1. Osseointegration of retrieved 3D-printed, off-the-shelf acetabular implants
- Author
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Antti Eskelinen, Alister Hart, Roberto Tirabosco, John A. Skinner, Anna Di Laura, Johann Henckel, Harry Hothi, Lorenzo Dall’Ava, Tampere University, Clinical Medicine, and Coxa PLC
- Subjects
3d printed ,Materials science ,02 engineering and technology ,Diseases of the musculoskeletal system ,Osseointegration ,Arthroplasty ,3d-printing ,03 medical and health sciences ,Fixation (surgical) ,0302 clinical medicine ,Off the shelf ,Orthopedics and Sports Medicine ,hip arthroplasty ,030222 orthopedics ,retrieval analysis ,Hip ,osseointegration ,Reverse Hybrid ,3126 Surgery, anesthesiology, intensive care, radiology ,021001 nanoscience & nanotechnology ,Hip arthroplasty ,RC925-935 ,Surgery ,0210 nano-technology ,additive manufacturing ,Biomedical engineering - Abstract
Aims The main advantage of 3D-printed, off-the-shelf acetabular implants is the potential to promote enhanced bony fixation due to their controllable porous structure. In this study we investigated the extent of osseointegration in retrieved 3D-printed acetabular implants. Methods We compared two groups, one made via 3D-printing (n = 7) and the other using conventional techniques (n = 7). We collected implant details, type of surgery and removal technique, patient demographics, and clinical history. Bone integration was assessed by macroscopic visual analysis, followed by sectioning to allow undecalcified histology on eight sections (~200 µm) for each implant. The outcome measures considered were area of bone attachment (%), extent of bone ingrowth (%), bone-implant contact (%), and depth of ingrowth (%), and these were quantified using a line-intercept method. Results The two groups were matched for patient sex, age (61 and 63 years), time to revision (30 and 41 months), implant size (54 mm and 52 mm), and porosity (72% and 60%) (p > 0.152). There was no difference in visual bony attachment (p = 0.209). Histological analysis showed greater bone ingrowth in 3D-printed implants (p < 0.001), with mean bone attachment of 63% (SD 28%) and 37% (SD 20%), respectively. This was observed for all the outcome measures. Conclusion This was the first study to investigate osseointegration in retrieved 3D-printed acetabular implants. Greater bone ingrowth was found in 3D-printed implants, suggesting that better osseointegration can be achieved. However, the influence of specific surgeon, implant, and patient factors needs to be considered. Cite this article: Bone Joint Res 2021;10(7):388–400.
- Published
- 2021