Dataset Information

Carbon Fiber/Polyether Ether Ketone (CF/PEEK) Implants Allow for More Effective Radiation in Long Bones.

ABSTRACT: BACKGROUND:Metallic implants show dose-modulating effects in radiotherapy and complicate its computed tomography (CT)-based planning. Dose deviations might not only affect the surrounding tissues due to backscattering and inadvertent dose increase but might also compromise the therapeutic effect to the target lesion due to beam attenuation. Later on, follow-up imaging is often obscured by metallic artefacts. Purposes: This study investigates the dosimetric impact of titanium and radiolucent carbon fiber/polyether ether ketone (CF/PEEK) implants during adjuvant radiation therapy in long bones. (1) Does the use of CF/PEEK implants allow for a more homogenous application of radiation? (2) Is the dose delivery to the target volume more efficient when using CF/PEEK implants? (3) Do CF/PEEK implants facilitate CT-based radiation therapy planning? Materials and methods: After CT-based planning, bone models of six ovine femora were irradiated within a water phantom in two immersion depths to simulate different soft-tissue envelopes. Plates and intramedullary nails of both titanium and CF/PEEK were investigated. Radiation dosage and distribution patterns were mapped using dosimetry films. Results: First, the planned implant-related beam attenuation was lower for the CF/PEEK plate (1% vs. 5%) and the CF/PEEK nail (2% vs. 9%) than for corresponding titanium implants. Secondly, the effective decrease of radiation dosage behind the implants was noticeably smaller when using CF/PEEK implants. The radiation dose was not significantly affected by the amount of surrounding soft tissues. A significant imaging artefact reduction was seen in all CF/PEEK models. Conclusion: CF/PEEK implants lead to a more reliable and more effective delivery of radiation dose to an osseous target volume. With regard to radiation therapy, the use of CF/PEEK implants appears to be particularly beneficial for intramedullary nails.

SUBMITTER: Laux CJ

PROVIDER: S-EPMC7178689 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Carbon Fiber/Polyether Ether Ketone (CF/PEEK) Implants Allow for More Effective Radiation in Long Bones.

Laux Christoph J CJ Villefort Christina C Ehrbar Stefanie S Wilke Lotte L Guckenberger Matthias M Müller Daniel A DA

Materials (Basel, Switzerland) 20200409 7

<h4>Background</h4>Metallic implants show dose-modulating effects in radiotherapy and complicate its computed tomography (CT)-based planning. Dose deviations might not only affect the surrounding tissues due to backscattering and inadvertent dose increase but might also compromise the therapeutic effect to the target lesion due to beam attenuation. Later on, follow-up imaging is often obscured by metallic artefacts. <i>Purposes:</i> This study investigates the dosimetric impact of titanium and r ...[more]

PMID: 32283675

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Project description:Polyether ether ketone is a bioinert polymer, that is of high interest in research and medicine as an alternative material for the replacement of bone implants made of metal. The biggest deficit of this polymer is its hydrophobic surface, which is rather unfavorable for cell adhesion and thus leads to slow osseointegration. In order to address this drawback, 3D-printed and polymer extruded polyether ether ketone disc samples that were surface-modified with titanium thin films of four different thicknesses via arc evaporation were investigated and compared with non-modified disc samples. Depending on the modification time, the thickness of the coatings ranged from 40 nm to 450 nm. The 3D-printing process does not affect the surface or bulk properties of polyether ether ketone. It turned out that the chemical composition of the coatings obtained did not depend on the type of substrate. Titanium coatings contain titanium oxide and have an amorphous structure. Microdroplets formed on the sample surfaces during treatment with an arc evaporator contain a rutile phase in their composition. Surface modification of the samples via arc evaporation resulted in an increase in the arithmetic mean roughness from 20 nm to 40 nm for the extruded samples and from 40 nm to 100 nm for the 3D-printed samples, with the mean height difference increasing from 100 nm to 250 nm and from 140 nm to 450 nm. Despite the fact that the hardness and reduced elastic modulus of the unmodified 3D-printed samples (0.33 GPa and 5.80 GPa) are higher than those of the unmodified extruded samples (0.22 GPa and 3.40 GPa), the surface properties of the samples after modification are approximately the same. The water contact angles of the polyether ether ketone sample surfaces decrease from 70° to 10° for the extruded samples and from 80° to 6° for the 3D-printed samples as the thickness of the titanium coating increases, making this type of coating promising for biomedical applications.

Project description:The current study provides more insights about the surface bioactivity of the silicon nitride (Si3N4) as a potential candidate for bone regeneration in craniofacial and orthopaedic applications compared with conventional implantation materials. Current skeletal reconstructive materials such as titanium and polyether ether ketone (PEEK) are limited by poor long-term stability, biocompatibility and prolonged healing. Si3N4 is an FDA-approved material for an intervertebral spacer in spinal fusion applications. It is biocompatible and has antimicrobial properties. Here, we hypothesize that Si3N4 was found to be an osteoconductive material and conducts the growth, differentiation of MC3T3-E1 cells for extracellular matrix deposition, mineralization and eventual bone regeneration for craniofacial and orthopaedic applications. MC3T3-E1 cells were used to study the osteoblastic differentiation and mineralization on sterile samples of Si3N4, titanium alloy and PEEK. The samples were then analysed for extracellular matrix deposition and mineralization by FTIR, Raman spectroscopy, SEM, EDX, Alizarin Red, qRT-PCR and ELISA. The in vitro study indicates the formation of collagen fibres and mineral deposition on all three sample surfaces. There was more profound and faster ECM deposition and mineralization on Si3N4 surface as compared to titanium and PEEK. The FTIR and Raman spectroscopy show formation of collagen and mineral deposition at 30 days for Si3N4 and titanium and not PEEK. The peaks shown by Raman for Si3N4 resemble closely to natural bone. Results also indicate the upregulation of osteogenic transcription factors such as RUNX2, SP7, collagen type I and osteocalcin. The authors concluded that Si3N4 rapidly conducts mineralized tissue formation via extracellular matrix deposition and biomarker expression in mouse calvarial pre-osteoblast cells. Thus, this study confirms that the bioactive Si3N4 could be a potential material for craniofacial and orthopaedic applications leading to rapid bone regeneration that resemble the natural bone structure.

Dataset Information

Carbon Fiber/Polyether Ether Ketone (CF/PEEK) Implants Allow for More Effective Radiation in Long Bones.

Publications

Carbon Fiber/Polyether Ether Ketone (CF/PEEK) Implants Allow for More Effective Radiation in Long Bones.

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