Microvascular response of striated muscle to common arthroplasty‐alloys: A comparative in vivo study with CoCrMo, Ti‐6Al‐4V, and Ti‐6Al‐7Nb

Abstract

The impairment of skeletal muscle microcirculation by a biomaterial may have profound consequences. Due to excellent physical and corrosion characteristics, CoCrMo-, Ti-6Al-4V-, and Ti-6Al-7Nb-alloys are commonly used in orthopedic surgery. Yet concern has been raised with regard to the implications of inevitable corrosion product of these metals on the surrounding biologic environment, particularly in the case of CoCrMo. We, therefore, studied in vivo nutritive perfusion and leukocytic response of striated muscle to these alloys, thereby drawing conclusions on their inflammatory potential. In 28 hamsters, utilizing the dorsal skinfold chamber preparation and intravital microscopy, we could demonstrate that the implant material CoCrMo has a marked impact on local microvascular parameters. While the Ti-alloys Ti-6Al-4V and Ti-6Al-7Nb induced only a transient and moderate inflammatory response, the implantation of a CoCrMo sample led to a distinct and persistent activation of leukocytes combined with disruption of the microvascular endothelial integrity and marked leukocyte extravasation. Animals with Ti-alloys showed a clear tendency of recuperation, while in all but one CoCrMo-treated animals, a breakdown of microcirculation prior to the scheduled end of the experiment was observed. Overall, the alloy Ti-6Al-7Nb was tolerated slightly better than Ti-6Al-4V under the chosen test conditions, though this discrepancy was not statistically significant. Conclusively, the commonly used biomaterials Ti-6Al-7Nb and Ti-6Al-4V induce a considerably lower inflammatory response in the skeletal muscle microvascular system, compared to a CoCrMo-alloy. With a minimum of adverse host reaction, our results indicate that for this particular model Ti-alloys are better tolerated than CoCrMo implant materials.

Improving cytocompatibility of Co28Cr6Mo by TiO 2 coating: gene expression study in human endothelial cells

“…More importantly, metal corrosion products can affect existing vessels. Hence, in addition to persistent inflammatory response, CoCrMo alloy decreased capillary perfusion in striated muscle in the hamster dorsal skinfold chamber, and simultaneously increased microvascular permeability and leucocyte extravasation [9]. The impact of Co28Cr6Mo and its corrosion products on peri-implant tissue could determine the overall response to the metal material.…”

“…In vitro as well as in vivo studies have shown that CoCrMo alloys affect the functionality of endothelial cells [9,12]. Similarly, corrosion products of CoCr-based materials, i.e.…”

Prolene–Monocryl-composite meshes do not increase microvascular Staphylococcus aureus adherence and do not sensitize for leukocytic inflammation

“…In the present study, we have chosen the Syrian golden hamster because the prepared tissue layers of the chamber are thinner in this species, resulting in a better microscopic image quality [22]. In former studies, the dorsal skinfold chamber has also been successfully used for the analysis of vascularization and biocompatibility of metallic implants [34][35][36], bone substitutes [26], and scaffolds for tissue engineering [25,37,38]. Moreover, in contrast to histological studies, this model bears the great advantage that the interaction of S. aureus with the microvascular endothelium can be visualized repetitively in vivo by means of intravital fluorescence microscopy [19,20].…”

The dorsal skinfold chamber: window into the dynamic interaction of biomaterials with their surrounding host tissue

“…Using this model, Kraft et al (2000) demonstrated that titanium only induces a transient up-regulation of leukocyte-endothelial cell interactions in venules of the host tissue during the fi rst 24 h after implantation, indicating a high degree of biocompatibility. This is also the case for commonly used titanium alloys, such as titanium-aluminium-vanadium (Ti-6Al-4V), titanium-aluminium-niobium (Ti-6Al-7Nb) and titaniummolybdenum (Ti-15Mo) (Kraft et al, 2005;Pennekamp et al, 2006Pennekamp et al, , 2007. Furthermore, modifi cation of titanium implants by plasma pre-treatment and collagen I coating contributes not only to a reduced foreign body reaction but also enhances angiogenesis at the implantation site (Hauser et al, 2009).…”