The effects of bulk versus particulate titanium and cobalt chrome alloy implanted into the rabbit tibia

Twenty-eight mature New Zealand white female rabbits were allocated into 4 groups of 7 rabbits. Group 1 received a coiled wire of cobalt chrome alloy (Vitallium) (16 gauge x 1 cm). Group 2 received an equal weight of cobalt chrome particles averaging 15.4 microns in diameter. Group 3 received a coiled wire implant of commercially pure (C.P.) titanium (16 gauge x 1 cm). Group 4 received the same weight of C.P. titanium particles averaging 3.8 microns. The implants were placed through a drill hole in the proximal right tibia; the left tibia served as a prepared but nonimplanted control. The animals were killed after 16 weeks and quantitative histology was performed on undecalcified sections of the implant area. Bulk cobalt chrome and titanium implants were surrounded by a thin, incomplete, fibrous tissue layer with decreased numbers of cells. Trabeculae of bone were present within this connective tissue envelope. Fingerlike projections of bone enveloped the implant where it abutted endosteal bone. Clumped and loosely scattered cobalt chrome and titanium particles were surrounded by a minimal amount of fibrous connective tissue. Smaller particles were present within cells. Hematopoietic cells abutted the bulk or particulate implants directly. There was no evidence of acute or chronic inflammation or foreign body reaction. These results should be contrasted with those of Howie et al. in which intraarticular cobalt chrome particles stimulated a rapid proliferation of macrophages and synovial degeneration after 1 week. This may be due to a direct toxic effect of metals in an intra-articular environment, the smaller particle size used in that study, or to abrasive injury to the hyaline cartilage and subsequent synovitis. Our results underscore the general inert properties of these metals in the short term, when implanted into bone in the sizes and physical forms chosen.