Anterior Lumbar Interbody Fusion Using a Personalized Approach: Is Custom the Future of Implants for Anterior Lumbar Interbody Fusion Surgery?

Mobbs, Ralph J.; Parr, William C.; Choy, Wen Jie; McEvoy, Aidan; Walsh, William R.; Phan, Kevin

doi:10.1016/j.wneu.2018.12.144

Cited by 50 publications

(62 citation statements)

References 46 publications

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“…Most of the current research on the design optimization of customized implants is focused on finding the optimal configuration to achieve the best performances in vivo [3][4][5][6]. Specifically, bespoke implants are produced to fit the patient's anatomical districts of interest even considering complex implant sites [7,8]. One of the most used strategies for the fabrication of bespoke devices is topological optimization [9][10][11], which usually leads to the design of lattice-integrated parts, especially functionally graded lattices [12,13].…”

Section: Introductionmentioning

confidence: 99%

Selective Laser Melting and Electron Beam Melting of Ti6Al4V for Orthopedic Applications: A Comparative Study on the Applied Building Direction

et al. 2020

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The 3D printing process offers several advantages to the medical industry by producing complex and bespoke devices that accurately reproduce customized patient geometries. Despite the recent developments that strongly enhanced the dominance of additive manufacturing (AM) techniques over conventional methods, processes need to be continually optimized and controlled to obtain implants that can fulfill all the requirements of the surgical procedure and the anatomical district of interest. The best outcomes of an implant derive from optimal compromise and balance between a good interaction with the surrounding tissue through cell attachment and reduced inflammatory response mainly caused by a weak interface with the native tissue or bacteria colonization of the implant surface. For these reasons, the chemical, morphological, and mechanical properties of a device need to be designed in order to assure the best performances considering the in vivo environment components. In particular, complex 3D geometries can be produced with high dimensional accuracy but inadequate surface properties due to the layer manufacturing process that always entails the use of post-processing techniques to improve the surface quality, increasing the lead times of the whole process despite the reduction of the supply chain. The goal of this work was to provide a comparison between Ti6Al4V samples fabricated by selective laser melting (SLM) and electron beam melting (EBM) with different building directions in relation to the building plate. The results highlighted the influence of the process technique on osteoblast attachment and mineralization compared with the building orientation that showed a limited effect in promoting a proper osseointegration over a long-term period.

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Section: Introductionmentioning

confidence: 99%

Selective Laser Melting and Electron Beam Melting of Ti6Al4V for Orthopedic Applications: A Comparative Study on the Applied Building Direction

et al. 2020

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“…This bilateral model allows two cancellous and three bicortical implants per side. Ten dowels (five each side) were implanted using an established osseointegration model in 2-year-old adult crossbred wethers [7,8,12,13,[25][26][27][28][29][30]. The sample size for this study was 8 implants per group in cortical sites and 5 implants per group in cancellous sites.…”

Section: Methodsmentioning

confidence: 99%

“…This study used radiographic, mechanical testing and histology in a well-reported adult ovine model to evaluate osseointegration of two commonly used arthroplasty implant surface technologies in cortical and cancellous bone [7,8,12,13,[25][26][27][28][29][30]. The null hypothesis was that there were no differences in bone fixation and mechanical properties as well as histological reaction between a hydroxyapatite-coated titanium alloy and a titanium plasma-coated titanium alloy dowel.…”

Section: Introductionmentioning

confidence: 99%

Bone ongrowth and mechanical fixation of implants in cortical and cancellous bone

et al. 2020

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Background: What is the right surface for an implant to achieve biological fixation? Surface technologies can play important roles in encouraging interactions between the implant surface and the host bone to achieve osseointegration. Preclinical animal models provide important insight into in vivo performance related to bone ongrowth and implant fixation. Methods: A large animal model was used to compare the in vivo response of HA and plasma-sprayed titanium coatings in a well-reported adult ovine model to evaluate bone ongrowth in terms of mechanical properties in cortical sites, and histology and histomorphometry in cortical and cancellous sites at 4 and 12 weeks. Results: Titanium plasma-sprayed surfaces outperformed the HA-coated samples in push-out testing in cortical sites while both surfaces supported new bone ongrowth and remodeling in cortical and cancellous sites. Conclusions: While both HA and Ti plasma provided an osteoconductive surface for bone ongrowth, the Ti plasma provided a more robust bone-implant interface that ideally would be required for load transfer and implant stability in the longer term.

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“…This bilateral model allows two cancellous and three bicortical implants per side. Ten dowels (five each side) were implanted using an established osseointegration model in two year old adult cross bred wethers [7,8,12,13,[25][26][27][28][29][30]. The sample size for this study was 8 implants per group in cortical sites and 5 implants per group in cancellous sites.…”

Section: Methodsmentioning

confidence: 99%

Bone ongrowth and mechanical fixation of implants in cortical and cancellous bone

Walsh

Pelletier

Bertollo

et al. 2020

Preprint

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Background What is the right surface for an implant to achieve biological fixation? Surface technologies can play important roles in encouraging interactions between the implant surface and the host bone to achieve osseointegration. Pre-clinical animal models provide important insight into in-vivo performance related to bone ongrowth and implant fixation.Methods A large animal model was used to compare the in vivo response of HA and plasma sprayed titanium coatings in a well reported adult ovine model to evaluate bone ongrowth in terms of mechanical properties in cortical sites, histology and histomorphometry in cortical and cancellous sites at 4 and 12 weeks. Results Titanium plasma sprayed surfaces outperformed the HA coated samples in push-out testing in cortical sites while both surfaces supported new bone ongrowth and remodeling in cortical and cancellous sites. Conclusions While both HA and Ti plasma provided an osteoconductive surface for bone ongrowth, the Ti plasma provided a more robust bone-implant interface that ideally would be required for load transfer and implant stability in the longer term.

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Anterior Lumbar Interbody Fusion Using a Personalized Approach: Is Custom the Future of Implants for Anterior Lumbar Interbody Fusion Surgery?

Cited by 50 publications

References 46 publications

Selective Laser Melting and Electron Beam Melting of Ti6Al4V for Orthopedic Applications: A Comparative Study on the Applied Building Direction

Selective Laser Melting and Electron Beam Melting of Ti6Al4V for Orthopedic Applications: A Comparative Study on the Applied Building Direction

Bone ongrowth and mechanical fixation of implants in cortical and cancellous bone

Bone ongrowth and mechanical fixation of implants in cortical and cancellous bone

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