umu.sePublications
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Biomodulation of an implant for enhanced bone-implant anchorage
Umeå University, Faculty of Medicine, Department of Clinical Sciences. Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopedics, Lund, Sweden.
Show others and affiliations
2019 (English)In: Acta Biomaterialia, ISSN 1742-7061, E-ISSN 1878-7568, Vol. 96, p. 619-630Article in journal (Refereed) Published
Abstract [en]

Aseptic loosening of implants is the major cause for revision surgery. By modulating the bone-implant interface, early bone-implant anchorage could be improved. Implant surface manipulation by the addition of osteopromotive molecules locally and systemically to promote implant integration has been described with limited success. This study describes a novel approach by making the implant capable of biologically modulating its surroundings. It was hypothesized that the early implant fixation would improve by filling the interior of the implant with a carrier providing spatio-temporal release of bone active drugs with known osteogenic effect. The implant consisted of a threaded polyether ether ketone (PEEK) hollow chamber with holes at the bottom. The implant was filled with a calcium sulphate (CaS)/hydroxyapatite (HA) carrier, delivering two bone active molecules; zoledronic acid (ZA) and bone morphogenic protein-2 (BMP-2). At first, a rat abdominal muscle pouch model indicated a sustained in-vivo release of both I-125-rhBMP-2 (57%) and C-14-ZA (22%) from the CaS/HA carrier over a period of 4-weeks. The biomodulated implant was then inserted in the proximal tibia in rats with the following experimental groups: G1) Empty implant, G2) Implant + CaS/HA, G3) Implant + CaS/HA + ZA and G4) Implant + CaS/HA + ZA + rhBMP-2. Significantly higher bone volume (BV) was seen around the implant in groups G3 (3.3 +/- 0.7 mm(3)) and G4 (3.1 +/- 0.7 mm(3)) compared to the control (1.3 +/- 0.4 mm(3)) using micro-computed tomography and qualitative histology. Group G3, also exhibited significantly higher pull-out force and absorbed energy when compared to the control group G1. These findings indicate that a low dose of ZA alone, released in a controlled manner from within a fenestrated implant is enough to improve implant anchorage without the need of adding rhBMP-2. This simple method of using a fenestrated implant containing a ceramic carrier releasing bone active molecules improved bone anchorage and could clinically reduce prosthetic failure. Statement of Significance Aseptic loosening remains as a major cause for implant revisions and early reaction of surrounding bone to the prosthesis is important for longevity. A novel approach to enhance early bone-implant anchorage is presented. The implant is filled with a carrier providing controlled release of bone active molecules. In an animal model, a calcium sulphate (CaS)/hydroxyapatite (HA) carrier was used to provide a spatio-temporal release of bone morphogenic protein-2 (BMP-2) and zoledronic acid (ZA). Significantly better bone-implant integration was achieved using ZA alone, thereby eliminating the need for adding BMP-2. The developed method of implant biomodulation holds potential to prevent implant loosening and is an alternative to prosthetic coatings or systemic drug treatment. Importantly, all constituents are approved for clinical use.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 96, p. 619-630
Keywords [en]
Implant anchorage, Fracture fixation, BMP-2, Zoledronic acid, Ceramic carrier
National Category
Medical Materials Biomaterials Science
Identifiers
URN: urn:nbn:se:umu:diva-164401DOI: 10.1016/j.actbio.2019.07.009ISI: 000486132900049PubMedID: 31301423OAI: oai:DiVA.org:umu-164401DiVA, id: diva2:1367776
Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2019-11-05Bibliographically approved

Open Access in DiVA

fulltext(6746 kB)7 downloads
File information
File name FULLTEXT01.pdfFile size 6746 kBChecksum SHA-512
5b3b81800eba9dd0b42feb07310a85238796962e669541e1ddacaee5ea53bc8758ac3d6412426cc6e92c3436d624a641d62112d4b006bade5510751cf7759e43
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Larsson, David

Search in DiVA

By author/editor
Larsson, DavidIsaksson, Hanna
By organisation
Department of Clinical Sciences
In the same journal
Acta Biomaterialia
Medical MaterialsBiomaterials Science

Search outside of DiVA

GoogleGoogle Scholar
Total: 7 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 8 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf