Bone ingrowth into weight‐bearing porous fiber titanium implants. Mechanical and biochemical correlations

Barth, Elin; Rønningen, Helge; Solheim, Ludvig Fjeld; Saethren, Birgitte

doi:10.1002/jor.1100040312

Cited by 18 publications

(19 citation statements)

References 21 publications

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“…Most OS patients are treated by a closely timed combination of chemotherapy (often CDP) and tumor resection, in many cases followed by a type of limb salvage procedure including DO (Cure Search: Children’s Oncology Group/COG). Surgical reconstruction, DO, and endoprostheses are also used commonly, yet these patients continue to be at risk for postoperative complications relating to inherent poor bone repair outcomes 1-4, 10, 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Neoadjuvant chemotherapy followed by surgery with additional adjuvant chemotherapy has become a common treatment approach (Cure Search/COG). However, since CDP is extensively used for the treatment of OS, we believe the effects of CDP treatment on direct bone regeneration need further study 10-12 . Therefore, we tested the effects of two CDP dosing regimens on bone regeneration in a mouse model of distraction osteogenesis (DO) 13-16 .…”

Section: Introductionmentioning

confidence: 99%

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Cisplatin inhibits bone healing during distraction osteogenesis

et al. 2013

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Osteosarcoma (OS) is the most common malignant bone tumor affecting children and adolescents. Many patients are treated with a combination of chemotherapy, resection, and limb salvage protocols. Surgical reconstructions after tumor resection include structural allografts, non-cemented endoprostheses, and distraction osteogenesis (DO), which require direct bone formation. Although cisplatin (CDP) is extensively used for OS chemotherapy, the effects on bone regeneration are not well studied. The effects of CDP on direct bone formation in DO were compared using two dosing regimens and both C57BL/6 (B6) and tumor necrosis factor receptor 1 knockout (TNFR1KO) mice, as CDP toxicity is associated with elevated TNF levels. Detailed evaluation of the five dose CDP regimen (2mg/kg/day), demonstrated significant decreases in new bone formation in the DO gaps of CDP treated versus vehicle treated mice (P<0.001). Further, no significant inhibitory effects from the 5 dose CDP regimen were observed in TNFR1KO mice. The two dose regimen significantly inhibited new bone formation in B6 mice. These results demonstrate that CDP has profound short term negative effects on the process of bone repair in DO. These data provide the mechanistic basis for modeling peri-operative chemotherapy doses and schedules and may provide new opportunities to identify molecules that spare normal cells from the inhibitory effects of CDP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cisplatin inhibits bone healing during distraction osteogenesis

et al. 2013

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“…Another explanation for the absence of increased mechanical strength by the relatively higher bone ingrowth and active mineralizing surfaces at HA-coated implants in press fit might be that maturation of bone was still incomplete. Recently, Barth et al (1986) reported that strength of the interface depends on the maturation of the mineralized bone matrix of the ingrown trabeculae. In the present study the ingrown bone was still immature.…”

Section: Discussionmentioning

confidence: 99%

Hydroxyapatite coating enhances fixation of porous coated implants: A comparison in dogs between press fit and noninterference fit

Søballe¹,

Hansen²,

Brockstedt-Rasmussen

et al. 1990

Acta Orthopaedica Scandinavica

185

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Intimate contact at the bone-porous surface interface is not always achievable in noncemented prosthetic implantation. We investigated the effect of hydroxyapatite (HA) coating on skeletal attachment in noninterference fit 4 weeks after implantation in 6 mature dogs. The pushout test of HA-coated implants surrounded by a 1-mm gap showed a twofold increased shear strength and fivefold increased shear stiffness compared with titanium alloy (Ti) coated implants. The fixation of Ti implants was reduced by two thirds when inserted in a gap as compared with press fit, whereas HA-coated implants in gap showed anchorage close to implants in press fit. Only minor differences were found between HA and Ti implants in press fit. Histomorphometric analysis showed a significant increase in bone in direct contact to HA-coated implant as compared with Ti implants inserted both in gap and press fit. The study indicates that tightness of surgical fit is an important factor for sufficient fixation of the implant. However, our results demonstrate that hydroxyapatite coating almost eliminates the negative influence of noninterference fit between bone and unloaded implant.The quantity of bone ingrowth into porous-coated implants depends, among other factors, on the interference fit obtained with the surrounding bone (Albrektsson and Albrektsson 1987, Cameron et al. 1976, Carlsson et al. 1988a, Harris et al. 1983, Sandborn et al. 1988). In the clinical situation, however, direct apposition of implant to bone is not always achievable Engh 1984, Engh et al. 1987 Schimmel and Huiskes 1988). Lack of optimal flatness after bone cutting, implant design deficiencies, and anatomic variations may result in gaps between the implant surface and surrounding bone Albrektsson 1987, Larsen andRyd 1990).Calcium phosphates in the form of granules have been employed to fill in gaps between bone and implant with no demonstrable effect on bone ingrowth at early time periods (Eschenroeder et al. 1987, Russotti et al. 1986. Recently, deposition of dense hydroxyapatite (HA) on titanium alloy (Ti) by plasma spraying technique has been shown to improve the HA-metal substrate interface shear strength , Thomas et al. 1987. HA coating provides earlier bone ingrowth compared with Ti (Geesink et al. 1988, Saballe et al. 1989a, b, c, Thomas et al. 1987.We examined the effect of HA coating on skeletal attachment of unloaded porous titanium implants inserted in noninterference fit compared with press fit insertion. Material and methodsExperimental design. Six skeletally mature labrador dogs of both sexes weighing 28 (22-31) kg comprised the material. Ti-and HA-coated implants were inserted in press fit or in noninterference fit in the distal femoral condyles. The dogs were killed after 4 weeks and the results were evaluated by the mechanical push-out test and histomorphometric analysis.Bone-density measurements. To investigate bone density at implantation site, CT scanning of the distal femora was performed 1 week before surgery as previously described (Saballe ...

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“…The dose and regimen were selected to be as similar as possible to current clinical use (2,7,13,14,17,23,26,29). The weights of the animals were monitored and the levels of blood urea nitrogen (BUN) were checked, …”

Section: Graft Handling and Experimental Designmentioning

confidence: 99%

The effects of cisplatin on the incorporation of fresh syngeneic and frozen allogeneic cortical bone grafts

Zart

Miya

Wolff

et al. 1993

Journal Orthopaedic Research

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Allograft transplantation with concomitant chemotherapy has proven successful in the treatment of malignant bone tumors. However, these chemotherapeutic agents may delay tissue healing, resulting in clinical complications. To clarify the effects of cisplatin on the healing of bone grafts, we studied the incorporation of stably fixed massive diaphyseal femoral syngeneic and allogeneic grafts in rats treated with cisplatin. These data were compared with those of historical controls from animals that did not receive cisplatin. Rats that were to receive a fresh syngeneic graft or frozen allogeneic graft were given cisplatin every 4 weeks starting 9 weeks preoperatively and continuing until the time of death. The total bone area of the graft in animals that received cisplatin was smaller than that of the graft in untreated control rats that did not receive cisplatin. The area of the frozen allograft did not increase between 2 and 4 months. Revascularization was incomplete in cisplatin-treated groups at 2 months, but by 4 months, vessel ingrowth in fresh syngeneic grafts approached control values. Frozen allografts remained poorly revascularized at 4 months. Host-graft union was poor at 2 months in cisplatin-treated rats compared with controls. In cisplatin-treated rats, the host-graft union of the frozen allograft remained inferior at 4 months while that of the syngeneic graft improved. Allogeneic cortical bone grafts are incorporated more slowly and incompletely than syngeneic grafts, and this handicap is exacerbated by the administration of cisplatin.

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Bone ingrowth into weight‐bearing porous fiber titanium implants. Mechanical and biochemical correlations

Cited by 18 publications

References 21 publications

Cisplatin inhibits bone healing during distraction osteogenesis

Cisplatin inhibits bone healing during distraction osteogenesis

Hydroxyapatite coating enhances fixation of porous coated implants: A comparison in dogs between press fit and noninterference fit

The effects of cisplatin on the incorporation of fresh syngeneic and frozen allogeneic cortical bone grafts

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