Porous titanium particles for acetabular reconstruction in total hip replacement show extensive bony armoring after 15 weeks
نویسندگان
چکیده
BACKGROUND AND PURPOSE The bone impaction grafting technique restores bone defects in total hip replacement. Porous titanium particles (TiPs) are deformable, like bone particles, and offer better primary stability. We addressed the following questions in this animal study: are impacted TiPs osteoconductive under loaded conditions; do released micro-particles accelerate wear; and are systemic titanium blood levels elevated after implantation of TiPs? ANIMALS AND METHODS An AAOS type-III defect was created in the right acetabulum of 10 goats weighing 63 (SD 6) kg, and reconstructed with calcium phosphate-coated TiPs and a cemented polyethylene cup. A stem with a cobalt chrome head was cemented in the femur. The goats were killed after 15 weeks. Blood samples were taken pre- and postoperatively. RESULTS The TiP-graft layer measured 5.6 (SD 0.8) mm with a mean bone ingrowth distance of 2.8 (SD 0.8) mm. Cement penetrated 0.9 (0.3-1.9) mm into the TiPs. 1 reconstruction showed minimal cement penetration (0.3 mm) and failed at the cement-TiP interface. There were no signs of accelerated wear, metallic particle debris, or osteolysis. Median systemic titanium concentrations increased on a log-linear scale from 0.5 (0.3-1.1) parts per billion (ppb) to 0.9 (0.5-2.8) ppb (p=0.01). INTERPRETATION Adequate cement pressurization is advocated for impaction grafting with TiPs. After implantation, calcium phosphate-coated TiPs were osteoconductive under loaded conditions and caused an increase in systemic titanium concentrations. However, absolute levels remained low. There were no signs of accelerated wear. A clinical pilot study should be performed to prove that application in humans is safe in the long term.
منابع مشابه
Porous titanium particles for acetabular reconstruction in total hip replacement show extensive bony armoring after 15 weeks A loaded in vivo study in 10 goats
متن کامل
Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement
Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DD...
متن کاملThe Effect of Trabecular Metal Porous Surface on Gap Healing and Bone Ingrowth Fixation in a Canine Total Hip Model
Introduction An exciting approach to reducing aseptic loosening of cementless implants is the stimulation and acceleration of bone ingrowth into the porous coatings of the implants. Improved fixation of components is an important factor for long term success of total hip and total knee replacement. While one method of stimulating bone formation utilizes biological agents such as BMP-2 or OP-1. ...
متن کاملTen-year follow-up of the non-porous Allofit cementless acetabular component.
Cementless acetabular fixation has demonstrated superior long-term durability in total hip replacement, but most series have studied implants with porous metal surfaces. We retrospectively evaluated the results of 100 consecutive patients undergoing total hip replacement where a non-porous Allofit component was used for primary press-fit fixation. This implant is titanium alloy, grit-blasted, w...
متن کاملA modified custom-made triflanged acetabular reconstruction ring (MCTARR) for revision hip arthroplasty with severe acetabular defects.
The treatment of extensive acetabular bone loss and pelvic discontinuity in revision total hip arthroplasty remains challenging. We report our preliminary experience with the modified custom-made triflanged acetabular reconstruction ring (MCTARR) in the management of such situations. The MCTARR is a custom-made metal reinforcement ring with a trabecular surface to encourage bone ingrowth and a ...
متن کامل