| Theme |
Bone tissue regeneration |
| Title |
Total ankle arthroplasty using alumina ceramic prostheses loaded with tissue engineered bone |
| Author |
Yasuhito Tanaka |
Department of Orthopaedic Surgery, Nara Medical University |
| Author |
Yoshinori Takakura |
Department of Orthopaedic Surgery, Nara Medical University |
| Author |
Hajime Ohgushi |
Research Institute for Cell Engineering, National Institute of Advanced Industrial Science and Technology (AIST) |
| [ Summary ] |
The risks of loosening of ankle prostheses are much higher than those of hip or knee prostheses. To enhance early bonding of an implant to bone, we devised a method of seeding the implant surface with bone marrow mesenchymal stem cells that differentiated into osteoblasts and bone matrix prior to implantation. The arthroplasties were performed on 10 ankles in 10 patients with osteoarthritis. Bone marrow was aspirated from the iliac crest and was cultured on the alumina ceramic prostheses with autogenic serum and dexamethasone. The operations were performed in a standard manner. All the patients were investigated 15 to 27 months postoperatively, with the average being 19 months. Clinical results were evaluated with the JSSF Ankle Hindfoot Scale. The bone bonding rate, which is the ratio of bonding area to the whole surface of the tibial component, was calculated. Mean values of the JSSF score improved from 40 points to 85 points. There were no major complications. The bone bonding rate was 53 % at 2 months postoperatively and 56 % at the follow-up. This demonstrated that tissue engineered total ankle arthroplasties can be performed safely and produce the satisfactory short term results. Coverage of osteoblast / bone matrix on the implant surface vested the ceramics with an osteogenic capability, which demonstrated early bone fixation. |