Abstract
BackgroundA study was designed to quantify the extent of porous osseointegration at the prosthesis-bone interface in the Prestige LP prosthesis containing a plasma-sprayed titanium coating.MethodsUsing an anterior surgical approach, cervical disc arthroplasty was performed in 8 mature male goats at the C3-C4 segment, followed by implantation of the Prestige LP prosthesis. The vertebral specimens were examined using microcomputed tomograph for histomorphometric quantification, and proceeded by routine paraffin processing for histological observation. Hence, the porous osseointegration at the prosthesis-bone interface was evaluated based on histologic and histomorphometric analyses.ResultsAt 6 months after surgery, there was no evidence of prosthesis migration, loosening, subsidence, or neurologic or vascular complications. Based on gross histologic analysis, there was excellent porous ingrowth at the prosthesis–bone interface, without significant histopathologic changes. Histomorphometric analysis at the prosthesis-bone interface indicated the mean porous ingrowth of 48.5% ± 10.4% and the total ingrowth range of 36.6 to 59.8%.ConclusionsAs the first comprehensive in vivo investigation into the Prestige LP prosthesis, this project established a successful animal model in the evaluation of cervical disc arthroplasty. Moreover, histomorphometric analysis of porous ingrowth at the prosthesis-bone interface was more favorable for cervical disc arthroplasty with the Prestige LP prosthesis compared to historical reports of appendicular total joint arthroplasty.
Highlights
A study was designed to quantify the extent of porous osseointegration at the prosthesis-bone interface in the Prestige LP prosthesis containing a plasma-sprayed titanium coating
Based on anteroposterior and lateral plain films, there was no evidence of prosthesis migration, loosening, or subsidence at the prosthesis-bone interface
Most importantly and most challenging is for device to encourage osseointegration at the prosthesisbone interface in order to minimize the incidence of clinical device loosening or migration after Cervical disc arthroplasty (CDA)
Summary
A study was designed to quantify the extent of porous osseointegration at the prosthesis-bone interface in the Prestige LP prosthesis containing a plasma-sprayed titanium coating. Cervical disc arthroplasty (CDA) is an exciting new technology to treat symptomatic cervical degenerative disc disease in patients who have failed conservative care. This technology allows for the maintenance of normal cervical spinal motion, and has the potential to prevent or reduce the risk of degeneration at adjacent levels, compared with the conventional fusion techniques [1,2,3]. Its long-term device fixation is acquired by a porous titanium coating on prosthesis endplate. The primary endplate bearing surface contains two layers of pure titanium, with a pore size of 75–300 μm, which
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