PMID- 30911283
OWN - NLM
STAT- MEDLINE
DCOM- 20190724
LR  - 20200225
IS  - 1449-1907 (Electronic)
IS  - 1449-1907 (Linking)
VI  - 16
IP  - 3
DP  - 2019
TI  - A 3D Printed Porous Titanium Alloy Rod with Diamond Crystal Lattice for Treatment 
      of the Early-Stage Femoral Head Osteonecrosis in Sheep.
PG  - 486-493
LID - 10.7150/ijms.30832 [doi]
AB  - Instruments made of porous titanium alloy and fabricated with a 3D printed 
      technique are increasingly used in experimental and clinical research. To date, 
      however, few studies have assessed their use in early-stage osteonecrosis of the 
      femoral head (ONFH). In this study, porous titanium alloy rods (Ti-Rod) with 
      diamond crystal lattice, fabricated using an electron beam melting (EBM) 
      technique, were implanted into sheep models (n=9) of early-stage ONFH for 6 
      months. Bone ingrowth and integration were investigated and compared with those 
      of sheep (n=9) undergoing core decompression (CD) alone. Following Ti-Rod 
      implantation, femoral heads showed fine osteointegration, with X-ray evaluation 
      showing compact integration between peripheral bone and rods without radiolucent 
      lines encircling the rods, as well as new bone growth along the metal trabeculae 
      without the intervention of fibrous tissue. The regions of interest (ROIs) of 
      femoral heads showed fine bone ingrowth after Ti-Rod implantation than CD alone. 
      By micro-CT evaluation, the ratios of bone volume to total volume (BV/TV) of ROIs 
      in Rod group was 930 % and 452 % higher than CD group after 3 (0.206 +/- 0.0095 vs. 
      0.020 +/- 0.0058, p < 0.05, n=3) and 6 (0.232 +/- 0.0161 vs. 0.042 +/- 0.0061, p < 
      0.05, n=3) months respectively. By histological evaluation, the BV/TV of ROIs in 
      Rod group was 647 % and 422 % higher than CD group after 3 (0.157 +/- 0.0061 vs. 
      0.021 +/- 0.0061, p < 0.05, n=3) and 6 (0.235 +/- 0.0145 vs. 0.045 +/- 0.0059, p < 
      0.05, n=3) months respectively. The new bone grew along metal trabeculae into the 
      center of the rod with a rapid bone ingrowth in Rod gorup. Whereas in CD group, 
      new bone grew mainly at the periphery of the decompressive channel with a slow 
      bone ingrowth. Mechanical analysis showed that maximum load on the femoral 
      head-necks was 31 % greater 6 months after Ti-Rod implantation than after CD 
      alone when the vertical press reached the apex (3751.75 +/- 391.96 vs. 2858.25 +/- 
      512.91 N, p < 0.05, n=3). The association of rod implantation with fine bone 
      ingrowth, osteointegration, and favorable mechanical properties suggests that 
      implantation of the porous titanium alloy rod with the diamond crystal lattice 
      may be a beneficial intervention for patients with early-stage ONFH.
FAU - Wang, Cairu
AU  - Wang C
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Liu, Da
AU  - Liu D
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Xie, Qingyun
AU  - Xie Q
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Liu, Jinbiao
AU  - Liu J
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Deng, Shaolin
AU  - Deng S
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Gong, Kai
AU  - Gong K
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Huang, Chen
AU  - Huang C
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Yin, Li
AU  - Yin L
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Xie, Meiming
AU  - Xie M
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
FAU - Guo, Zheng
AU  - Guo Z
AD  - Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, 
      Xi'an, Shaanxi 710032, China.
FAU - Zheng, Wei
AU  - Zheng W
AD  - Department of Orthopaedics, The General Hospital of Western Theater Command, 
      Chengdu, Sichuan 610083, China.
LA  - eng
PT  - Journal Article
DEP - 20190309
PL  - Australia
TA  - Int J Med Sci
JT  - International journal of medical sciences
JID - 101213954
RN  - 0 (Alloys)
RN  - 7782-40-3 (Diamond)
RN  - D1JT611TNE (Titanium)
MH  - Alloys/*chemistry
MH  - Animals
MH  - Diamond/chemistry
MH  - Female
MH  - Femur Head Necrosis/diagnostic imaging/*therapy
MH  - *Printing, Three-Dimensional
MH  - *Prostheses and Implants
MH  - Sheep
MH  - Titanium/chemistry
MH  - X-Ray Microtomography
PMC - PMC6428983
OTO - NOTNLM
OT  - bone integration and ingrowth
OT  - diamond crystal lattice
OT  - osteonecrosis of the femoral head
OT  - porous titanium alloy
OT  - sheep
COIS- Competing Interests: The authors have declared that no competing interest exists.
EDAT- 2019/03/27 06:00
MHDA- 2019/07/25 06:00
PMCR- 2019/01/01
CRDT- 2019/03/27 06:00
PHST- 2018/10/21 00:00 [received]
PHST- 2019/02/08 00:00 [accepted]
PHST- 2019/03/27 06:00 [entrez]
PHST- 2019/03/27 06:00 [pubmed]
PHST- 2019/07/25 06:00 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - ijmsv16p0486 [pii]
AID - 10.7150/ijms.30832 [doi]
PST - epublish
SO  - Int J Med Sci. 2019 Mar 9;16(3):486-493. doi: 10.7150/ijms.30832. eCollection 
      2019.