Silica coated high performance oxide ceramics promote greater ossification than titanium implants: an in vivo study

Abstract

Background This in vitro study investigated the osseointegration and implant integration of high performance oxide ceramics (HPOC) compared to titanium implants in rabbits. Methods Histomorphometry was conducted around the distal, proximal, medial, and lateral aspects of the HPOC to quantify the amount of mature and immature ossification within the bone interface. Histomorphometry was conducted by a trained musculoskeletal pathologist. The region of interest (ROI) represented the percentage of surrounding area of the implant. The percentage 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 were quantitatively investigated. Results All 34 rabbits survived the 6- and 12-week experimental period. All HPOC implants remained in situ. The mean weight difference from baseline was + 647.7 mg (P < 0.0001). The overall OIC of the ceramic group was greater at 6 weeks compared to the titanium implants (P = 0.003). The other endpoints of interest were similar between the two implants at all follow-up points. No difference was found in BIC at 6- and 12-weeks follow-up. No bone necrosis, resorption, or inflammation were observed. Conclusion HPOC implants demonstrated a greater osteoid implant contact at 6 weeks compared to the titanium implants, with no difference found at 12 weeks. The percentage of bone implant contact of HPOC implants was similar to that promoted by titanium implants.

Fostering Excellence in Knee Arthroplasty: Developing Optimal Patient Care Pathways and Inspiring Knowledge Transfer of Advanced Surgical Techniques

“…These surfaces already provide substantial primary stability in cancellous bone 46 thus limiting micromotion before osteointegration. [47][48][49][50] Their surfaces also strongly promote osseointegration through the bone on-or ingrowth. 51 One reason why the topic of cementless implant fixation in TKA is also more and more relevant is the fact, that a cemented interface never osseointegrates and thus also does not allow bone-remodelling according to functional requirements placed on it.…”

“…70 For TKA, two main approaches have been chosen: the manufacturing of full-thickness ceramic implants and the creation of ceramic surfaces. [48][49][50] To date, the company PETER BREHM GmbH (Weisendorf, Germany) is the only manufacturer worldwide that offers an all-ceramic primary knee endoprosthesis (BPK-S INTEGRATION Ceramic). Smith & Nephew (London, England) additionally provides a prosthesis (LEGION) where, even if not the tibial component, at least the femoral component is made of solid ceramic consisting of Zirconium and Niob.…”

Osteointegration of functionalised high-performance oxide ceramics: imaging from micro-computed tomography

“…To overcome this limitation to clinical application, we developed biologically functionalised HPOC [ 10 , 11 ]. Three different coating modalities were evaluated: (1) isolated silanised HPOC (sHPOC) with or without (2) Arg-Gly-Asp (sHPOC-RGD) or (3) bone morphogenic protein-2 (sHPOC-BMP2) peptide coatings [ 12 – 14 ]. For each coating method, we evaluated contact guidance, adhesions, surrounding mesenchymal stromal cells osteogenic differentiation, and their cytotoxic potential [ 15 , 16 ].…”

“…For each coating method, we evaluated contact guidance, adhesions, surrounding mesenchymal stromal cells osteogenic differentiation, and their cytotoxic potential [ 15 , 16 ]. Moreover, the osseointegration potential of functionalised HPOC was compared with titanium implants in rabbits using histomorphometry [ 12 – 14 ]. All coating modalities similarly promoted in vivo ossification to the titanium implants [ 12 – 14 ].…”

“…Moreover, the osseointegration potential of functionalised HPOC was compared with titanium implants in rabbits using histomorphometry [ 12 – 14 ]. All coating modalities similarly promoted in vivo ossification to the titanium implants [ 12 – 14 ].…”