The apposition of new bone to polished solid implants and to implants with surfaces that had been blasted with one of three methods of grit-blasting was studied in a rabbit intramedullary model to test the hypothesis that blasted implant surfaces support osseous integration. Intramedullary titanium-alloy (Ti-6Al-4V) plugs, press-fit into the distal aspect of the femoral canal, were implanted bilaterally in fifty-six rabbits. Four surface treatments were studied: polished (a surface roughness of 0.4 to 0.6 micrometer) and blasted with stainless-steel shot (a surface roughness of five to seven micrometers), with thirty-six-grit aluminum oxide (a surface roughness of five to seven micrometers), or with sixty-grit aluminum oxide (a surface roughness of three to five micrometers). Localized attachment of new bone to the surfaces of the blasted implants was present radiographically at twelve weeks. The total bone area was significantly affected by the level of the section (the diaphysis had a greater bone area than the proximal part of the metaphysis and the proximal part of the metaphysis had a greater bone area than the distal part of the metaphysis; p < 0.001) and the quadrant within each section (the posterior and anterior quadrants had greater bone area than the medial and lateral quadrants; p < 0.00001). The length of the bone-implant interface was significantly affected by the surface treatment (the length of the bone- implant interface for the implants that had been blasted with sixty-grit aluminum oxide was greater than the length for the polished implants; p = 0.02), the time after implantation (the interface was longer at six and twelve weeks than at three weeks; p < 0.00001), and the level of the section (the interface was longer at the diaphysis than at the proximal part of the metaphysis and longer at the proximal part of the metaphysis than at the distal part of the metaphysis; p = 0.004). Blasting of the surface of titanium-alloy implants did not have an effect on the area of bone formation around the implants, but it did significantly affect the area of bone formation on the implant and the shear strength at the bone-implant interface. The two effects were not necessarily parallel, as significantly less (p < 0.05) bone formed on implants that had been blasted with stainless- steel shot than on those blasted with aluminum grit, whereas their interface shear strengths were similar. CLINICAL RELEVANCE: The data from this study suggest that blasted titanium surfaces support extensive bone growth directly onto the implant. This method may provide an excellent surface for bone- implant integration.
ASJC Scopus subject areas
- Orthopedics and Sports Medicine