Diabetes as a Risk Factor for Orthopedic Implant Surface Performance: A Retrieval and In Vitro Study

被引：2

作者：

Arteaga A. ^{[1
]}

Qu J. ^{[2
]}

Haynes S. ^{[3
]}

Webb B.G. ^{[3
]}

LaFontaine J. ^{[4
]}

Rodrigues D.C. ^{[1
]}

机构：

[1] Department of Biomedical Engineering, University of Texas at Dallas, Richardson, TX

[2] Department of Interdisciplinary Studies, University of Texas at Dallas, Richardson, TX

[3] Department of Orthopaedic Surgery, John Peter Smith Hospital, Ft. Worth, TX

[4] Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX

来源：

Journal of Bio- and Tribo-Corrosion | 2021年 / 7卷 / 02期

基金：

美国国家卫生研究院;

关键词：

Diabetes; Orthopedic implants; Retrieval; Stainless steel; Titanium alloy;

D O I：

10.1007/s40735-021-00486-8

中图分类号：

学科分类号：

摘要：

Orthopedic devices are often associated with increased risk for diabetic patients due to impaired wound healing capabilities. Adverse biological responses for immunocompromised patients at the implant–tissue interface can lead to significant bone resorption that may increase failure rates. The goal of this study was to characterize the surface of implants removed from diabetic patients to determine underlying mechanisms of diabetes-induced impaired osseointegration. Thirty-nine retrieved titanium and stainless-steel orthopedic devices were obtained from diabetic and non-diabetic patients, and compared to non-implanted controls. Optical Microscopy, Scanning Electron Microscopy, Energy-Dispersive X-ray Spectroscopy, and X-ray Photoelectron Spectroscopy revealed changes in morphology, chemical composition, oxidation state, and oxide thickness of the retrieval specimens, respectively. Additionally, titanium disks were immersed for 28 days in simulated in vitro diabetic conditions followed by Inductively Coupled Plasma-Optical Emission Spectroscopy to quantify metal dissolution. Electrochemical testing was performed on specimens from retrievals and in vitro study. Aside from biological deposits, retrievals demonstrated surface discoloration, pit-like formations, and oxide thinning when compared to non-implanted controls, suggesting exposure to unfavorable acidic conditions. Cyclic load-bearing areas on fracture-fixation screws and plates depicted cracking and delamination. The corrosion behavior was not significantly different between diabetic and non-diabetic conditions of immersed disks or implant type. However, simulated diabetic conditions elevated aluminum release. This elucidates orthopedic implant failures that potentially arise from diabetic environments at the implant–tissue interface. Design of new implant surfaces should consider specific strategies to induce constructive healing responses in immunocompromised patients while also mitigating corrosion in acidic diabetic environments. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.

引用

共 39 条

[1]

Ciampolini J., Hubble M.J.W., Early failure of total hip replacements implanted at distant hospitals to reduce waiting lists, Ann R Coll Surg Engl, 87, (2005)

[2]

Kumar V., Patel B.Y., Robinson A.H., Diabetes and orthopaedic surgery: a review, Orthop Trauma, 33, pp. 212-216, (2019)

[3]

Statistics about Diabetes | ADA

[4]

Wukich D.K., Diabetes and its negative impact on outcomes in orthopaedic surgery, World J Orthop, 6, pp. 331-339, (2015)

[5]

Eliaz N., Corrosion of metallic biomaterials: a review, Materials (Basel), 12, (2019)

[6]

Trindade R., Albrektsson T., Tengvall P., Wennerberg A., Foreign body reaction to biomaterials: on mechanisms for buildup and breakdown of osseointegration, Clin Implant Dent Relat Res, 18, pp. 192-203, (2016)

[7]

Cadosch D., Al-Mushaiqri M.S., Gautschi O.P., Et al., Biocorrosion and uptake of titanium by human osteoclasts, J Biomed Mater Res Part A, 95A, pp. 1004-1010, (2010)

[8]

Huber M., Reinisch G., Trettenhahn G., Et al., Presence of corrosion products and hypersensitivity-associated reactions in periprosthetic tissue after aseptic loosening of total hip replacements with metal bearing surfaces, Acta Biomater, 5, pp. 172-180, (2009)

[9]

Anderson J.M., Brown S.A., Merrit K., Implant Retrieval and Evaluation, Biomater Sci, (2013)

[10]

Zink T.M., McGrory B.J., Mechanically assisted crevice corrosion in a metal-on-polyethylene total hip presenting with lower extremity vascular compromise, Arthroplast today, 6, pp. 445-450, (2020)

← 1 2 3 4 →