3D打印多孔钛金属植入物不同孔隙率对骨长入影响的实验研究

刘路坦; 牛国旗; 周乾坤; 陈辉; 聂虎; 王震寰

doi:10.13898/j.cnki.issn.1000-2200.2019.09.004

3D打印多孔钛金属植入物不同孔隙率对骨长入影响的实验研究

Study on the effect of different porosity of 3D printing porous titanium implants on bone ingrowth

摘要

摘要:
目的通过动物实验探讨3D打印多孔钛金属植入物不同孔隙率对骨长入的影响。
方法18只健康新西兰兔随机分为A、B、C组，各6只。利用3D打印技术制备3种孔隙率的多孔钛板：A组35%，B组55%，C组75%，分别将多孔钛板植入兔股骨干置板区域。于术后第4、16周取股骨干标本进行X线片、大体观察和组织学观察，比较3组新生骨形成率。
结果术后4周，各组钛板周围及与骨面间可见纤维组织，未见明显骨痂形成，X线片见部分钛板与骨面有间隙；术后16周，各组钛板周围及与骨面之间有新骨形成连接，个别钛板被骨痂包裹，X线片见钛板与骨面贴合紧密。组织学观察：A组钛板边缘有新骨生成，但中间孔隙内仅有少量骨组织长入；B组钛板孔隙内部分骨组织长入，但与钛板之间存在一定缝隙；C组钛板孔隙间新骨长入密度较高，且与钛板结合紧密。3组新生骨形成率差异有统计学意义（P < 0.01），A组均明显低于B、C组（P < 0.01），B组亦明显低于C组（P < 0.01）。
结论3D打印多孔钛板的孔隙结构，可以允许新生骨长入；不同孔隙率影响3D打印钛金属植入物的新生骨长入效果，75%孔隙率较35%、55%更有利于骨长入，可与经适当处理的皮质骨表面实现良好的骨性融合。

Abstract:
ObjectiveTo investigate the effects of different porosity of 3D printing porous titanium implants on bone ingrowth through animal experiments.
MethodsEighteen healthy New Zealand rabbits were randomly divided into A, B and C groups.Three kinds of porosity porous titanium plates in A, B and C groups prepared by 3D printing technology were 35%, 55% and 75%, respectively.The titanium plate was implanted into the femoral shaft plate area of rabbits.After 4 weeks and 16 weeks of operation, the femoral shaft specimens were examined using X-ray, and the gross and histological observation in bone tissue section were implemented.The rates of new bone formation in three groups were compared.
ResultsAfter 4 weeks of operation, the fibrous tissue was found around the titanium plate and between titanium plate and bone surface, and no obvious callus formation was observed in each group.The results of X-ray films showed that some gaps were identified between titanium plate and the bone surface.After 16 weeks of operation, there were new bone connections around titanium plate and between titanium plate and bone surface in each group, a few titanium plates were wrapped by bone scabs, and the results of X-ray films showed that the titanium plate was closely attached to the bone surface.The results of histological observation showed that some new bone formation could be seen at the edge of titanium plate, but only a small amount of bone tissue grew into the middle pore in group A; In group B, some bone tissue grew into the pores, but there was a certain gap between pores and titanium plate; In group C, the density of new bone between pores of titanium plate was higher, and it was closely bound to titanium plate.The differences of the rates of new bone formation among three groups were statistically significant(P < 0.01), the rate of new bone formation in group A was significantly lower that in B and C groups(P < 0.01), and the rate of new bone formation in group B was significantly lower that in group C(P < 0.01).
ConclusionsThe pore structure of 3D printing porous titanium plate can allow new bone to grow in.Different porosities affect the effect of new bone ingrowth of 3D printed titanium implants The 75% porosity is more beneficial to bone ingrowth compared with 35% and 55% porosity.The printing porous titanium plates can achieve good bone fusion with proper treating cortical bone surface.

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