Acceso usuarios
Esteban Lobos Centeno, Fernando Vanoli, Pablo López, Martín M. Mangupli, Christian Antonio Allende Nores
Introducción: El objetivo de este estudio fue analizar y comparar las características de las membranas que se forman alrededor de espaciadores de cemento y aquellas que rodean a implantes de titanio y acero.Materiales y Métodos: Veinte conejos en 2 grupos de 10: grupo 1, espaciador de cemento con antibióticos en fémur derecho y clavo de titanio (TEN) en fémur izquierdo; grupo 2, espaciador de cemento con antibióticos más corticoide en fémur derecho y clavija de acero en fémur izquierdo. A las 6 semanas se extrajeron las membranas. Se evaluaron sus características macroscópicas, bioquímicas, histológicas y en las imágenes.Resultados: Macroscopia: la membrana del cemento con antibióticos era significativamente más ancha y, en el cemento con corticoide y el TEN, era muy fina y adherente. Microscopia: menos inflamación en el cemento con corticoide (p = 0,0502), sin diferencias con las clavijas (p = 0,322). La proliferación epitelial era mayor en las clavijas (p = 0,026) y escasa en el cemento con corticoide (p = 0,071). Hubo una leve tendencia a la proliferación vascular (p = 0,107), de menor actividad, en el grupo con corticoide vs. sin corticoide. No hubo diferencias entre clavija y TEN (p = 0,737). No hubo diferencias significativas en las radiografías y la tomografía (p = 0,988). En la resonancia magnética, la mayoría de las respuestas en el grupo 2 indicaron sin osteointegración, debido a distorsión de la imagen (metal).Conclusiones: Diferentes materiales y los diferentes agregados alteran macroscópica e histológicamente las membranas. El cemento con corticoide presentó menor inflamación y fibrosis, menos proliferación vascular, y membranas más finas y adherentes. AbstractBackground: The objective of this study is to analyze and compare the characteristics of the membranes that form around cement spacers; as well as the one that develops around titanium and steel implants.Materials and Methods: 20 rabbits were divided into 2 groups of 10. In Group 1, an antibiotic-coated cement spacer was placed on the right femur, and a titanium elastic nail (TEN) on the left one. In Group 2, an antibiotic/steroid-coated cement spacer was placed on the right femur, and a steel peg on the left one. At 6 weeks, the membranes were removed and its macroscopic, imaging, biochemical and histological characteristics wereevaluated.Results: Macroscopy: The membrane induced by the ATB-coated cement spacer was significantly wider, whereas the one induced by the steroid-coated cement spacer and the TEN was very thin and adherent. Microscopy: The membrane induced by the steroid-coated cement spacer showed less inflammation (p = 0.0502) and was similar to the one induced by the steel peg (p = 0.322). Steel pegs showed greater epithelial proliferation (p = 0.026), which was scarce on the membrane induced by the steroid-coated cement spacer (p = 0.071). There was a mild tendency towards less active vascular proliferation (p = 0.107) in the group of the steroid-coated cement spacer vs. the one without steroids. There were no differences between the steel peg and the TEN (p = 0.737). X-rays and CT showed no significant differences (p = 0.988). In MRIs, most of the responses indicated lack of osseointegration in the steel peg group due to metallic artifacts.Conclusions: Different materials (titanium, steel and cement) with different agents added to them (antibiotics and steroids), alter the membranes both macroscopically and histologically. The steroidcoated cement spacer showed less inflammation and fibrosis, less vascular proliferation, and thinner and adherent membranes.
Background: The objective of this study is to analyze and compare the characteristics of the membranes that form around cement spacers; as well as the one that develops around titanium and steel implants.Materials and Methods: 20 rabbits were divided into 2 groups of 10. In Group 1, an antibiotic-coated cement spacer was placed on the right femur, and a titanium elastic nail (TEN) on the left one. In Group 2, an antibiotic/steroid-coated cement spacer was placed on the right femur, and a steel peg on the left one. At 6 weeks, the membranes were removed and its macroscopic, imaging, biochemical and histological characteristics were evaluated.Results: Macroscopy: The membrane induced by the ATB-coated cement spacer was significantly wider, whereas the one induced by the steroid-coated cement spacer and the TEN was very thin and adherent. Microscopy: The membrane induced by the steroid-coated cement spacer showed less inflammation (p = 0.0502) and was similar to the one induced by the steel peg (p = 0.322). Steel pegs showed greater epithelial proliferation (p = 0.026), which was scarce on the membrane induced by the steroid-coated cement spacer (p = 0.071). There was a mild tendency towards less active vascular proliferation (p = 0.107) in the group of the steroid-coated cement spacer vs. the one without steroids. There were no differences between the steel peg and the TEN (p = 0.737). X-rays and CT showed no significant differences (p = 0.988). In MRIs, most of the responses indicated lack of osseointegration in the steel peg group due to metallic artifacts.Conclusions: Different materials (titanium, steel and cement) with different agents added to them (antibiotics and steroids), alter the membranes both macroscopically and histologically. The steroidcoated cement spacer showed less inflammation and fibrosis, less vascular proliferation, and thinner and adherent membranes.
