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Histological, mechanical, and radiological study of osteoformation in titanium foam implants

  • Experimental research - Spine
  • Published:
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Abstract

Background

Titanium (Ti) is widely used for implants because of its high mechanical reliability and because it aids osteoformation. However, it also produces artifacts during radiological imaging. Further, Ti implants can sometimes cause the surrounding bone to break. Owing to recent advances, Ti can be transformed into sponge-like, porous materials having a three-dimensional network of pores; such materials are called Ti foams. These foams exhibit distinct characteristics that make them more suitable than nonporous Ti. The objective of this study was to evaluate Ti foams as implant materials.

Methods

Implants based on Ti foams having porosities of 80 % and 90 % were embedded in the femurs of 11 rabbits. Implants based on 0 % porosity Ti were used as controls. Five rabbits were sacrificed 4 weeks after implantation, while the remaining were sacrificed after 12 weeks. The femurs containing the Ti implants were harvested and analyzed.

Results

Biomechanical analyses showed that the 80 % porosity implants induced greater osteoformation. There were significant differences in the average pushout strengths of the control and 80 % porosity implants after 4 weeks (p = 0.048) and 12 weeks (p = 0.001). Histopathological analyses confirmed osteoformation in the case of the 80 % porosity implants. Analyses of the micro-computed tomography images of the Ti foam-based implants did not suggest the presence of artifacts.

Conclusions

The 80 % porosity Ti implants did not exhibit the shortcomings associated with conventional Ti implants. In addition, they induced greater osteoformation. Finally, the Ti foams did not produce radiological artifacts.

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References

  1. Bärlocher CB, Barth A, Krauss JK, Binggeli R, Seiler RW (2002) Comparative evaluation of microdiscectomy only, autograft fusion, polymethylmethacrylate interposition, and threaded titanium cage fusion for treatment of single-level cervical disc disease: a prospective randomized study in 125 patients. Neurosurg Focus 12:E4

    Article  PubMed  Google Scholar 

  2. Bobyn JD, Pilliar RM, Cameron HU, Weatherly GC (1980) The optimum pore size for the fixation of porous-surfaced metal implants by the ingrowth of bone. Clin Orthop Relat Res 150:263–270

    PubMed  Google Scholar 

  3. Caroli E, Orlando ER, D’Andrea G, Ferrante L (2007) Anterior cervical fusion with interbody titanium cage containing surgical bone site graft: our institution’s experience in 103 consecutive cases of degenerative spondylosis. J Spinal Disord Tech 20:216–220

    Article  PubMed  Google Scholar 

  4. Edward B (2005) Spine Surgery: Techniques, Complication Avoidance, and Management. Elsevier, Philadelphia

    Google Scholar 

  5. Hacker RJ, Cauthen JC, Gilbert TJ, Griffith SL (2000) A prospective randomized multicenter clinical evaluation of an anterior cervical fusion cage. Spine 25:2646–2654

    Article  PubMed  CAS  Google Scholar 

  6. Hacker RJ (2000) A randomized prospective study of an anterior cervical interbody fusion device with a minimum of 2 years of follow-up results. J Neurosurg 93:222–226

    PubMed  CAS  Google Scholar 

  7. Hauerberg J, Kosteljanetz M, Bøge-Rasmussen T, Dons K, Gideon P, Springborg JB, Aase W (2008) Anterior cervical discectomy with or without fusion with ray titanium cage: a prospective randomized clinical study. Spine 33:458–464

    Article  PubMed  Google Scholar 

  8. Hanawa T, Ota M (1991) Calcium phosphate naturally formed on titanium in electrolyte solution. Biomaterials 12:767–774

    Article  PubMed  CAS  Google Scholar 

  9. Hanawa T, Kamiura Y, Yamamoto S, Kohgo T, Amemiya A, Ukai H, Murakami K, Asaoka K (1997) Early bone formation around calcium-ion-implanted titanium inserted into rat tibia. J Biomed Mater Res 36:131–136

    Article  PubMed  CAS  Google Scholar 

  10. Hellbusch LC, Spangler WJ, Bowder A (2012) Radiographic PEEK double-lucency finding after anterior cervical discectomy and fusion with local autograft and PEEK spacer: a preliminary study. J Neurosurg Spine 16:248–250

    Article  PubMed  Google Scholar 

  11. Hida K, Iwasaki Y, Yano S, Akino M, Seki T (2008) Long-term follow-up results in patients with cervical disk disease treated by cervical anterior fusion using titanium cage implants. Neurol Med Chir (Tokyo) 48:440–462

    Article  Google Scholar 

  12. Huang HN, Yang J, Goto M, Watanabe T (1998) Young’s modulus of sintered materials for structual machine parts. (in Japanese) Journal of the Japan Society of Powder and. Powder Metall 45:896–900

    Article  CAS  Google Scholar 

  13. Hulbert SF, Young FA, Mathews RS, Klawitter JJ, Talbert CD, Stelling FH (1970) Potential of ceramic materials as permanently implantable skeletal prostheses. J Biomed Mater Res 4:433–456

    Article  PubMed  CAS  Google Scholar 

  14. Imwinkelried T (2007) Mechanical properties of open-pore titanium foam. J Biomed Mater Res A 81:964–970

    Article  PubMed  Google Scholar 

  15. Itälä AI, Ylänen HO, Ekholm C, Karlsson KH, Aro HT (2001) Pore diameter of more than 100 micron is not requisite for bone ingrowth in rabbits. J Biomed Mater Res 58:679–683

    Article  PubMed  Google Scholar 

  16. Kato K, Yamamoto A, Ochiai S, Daigo Y, Isobe T, Matano S (2012) Cell proliferation, corrosion resistance and mechanical properties of novel titanium foam with sheet shape. Mater Trans 53:724–732

    Article  CAS  Google Scholar 

  17. Kato K, Ochiai S, Yamamoto A, Daigo Y, Honma K, Matano S, Omori K (2013) Novel multilayer Ti foam with cortical bone strength and cytocompatibility. Acta Biomater 9:5802–5809

    Article  PubMed  CAS  Google Scholar 

  18. Kuboki Y, Takita H, Kobayashi D, Tsuruga E, Inoue M, Murata M, Nagai M, Dohu Y, Ohgushi H (1998) BMP-induced osteogenesis on the surface of hydroxyapatite with geometrically feasible and nonfeasible structures: topology of osteogenesis. J Biomed Mater Res 39:190–199

    Article  PubMed  CAS  Google Scholar 

  19. Kurtz SM, Devine JN (2007) PEEK biomaterials in trauma, orthopedic, and spinal implants. Biomaterials 28:4845–4869

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  20. Lausmaa J, Kasemo B, Hansson S (1985) Accelerated oxide growth on titanium implants during autoclaving caused by fluorine contamination. Biomaterials 6:23–27

    Article  PubMed  CAS  Google Scholar 

  21. Lausmaa J, Mattssin L, Rolander U, Kasemo B (1986) Chemical composition and morphology of titanium surface oxide. Mater Res 55:351–359

    CAS  Google Scholar 

  22. Moreland DB, Asch HL, Clabeaux DE, Castiglia GJ, Czajka GA, Lewis PJ, Egnatchik JG, Cappuccino A (2004) Anterior cervical discectomy and fusion with implantable titanium cage: initial impressions, patient outcomes and comparison to fusion with allograft. Spine J 4:184–191

    Article  PubMed  Google Scholar 

  23. Oh IH (2002) Microstructures and mechanical properties of porous titanium compacts prepared by powder sintering. Mater Trans 43:443–448

    Article  CAS  Google Scholar 

  24. Sakamoto M, Nakasu M, Matsumoto T, Okihana H (2007) Development of superporous hydroxyapatites and their examination with a culture of primary rat osteoblasts. J Biomed Mater Res A 82:238–242

    Article  PubMed  Google Scholar 

  25. Schmieder K, Wolzik-Grossmann M, Pechlivanis I, Engelhardt M, Scholz M, Harders A (2006) Subsidence of the wing titanium cage after anterior cervical interbody fusion: 2-year follow-up study. J Neurosurg Spine 4:447–453

    Article  PubMed  Google Scholar 

  26. Schulze RK, Berndt D, d’Hoedt B (2010) On cone-beam computed tomography artifacts induced by titanium implants. Clin Oral Implants Res 21:100–107

    Article  PubMed  Google Scholar 

  27. Trammell TR, Flint K, Ramsey CJ (2012) A comparison of MRI and CT imaging clarity of titanium alloy and titanium alloy with cobalt-chromium-alloy pedicle screw and rod implants in the lumbar spine. J Bone Joint Surg Am 15:1479–1483

    Article  Google Scholar 

  28. Ullrich M, Alexander G, Andrea H (2003) Clinical experience with Cespace, the new intervertebral disc spacer by Aesculp for spondylodesis of the cervical spine, in comparison with similar products by Weber, Intromed, and Acromed. Neurosurg Q 13:40–50

    Article  Google Scholar 

  29. van Jonbergen HP, Spruit M, Anderson PG, Pavlov PW (2005) Anterior cervical interbody fusion with a titanium box cage: early radiological assessment of fusion and subsidence. Spine J 5:645–649

    Article  PubMed  Google Scholar 

  30. Willie BM, Yang X, Kelly NH, Merkow J, Gagne S, Ware R, Wright TM, Bostrom MP (2010) Osseointegration into a novel titanium foam implant in the distal femur of a rabbit. J Biomed Mater Res 92:479–488

    Google Scholar 

  31. Yamagata T, Takami T, Uda T, Ikeda H, Nagata T, Sakamoto S, Tsuyuguchi N, Ohata K (2012) Outcomes of coIkeda H, Nagata T, Sakamoto S: Outcomes of contemporary use of rectangular titanium stand-alone cages in anterior cervical discectomy and fusion: Cage subsidence and cervical alignment. J Clin Neurosci 19:1673–1678

    Article  PubMed  Google Scholar 

  32. Medical Device Recalls > Zimmer Spine, Inc. - PEEK Ardis Inserter http://www.fda.gov/medicaldevices/safety/listofrecalls/ucm333581.htm. Accessed: December 26, 2012

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Acknowledgments

We thank Mr. T. Matsumoto and Mr. M. Shibazaki, Division of New Ceramics, Hoya Corporation/PENTAX Medical Company, for technical support.

Disclosure

This work was funded by Hoya Corporation/PENTAX Medical Company. The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Kiyoshi Ito, Tetsuyoshi Horiuchi & Kazuhiro Hongo

  2. School of Density, Nihon University, Tokyo, Japan

    Yoshinori Arai

  3. Matsumoto Dental University, Matsumoto, Japan

    Ichiro Kawahara

Authors
  1. Kiyoshi Ito
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  2. Tetsuyoshi Horiuchi
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  3. Yoshinori Arai
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  4. Ichiro Kawahara
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  5. Kazuhiro Hongo
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Corresponding author

Correspondence to Kiyoshi Ito.

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Comment

Surgeons, with the help of keen manufacturers, have long sought a good bone substitute, which would preclude the use of a host graft. Is Titanium foam the answer? It is certainly attractive, but as the authors say, there may be some restrictions if surgeons plan to use it in anterior cervical discectomy and fusion (ACDF), the most obvious place for its use. As a surgeon brought up on the Cloward’s procedure, I wonder how long it will be before we revisit the autologous illiac crest graft which, from memory, seemed to work very well.

Michael Powell

London, UK

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Ito, K., Horiuchi, T., Arai, Y. et al. Histological, mechanical, and radiological study of osteoformation in titanium foam implants. Acta Neurochir 156, 2165–2172 (2014). https://doi.org/10.1007/s00701-014-2122-9

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  • DOI: https://doi.org/10.1007/s00701-014-2122-9

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