Abstract
The multi-spiked connecting scaffold (MSC-Scaffold) prototype is the essential innovation in the fixation of components of resurfacing total hip arthroplasty (THRA) endoprostheses in the subchondral trabecular bone. We conducted the computed micro-tomography (micro-CT) assessment of the subchondral trabecular bone microarchitecture before and after the MSC-Scaffold embedding in femoral heads removed during long-stem endoprosthesis total hip arthroplasty (THA) of different bone densities from 4 patients with hip osteoarthritis (OA). The embedding of the MSC-Scaffold in subchondral trabecular bone causes the change in its relative area (BA/TA, bone area/total area ratio) ranged from 18.2% to 24.7% (translating to the calculated density ρB relative change 11.1–14.4%, and the compressive strength S relative change 75.3–122.7%) regardless of its initial density (before the MSC-Scaffold embedding). The densification of the trabecular microarchitecture of subchondral trabecular bone due to the MSC-Scaffold initial embedding gradually decreases with the increasing distance from the apexes of the MSC-Scaffold’s spikes while the spatial extent of this subchondral trabecular bone densification ranged from 1.5 to 2.5 mm (which is about half the height of the MSC-Scaffold’s spikes). It may be suggested, despite the limited number of examined femoral heads, that: (1) the magnitude of the effect of the MSC-Scaffold embedding on subchondral trabecular bone densification may be a factor contributing to the maintenance of the MSC-Scaffold also for decreased initial bone density values, (2) the deeper this effect of the subchondral trabecular bone densification, the better strength of subchondral trabecular bone, and as consequence, the better post-operative embedding of the MSC-Scaffold in the bone should be expected.
Highlights
Osteoarthritis (OA) is a common disease that mainly involves cartilage destruction, synovial inflammation, osteophyte formation, and subchondral trabecular bone sclerosis with progressive functional disability and reduced quality of life [1]
This change translates to the increase of the calculated subchondral bone density ρB and the predicted compressive strength S, regardless of the initial density of the bone
The micro-CT assessment of the subchondral trabecular bone relative area and density in the femoral heads, removed during total hip arthroplasty (THA) from OA patients before and after mechanical embedding of the MSC-Scaffold prototype for total hip arthroplasty (THRA) endoprostheses into these heads, was carried out
Summary
Osteoarthritis (OA) is a common disease that mainly involves cartilage destruction, synovial inflammation, osteophyte formation, and subchondral trabecular bone sclerosis with progressive functional disability and reduced quality of life [1]. The multi-spiked connecting scaffold (MSC-Scaffold) prototype is the essential innovation in the fixation of components of THRA endoprostheses in the periarticular trabecular bone. It was designed and manufactured in the selective laser melting (SLM) technology of Ti-alloy powder, developed in the mechanical laboratory and numerical studies, and verified in animals (10 swines) in our bioengineering-clinical research team guided by Uklejewski [6,7,8,9,10,11,12,13], based on the concept of such fixation proposed by Rogala [14,15]. The fixation procedure of THRA endoprosthesis with the biomimetic MSC-Scaffold proceeds in two steps as follows: (1) the surgical initial embedding of the endoprosthesis components into the periarticular trabecular bone to approximately half the height of the MSC-Scaffold spikes by the operating surgeon, and (2) the biologic fixation due to bone tissue ingrowth into the remaining inter-spikes region of the MSC-Scaffold during the post-operative rehabilitation of OA patient
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