Attachment of prostheses to the musculo‐skeletal system by tissue ingrowth and mechanical interlocking

Hulbert, Samuel F.; Cooke, Francis W.; Klawitter, J. J.; Leonard, Ralph B.; Sauer, Barry W.; Moyle, D.D.; Skinner, Harry B.

doi:10.1002/jbm.820070303

Cited by 126 publications

(38 citation statements)

References 20 publications

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“…1 For anchoring load-bearing implants within the skeletal system, biological fixation of implants by active bone growth onto surfaces or into porous surface structures has long been applied. 2 Particularly, titanium (Ti) dental implants have been widely used clinically and experimentally to provide a structural and functional connection between ordered living bone and the surface of load-carrying implants. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] As long as there is stable and adequate surface structure in implants, woven bone ongrowth will lead to subsequent mechanical and biological fixation of implants.…”

Section: Introductionmentioning

confidence: 99%

Effects of enamel matrix derivative to titanium implantation in rat femurs

Shimizu-Ishiura

Tanaka

Lee

et al. 2002

J. Biomed. Mater. Res.

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The effects of enamel matrix derivative (EMD; Emdogain) on new trabecular bone induction after pure bioinert titanium (Ti) implantation in the rat femur were examined by means of routine light and transmission electron microscopy, immunohistochemistry, and backscattered electron image analysis. Newly designed mini-Ti implants (3.5 mm in length and 1.6 mm in diameter) were placed in the corticotrabecular area of the femur with either EMD or its carrier, propylene glycol alginate, as control. On post-implantation days 4, 7, 14, and 30, the dissected femur was examined in the transverse direction through Ti implants. In both control and EMD-applied femurs, trabecular bone formation was recognized over the implant surfaces and within medullary cavities even at 4 days post-implantation. These newly formed bone trabeculae around the Ti implants were immunoreactive for bone sialoproteins as a bone matrix marker, and osteoclastic bone resorption became evident in these bone trabeculae after 7 days post-implantation. Although trabecular bone area around the implants was markedly decreased at 30 days post-implantation compared with those at 14 days, the trabecular bone areas in EMD-applied femurs were significantly greater than those in propylene glycol alginate-applied femurs at both 14 and 30 days post-implantation. Our results suggest that EMD is an effective biological matrix for enhancing new trabecular bone induction and resulting attachment of orthopedic prostheses to the recipient bone.

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Section: Introductionmentioning

confidence: 99%

Effects of enamel matrix derivative to titanium implantation in rat femurs

Shimizu-Ishiura

Tanaka

Lee

et al. 2002

J. Biomed. Mater. Res.

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“…For soft tissue, a large pore size (approximately 900 pm) provided an optimal peeloff strength when the soft tissue was mechanically torn away from the metal surface (18). Anchorage of prostheses to bone by bone ingrowth occurred in a large variety of porous coatings, in different materials, and under different loading conditions (2,3, 8,11,12,14,19,24). The initial fixation strength of tendons to bone with and without a bone block has been studied widely (9,17,20,23).…”

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confidence: 99%

Tendons attached to prostheses by tendon‐bone block fixation: An experimental study in dogs

Gottsauner‐Wolf

Egger

Schultz

et al. 1994

Journal Orthopaedic Research

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To develop a method of tendon attachment to a metallic endoprosthesis, we evaluated fixation strength, clinical function of the tendon, and morphological changes in an experimental model. The canine supraspinatus tendon was removed from the greater tubercle of the humerus and attached to a titanium prosthesis. In 12 animals, the bone block underlying the tendon insertion was preserved and attached in one limb; the soft part of the tendon was attached directly to the prosthesis in the contralateral limb. Fixation strength was evaluated after 16 weeks of in vivo implantation (12 specimens) and compared with the in vitro fixation strength (12 specimens) and with intact normal controls (six specimens from cadavera). Function of the tendon in vivo was evaluated by force-plate analysis (at 3-week intervals). All specimens were evaluated histologically. Sixteen weeks after surgery, the tendon-bone block attachment was significantly stronger (mean, 16%) than the direct tendon attachment and not significantly different from the normal control, and the direct tendon attachment was significantly weaker (mean, 68%) than the normal control. There was significantly more weight-bearing on the limbs with a tendon-bone block attachment than on the limbs with a direct tendon attachment at both 3 and 6 weeks postoperatively. Both front legs showed increased weight-bearing with time, but the differences were not statistically significant. Anchorage by tissue ingrowth to the titanium prosthesis was found consistently--there was bone ingrowth in the tendon-bone block attachments and fibrous tissue ingrowth in the direct tendon attachments. When a bone block was preserved, the strength and stiffness were comparable with those of a normal tendon insertion.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Optimum pore size for bone ingrowth is 100 lm, whereas pore size more than 200 lm facilitates development of mature osteon [12]. Level of porosity should be larger than 50-60 %, the minimal interconnection size should be larger than 50-100 lm and the mean pore size should be between 100 and 500 lm [13].…”

Section: Discussionmentioning

confidence: 99%

Autogenous Bone Marrow Aspirate Coated Synthetic Hydroxyapatite for Reconstruction of Maxillo-Mandibular Osseous Defects: A Prospective Study

Gali

Devireddy

Rao

et al. 2016

J. Maxillofac. Oral Surg.

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Purpose This prospective study was conducted to evaluate the bone regeneration capacity of synthetic hydroxyapatite mixed with autogenous bone marrow aspirate when used as a bone graft substitute in maxillo-mandibular osseous defects. Methods This study included nine patients with histopathalogically proven benign osteolytic lesions in maxilla and mandible that were treated with enucleation or marginal resection followed by bone marrow aspirate coated synthetic biphasic hydroxyapatite (hydroxyapatite and beta tricalcium phosphate) graft placement. Incorporation of graft was assessed based on Irwin's radiologic staging. The efficacy of graft to form new bone was radiologically evaluated by observing the sequential changes of density at grafted site using gray scale level histogram which was processed in adobe photoshop 7.0 elements. Clinical assessment of recipient and donor sites was done. Results Based on Irwin's radiologic staging, at 6 month follow up period, obvious incorporation of graft with new bone was observed. Sequential changes in bone density measured by gray scale histogram revealed initial resorption followed by replacement of BMA coated hydroxyapatite with new bone formation. None of the patients eventually had complications like infection, wound dehiscence, graft loss at recipient sites at 6 months follow up period. Conclusion Autogenous bone marrow aspirate in combination with synthetic hydroxyapatite is an effective option for accelerating bone regeneration in small to moderate sized jaw bone defects. This mixture provides all the three critical elements needed for bone regeneration (osteogenesis, osteoinduction and osteoconduction) with an added advantage of obviating donor site morbidity.

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Attachment of prostheses to the musculo‐skeletal system by tissue ingrowth and mechanical interlocking

Cited by 126 publications

References 20 publications

Effects of enamel matrix derivative to titanium implantation in rat femurs

Effects of enamel matrix derivative to titanium implantation in rat femurs

Tendons attached to prostheses by tendon‐bone block fixation: An experimental study in dogs

Autogenous Bone Marrow Aspirate Coated Synthetic Hydroxyapatite for Reconstruction of Maxillo-Mandibular Osseous Defects: A Prospective Study

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