In Vivo Corrosion of Two Novel Magnesium Alloys ZEK100 and AX30 and Their Mechanical Suitability as Biodegradable Implants

In magnesium alloys, the components used modify the alloy properties. For magnesium implants in contact with bone, rare earths alloys are commonly examined. These were shown to have a higher corrosion resistance than other alloys and a high mechanical strength, but their exact composition is hard to predict. Therefore a reduction of their content could be favorable. The alloys ZEK100 and AX30 have a reduced content or contain no rare earths at all. The aim of the study was to investigate their in vivo degradation and to assess the suitability of the in vivo μCT for the examination of their corrosion. Implants were inserted in rabbit tibiae. Clinical examinations, X-rays and in vivo μCT scans were done regularly. Afterwards implants were analyzed with REM, electron dispersive X-ray (EDX), weighing and mechanical testing. The in vivo μCT is of great advantage, because it allows a quantification of the corrosion rate and qualitative 3D assessment of the corrosion morphology. The location of the implant has a remarkable effect on the corrosion rate. Due to its mechanical characteristics and its corrosion behavior, ZEK100 was judged to be suitable, while AX30, which displays favorable degradation behavior, has too little mechanical strength for applications in weight bearing bones

Suitability of Permanent Probe Implants For the Measurement of Intramedullary Perfusion and Temperature Near the Bone Cortex: A Pilot Study Using a Rabbit Model

This study was conducted to test the suitability of permanent probe implants for the measurement of  intramedullary perfusion by laser Doppler flowmetry and for the measurement of temperature near the  bone cortex. Measurements were carried out on the conscious animal in order to rule out the influence of  anaesthesia on intramedullary perfusion and temperature. During the first experimental animal trials, some  of the probes made of polysulphon broke and/or gave false temperature measurements, so the original  probe design was modified. The probes were reinforced with metal, and the temperature sensors were made  less permeable to moisture. These modified probes were found to be suitable for permanent measurement  of intramedullary perfusion and of temperature near the cortex in the conscious rabbit.

Early Predictability of Grasping Movements by Neurofunctional Representations: A Feasibility Study

Human grasping is a relatively fast process and control signals for upper limb prosthetics cannot be generated and processed in a sufficiently timely manner. The aim of this study was to examine whether discriminating between different grasping movements at a cortical level can provide information prior to the actual grasping process, allowing for more intuitive prosthetic control. EEG datasets were captured from 13 healthy subjects who repeatedly performed 16 activities of daily living. Common classifiers were trained on features extracted from the waking-state frequency and total-frequency time domains. Different training scenarios were used to investigate whether classifiers can already be pre-trained by base networks for fine-tuning with data of a target person. A support vector machine algorithm with spatial covariance matrices as EEG signal descriptors based on Riemannian geometry showed the highest balanced accuracy (0.91 ± 0.05 SD) in discriminating five grasping categories according to the Cutkosky taxonomy in an interval from 1.0 s before to 0.5 s after the initial movement. Fine-tuning did not improve any classifier. No significant accuracy differences between the two frequency domains were apparent (p > 0.07). Neurofunctional representations enabled highly accurate discrimination of five different grasping movements. Our results indicate that, for upper limb prosthetics, it is possible to use them in a sufficiently timely manner and to predict the respective grasping task as a discrete category to kinematically prepare the prosthetic hand

Repetitive recombinant human bone morphogenetic protein 2 injections improve the callus microarchitecture and mechanical stiffness in a sheep model of distraction osteogenesis

Evidence suggests that recombinant human bone morphogenetic protein 2 (rhBMP-2) increases the mechanical integrity of callus tissue during bone healing. This effect may be either explained by an increase of callus formation or a modification of the trabecular microarchitecture. Therefore the purpose of the study was to evaluate the potential benefit of rhBMP-2 on the trabecular microarchitecture and on multidirectional callus stiffness. Further we asked, whether microarchitecture changes correlate with optimized callus stiffness. In this study a tibial distraction osteogenesis (DO) model in 12 sheep was used to determine, whether percutaneous injection of rhBMP-2 into the distraction zone influences the microarchitecture of the bone regenerate. After a latency period of 4 days, the tibiae were distracted at a rate of 1.25 mm/day over a period of 20 days, resulting in total lengthening of 25 mm. The operated limbs were randomly assigned to one treatment groups and one control group: (A) triple injection of rhBMP-2 (4 mg rhBMP-2/injection) and (B) no injection. The tibiae were harvested after 74 days and scanned by µCT (90 µm/voxel). In addition, we conducted a multidirectional mechanical testing of the tibiae by using a material testing system to assess the multidirectional strength. The distraction zones were tested for torsional stiffness and bending stiffness antero-posterior (AP) and medio-lateral (ML) direction, compression strength and maximum axial torsion. Statistical analysis was performed using multivariate analysis of variance (ANOVA) followed by student's t-test and Regression analysis using power functions with a significance level of P<0.05. Triple injections of rhBMP-2 induced significant changes in the trabecular architecture of the regenerate compared with the control: increased trabecular number (Tb.N.) (treatment group 1.73 mm/1 vs. control group 1.2 mm/1), increased cortical bone volume fraction (BV/TV) (treatment group 0.68 vs. control group 0.47), and decreased trabecular separation (Tb.Sp.) (treatment group 0.18 mm vs. control group 0.43 mm)

Biodegradation of a magnesium alloy implant in the intercondylar femoral notch showed an appropriate response to the synovial membrane in a rabbit model in vivo

Degradable magnesium alloys are promising biomaterials for orthopedic applications. The aim of this study was to evaluate the potential effects on both the synovial membrane (synovialis) and the synovial fluid (synovia) of the degradation products of a MgYREZr-pin implanted in the intercondylar femoral notch in a rabbit model. Thirty-six animals were randomized into two groups (MgYREZr or Ti6Al4V alloy) of 18 animals each. Each group was then divided into three subgroups with implantation periods of 1, 4, and 12 weeks, with six animals in each subgroup. The initial inflammatory reaction caused by the surgical trauma declined after 12 weeks of implantation, and elucidated a progressive recovery of the synovial membrane. Compared with control Ti6Al4V pins, there were no significant differences between the groups. However, after 12 weeks, recovery of the synovial membrane was more advanced in the titanium group, in which 92% showed no signs of synovitis, than in the magnesium group. A cytotoxicity test with L929 cells and human osteoblasts (HOB) was also conducted, according to EN ISO 10993-5/12, and no toxic leachable products were observed after 24 h of incubation. In conclusion, the MgYREZr alloy seems to be a suitable material for intra-articular degradable implants. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav

Correction: Mechanical properties of femoral trabecular bone in dogs

<p>Abstract</p> <p>After the publication of this work <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>, we became aware of the fact that the frequency of the ultrasound transmitter that we used for determining the elastic moduli of the trabecular bone specimens was not correctly specified. The oscillation frequency of the ultrasound transmitter was 2 MHz (and not 100 MHz as stated in our work) while we used a sampling rate of 100 MHz. In our publication, the oscillation frequency and sampling rate were confounded. Therefore also the statement in the discussion that we might have determined elastic moduli of trabecular bone tissue rather than the elastic properties of whole specimens because we used an ultrasound frequency > 2 MHz is wrong and has to be omitted.</p> <p>For measurement, the cubic bone specimens were not immersed in Ringer's solution but only were kept moist all the time.</p> <p>Apart from these corrections concerning the methods and interpretation of the data, the results reported in our publication and the conclusions are absolutely correct.</p> <p>We apologize for the inconvenience that this inaccuracy may have caused.</p

FE-Simulation zur Lokalisierung hoch beanspruchter Bereiche in der Hüftpfanne von Endoprothesen

The implantation of a total hip prosthesis is an operation which is performed frequently due to advanced hip jointdamage both in humans and in veterinary medicine in dogs. The long-term result of a hip prosthesis is mainly determined by aseptic loosening of the prosthesis; among other causes, abrasion particles of the tribological pairing are responsible for the loosening. For the analysis of the surface stresses with different tribological pairings, a finite element model was generated which was based on the CAD data of a commercial total hip prosthesis. After transmission of a physiological force in the components of the three tribological pairings ceramic/polyethylene, ceramic/ceramic and metal/polyethylene, stresses were calculated. Stresses in the ceramic/ceramic tribological pairings were conspicuously higher than in the other material pairings. In the future adapted prostheses have to be developed that ensure optimal friction and absorption characteristics of the components.Die Implantation einer Hüfttotalendoprothese ist ein operativer Eingriff, der in Deutschland häufig aufgrund eines fortgeschrittenen Hüftgelenkschadens sowohl beim Menschen als auch in der Veterinärmedizin beim Hund durchgeführt wird. Das Langzeitergebnis einer Hüfttotalendoprothese wird hauptsächlich durch die aseptische Lockerung der Prothese bestimmt; Abriebpartikel der Gleitpaarung sind für eine Lockerung mit verantwortlich. Zur Analyse der Oberflächenspannungen bei unterschiedlichen Gleitpaarungen wurde ein Finite-Element-Modell generiert, das auf den CAD-Daten einer handelsüblichen Hüfttotalendoprothese basiert. Nach Einleitung einer physiologischen Gelenkkraft wurden Spannungen in den Komponenten der drei Gleitpaarungen Keramik/Polyethylen, Keramik/Keramik und Metall/Polyethylen berechnet. Dabei zeigten sich bei der Gleitpaarung Keramik/Keramik deutlich höhere Spitzenspannungen als bei den beiden übrigen Gleitpaarungen. In weiteren Arbeiten sollen angepasste Prothesen entwickelt werden, die optimale Reib- und Dämpfungseigenschaften der Komponenten sicherstellen

In vivo assessment of the host reactions to the biodegradation of the two novel magnesium alloys ZEK100 and AX30 in an animal model

Background Most studies on biodegradable magnesium implants published recently use magnesium-calcium-alloys or magnesium-aluminum-rare earth-alloys. However, since rare earths are a mixture of elements and their toxicity is unclear, a reduced content of rare earths is favorable. The present study assesses the in vivo biocompatibility of two new magnesium alloys which have a reduced content (ZEK100) or contain no rare earths at all (AX30). Methods 24 rabbits were randomized into 4 groups (AX30 or ZEK100, 3 or 6 months, respectively) and cylindrical pins were inserted in their tibiae. To assess the biodegradation μCT scans and histological examinations were performed. Results The μCT scans showed that until month three ZEK100 degrades faster than AX30, but this difference is leveled out after 6 months. Histology revealed that both materials induce adverse host reactions and high numbers of osteoclasts in the recipient bone. The mineral apposition rates of both materials groups were high. Conclusions Both alloys display favorable degradation characteristics, but they induce adverse host reactions, namely an osteoclast-driven resorption of bone and a subsequent periosteal formation of new bone. Therefore, the biocompatibility of ZEK100 and AX30 is questionable and further studies, which should focus on the interactions on cellular level, are needed

Clinical results of the Metha short hip stem: a perspective for younger patients?

In recent years, various uncemented proximal metaphyseal hip stems were introduced for younger patients as a bone preserving strategy. Initial osteodensitometric analyses of the surrounding bone of short stems indicate an increase of bone mass with secondary bone ingrowth fixation as a predictor of long-term survival of these types of implants. We report the outcome of 151 modular Metha short hip stem implants in 148 patients between March 2005 and October 2007. The mean follow-up was 5.8±0.7 years and the mean age of the patients was 55.7±9.8 years. Along with demographic data and co-morbidities, the Harris Hip Score (HHS), the Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and also the results of a patient-administered questionnaire were recorded pre-operatively and at follow-up. The mean HHS increased from 46±17 pre-operatively to 90±5 the HOOS improved from 55±16 pre-operatively to 89±10 at the final follow-up. A total of three patients have been revised, two for subsidence with femoral revision and one for infection without femoral revision (Kaplan Meier survival estimate 98%). The radiological findings showed no radiolucent lines in any of the patients. The modular Metha short hip stem was implanted in younger patients, who reported an overall high level of satisfaction. The clinical and radiographic results give support to the principle of using short stems with metaphyseal anchorage. However, long-term results are necessary to confirm the success of this concept in the years to come

Changes in strain patterns after implantation of a short stem with metaphyseal anchorage compared to a standard stem: an experimental study in synthetic bone

Short stem hip arthroplasties with predominantly metaphyseal fixation, such as the METHA® stem (Aesculap, Tuttlingen, Germany), are recommended because they are presumed to allow a more physiologic load transfer and thus a reduction of stress-shielding. However, the hypothesized metaphyseal anchorage associated with the aforementioned benefits still needs to be verified. Therefore, the METHA short stem and the Bicontact® standard stem (Aesculap, Tuttlingen, Germany) were tested biomechanically in synthetic femora while strain gauges monitored their corresponding strain patterns. For the METHA stem, the strains in all tested locations including the region of the calcar (87% of the non-implanted femur) were similar to conditions of synthetic bone without implanted stem. The Bicontact stem showed approximately the level of strain of the non-implanted femur on the lateral and medial aspect in the proximal diaphysis of the femur. On the anterior and posterior aspect of the proximal metaphysis the strains reached averages of 78% and 87% of the non-implanted femur, respectively. This study revealed primary metaphyseal anchorage of the METHA short stem, as opposed to a metaphyseal-diaphyseal anchorage of the Bicontact stem