Systemic dihydrotestosterone enhances periimplant mineralization around titanium implants

U. Maus; M. Lühmann; S. Andereya; H. Schmidt; G. Zombory; C. Siebert; C. Niedhart

doi:10.1055/s-0037-1621664

Osteologie, Table of Contents

Osteologie 2012; 21(01): 23-28
DOI: 10.1055/s-0037-1621664

Original and review articles

Schattauer GmbH

Systemic dihydrotestosterone enhances periimplant mineralization around titanium implants

Die systemische Applikation von Dihydrotestosteron erhöht die periimplantäre Mineralisation um Titanimplantate

U. Maus

¹Department of Orthopedic Surgery, University of Mainz, Germany

²OZOM – Orthopedic Center Oldenburger Münsterland, St. Antonius-Stift, Emstek, Germany

,

M. Lühmann

³Department of Trauma Surgery, Medical center city region Aachen, Würselen, Germany

,

S. Andereya

⁴Department of Orthopedic Surgery and Traumatology, University of Aachen, Germany

,

H. Schmidt

³Department of Trauma Surgery, Medical center city region Aachen, Würselen, Germany

,

G. Zombory

⁴Department of Orthopedic Surgery and Traumatology, University of Aachen, Germany

,

C. Siebert

⁵Department of Orthopedic Surgery and Sport injuries, Medical school Hannover – Annastift e.V., Hannover, Germany

,

C. Niedhart

⁴Department of Orthopedic Surgery and Traumatology, University of Aachen, Germany

› Author Affiliations

Abstract

Zusammenfassung

Trotz Verbesserungen der Einheilung von Titan-implantaten durch Oberflächenmodifikationen kann die postoperative Rehabilitation durch Phasen der Ent- oder Teilbelastung verzögert sein, um eine Osseointegration der Implantate ermöglichen. Außerdem wird die postoperative Rehabilitation gerade bei älteren Patienten durch die reduzierte Muskelfunktion beeinflusst. Androgene spielen eine wichtige Rolleals anabole Substanzen des Knochenstoffwechsels und erhöhen Muskelkraft und Aktivität. Ziel der vorliegenden Studie war die Evaluation der Effekte einer systemischen Vorbehandlung mit Androgenen auf die Osseointegration von Ti6Al4VA-Implantaten bei 20 Sprague-Dawley Ratten. Zur Vorbehandlung wurde den Tieren zwei Tage vor der Operation entweder ein Placebo oder 1 mg 5β-Androstan-17β-ol-one (DHT) subkutan injiziert. Die Ti6Al4VA-Implantate wurden beidseits pressfit in die Femura implantiert. Nach 14 Tagen wurden die Tiere euthanisiert, die Proben in Methylmetacrylat eingebettet und histologisch sowie histomorphometrisch untersucht. Die biomechanische Untersuchung mittels Ausrissversuch ergab inkonsistente Ergebnisse ohne signifikante Unterschiede. Die histologische Untersuchung ergab einen direkten Kontakt zwischen mineralisiertem Knochen bzw. Osteoid und Implantatoberfläche. In der Gruppe, die mit DHT vorbehandelt wurde, zeigte sich ein signifikant höherer Anteil an mineralisiertem Gewebe am Knochen-Implantat-Interface (51,24 ±10,48 % vs. 39,50 ±9,31 %, p < 0,05), während der Anteil an Osteoid signifikant geringer war (33,11 ±7,76 % vs. 47,59 ±7,76 %, p < 0,01). Die präoperative Vorbehandlung mit DHT führte zu einer verbesserten Mineralisation des periimplantären Osteoids um Ti6Al4VAImplantate. Die systemische Applikation von DHT könnte daher eine mögliche Option darstellen, um gleichzeitig die Osseointegration der Implantate zu verbessern und die postoperative Rehabilitation durch die Erhöhung der Muskelkraft zu verkürzen.

Summary

Despite the improvement of titanium implants by surface modification, postoperative rehabilitation can be prolonged to permit the osseointegration of the implant. Furthermore, muscular weakness of elderly patients lengthens the period of rehabilitation. Androgens play an important role as anabolic agent in bone metabolism and also increase muscular strength and activity. We evaluated the effects of systemic androgen pre-treatment on the osseointegration of Ti6Al4VA-implants in 20 rats, which received either no treatment or 1 mg 5β-Androstan-17β-ol-one (DHT) subcutaneously two days before surgery. Ti6Al4VA implants were inserted press-fit into the femur bilaterally. After 14 days histological and histomorphometrical analysis was performed after embedding specimens in methylmetacrylate. Biomechanical analysis was conducted by a pull-out test, which showed very inconsistent data without significant differences. Histology showed bone and implant in close contact and wide seams of osteoid in direct contact with the implant surface. Stimulation with DHT significantly increased the bone content at the bone-implant interface (51.24 ±10.48 % vs. 39.50 ±9.31 %, p < 0.05), while the ratio of osteoid was significantly reduced (33.11 ±7.76 % vs. 47.59 ±7.76 %, p < 0.01). Preoperative stimulation with DHT improved mineralization of periimplant osteoid around Ti6Al4VA implants. Systemic DHT therefore may represent a solution leading to both improved osseo integration and shortened rehabilitation thanks to muscular strengthening.

Schlüsselwörter

Knochen - Kalzifizierung - Titanlegierungen - Osseointegration

Keywords

Bone - calcification - titanium (alloys) - osseointegration

Full Text

References

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