In vivo evaluation of defined polished titanium surfaces to prevent soft tissue adhesion

Soft tissue-implant adhesion is often required for implant integration into the body; however, in some situations, the tissue is required to glide freely over an implant. In the case of distal radius fracture treatment, current literature describes how titanium and its alloys tend to lead to more intra-tendon inflammatory reactions compared with stainless steel. This leads to tendon-implant adhesion and damage possibly causing limited palmar flexion and even tendon rupture. The goal of this study was to analyze the effect of different surface polishings of titanium and titanium molybdenum implants on soft tissue reactions in vivo, with the aim to prevent direct soft tissue adhesion. Using a nonfracture model, to allow for study of the soft-tissue-implant surface interactions only, six surface variants of the same plate design were implanted onto the tibia of 24 New Zealand white rabbits and left in situ for 12 weeks. Results indicate that paste polished commercially pure titanium and titanium molybdenum alloy had the least soft tissue adhesion, with the concomitant development of a soft tissue capsule. Surface topography did not appear influence the thickness of the connective tissue surrounding the plate. Therefore, suitable surface polishing could be applied to plates for clinical use, where free gliding of tissues is required.