In vitro antibacterial activity and cytocompatibility of magnesium-incorporated poly(lactide-co-glycolic acid) scaffolds.

BACKGROUND: Bone defects are often combined with the risk of infection in the clinic, and artificial bone substitutes are often implanted to repair the defective bone. However, the implant materials are carriers for bacterial growth, and biofilm can form on the implant surface, which is difficult to eliminate using antibiotics and the host immune system. Magnesium (Mg) was previously reported to possess antibacterial potential. METHODS: In this study, Mg was incorporated into poly(lactide-co-glycolic acid) (PLGA) to fabricate a PLGA/Mg scaffold using a low-temperature rapid-prototyping technique. All scaffolds were divided into three groups: PLGA (P), PLGA/10 wt% Mg with low Mg content (PM-L) and PLGA/20 wt% Mg with high Mg content (PM-H). The degradation test of the scaffolds was conducted by immersing them into the trihydroxymethyl aminomethane-hydrochloric acid (Tris-HCl) buffer solution and measuring the change of pH values and concentrations of Mg ions. The antibacterial activity of the scaffolds was investigated by the spread plate method, tissue culture plate method, scanning electron microscopy and confocal laser scanning microscopy. Additionally, the cell attachment and proliferation of the scaffolds were evaluated by the cell counting kit-8 (CCK-8) assay using MC3T3-E1 cells. RESULTS: The Mg-incorporated scaffolds degraded and released Mg ions and caused an increase in the pH value. Both PM-L and PM-H inhibited bacterial growth and biofilm formation, and PM-H exhibited higher antibacterial activity than PM-L after incubation for 24 and 48 h. Cell tests revealed that PM-H exerted a suppressive effect on cell attachment and proliferation. CONCLUSIONS: These findings demonstrated that the PLGA/Mg scaffolds possessed favorable antibacterial activity, and a higher content of Mg (20%) exhibited higher antibacterial activity and inhibitory effects on cell attachment and proliferation than low Mg content (10%).

Incorporation of nanosized calcium silicate improved osteointegration of polyetheretherketone under diabetic conditions.

Diabetes can impair osteoblastic functions and negatively interfere with osteointegration at the bone/implant interface. Previously, we prepared a nanosized calcium silicate (CS) incorporated-polyetheretherketone (PK) biocomposite (CS/PK) and found that the CS/PK composite exhibited enhanced osteoblast functions in vitro and osteointegration in vivo, but its bioperformance under diabetic conditions remained elusive. In this study, MC3T3-E1 cells incubated on CS/PK and PK samples were subjected to diabetic serum (DS) and normal serum (NS); cell attachment, morphology, spreading, proliferation, and osteogenic differentiation were compared to assess in vitro osteoblastic functions on the surfaces of different materials. An in vivo test was performed on diabetic rabbits implanted with CS/PK or PK implants into the cranial bone defect to assess the osteointegration ability of the implants. In vitro results showed that diabetes inhibited osteoblastic functions evidenced by impaired morphology and spreading, and decreased attachment, proliferation, and osteogenic differentiation compared with the findings under normal conditions. Notably, CS/PK ameliorated osteoblastic disfunction under diabetic conditions in vitro. In vivo results from micro-CT and histologic examinations revealed that rabbits with CS/PK implants exhibited improved osteointegration at the bone/implant interface under diabetic conditions compared with PK. Therefore, the CS/PK composite improved the impaired osteointegration induced by diabetes and is a promising orthopedic or craniofacial implant material that may obtain good clinical performance in diabetic patients.

Carbonic anhydrase III protects osteocytes from oxidative stress.

Osteocytes are master orchestrators of bone remodeling; they control osteoblast and osteoclast activities both directly via cell-to-cell communication and indirectly via secreted factors, and they are the main postnatal source of sclerostin and RANKL (receptor activator of NF-kB ligand), two regulators of osteoblast and osteoclast function. Despite progress in understanding osteocyte biology and function, much remains to be elucidated. Recently developed osteocytic cell lines-together with new genome editing tools-has allowed a closer look at the biology and molecular makeup of these cells. By using single-cell cloning, we identified genes that are associated with high Sost/sclerostin expression and analyzed their regulation and function. Unbiased transcriptome analysis of high- vs. low-Sost/sclerostin-expressing cells identified known and novel genes. Dmp1 (dentin matrix protein 1), Dkk1 (Dickkopf WNT signaling pathway inhibitor 1), and Phex were among the most up-regulated known genes, whereas Srpx2, Cd200, and carbonic anhydrase III (CAIII) were identified as novel markers of differentiated osteocytes. Aspn, Enpp2, Robo2, Nov, and Serpina3g were among the transcripts that were most significantly suppressed in high-Sost cells. Considering that CAII was recently identified as being regulated by Sost/sclerostin and capable of controlling mineral homeostasis, we focused our attention on CAIII. Here, we report that CAIII is highly expressed in osteocytes, is regulated by parathyroid hormone both in vitro and in vivo, and protects osteocytes from oxidative stress.-Shi, C., Uda, Y., Dedic, C., Azab, E., Sun, N., Hussein, A. I., Petty, C. A., Fulzele, K., Mitterberger-Vogt, M. C., Zwerschke, W., Pereira, R., Wang, K., Divieti Pajevic, P. Carbonic anhydrase III protects osteocytes from oxidative stress.

Core decompression in combination with nano-hydroxyapatite/polyamide 66 rod for the treatment of osteonecrosis of the femoral head.

BACKGROUND: The aim of this study was to investigate the effectiveness of core decompression in combination with a nano-hydroxyapatite/polyamide 66 (n-HA/PA66) rod and a porous bioglass bone graft for the treatment of osteonecrosis of the femoral head (ONFH). METHODS: Sixty-four patients (84 hips) with ONFH were allocated to a program of either core decompression (CD) in combination with a n-HA/PA66 rod and a porous bioglass bone graft (treatment group) or CD with an autologous cancellous bone graft (control group). Clinical and radiographic retrospective follow-ups were performed on all patients with the prospectively collected data. RESULTS: The overall clinical failure rate in the treatment group (9/38, 23.68%) was lower than that of the control group (24/46, 52.17%) (p < 0.05). Harris hip scores (HHS) were significantly increased in both groups post-surgery (p < 0.05). There was a significant difference between the two groups on HHS improvement for Steinberg IIC and IIIA (p < 0.05 and p < 0.001, respectively). The visual analogue scale (VAS) was significantly decreased in both groups post-surgery (p < 0.05). Especially, significant difference in the VAS improvement was observed between the groups for IIB, IIC and IIIA (p < 0.05, p < 0.05 and p < 0.01, respectively). CONCLUSIONS: Core decompression combined with the implantation of a n-HA/PA66 rod and a bioglass bone graft can significantly decrease hip pain, improve hip function, and prevent the collapse of the femoral head in patients with ONFH. As the effectiveness of this approach appears to vary with Steinberg stage, we suggest that this treatment procedure may be suitable for patients with early to middle stage ONFH.

Biotribological properties of 3D printed high-oriented short carbon fiber reinforced polymer composites for artificial joints.

Short carbon fiber (SCF) reinforced polymer composites are expected to possess outstanding biotribological and mechanical properties in certain direction, while the non-oriented SCF weakens its reinforcing effect in the matrix. In this work, high-oriented SCF was achieved during nozzle extrusion, and then SCF reinforced polyether-ether-ketone (PEEK) composites were fabricated by fused deposition modeling (FDM). The concrete orientation process of SCF was theoretically simulated, and significant shear stress difference was generated at both ends of SCF. As a result, the SCF was distributed in the matrix in a hierarchical structure, containing surface layer I, II and core layer. Moreover, the SCF was oriented highly along the printing direction and demonstrated a more competitive orientation distribution compared to other studies. The SCF/PEEK composites showed a considerable improvement in wear resistance by 44 % due to self-lubricating and load-bearing capability of SCF. Besides, it demonstrated enhancements in Brinell hardness, compressive and impact strength by 48.52 %, 16.42 % and 53.64 %, respectively. In addition, SCF/PEEK composites also showed good cytocompatibility. The findings gained herein are useful for developing the high-oriented SCF reinforced polymer composites with superior biotribological and mechanical properties for artificial joints.

Inflammatory response to orthopedic biomaterials after total hip replacement.

BACKGROUND: The aim of the present study was to investigate early inflammatory response in the first 3 days after the implantation of hip prostheses, and to compare the early inflammation responses associated with the use of different combinations of bearing materials. METHODS: 34 patients were enrolled, all of whom underwent unilateral total hip replacement and had identical hip prostheses, except for the bearing materials. These consisted of polyethylene on alumina (n = 8), polyethylene on CoCr (n = 11), or alumina on alumina (n = 15). Blood samples were collected preoperatively in the morning of the day of surgery, and at 6 h, 1 day, 2 days, and 3 days postoperatively. CK, CRP, and IL-6 in peripheral blood were measured. Pain score was obtained at 2 days after surgery. RESULTS: There were no significant differences in the pre- and postoperative background variables among the groups. Pain scores of different groups were not significantly different either (P > 0.05). There were also no significant differences in the levels of CK, CRP, and IL-6 when patients with the three combinations of bearing materials were compared. CONCLUSIONS: We concluded that varying the bearing materials used in the hip prosthesis did not influence the early inflammatory response after prosthesis implantation.

[Effectiveness of shape memory alloy embracing device in treatment of Vancouver B2 periprosthetic femoral fracture].

Objective: To analyze the effectiveness of shape memory alloy embracing device in the treatment of Vancouver B2 periprosthetic femoral fracture after primary hip arthroplasty. Methods: The clinical data of 30 patients (30 hips) with Vancouver B2 periprosthetic femoral fracture after primary hip arthroplasty between January 2019 and January 2021 were analyzed retrospectively. Among them, 15 cases were treated with shape memory alloy embracing device for fracture fixation (group A) and 15 cases with titanium cable cerclage (group B). There was no significant difference in general data such as gender, age, body mass index, the cause of primary arthroplasty and surgical method, prosthesis type, the cause and side of femoral fracture, the time from injury to operation, and comorbidities between the two groups ( P>0.05). The operation time, intraoperative blood loss, and hospital stay of the two groups were recorded. The fracture healing was examined by X-ray film, and the hip joint function was evaluated by Harris score. Results: The operations in both groups were completed successfully, and the incisions healed by first intention after operation with no vascular or nerve injury. The operation time and hospital stay in group A were significantly shorter than those in group B ( P<0.05), but there was no significant difference in intraoperative blood loss between group A and group B ( t=-0.518， P=0.609). Patients were followed up 12-20 months (mean, 16.3 months) in group A and 12-22 months (mean, 16.7 months) in group B. X-ray film showed that all fractures healed, the healing time was (14.73±2.05) weeks in group A and (17.27±2.60) weeks in group B, and there was a significant difference between the two groups ( t=-2.960， P=0.006). During follow-up, there was no complication such as prosthesis loosening, periprosthetic infection, joint stiffness, or internal fixator loosening. The Harris score of group A was significantly better than that of group B at 3, 6, and 12 months after operation ( P<0.05). Conclusion: Compared with titanium cable cerclage, using shape memory alloy embracing device to fix Vancouver B2 periprosthetic femoral fracture can accelerate fracture healing, shorten operation time, and reduce intraoperative blood loss. Patients can perform functional exercise earlier and restore joint function better.

[Design & fabrication of porous core implant with preset channel network for osteonecrosis of the femoral head].

Referring to the anatomical characterization of natural spongy bone and channel network in cortical bone, we designed a new pattern of biomimetic impalnt with preset channel for blood vessel inserting to treat early femoral head necrosis. The surgical ptrocedure was simulated by CAD model. Ceramic stereolithography was applied to fabricate the green part. Other process, such as dehydration, rinsing, drying and sintering, were taken successively. The final ceramic part kept identical with the engineered part either in the shape or in the internal structure. No deformation or crack happened. Pore size, interconnected pore size, porosity and interconnected porosity of ceramic part could satisfy cellular grouth. Spectrum analysis showed that no phase transition or chemical reaction happened during fabrication process. The biocompatibility of the final part kept the same with original during beta-TCP powder. The compressive strength was 23.54 MPa, close to natural spongy bone. It is an ideal implant to treat early femoral head necroseis because it makes preimplantation of cells and biological factors, blood velssel inserting, early establishment of blood supply possible. At the same time, it could provide enough mechanical support to prevent collapse of femoral head. It could provide a wide clinical foreground.

Effects of different sulfonation times and post-treatment methods on the characterization and cytocompatibility of sulfonated PEEK.

Polyetheretherketone (PEEK) has been becoming a popular implant material in orthopaedic applications. The lack of bioactivity affects PEEK's long-term lifetime, and appropriate surface modification is an effective way to enhance its bioactivity. Sulfonation of PEEK can endow PEEK with a 3 D porous network surface and improve its bioactivity. This study is aimed at exploring an optimal sulfonation time and a post-treatment method of PEEK sulfonation. PEEK was immersed into concentrated sulfuric acid for different sulfonation times and experienced different post-treatment methods to turn into sulfonated PEEK (SPEEK). The immersion times were 0.5 min (SPEEK0.5), 1 min (SPEEK1), 3 min (SPEEK3), 5 min (SPEEK5) and 7 min (SPEEK7), and the post-treatment methods were acetone rinsing (SPEEK-T1), hydrothermal treatment (SPEEK-T2) and NaOH immersion (SPEEK-T3). Scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), Fourier transform infrared spectroscopy, hydrophilic property, ion release and cell viability evaluations were performed to optimize the sulfonation time, and the SEM, EDS, ion release and cell viability were analysed to optimize the post-treatment method. The results showed a porous network structure was formed on all samples of SPEEK, and the porous structure became more obvious and the S concentration increased with increasing sulfonation time. However, too long of an immersion time (SPEEK7) tended to damage the superficial porous structure and left a higher content of sulfuric acid, which could inhibit the growth of MC3T3E1 cells on its surface. In addition, the surface morphology, residual sulfuric acid and cytocompatibility of SPEEK-T1, SPEEK-T2 and SPEEK-T3 were not distinctly different. In conclusion, a 5-min sulfonation time was considered to be the optimal selection, and acetone rinsing, hydrothermal treatment and NaOH immersion showed the same effect in removing the residual sulfuric acid. The understanding of optimal sulfonation time and post-treatment method can provide a theoretical basis in preparing SPEEK for orthopaedic applications.

Prefabrication of vascularized porous three-dimensional scaffold induced from rhVEGF(165): a preliminary study in rats.

BACKGROUND/AIMS: Several shortcomings have limited the routine use of autogenous vascularized bone graft. The present study investigates the prefabrication of vascularized scaffold with the desired shape and microarchitecture combined with recombinant human vascular endothelial growth factor 165 (rhVEGF(165)) to mimic autogenous vascularized bone graft. METHODS: Eighty-five porous calcium phosphate cement scaffolds constructed by rapid prototyping technology were divided into four groups: group A [rhVEGF(165)-fibrin sealant (FS) scaffold], group B (hVEGF(165) scaffold), group C (FS scaffold), and group D (scaffold alone). The release of rhVEGF(165) from the scaffolds was examined in vitro. The vessel density, relative functionalized vessels, vessel diameter and relative vessel area were also measured. RESULTS: The sustained release of hVEGF(165) lasted 14 days in the absence of plasmin and 12 days in the presence of plasmin in group A and 10 days in group B. There was no statistical difference between groups A and B at 2 or 4 weeks in terms of vessel density, relative functionalized vessels, vessel diameter, and relative vessel area, as between groups C and D. However, the above parameters were greater in groups A and B than groups C and D. CONCLUSION: The scaffolds with the desired shape and microarchitecture combined with rhVEGF(165) could shorten the time needed for the construction of prefabricated vascularized grafts and accelerate the maturation of the vessels.

Incomplete digestion preserves chondrocytes from dedifferentiating in long-termed culture on plastic substrate.

Epiphyseal pieces from young rat's costal cartilage were predigested for 30min by hyaluronidase then digested by collagenase for 1h with gentle beating applied. Resulted grape-like chondrocytes connecting with the residual cartilage matrix were seeded in plastic culture dishes and 4 passages at about 12-days interval were carried out. Morphological observations were performed daily. Compared with completely isolated chondrocytes at the same passage, detection for collagen II, integrin-beta(1) and focal adhesion kinase by immunochemistry staining, Western Blot and RT-PCR were performed to evaluate the preservation of chondrocytic phenotype and cellular functions. Primary chondrocytes isolated by complete enzymatic digestion served as control. Completely isolated chondrocytes in the monolayer culture were ready to lose the chondrocytic phenotype marked by the down-regulation of collagen II secretion and specific morphological alterations which were characterized as the cells gradually became long and spindle-like from their originally rounded shape. In case of the incompletely digested chondrocytes, the expression of collagen II was stable during the whole experiment while extensive cell-cell contacts and matrix-cell connections were observed. Transcription and expression of integrin-beta(1) and FAK were active and paracrine of BMP-7 was positive. These results suggested stable chondrocytic phenotype. Conclusionly, by the incomplete digestion method, the requisite time for enzymatic isolation was reduced and chondrocytes with residual matrix were harvested instead of mono-cell suspension. Compared with the novel techniques, the incomplete digestion shortened the enzymatic procedure greatly and simplified the subculturing operations with less financial cost. Especially, as extracellular matrix was preserved, chondrocytes expressed stable phenotype in a rather long-termed culture.

Effect of one versus two distal locking bolts on the biomechanics of tibial interlocking nail: a comparative study using a new model.

OBJECTIVE: To investigate the impact of one versus two distal locking bolts on the mechanical properties of tibial interlocking intramedullary nails. METHODS: Twenty 9-mm titanium alloy locking nails were divided into two equal groups in which the nails were fixed with only one and two distal locking bolts, respectively. Each group was further divided into two sub-groups for compression and torsion tests separately using a universal material-testing machine. RESULTS: In the compression tests, the average maximum strength of double bolts was greater than that of the single bolt (P<0.05), but the number of the bolts did not significantly affect the results of the torsion tests in terms of the either the maximum torsion moment or angle (P>0.05). CONCLUSION: One distal bolt is sufficient for fixing stable fractures and double bolts are recommended for management of serious fractures. The model we used is convenient and economic for examining the biomechanics of the tibial nails, especially for comparative purposes.

The effect of interface microstructure on interfacial shear strength for osteochondral scaffolds based on biomimetic design and 3D printing.

Interface integration between chondral phase and osseous phase is crucial in engineered osteochondral scaffolds. However, the integration was poorly understood and commonly failed to meet the need of osteochondral scaffolds. In this paper, a biphasic polyethylene glycol (PEG)/ß-tricalcium phosphate (ß-TCP) scaffold with enhanced interfacial integration was developed. The chondral phase was a PEG hydrogel. The osseous phase was a ß-TCP ceramic scaffold. The PEG hydrogel was directly cured on the ceramic interface layer by layer to fabricate osteochondral scaffolds by 3D printing technology. Meanwhile, a series of interface structure were designed with different interface pore area percentages (0/10/20/30/40/50/60%), and interfacial shear test was applied for interface structure optimization (n=6 samples/group). The interfacial shear strength of 30% pore area group was nearly three folds improved compared with that of 0% pore area percentage group, and more than fifty folds improved compared with that of traditional integration (5.91±0.59 kPa). In conclusion, the biomimetic PEG/ß-TCP scaffolds with interface structure enhanced integration show promising potential application for osteochondral tissue engineering.

Cartilage repair and subchondral bone migration using 3D printing osteochondral composites: a one-year-period study in rabbit trochlea.

Increasing evidences show that subchondral bone may play a significant role in the repair or progression of cartilage damage in situ. However, the exact change of subchondral bone during osteochondral repair is still poorly understood. In this paper, biphasic osteochondral composite scaffolds were fabricated by 3D printing technology using PEG hydrogel and ß-TCP ceramic and then implanted in rabbit trochlea within a critical size defect model. Animals were euthanized at 1, 2, 4, 8, 16, 24, and 52 weeks after implantation. Histological results showed that hyaline-like cartilage formed along with white smooth surface and invisible margin at 24 weeks postoperatively, typical tidemark formation at 52 weeks. The repaired subchondral bone formed from 16 to 52 weeks in a "flow like" manner from surrounding bone to the defect center gradually. Statistical analysis illustrated that both subchondral bone volume and migration area percentage were highly correlated with the gross appearance Wayne score of repaired cartilage. Therefore, subchondral bone migration is related to cartilage repair for critical size osteochondral defects. Furthermore, the subchondral bone remodeling proceeds in a "flow like" manner and repaired cartilage with tidemark implies that the biphasic PEG/ß-TCP composites fabricated by 3D printing provides a feasible strategy for osteochondral tissue engineering application.

[Cartilage repair and subchondral bone reconstruction based on three-dimensional printing technique].

OBJECTIVE: To investigate whether subchondral bone microstructural parameters are related to cartilage repair during large osteochondral defect repairing based on three-dimensional (3-D) printing technique. METHODS: Biomimetic biphasic osteochondral composite scaffolds were fabricated by using 3-D printing technique. The right trochlea critical sized defects (4.8 mm in diameter, 7.5 mm in depth) were created in 40 New Zealand white rabbits (aged 6 months, weighing 2.5-3.5 kg). Biomimetic biphasic osteochondral composite scaffolds were implanted into the defects in the experimental group (n = 35), and no composite scaffolds implantation served as control group (n = 5); the left side had no defect as sham-operation group. Animals of experimental and sham-operation groups were euthanized at 1, 2, 4, 8, 16, 24, and 52 weeks after operation, while animals of control group were sampled at 24 weeks. Subchondral bone microstructural parameters and cartilage repair were quantitatively analyzed using Micro-CT and Wayne scoring system. Correlation analysis and regression analysis were applied to reveal the relationship between subchondral bone parameters and cartilage repair. The subchondral bone parameters included bone volume fraction (BV/TV), bone surface area fraction (BSA/BV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular spacing (Tb.Sp). RESULTS: In the experimental group, articular cartilage repair was significantly improved at 52 weeks postoperatively, which was dominated by hyaline cartilage tissue, and tidal line formed. Wayne scores at 24 and 52 weeks were significantly higher than that at 16 weeks in the experimental group (P < 0.05), but no significant difference was found between at 24 and 52 weeks (P > 0.05); the scores of experimental group were significantly lower than those of sham-operation group at all time points (P < 0.05). In the experimental group, new subchondral bone migrated from the surrounding defect to the centre, and subchondral bony plate formed at 24 and 52 weeks. The microstructural parameters of repaired subchondral bone followed a "twin peaks" like discipline to which BV/TV, BSA/BV, and Tb.N increased at 2 and 16 weeks, and then they returned to normal level. The Tb.Sp showed reversed discipline compared to the former 3 parameters, no significant change was found for Tb.Th during the repair process. Correlation analysis showed that BV/TV, BSA/BV, Tb.Th, Tb.N, and Tb.Sp were all related with gross appearance score and histology score of repaired cartilage. CONCLUSION: Subchondral bone parameters are related with cartilage repair in critical size osteochondral repair in vivo. Microstructural parameters of repaired subchondral bone follow a "twin peaks" like discipline (osteoplasia-remodeling-osteoplasia-remodeling) to achieve reconstruction, 2nd week and 16th week are critical time points for subchondral bone functional restoration.

Preparation and properties of composite MAO/ECD coatings on magnesium alloy.

Magnesium alloys are potential biodegradable implants because of their outstanding biological performance and biodegradability in the bioenvironment. However, the rapid corrosion of magnesium and its alloys in human body fluids or blood plasma limits their clinical application. In the present work, we first fabricated porous micro-arc oxidation (MAO) coatings containing Ca/P on the magnesium alloy substrate by conducting MAO in the electrolyte containing calcium gluconate. Subsequently, hydroxyapatite (HA) coatings were prepared using electrochemical deposition (ECD) on the MAO coatings. Finally, a MAO/ECD composite coating was successfully fabricated on the magnesium alloy. The phase, morphology and composition of the biological coatings were monitored with X-ray diffraction and scanning electron microscopy with energy dispersive X-ray spectroscopy, and corrosion resistance was evaluated by means of electrochemical methods in a simulated body fluid. The experimental results indicated that the formation of HA-containing composite coatings on magnesium alloy effectively decreases its corrosion rate and more importantly endows it with a potential bioactivity. We believe that the combined use of MAO and ECD to modify magnesium alloys would make them more attractive for clinical applications.

The influence of UV irradiation on the biological properties of MAO-formed ZrO2.

Zirconium and its alloys are thought to be ideal materials for dental and orthopedic implants. However, the surface of native zirconium is bio-inert. It has been reported that micro-arc oxidation (MAO) is a convenient and effective method to improving the biocompatibility and bioactivity of the zirconium surface, and ultraviolet (UV) irradiation can improve the bioactivity of the MAO-formed ZrO(2) without altering its surface morphology, grain size and phase component. The aim of the present study was to evaluate the influence of UV irradiation on the biocompatibility and bioactivity of MAO-formed ZrO(2). Two types of samples were established. Those formed by MAO were labeled as MAO ZrO(2) samples, while those that underwent UV irradiation after MAO treatment were labeled as MAO-UV ZrO(2) samples. In the in vitro study, osteoblasts were seeded on the surfaces of the MAO and MAO-UV samples and were then studied by inverted phase contrast microscopy, scanning electron microscope (SEM) and MTT (3-(4.5-dimethyl-2-thiazolyl)-2.5-diphenayl-2H-tetrazolium bromide) testing. While in the in vivo study, the samples were implanted into calvarias of New Zealand white rabbits and were then evaluated by histology and shear strength analysis. The results indicated that the MAO-UV surfaces showed better biocompatibility, faster new bone formation and firmer bonds with bone than the MAO surfaces. Therefore, UV irradiation may be an optimal second-stage treatment that can improve the properties of MAO-formed ZrO(2).

Osteogenesis of the construct combined BMSCs with beta-TCP in rat.

BACKGROUND: The use of artificial bone graft substitutes has increased as the surgical applications widen and the availability of allograft bone decreases. The present study was to evaluate the construct combined bone marrow stromal cells (BMSCs) with beta-tricalcium phosphate (beta-TCP) as bone substitute implanted in rat dorsal muscles. METHODS: To study the osteogenic capability in vivo, specimens were harvested on 1 week, 4 weeks and 8 weeks after implantation, and were analyzed by hematoxylin and eosin (HE) staining. The percentages of new bone formation for each implant type and implantation period were determined by histomorphometry. RESULTS: After 1 week of implantation, new bone formation for both beta-TCP and BMSCs+beta-TCP group had no formed. After 4 weeks of implantation, the amount of bone formation was increased to 1.32 % in beta-TCP group and 6.35% in BMSCs+beta-TCP group. After 8 weeks of implantation, more bone was found in the BMSCs+beta-TCP group (21.58 %), while in the beta-TCP group bone formation was increased to 4.78%. Significant differences between the two groups have been observed. CONCLUSIONS: Based on these results, we conclude that bone substitutes constructed by porous beta-TCP scaffold loaded with osteogenically induced BMSCs could promote newly formed bone.

[Selection of the type in revision total hip replacement for failed hip arthroplasty].

OBJECTIVE: To evaluate the selection of the type of prosthesis in revision hip arthroplasty. METHODS: There were 33 hips in our study, male in 7 hips and female in 26 hips. The average age of the patients were 59 years. The reasons of the revision included aseptic loosing in 22 hips, infection in 8 hips (2 infection hips with discharging sinuses), and acetabular erosion in 3 hips. The operations for revision were 13 cemented and 12 cementless acetabular prosthesis with autograft in morselized form; the femoral revision were all selected in cemented prosthesis. The revision for infection hip were all cemented prosthesis of extensively porouse-coated. RESULTS: The average follow-up duartion was 3.9 years and 11 months. There was a radiolucency but no clinical instability accompanied in 2 hips and remaining moderate pain in 4 hips. No dislocation and fracture were seen in the series. Harris score were improved to 82.4 (68-88). CONCLUSION: The commonest reason of revision hip arthroplasty was aseptic loosing. The acetabular prosthesis in revision could select cemented or cementless components and femoral prosthesis could select extensively coated stem. The cemented components could yield good results in infection hips revision.