Comparison of two pore sizes of LAE442 scaffolds and their effect on degradation and osseointegration behavior in the rabbit model

The magnesium alloy LAE442 emerged as a possible bioresorbable bone substitute over a decade ago. In the present study, using the investment casting process, scaffolds of the Magnesium (Mg) alloy LAE442 with two different and defined pore sizes, which had on average a diameter of 400 μm (p400) and 500 μm (p500), were investigated to evaluate degradation and osseointegration in comparison to a ß‐TCP control group. Open‐pored scaffolds were implanted in both greater trochanter of rabbits. Ten scaffolds per time group (6, 12, 24, and 36 weeks) and type were analyzed by clinical, radiographic and μ‐CT examinations (2D and 3D). None of the scaffolds caused adverse reactions. LAE442 p400 and p500 developed moderate gas accumulation due to the Mg associated in vivo corrosion, which decreased from week 20 for both pore sizes. After 36 weeks, p400 and p500 showed volume decreases of 15.9 and 11.1%, respectively, with homogeneous degradation, whereas ß‐TCP lost 74.6% of its initial volume. Compared to p400, osseointegration for p500 was significantly better at week 2 postsurgery due to more frequent bone‐scaffold contacts, higher number of trabeculae and higher bone volume in the surrounding area. No further significant differences between the two pore sizes became apparent. However, p500 was close to the values of ß‐TCP in terms of bone volume and trabecular number in the scaffold environment, suggesting better osseointegration for the larger pore size

Assessment of bone ingrowth potential of biomimetic hydroxyapatite and brushite coated porous E-beam structures

The bone ingrowth potential of biomimetic hydroxyapatite and brushite coatings applied on porous E-beam structure was examined in goats and compared to a similar uncoated porous structure and a conventional titanium plasma spray coating. Specimens were implanted in the iliac crest of goats for a period of 3 (4 goats) or 15 weeks (8 goats). Mechanical implant fixation generated by bone ingrowth was analyzed by a push out test. Histomorphometry was performed to assess the bone ingrowth depth and bone implant contact. The uncoated and hydroxyapatite-coated cubic structure had significantly higher mechanical strength at the interface compared to the Ti plasma spray coating at 15 weeks of implantation. Bone ingrowth depth was significantly larger for the hydroxyapatite- and brushite-coated structures compared to the uncoated structure. In conclusion, the porous E-beam surface structure showed higher bone ingrowth potential compared to a conventional implant surface after 15 weeks of implantation. Addition of a calcium phosphate coating to the E-beam structure enhanced bone ingrowth significantly. Furthermore, the calcium phosphate coating appears to work as an accelerator for bone ingrowth

Differential thermography for experimental, full-field stress analysis of hip arthroplasty

A hip prosthesis implant produces a significant deviation in the stress pattern compared with the physiologic condition. In this work, the stress patterns are evaluated experimentally on synthetic femora, by means of thermoelastic stress analysis. Two factors have been considered: stem implantation and head offset. Stress maps were obtained using differential thermography and correlated to these factors. Thermoelastic stress maps have demonstrated to be sensitive to the implant and the head offset. In detail, the standard deviation of stresses can reduce from -5% to -50% (with reference to the physiologic one), depending on stem design; peak stresses change their position or disappear for different implant position or press-fitting, the sensitivity of average stresses to the offset is at least equal to 0.07MPa/mm. On the whole, a methodology was developed, allowing the experimental evaluation and comparison of the stress distributions produced by different implant

Maintenance of bone mineral density after implantation of a femoral neck hip prosthesis

<p>Abstract</p> <p>Background</p> <p>Stress shielding of the proximal femur has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to investigate the changes of bone-mineral density in the proximal femur and the clinical outcome after implantation of a short femoral-neck prosthesis.</p> <p>Methods</p> <p>We prospectively assessed the clinical outcome and the changes of bone mineral density of the proximal femur up to one year after implantation of a short femoral neck prosthesis in 20 patients with a mean age of 47 years (range 17 to 65). Clinical outcome was assessed using the Harris Hip Score. The WOMAC was used as a patient-relevant outcome-measure. The bone mineral density was determined using dual energy x-ray absorptiometry, performed 10 days, three months and 12 months after surgery.</p> <p>Results</p> <p>The Harris Hip Score improved from an average preoperative score of 46 to a postoperative score at 12 months of 89 points, the global WOMAC index from 5,3 preoperatively to 0,8 at 12 months postoperatively. In contrast to conventional implants, the DEXA-scans overall revealed a slight increase of bone mineral density in the proximal femur in the 12 months following the implantation.</p> <p>Conclusion</p> <p>The short femoral neck stem lead to a distinct bone reaction. This was significantly different when compared to the changes in bone mineral density reported after implantation of conventional implants.</p

Differences in External and Internal Cortical Strain with Prosthesis in the Femur

The contact between a femoral stem prosthesis and the internal surface of the cortical bone with the stress in the interface is of crucial importance with respect to loosening. However, there are no reports of strain patterns at this site, and the main aim of the current study was to investigate differences of internal and external cortical strain in the proximal femur after insertion of a stem prosthesis. The external cortical strain of a human cadaveric femur was measured with strain gauges before and after implantation of a stem prosthesis. By use of optical fibres embedded longitudinally in the endosteal cortex, deformations at the implant–internal cortex interface could also be measured. The main external deformation during loading of the intact femur occurred as compression of the medial cortex; both at the proximal and distal levels. The direction of the principal strain on the medial and lateral aspects was close to the longitudinal axis of the bone. After resection of the femoral neck and insertion of a stem prosthesis, the changes in external strain values were greatest medially at the proximal level, where the magnitude of deformation in compression was reduced to about half the values measured on the intact specimen. Otherwise, there were rather small changes in external principal strain. However, by comparing vertical strain in the external and internal cortex of the proximal femur, there were great differences in values and patterns at all positions. The transcortical differences in strain varied from compression on one side to distraction on the other and vice versa in some of the positions with a correlation coefficient of 0.07. Our results show that differences exist between the external and internal cortical strain when loading a stem prosthesis. Hence, strain at the internal cortex does not correspond and can not be deducted from measured strain at the external cortex