Understanding The Impact of Diabetes on Implant Performance: A Retrieval Study

建议书摘要和摘要 由于伤口受损，整形外科设备通常被认为是糖尿病患者的高风险设备。 由于巨噬细胞、胶原酶和细胞增殖减少而导致的愈合能力。它仍然不是 人们清楚地知道哪些生物因素决定周围骨愈合的有效程度 糖尿病条件下的骨科植入物。这可能会对成功和绩效产生不利影响 由于种植体表面的腐蚀、微动、脱位、感染或坏死 周围组织，甚至外科医生的失误。为了更好地确定未来的植入物如何成为 在更成功的糖尿病患者中，我们希望建立腐蚀量之间的相关性 种植体表面和种植体暴露的环境。这项研究的总体目标是 了解糖尿病患者取出的种植体的表面特性、形态特征和失效模式 病人。 综上所述，接受分析的植入物将首先接受光学显微镜检查，以确定 生物和金属产品在表面上的存在程度。这项技术还将使识别 具有有趣特征的区域以供进一步分析。然后将根据视觉程度对植入物进行排名 生物和金属/磨损沉积。随后将对样品进行一系列清洁步骤 遵循我们小组之前制定的表面准备方案。标本将再次成像 利用光学显微镜，感兴趣的区域将被标记，并根据生物和磨损程度进行排序 产品。然后对样品进行扫描电子显微镜检查，然后进行能量分析 色散X射线光谱和X射线光电子能谱(XPS)在化学分析中的应用 表面的组成和氧化状态。在此之后，标本将受到 用于研究材料腐蚀性能的电化学测试。免疫调节可以 是在受损的全身条件下促进骨愈合的重要机制。进一步 有必要研究可以调节炎症反应的表面特征 促进骨愈合。

Proposal Summary and Abstract Orthopedic devices have often been considered a higher risk to diabetic patients due to impaired wound healing abilities that can be caused by reduced macrophages, collagenase, and cell proliferation. It is still not well understood exactly which biological factors determine how effective bone healing is surrounding orthopedic implants within diabetic conditions. This can have adverse effects on the success and performance of the implant due to corrosion of the surface, micro motion, dislocation, infection or necrosis of the surrounding tissues, or even surgeon error. In order to better determine how future implants can become more successful in diabetic patients we would like to establish a correlation between the amount of decay of the implant surface and the environment that the implant was exposed to. The overall goal of this study is to understand surface properties, morphological features and failure modes of implants removed from diabetic patients. In summary, the implants received for analysis will be first subjected to optical microscopy to identify the degree of biological and metallic products present on the surface. This technique will also enable identification of areas with interesting features for further analysis. Then the implants will be ranked for the degree of visual biological and metallic/wear deposition. Specimens will be subsequently subjected to a series of cleaning steps following previous protocols developed in our group for surface preparation. Specimens will be again imaged with optical microscopy, areas of interest will be marked and ranked for degree of biological and wear products. Then specimens will be investigated with Scanning Electron Microscopy, followed by Energy Dispersive X-ray Spectroscopy and X-ray Photoelectron Spectroscopy (XPS) for analysis of the chemical composition and oxidation state, respectively, of surfaces. Following this, specimens will be subjected to electrochemical testing for investigation of the corrosion properties of the materials. Immunomodulation may be an important mechanism to improve osseous healing under compromised systemic conditions. Further investigation is warranted of the surface characteristics that can modulate the inflammatory response to promote osseous healing.