Preclinical evaluation of a mini-arthroplasty implant based on polyetheretherketone and Ti6AI4V for treatment of a focal osteochondral defect in the femoral head of the hip

A mini or partial arthroplasty may offer the advantages of reduced pain, shorter hospital stay, and increased range of motion, which are beneficial for the treatment of large-sized focal osteochondral defects. We aimed to evaluate the in vivo histologic response and function of our nonresorbable, composite structure implant, developed using polyetheretherketone (PEEK) and Ti6AI4V alloy, as a treatment for full-thickness osteochondral defects in the femoral head of the hip using a goat model. The gross and imaging appearance and histologic results were compared to those of a similar size cobalt-chromium-molybdenum (CoCrMo) alloy implant placed in a defect in the femoral head and evaluated up to 12 weeks. The X radiographs showed that there was no evidence of loosening of the implants for both the PEEK-Ti6AI4V and CoCrMo groups. Magnetic resonance imaging results showed no inflammatory signal findings in both PEEK-Ti6AI4V and CoCrMo implants. Macroscopically and histologically, there was lesser cartilage degeneration in the PEEK-Ti6AI4V implant than in the CoCrMo implant. The modified macroscopic articular evaluation score was lower in the PEEK-Ti6AI4V group than in the CoCrMo group (p < 0.05), and the histological score of the periprosthetic and acetabular cartilage was lower in the PEEK-Ti6AI4V group than in the CoCrMo group (P < 0.05). The micro-computed tomography results showed that the uncemented PEEK-Ti6AI4V implant has better osseointegration and higher bone-implant contact than the cemented CoCrMo implant. The peri-implant bone mass was higher in the PEEK-Ti6AI4V implant(p < 0.05). Meanwhile, the optical profile analytical results showed that the surface roughness of the cartilage in the acetabulum was higher in the CoCrMo group. In conclusion, the mini-arthroplasty implant based on PEEK-Ti6AI4V was superior to an identical CoCrMo alloy implant as a treatment for local osteochondral defect in the femoral head, owing to its in vivo cartilage protection and better osseointegration.

[1]  Zhiguo Yuan,et al.  A partial hemi-resurfacing preliminary study of a novel magnetic resonance imaging compatible polyetheretherketone mini-prosthesis for focal osteochondral defects , 2020, Journal of orthopaedic translation.

[2]  W. Shon,et al.  Total Hip Arthroplasty: Past, Present, and Future. What Has Been Achieved? , 2019, Hip & pelvis.

[3]  M. Wimmer,et al.  Articulation of an alumina-zirconia composite ceramic against living cartilage - An in vitro wear test. , 2019, Journal of the mechanical behavior of biomedical materials.

[4]  R. Pan,et al.  Autologous Chondrocyte Implantation Versus Microfracture in the Knee: A Meta-Analysis and Systematic Review. , 2019, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[5]  K. Kang,et al.  Total knee arthroplasty application of polyetheretherketone and carbon-fiber-reinforced polyetheretherketone: A review. , 2019, Materials science & engineering. C, Materials for biological applications.

[6]  M. Schotanus,et al.  Cemented versus uncemented hemiarthroplasty of the hip in patients with a femoral neck fracture: a comparison of two modern stem design implants , 2018, European Journal of Orthopaedic Surgery & Traumatology.

[7]  Zhe Du,et al.  The degree of peri-implant osteolysis induced by PEEK, CoCrMo, and HXLPE wear particles: a study based on a porous Ti6Al4V implant in a rabbit model , 2018, Journal of Orthopaedic Surgery and Research.

[8]  Raju Vaishya,et al.  Medical textiles in orthopedics: An overview. , 2017, Journal of clinical orthopaedics and trauma.

[9]  P. Persiani,et al.  Assessment and therapeutic choice in septic arthritis of the hip in an intravenous drug abuser: case report at 14 years follow-up and review of literature. , 2017, La Clinica terapeutica.

[10]  S. Cook,et al.  Biological and functional evaluation of a novel pyrolytic carbon implant for the treatment of focal osteochondral defects in the medial femoral condyle: assessment in a canine model , 2016, Journal of Orthopaedic Surgery and Research.

[11]  T. Kamarul,et al.  Preparation Methods for Improving PEEK's Bioactivity for Orthopedic and Dental Application: A Review , 2016, International journal of biomaterials.

[12]  Ferris M. Pfeiffer,et al.  Optimising femoral-head osteochondral allograft transplantation in a preclinical model , 2015, Journal of orthopaedic translation.

[13]  M. Deakin,et al.  Hemiarthroplasty using cemented or uncemented stems of proven design: a comparative study. , 2015, The bone & joint journal.

[14]  Jakob Klit.  Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures. , 2014, Danish medical journal.

[15]  C. Bozynski,et al.  Evaluation of Synthetic Osteochondral Implants , 2013, The Journal of Knee Surgery.

[16]  S. Goldstein,et al.  Preclinical evaluation of a novel implant for treatment of a full-thickness distal femoral focal cartilage defect. , 2013, The Journal of arthroplasty.

[17]  M. Kocher,et al.  Chondral Lesions of the Hip: Microfracture and Chondroplasty , 2010, Sports medicine and arthroscopy review.

[18]  D. Saris,et al.  Cartilage degeneration in the goat knee caused by treating localized cartilage defects with metal implants. , 2010, Osteoarthritis and cartilage.

[19]  D. Saris,et al.  Treatment Selection in Articular Cartilage Lesions of the Knee , 2009, The American journal of sports medicine.

[20]  A J Verbout,et al.  Articular cartilage degeneration following the treatment of focal cartilage defects with ceramic metal implants and compared with microfracture. , 2009, The Journal of bone and joint surgery. American volume.

[21]  Kyriacos A Athanasiou,et al.  Success rates and immunologic responses of autogenic, allogenic, and xenogenic treatments to repair articular cartilage defects. , 2009, Tissue engineering. Part B, Reviews.

[22]  L. Hangody,et al.  [Surgical treatment options for weight bearing articular surface defect]. , 2006, Orvosi hetilap.

[23]  D. V. Van Sickle,et al.  Safety of, and biological and functional response to, a novel metallic implant for the management of focal full‐thickness cartilage defects: Preliminary assessment in an animal model out to 1 year , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[24]  J. Bijlsma,et al.  Inhibition of COX-2 by celecoxib in the canine groove model of osteoarthritis. , 2006, Rheumatology.

[25]  P. Beaulé,et al.  Surface arthroplasty for osteonecrosis of the hip: hemiresurfacing versus metal-on-metal hybrid resurfacing. , 2004, The Journal of arthroplasty.

[26]  N. Sugano,et al.  Comparison between bipolar hemiarthroplasty and THA for osteonecrosis of the femoral head. , 2004, Clinical orthopaedics and related research.

[27]  G. Keene,et al.  Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip--a systematic review. , 2002, Injury.

[28]  L. Hangody,et al.  Mosaicplasty for the Treatment of Articular Defects of the Knee and Ankle , 2001, Clinical orthopaedics and related research.

[29]  J. Drukker,et al.  The reliability of the mankin score for osteoarthritis , 1992, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[30]  S W O'Driscoll,et al.  Durability of regenerated articular cartilage produced by free autogenous periosteal grafts in major full-thickness defects in joint surfaces under the influence of continuous passive motion. A follow-up report at one year. , 1988, The Journal of bone and joint surgery. American volume.

[31]  R. Salter,et al.  The chondrogenic potential of free autogenous periosteal grafts for biological resurfacing of major full-thickness defects in joint surfaces under the influence of continuous passive motion. An experimental investigation in the rabbit. , 1986, The Journal of bone and joint surgery. American volume.