One of the key challenges in employing biomaterials is determining how to fix them into the surrounding tissue. To enhance the interaction with surrounding bone, amorphous hydroxyapatite (HA) was coated onto the surface of the bio-inert poly(vinyl alcohol) hydrogel (PVA-H), as an artificial cartilage material, by a pulsed laser deposition technique. Next we examined the binding effects of the HA thin film (300 nm thick) to the underlying bone using osteoblast proliferation and differentiation. A mouse osteoblast cell line, MC3T3E1, was cultured on the HA-coated and noncoated PVA-H with a water content of 33% or 53% for 3 weeks. Cell proliferation, alkaline phosphatase (ALP) activity, and levels of osteocalcin were evaluated for biocompatibility and differentiation. HA coating enhanced the cell proliferation, the ALP activity, and the levels of osteocalcin on both low and high water-content PVA-Hs. The cell growth rates on the PVA-H were lower than on tissue culture dishes even after the HA coating was added; however, osteoblastic differentiation was highly promoted by the HA coating on low water content PVA-H. These results suggested that the HA coating on the PVA-H enhanced the affinity between the bone and the PVA-H as an artificial cartilage material in surface replacement arthroplasty.
The key problem with artificial joint materials is obtaining quick and firm attachment onto the underlying bone. In developing artificial articular cartilage, composed of polyvinyl alcohol hydrogel (PVA-H), this problem was solved by using a composite osteochondral device (COD). This enables attachment within four weeks post-operation by massive bone ingrowth into the pores. The COD consists of PVA-H as an artificial cartilage and titanium fiber mesh (TFM) as porous artificial bone. In this study, the strength of the shear resistance force at the interface of the PVA-H and the TFM fabricated by injection molding and the changes in the mechanical properties of the PVA-H fabricated by high temperature during the injection-molding process were examined. The shear resistance force was strengthened markedly by using injection molding and no important deterioration of the PVA-H was found. Morphological examination of canine spines, to which artificial intervertebral discs made of the COD were implanted, showed good bonding of the COD with the vertebral bodies for an extended period of 30 months, and encouraged us to use the COD clinically.
To investigate the mechanism underlying femoral neck fracture, it is necessary to determine the various mechanical properties, including the bone strength, of the primary compressive group. We investigated the mechanical anisotrophy of the primary compressive group by comparing differences in its mechanical properties, depending on the loading direction. Twenty-three femoral heads of 20 female and 3 male patients with femoral neck fracture were studied. The mean age of these patients was 79.9 years (range, 63-98 years). A total of 82 cubic specimens (6.5 mm in length) were obtained (one to six specimens from each femoral head). The specimens obtained from each femoral head were randomly assigned into two groups: parallel and perpendicular. The parallel group included 43 specimens, and the perpendicular group included 39 specimens. A compressive load was applied either parallel or perpendicular to the primary compressive group of the specimens in each respective group. Three parameters were obtained: compressive stiffness, maximum stress, and maximum energy. We calculated the regression of three parameters against the square of the apparent dry density. These mechanical properties were compared between the two groups by testing the difference of the slopes in two regression lines by using analyses of covariance, in which two main effects of group (nominal value) and the square of the apparent dry density (continuous value) and an interaction between two factors were modeled. Three parameters were significantly correlated with the square of the apparent dry density in both groups. In all three measurements, the difference of the slopes between two regression lines was significantly different. This means that all three measurements decreased in the parallel group more than in the perpendicular one, as apparent dry density decreased. We consider that the bone strength of the proximal femur decreases more when stress is applied in the longitudinal direction (as in walking) and less when stress is applied in the transverse direction (as in a fall) when bone density decreases.
The antidegenerative effects of partial disc replacement surgery were demonstrated by quantitative radiologic and histologic analyses. Degeneration of the anulus fibrosus after the replacement treatment was delayed by preserving disc height and occupying the space of the nucleus pulposus. Properly designed implants and minimally invasive techniques are necessary for long-term success.
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