Tissue reaction to bone plates made of pure titanium: a prospective, quantitative clinical study

Abstract

In 54 patients fractures of the long bones were stabilized with limited-contact dynamic compression plates (LC-DCP) made of titanium. The implant surfaces were anodized to an interference colour of gold. The surface morphology effects the tissue response to the implant and was therefore examined. At implant retrieval, about 18 months post operatively (range 11 to 27), samples of the soft tissue layer covering the plate were excised and analysed by histomorphometrical means. The aim was to study the soft tissue reactions at the implant site and further to correlate itto the clinical symptoms of the patients. At retrieval the plates were covered by a connective tissue layer of 2 mm thickness on average. In patients with local pain a comparatively significant higher number of round cells (p=0.001) and macrophages (p=0.01) was found. This is consistent with a chronic granulomatous inflammatory reaction. The localized tissue discoloration observed in about half of the patients was confirmed as being due to titanium, but it was not the focus of a cellular reaction and was not correlated with pain. In general the implant showed good biocompatibility with excellent or good clinical results in 96% of patients.

Diferencias entre las membranas inducidas por diferentes implantes y cementos. Estudio experimental. [Differences among membranes induced by different implants and cements. Experimental study]

“…8 Está bien documentada la mayor tolerancia observada con implantes de titanio en animales y en seres humanos. [28][29][30] conclusIones Las membranas que se formaron alrededor de los materiales de osteosíntesis no difirieron significativamente desde el punto de vista anatomopatológico. Sí, se hallaron diferencias entre las membranas del cemento con corticoide y el cemento con antibiótico.…”

Osteosarcoma at the site of titanium orthopaedic implants in a dog

“…These findings suggest that neither implant corrosion nor the presence of particulates is a prerequisite for the formation of neoplasia adjacent to titanium implants. Peri‐implant titanium particles have been noted adjacent to both normally functioning and malfunctioning orthopaedic implants in humans, 38,39 forming grossly visible black tissue discolouration in 50% of patients with normally functioning titanium LC‐DCP plates 39 . This suggests that a finding of peri‐implant particulate metal in patients with neoplasia adjacent to implants would not necessarily be significant.…”

Priming the Surface of Orthopedic Implants for Osteoblast Attachment in Bone Tissue Engineering

“…that are used in alloys for the fabrication of orthopedic implants because it possesses many desirable properties - high load-bearing capacity, compatible elastic modulus to native bone, 58 high corrosion resistance, 59 and good biocompatibility. 60 However, in a small number of recipients of titanium implants, allergic reactions in response to the implants were observed. 61 , 62 In order to minimize such allergic reactions, it is necessary to osseointegrate the implant with the native bone, viz.…”