Progression of Bone Ingrowth and Attachment Strength for Stability of Percutaneous Osseointegrated Prostheses
Progression of Bone Ingrowth and Attachment Strength for Stability of Percutaneous Osseointegrated Prostheses
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DOI：
10.1007/s11999-013-3381-0
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发表时间：
2014-10-01
影响因子：
4.2
通讯作者：
Bachus, Kent N.
中科院分区：
文献类型：
--
作者：
Jeyapalina, Sujee;Beck, J. Peter;Bachus, Kent N.
经皮骨整合假体（POP）装置在欧洲已在临床上使用了数十年。不幸的是，它们在美国的引入被推迟，部分原因是缺乏记录骨整合和机械稳定性进展的数据。我们确定了骨骼长入多孔涂层 POP 装置的进展情况，并建立了与机械稳定性的相互关系。截肢后，64 只骨骼成熟的绵羊接受了定制的多孔涂层 POP 装置，然后被随机分为 5 个时间组，随后测量骨骼长入可用孔隙空间的百分比（n = 32) 和机械拔出力 (n = 32)。植入后，骨向内生长加速（0 至 3 个月内为 48%），产生的平均拔出力为 5066 +/- 1543 N。随后，骨向内生长缓慢但持续进行（3 至 12 个月内为 23%），最终平均拔出力为植入后 12 个月时为 13,485 +/- 1855 N。骨向内生长和机械拔出稳定性之间存在高度线性相关性（R = 0.94）。该承重模型显示骨向内生长加速进入多孔涂层；手术后 3 个月在多孔涂层 POP 装置内观察到的向内生长量足以产生机械稳定性。数据记录了骨骼向内生长到多孔涂层 POP 装置的进展情况，并在向内生长和拔出强度之间建立了很强的相互关系。需要进一步的人体数据来验证这些发现。
Percutaneous osseointegrated prosthetic (POP) devices have been used clinically in Europe for decades. Unfortunately, their introduction into the United States has been delayed, in part due to the lack of data documenting the progression of osseointegration and mechanical stability.We determined the progression of bone ingrowth into porous-coated POP devices and established the interrelationship with mechanical stability.After amputation, 64 skeletally mature sheep received a custom porous-coated POP device and were then randomized into five time groups, with subsequent measurement of percentage of bone ingrowth into the available pore spaces (n = 32) and the mechanical pullout force (n = 32).Postimplantation, there was an accelerated progression of bone ingrowth (similar to 48% from 0 to 3 months) producing a mean pullout force of 5066 +/- 1543 N. Subsequently, there was a slower but continued progression of bone ingrowth (similar to 23% from 3 to 12 months) culminating with a mean pullout force of 13,485 +/- 1855 N at 12 months postimplantation. There was a high linear correlation (R = 0.94) between the bone ingrowth and mechanical pullout stability.This weightbearing model shows an accelerated progression of bone ingrowth into the porous coating; the amount of ingrowth observed at 3 months after surgery within the porous-coated POP devices was sufficient to generate mechanical stability.The data document progression of bone ingrowth into porous-coated POP devices and establish a strong interrelationship between ingrowth and pullout strength. Further human data are needed to validate these findings.