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Related Experiment Videos

Hydroxyapatite coating converts fibrous tissue to bone around loaded implants

K Søballe1, E S Hansen, H Brockstedt-Rasmussen

  • 1Biomechanics Laboratory, Orthopaedic Hospital, Aarhus, Denmark.

The Journal of Bone and Joint Surgery. British Volume
|March 1, 1993
PubMed
Summary

Immobilizing titanium (Ti) or hydroxyapatite (HA)-coated implants promotes bone growth and stronger fixation. HA coating showed better initial fixation, while immobilizing Ti implants significantly improved stability compared to continuous micromovement.

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Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Tissue Engineering

Background:

  • Micromovement influences implant fixation, leading to fibrous tissue around titanium (Ti) implants and fibrocartilage around hydroxyapatite (HA)-coated implants.
  • Previous studies indicated differing tissue responses to Ti and HA coatings under micromovement.
  • Understanding the effect of immobilisation on these established tissue responses is crucial for optimizing implant integration.

Purpose of the Study:

  • To investigate the effect of immobilising Ti- or HA-coated implants after initial micromovement-induced fibrous membrane formation.
  • To compare the fixation strength and bone ingrowth of immobilised implants versus continuously loaded implants.
  • To evaluate the long-term stability and osseointegration of different implant coatings under varying mechanical conditions.

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Main Methods:

  • Mature dogs received Ti- or HA-coated implants in the medial femoral condyles.
  • Implants were subjected to 150 microns of movement per gait cycle for four weeks.
  • Half the implants were then immobilised, while the other half continued to experience micromovement until 16 weeks.
  • Evaluations included push-out tests and histological analysis.

Main Results:

  • Continuously loaded Ti implants had fibrous membranes; HA implants showed bone bridging.
  • Immobilised implants of both types were surrounded by bone.
  • HA-coated implants demonstrated superior fixation under continuous micromovement (p < 0.001).
  • Immobilised Ti implants exhibited four times stronger fixation than continuously loaded Ti implants (p < 0.01).
  • Bone ingrowth was greater in immobilised HA implants than immobilised Ti implants (p < 0.01).
  • HA coating showed 66% resorption by 16 weeks, with 25% replaced by new bone.

Conclusions:

  • Immobilisation is key for achieving bone fixation around both Ti and HA implants.
  • HA coating offers better initial stability under micromovement compared to Ti.
  • While Ti implant fixation significantly improves with immobilisation, HA implants show less benefit from this intervention.
  • HA coating undergoes resorption and replacement by bone, suggesting a dynamic integration process.