Tibial Implants: Biomechanical and Histomorphometric Studies of Hydroxyapatite-Coated and Uncoated Stainless Steel and Titanium Screws in Long-Term Ovariectomized Sheep
Restricted accessResearch articleFirst published online September, 2001
Tibial Implants: Biomechanical and Histomorphometric Studies of Hydroxyapatite-Coated and Uncoated Stainless Steel and Titanium Screws in Long-Term Ovariectomized Sheep
This study was designed to evaluate osteointegration of HA-coated and uncoated titanium and stainless steel screws in the cortical bone of long-term (24 months) ovariectomized sheep (OVX group), in comparison with Sham-aged sheep (control group). The screws were tested biomechanically (extraction torque) and histomorphometrically (affinity index: Al) 12 weeks after their implantation in tibial diaphyses. Tibial cortical bone parameters showed significant differences between the groups, showing a reduction of the selected parameters in the OVX group. ANOVA showed significant effects for both material and ovariectomy factors on obtained extraction torque (material: F=159.26, p < 0.0005; ovariectomy: F=20.04, p < 0.0005) and Al data (material: F=8.04, p < 0.001; ovariectomy: F=7.17, p < 0.05). In both groups the extraction torque for coated screws of both materials was significantly higher than for uncoated screws, and uncoated titanium had a better extraction torque than uncoated stainless steel. In the OVX group, the HA-coated stainless steel and titanium Al data were significantly higher than uncoated Al data. In conclusion, the biomechanical and histomorphological results obtained suggest employing HA-coated screws in the presence of osteopenic cortical bone.
AroH.T., MarkelD.M., ChaoE.Y.S.. Cortical bone reactions at the interface of external fixation half-pins under different loading conditions. J Trauma1993; 35: 776–85.
2.
HydalC., PearsonS., TepicS., PerrenS.M.. Induction and prevention of pin loosening in external fixation: an in vivo study on sheep tibiae. J Orthop Trauma1991; 5: 485–92.
3.
HayashiK., MatsugushiN., UenoyamaK., KanemaruT., SugiokaY.. Evaluation of metal implants coated with several types of ceramics as biomaterials. J Biomed Mater Res1989; 23: 1247–59.
4.
WillmannG.. The evolution of ceramics in total hip replacement. Hip International2000; 10(4): 193–203.
5.
KleinC., PatkaP., van der LubbeH., WolkeJ., de GrootK.. Plasma-sprayed coatings of tetracalciumphosphate, hydroxyl-apatite, and α-TCP on titanium alloy: An interface study. J Biomed Mater Res1991; 25: 53–65.
MoroniA., OrientiL., SteaS., VisentinM.. Improvement of the bone pin interface with hydroxyapatite coating. An in vivo long term experimental study. J Orthop Trauma1996; 10: 236–42.
8.
BaxterJ.C., FattoreL.. Osteoporosis and osseointegration of implants. J Prosthodont1993; 2: 120–5.
9.
BlomqvistJ.E., AlberiusP., lsakssonS., LindeA., HanssonB.G.. Factors in implant integration failure after bone grafting: an osteometric and endocrinologic matched analysisInt J Oral Maxillofac Surg1996; 25: 63–8.
10.
LinderL., CarlssonA., MarsalL., BjurstenL.M., BranemarkP.I.. Clinical aspects of osseointegration in joint replacement. A histologic study of titanium implants. J Bone Joint Surg (Br)1988; 70: 550–5.
11.
PanagiatopoulosE., FortisA.P., TyllianakisM., ArmonisA., LambrisE.. The role of osteoporosis and fracture comminution in the outcome of anatomically reduced and adequately fixed intertrochanteric femoral fractures. Hip International2000; 10(1): 21–5.
12.
FiniM., Nicoli AldiniN., GandolfiM.G.Biomaterials for orthopaedic surgery in osteoporotic bone: a comparative study in osteopenic rats. Int J Artif Organs1997; 20: 291–7.
13.
FujimotoT., NumiA., SawaT., UedaM.. Effects of steroid-induced osteoporosis on osseointegration of titanium implants. Int J Oral Maxillofac Implants1998; 13: 183–9.
14.
HartkeJ.. Non-primate models of osteoporosis. Lab Anim Sci1998; 48(6): 623–9.
15.
Hayashik, UenoyamaK., MashimaT., SugiokaY.. Remodelling of bone around hydroxyapatite and titanium in experimental osteoporosis. Biomaterials1994; 15: 11–6.
16.
JeromeC.P.. Primate models of osteoporosis. Lab Anim Sci1998; 48(6): 618–22.
17.
MoriH., ManabeM., KurachiY., NagumoM.. Osseointegration of dental implants in rabbit bone with low mineral density. J Oral Maxillofac Surg1997; 55: 351–62.
18.
ThompsonD.D., SimmonsH.A., PineC.M., KeH.Z.. FDA guidelines and animal models for osteoporosis. Bone1995; 17(suppl.): S125–33.
19.
FiniM., PieriniG., GiavaresiG.The ovariectomised sheep as a model for testing biomaterials and prosthetic devices in osteopenic bone: a preliminary study on iliac crest biopsies. Int J Artif Organs2000; 23(4): 275–81.
20.
HombyS.B., FordS.L., MaseC.A., EvansG.P.. Skeletal changes in the ovariectomized ewe and subsequent response to treatment with 17 beta estradiol. Bone1995; 17(suppl.): S389–94.
21.
JohnsonR.B., GilbertJ.A., CooperR.C.Alveolar bone loss one year following ovariectomy in sheep. J Periodontol1997; 68: 864–71.
22.
NewmanE., TurnerA.S., WarkJ.D.. The potential of sheep for the study of osteopenia: current status and comparison with other animal models. Bone1995; 16(suppl.): S277–84.
23.
ThorndikeE.A., TurnerA.S.. In search of an animal model for postmenopausal diseases. Front Biosc1998; 3: 17–26.
24.
TurnerA.S., MallinckrodtC.H., AlvisM.R., BryantH.U.. Dose-response effects of estradiol implants on bone mineral density in ovariectomized ewes. Bone1995; 17(suppl.): S421–7.
25.
TurnerA.S., AlvisM., MyersW., StevensM.L., LundyM.W.. Changes in bone mineral density and bone-specific alkaline phosphatase in ovariectomized ewes. Bone1995; 17(suppl.): S395–402.
26.
TurnerA.S., AthanasiouK.A., ZhuC.F., AlvisM.R., BryantH.U.. Biochemical effects of estrogen on articular cartilage in ovariectomized sheep. Osteoarthritis Cartilage1997; 5(1): 63–9.
27.
ParfittA.M., DreznerM.K., GloneuxF.H.Bone histomorphometry: standardization of nomenclature, symbols, and units. J Bone Miner Res1987; 2(6): 595–610.
28.
MartinR.B., PaulH.A., BargarW.L., DannucciG.A., SharkeyN.A.. Effects of estrogen deficiency on the growth of tissue into porous titanium implants. J Bone Joint Surg (Am)1988; 70: 540–7.
29.
SoballeK., HansenE.S., Brockstedt-RasmussenH.. Fixation of titanium and hydroxyapatite coated implants in arthritic osteopenic bone. J Arthroplasty1991; 6: 307–16.
30.
SoballeK., HansenE.S., Brockstedt-RasmussenH.Gap healing enhanced by hydroxyapatite coating in dogs. Clin Orthop1991; 272: 300–7.
31.
CookS.D., ThomasK.A., HaddadR.J.. Histological analysis of retrieved human porous-coated joint components. Clin Orthop1988; 234: 90–101.
32.
GeesinkR.G.T.. Hydroxylapatite-coated total hip replacement. Five year clinical and radiological results. In: GeesinkR.G.T., ManleyM.T., eds. Hydroxilapatite coatings in orthopedic surgery.New York: Raven Press, 1993; 171–208.
33.
FurlongR.. A new concept of prosthetic fixation. In: GeesinkR.G.T., ManleyM., eds. Hydroxilapatite coatings in orthopedic surgery.New York: Raven Press, 1993; 25–31.
34.
MoroniA., LarsenS.T., MaltarelloM.C., OrientiL., SteaS., GianniniS.. A comparison of hydroxyapatite-coated, titanium-coated, and uncoated tapered 1 external-fixation pins. An in vivo study in sheep. J Bone Joint Surg1998; 80(4): 547–54.
35.
RoccaM., OrientiL., SteaS., MoroniA., FiniM., GiardinoR.. Comparison among three different biocoatings for orthopedic prostheses: an experimental animal study. Int J Artif Organs1998; 21: 553–8.
36.
KimmelD.B., WronskiT.J.. Non-destructive measurement of bone mineral in femurs from ovariectomized rats. Calcif Tissue Int1990; 46: 101–10.
