Paweł Skowronek1, Paweł Olszewski1, Wojciech Święszkowski2, Marek Synder3, Marcin Sibiński3, Jacek Mazek4. 1. 1 Clinic of Orthopaedic and Traumatology, Jan Kochanowski University of Kielce, Kielce, Poland. 2. 2 Department of Materials Engineering at the Warsaw University of Technology, Warsaw, Poland. 3. 3 Clinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Lodz, Poland. 4. 4 Centre for Specialised Surgery ORTOPEDIKA Warsaw, Warsaw, Poland.
Abstract
BACKGROUND: Trabecular metal implants with a porous architecture that allows for the incorporation of bone into the implant during healing are gaining popularity in alloplastic revision procedures. The bi-products of drilling titanium alloy (Ti) and tantalum (Ta) implants have not been previously assessed. METHODS: Four holes were drilled in each of 2 spatially porous trabecular implants, one Ta and the other Ti alloy (Ti-6Al-7Nb), for this pilot in vitro study. The particles were flushed out with a continuous flow of saline. The particles' weight and the volume were then measured using a Radwag XA 110/2X (USA) laboratory balance. The total volume of the obtained metal fines was measured by titration using a 10 mm3 measurement system. RESULTS: A cobalt carbide bit was used since the holes could not be made with a standard bone drill. Each Ti and Ta implant lost 1.26 g and 2.48 g of mass, respectively. The volume of free particles recovered after each stage was 280 mm3 and 149 mm3, respectively. Approximately 0.6% of the total implant mass was not recovered after drilling (roughly 2% of the mass of the particles created by drilling), despite the use of 5 µm filters. CONCLUSIONS: It is technically difficult to drill holes in Ti and Ta implants using standard surgical tools. The drilling process creates a considerable amount of metal particles, which cannot be recovered despite intensive flushing. This may have an adverse influence on the bio-functionality (survival) of the endoprosthesis and present deleterious systemic consequences.
BACKGROUND: Trabecular metal implants with a porous architecture that allows for the incorporation of bone into the implant during healing are gaining popularity in alloplastic revision procedures. The bi-products of drilling titanium alloy (Ti) and tantalum (Ta) implants have not been previously assessed. METHODS: Four holes were drilled in each of 2 spatially porous trabecular implants, one Ta and the other Ti alloy (Ti-6Al-7Nb), for this pilot in vitro study. The particles were flushed out with a continuous flow of saline. The particles' weight and the volume were then measured using a Radwag XA 110/2X (USA) laboratory balance. The total volume of the obtained metal fines was measured by titration using a 10 mm3 measurement system. RESULTS: A cobalt carbide bit was used since the holes could not be made with a standard bone drill. Each Ti and Ta implant lost 1.26 g and 2.48 g of mass, respectively. The volume of free particles recovered after each stage was 280 mm3 and 149 mm3, respectively. Approximately 0.6% of the total implant mass was not recovered after drilling (roughly 2% of the mass of the particles created by drilling), despite the use of 5 µm filters. CONCLUSIONS: It is technically difficult to drill holes in Ti and Ta implants using standard surgical tools. The drilling process creates a considerable amount of metal particles, which cannot be recovered despite intensive flushing. This may have an adverse influence on the bio-functionality (survival) of the endoprosthesis and present deleterious systemic consequences.
Entities:
Keywords:
Arthroplasty; augments; drilling; hip loosening; revision
Authors: Paweł Skowronek; Paweł Olszewski; Wojciech Święszkowski; Marcin Sibiński; Marek Synder; Michał Polguj Journal: BMC Musculoskelet Disord Date: 2019-10-24 Impact factor: 2.362