Wound healing around bone-anchored percutaneous devices in experimental diabetes mellitus

The objective of this investigation was to study the influence of impaired wound healing on the tissue response to bone-anchored percutaneous devices. For this reason, diabetes mellitus was induced in rabbits with alloxan. Untreated rabbits were used as controls. Skin-penetrating titanium implants were inserted in the tibial bone of diabetic and healthy animals. The enossal part of half of the implants was provided with a thin magnetron-sputtered calcium-phosphate coating. The soft-tissue and bone response was evaluated clinically, histologically, and histomorphometrically. We did not observe more infectious complications in diabetic animals. Furthermore, histological analysis revealed no differences in soft-tissue response between diabetic and healthy animals. A close bone-implant contact was observed for all implants. Nevertheless, the density of cortical bone around the implants was clearly lower in diabetic animals compared with control animals. In control rabbits, but not diabetic animals, coated implants showed more downgrowth of bone into the marrow cavity than uncoated ones. In general, diabetes mellitus was shown to have no adverse effect on the clinical performance of the percutaneous devices. We think that this is due to the good fixation of the implants in diabetic as well as control animals. Therefore, we conclude that the presence of impaired healing in chronic health disorders like diabetes is no contra-indication for the anchorage of percutaneous implants in cortical bone.