Non-Destructive Testing of Ceramic Knee Implants Using Micro-Computed Tomography

Trieb, Klemens; Glinz, Jonathan; Reiter, Michael; Kastner, Johann; Senck, Sascha

doi:10.1016/j.arth.2019.05.006

Cited by 15 publications

(7 citation statements)

References 24 publications

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“…Ceramic implants have several advantages, such as their high hardness and wear resistance, light weight, low modulus of elasticity, outstanding resistance to creep and compressive stress, and no artefacts at imaging [ 10 , 11 , 12 ]. Functionalised ceramics with RGD biologically activate the implant surface, enhancing the interaction at the bone implant interface, thus preserving the overall structure and characteristics of the ceramic.…”

Section: Discussionmentioning

confidence: 99%

“…Current research to develop alternatives to metal alloys is ongoing. In this context, ceramic implants offer several advantages: hardness and wear resistance; light weight; low modulus of elasticity; outstanding resistance to creep and compressive stress; and lack of artefacts at imaging [ 10 , 11 , 12 ]. Although it reduces particle release, the risk of rejection, and implant loosening, the biological inactivity of ceramic impairs the integration of the implant into the surrounding bone tissue [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Histomorphometry of Ossification in Functionalised Ceramics with Tripeptide Arg-Gly-Asp (RGD): An In Vivo Study

Migliorini

Schenker

Maffulli

et al. 2022

Life

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The present study investigated the osseointegration promoted by functionalised ceramics with peptide Arg-Gly-Asp (RGD) in a rabbit model in vivo. Histomorphometry of the RGD functionalised ceramic implants was conducted by a trained pathologist to quantify the amount of mature and immature ossification at the bone interface, and then compared to titanium alloy implants. The region of interest was the area surrounding the implant. The percentage of ROI covered by osteoid implant contact and mature bone implant contact were assessed. The presence of bone resorption, necrosis, and/or inflammation in the areas around the implant were quantitatively investigated. All 36 rabbits survived the experimental period of 6 and 12 weeks. All implants remained in situ. No necrosis, bone resorption, or inflammation were identified. At 12 weeks follow-up, the overall mean bone implant contact (p = 0.003) and immature osteoid contact (p = 0.03) were improved compared to the mean values evidenced at 6 weeks. At 6 weeks follow-up, the overall osteoid implant contact was greater in the RGD enhanced group compared to the titanium implant (p = 0.01). The other endpoints of interest were similar between the two implants at all follow-up points (p ≥ 0.05). Functionalised ceramics with peptide RGD promoted ossification in vivo. The overall osteoid and bone implant contact improved significantly from 6 to 12 weeks. Finally, RGD enhanced ceramic promoted faster osteoid implant contact in vivo than titanium implants. Overall, the amount of ossification at 12 weeks is comparable with the titanium implants. No necrosis, bone resorption, or inflammation were observed in any sample.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Histomorphometry of Ossification in Functionalised Ceramics with Tripeptide Arg-Gly-Asp (RGD): An In Vivo Study

Migliorini

Schenker

Maffulli

et al. 2022

Life

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“…[ 13 , 14 ] The behavior of the ceramic knee in CT scan has been documented with respect to artifacts. [ 24 ] This study carried out here was designed with a view to broad clinical and diagnostic use. [ 25 ] Metal implants in particular are being released for MRI examinations in an increasingly restrictive manner.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of temperature of a full ceramic total knee arthroplasty during MRI examinations

Trieb

Artmann²,

Krupa³

et al. 2022

Medicine

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Background: A diagnosis by magnetic resonance imaging (MRI) is often necessary before surgery of degenerative spine diseases. This can lead to a possible conflict with an inserted implant of the hip or knee. Heat generation or movement could be caused by the magnetic field. The aim of this study is to investigate temperature development in vitro in a 1.5T MRI of a ceramic knee arthroplasty. Methods: A full ceramic, complete metal-free non-constrained primary total knee arthroplasty is investigated. Temperature change was measured between platinum resistors before and after each MRI sequence by change of resistance. The knee implant was placed in a plastic container after the sensors were attached. Then the container was completely filled with ultrasound gel. To document any possible movement of the implant, a grid was placed under the container to document the position of the implant before and after the scans. Results: A total of four standard knee sequences were performed. The temperature at sites 1 to 5 per implant was always documented in the as-is state before MRI and then after each sequence. A total of 5 temperature measurement points were taken per implant. It was found that there were extremely small temperature variations. These were always in the range of less than 1°C. There was no case of movement of the implant triggered by the MRI scan. Conclusions: The experimental investigations carried out here showed homogeneous results with this experimental setup. It is concluded that, at least in vitro, that this ceramic knee implant can be used in MRI examinations without heating or movement.

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“…Titanium and its alloys are currently the best metals in terms of osseointegration; in contrast, given its absence of osseointegration, ceramic is biologically inert [4][5][6]. Ceramic implants have several advantages: high hardness and wear resistance, light weight, low modulus of elasticity and ductility, outstanding resistance to creep and compressive stress, and absence of artefacts in advanced imaging [7][8][9]. Titanium alloys may be responsible for hypersensitivity reactions, which may compromise implant longevity.…”

Section: Introductionmentioning

confidence: 99%

Functionalised High-Performance Oxide Ceramics with Bone Morphogenic Protein 2 (BMP-2) Induced Ossification: An In Vivo Study

Migliorini

Eschweiler

Maffulli

et al. 2022

Life

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This study investigated the in vivo osseointegration potential of high-performance oxide ceramics (HPOCs) with peptide bone morphogenic protein 2 (BMP-2), comparing them with titanium implants. Histomorphometry was conducted around the distal, proximal, medial, and lateral sides of the implants to quantify the amount of mature and immature ossification within the bone interface. We hypothesised that HPOCs functionalised with BMP-2 promote ossification. HPOCs functionalised with BMP-2 were manufactured at the Department of Dental Materials Science and Biomaterial Research of the RWTH University Aachen, Germany. Histomorphometry was conducted by a professional pathologist in all samples. The region of interest (ROI) represented the percentage of the surrounding area of the implant. The percentages of ROI covered by osteoid implant contact (OIC) and mature bone–implant contact (BIC) were assessed. The surrounding presence of bone resorption, necrosis, and/or inflammation was quantitatively investigated. A total of 36 rabbits were used for the experiments. No bone resorption, necrosis, or inflammation was found in any sample. At the 12-week follow-up, the overall BIC was significantly increased (p < 0.0001). No improvement was evidenced in OIC (p = 0.6). At the 6-week follow-up, the overall OIC was greater in the BMP-2 compared to the titanium group (p = 0.002). The other endpoints of interest evidenced similarity between the two implants at various follow-up time points (p > 0.05). In conclusion, alumina HPOCs functionalised with peptide BMP-2 promote in vivo ossification in a similar fashion to titanium implants.

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Non-Destructive Testing of Ceramic Knee Implants Using Micro-Computed Tomography

Cited by 15 publications

References 24 publications

Histomorphometry of Ossification in Functionalised Ceramics with Tripeptide Arg-Gly-Asp (RGD): An In Vivo Study

Histomorphometry of Ossification in Functionalised Ceramics with Tripeptide Arg-Gly-Asp (RGD): An In Vivo Study

Evaluation of temperature of a full ceramic total knee arthroplasty during MRI examinations

Functionalised High-Performance Oxide Ceramics with Bone Morphogenic Protein 2 (BMP-2) Induced Ossification: An In Vivo Study

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