ATLANT implants was 1.5-time less (p=0.002) than around TANTALUM. The BA% around the rest of the materials was not statistically different. Conclusions Bone formation around the studied porous titanium and tantalum materials in the osteoporosis model was lower than in normal bone. There were differences in bone formation around the different materials in the osteoporosis model, while in the normal bone model these differences were absent.
Background: To compare structural features of femoral bone of ovariectomized and non-ovariectomized rats after implantation of porous materials (TANTALUM, CONCELOC, TTM, ATLANT).Methods: Experiments were carried out on 56 white laboratory female rats aged 6-months. Rats were randomly assigned into groups: Sham-operated control group (SH) or ovariectomy group (OVX). Four different commercial implant materials (TTM, CONCELOC, TANTALUM, ATLANT) were placed into the defects (diameter 2.5mm, depth 3.0mm) in the distal metaphysis of femurs. Rats were sacrificed 45-days after surgery. Histological study was performed and the percentage of bone area (BA%) around the implant at a distance of 500μm in the cancellous area was measured.Results: Formation of mature bone tissue of varying degrees around all of the implants was detected. In OVX rats cancellous bone defect zone was characterized by a high density of osteocytes on the surface. In the SH group, no differences in BA% among implant materials were found. In OVX rats the BA% around ATLANT implants was 1.5-time less (p=0.002) than around TANTALUM. The BA% around the rest of the materials was not statistically different.Conclusions: Bone formation around the studied porous titanium and tantalum materials in the osteoporosis model was lower than in normal bone. There were differences in bone formation around the different materials in the osteoporosis model, while in the normal bone model these differences were absent.
Total hip arthroplasty (THA) is one of the most common andclinically successfulorthopedic surgeries aimedto eliminate painand improve walking functionin patients with osteoarthritisof the III–IV stages. Low mineralbone density (BMD) affectsthe survivorship of implants after THA and may cause longrecoveryterms. Objective. Analyze the results THA in patientswith normal andlow BMD within a year after surgery. Methods.49 patients (aged 30‒75 years) were examined before and afteruncementedprimary THA. According to the results of two-photonX-ray absorptiometry before the surgery, they were divided intotwo groups: I, normal BMD — 27 (55.1 %) patients, T-criterionat the level of the proximal part of the unaffected femur ‒1 ormore; II, reduced BMD — 22 (44.9 %), T-criterion is smallerfor‒1. BMD, pain for VAS and function of the operated limbaccordingto Harris score, it was assessed before THA and one weeklater; 2, 6, 12 months. Biomechanical examinations of the bearingcapacity of the limb were performed before thesurgeryand6 months after. Results. On all terms of postoperative followup,the indicator forVAS in patients of the II group was statisticallyworse, but pain syndrome decreased in parallel. Harriship score was significantly lower in patients of the II group determinedbeforesurgeryand after it up to 2 monthsoffollow-up;after 6 months indicators became statistically similar. Accordingto the results of statography regardless of BMD before the surgicaltreatment, the average support on the affected limb was(12.7 ± 9.2) % less than healthy (p = 0.019). By 6 months afterTHA, the difference in foot load was insignificant (p = 0.675).Conclusions. One year after THA, recovery of function accordingto the Harris hip score established in bothgroups. However,this process occurs in patients with low BMDand took placemore slowly: only 6 months after surgery, the indicator leveledoff with the normal group BMD, 6 months after surgery in patientsof both groups, with the restoration of support on the operatedlimb during two-support standing was recorded.
BACKGROUND Today, biological fixation of uncemented press-fit acetabular components plays an important role in total hip arthroplasty. Long-term stable fixation of these implants depends on the osseointegration of the acetabular cup bone tissue into the acetabular cup implant, and their ability to withstand functional loads. AIM To compare the strength of bone-implant osseointegration of four types of porous metal implants in normal and osteoporotic bone in rabbits. METHODS The study was performed in 50 female California rabbits divided into non-ovariectomized (non-OVX) and ovariectomized groups (OVX) at 6 mo of age. Rabbits were sacrificed 8 wk after the implantation of four biomaterials [TTM, CONCELOC, Zimmer Biomet's Trabecular Metal (TANTALUM), and ATLANT] in a 5-mm diameter defect created in the left femur. A biomechanical evaluation of the femur was carried out by testing implant breakout force. The force was gradually increased until complete detachment of the implant from the bone occurred. RESULTS The breakout force needed for implant detachment was significantly higher in the non-OVX group, compared with the OVX group for all implants (TANTALUM, 194.7 ± 6.1 N vs 181.3 ± 2.8 N; P = 0.005; CONCELOC, 190.8 ± 3.6 N vs 180.9 ± 6.6 N; P = 0.019; TTM, 186.3 ± 1.8 N vs 172.0 N ± 11.0 N; P = 0.043; and ATLANT, 104.9 ± 7.0 N vs 78.9 N ± 4.5 N; P = 0.001). In the OVX group, The breakout forces in TANTALUM, TTM, and CONCELOC did not differ significantly ( P = 0.066). The breakout force for ATLANT in the OVX group was lower by a factor of 2.3 compared with TANTALUM and CONCELOC, and by 2.2 compared with TTM ( P = 0.001). In the non-OVX group, the breakout force for ATLANT was significantly different from all other implants, with a reduction in fixation strength by a factor of 1.9 ( P = 0.001). CONCLUSION TANTALUM, TTM, and CONCELOC had equal bone-implant osseointegration in healthy and in osteoporotic bone. ATLANT had significantly decreased osseointegration ( P = 0.001) in healthy and in osteoporotic bone.
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