Multicycle mechanical performance of titanium and stainless steel transpedicular spine implants.

STUDY DESIGN: This was a prospective in vitro study comparing titanium alloy and stainless steel alloy in transpedicular spine implants from two different manufactures. OBJECTIVE: To compare the multicycle mechanical performance of these two alloys, used in each of two different implant designs. SUMMARY OF BACKGROUND DATA: Transpedicular spine implants primarily have been manufactured from stainless steel, but titanium alloy offers imaging advantages. However, the notch sensitivity of titanium alloy has caused concern regarding how implants made from this material will compare in stiffness and fatigue life with implants made from stainless steel. METHODS: Twenty-four implants (two alloys, two designs, six implants per group) were mounted in machined polyethylene wafers and repetitively loaded (up to 1 million cycles) from 80 N to 800 N using a 5-Hertz sinusoidal waveform. Load and displacement data were automatically and periodically sampled throughout the entire test. RESULTS: Implant stiffness increased with cycle load number, reached a steady state, then declined just before fatigue failure. Stiffness varied less in titanium transpedicular spine implants than in their stainless counterparts. All stainless steel implant types were stiffer (steady-state value, P < 0.0001) than their titanium alloy counterparts. One titanium implant design failed with fewer (P < 0.05) load cycles than its stainless steel counterpart, whereas a stainless steel implant of another design failed with fewer (P < 0.002) load cycles than its titanium counterpart. Overall, fatigue life, i.e., the total number of load cycles until failure, was related to implant type (P < 0.0001), but not to implant material. CONCLUSIONS: A transpedicular spine implant's fatigue lifetime depends on both the design and the material and cannot be judged on material alone. Stainless steel implants are stiffer than titanium alloy implants of equal design and size; however, for those designs in which the fatigue life of the titanium alloy version is superior, enlargement of the implant's components can compensate for titanium's lower modulus of elasticity and result in an implant equally stiff as its stainless steel counterpart. Such an implant made from titanium alloy would then be clinically preferable because of titanium's previously reported imaging advantages.

Calcitonin alters bone quality in beagle dogs.

Because of its antiresorptive properties, calcitonin is widely used to prevent and treat osteoporosis. A stimulatory effect of calcitonin on osteoblasts has also been reported; however, a recent histologic study points to a negative effect of calcitonin on mineralization of cancellous bone. The present experiment was performed to determine whether the observed histological signs of alterations in mineralization are also observed in cortical bone and whether this results in changes in mechanical properties, mineral densities, or mineral properties of canine bone. Sixteen female adult beagle dogs were randomly allocated to receive either human calcitonin at a dose of 0.25 mg/dog (50 IU, n = 8) or vehicle (mannitol, n = 8) every other day for 16 weeks. At the end of the study, the dogs were euthanized. Both tibiae, L1 and L5 vertebrae, and iliac crest bone samples were excised and defleshed. Torsional mechanical properties of tibial diaphyses and compressive strengths of vertebrae were measured. Bone mineral densities (BMD) of tibiae and vertebrae were measured by using dual-energy X-ray absorptiometry. Ultrastructural mineral characteristics of iliac crest bone were determined by gravimetry and Fourier transform infrared spectroscopy (FTIR). Bone histomorphometry was performed in the cortical envelope of the iliac crest. Tibiae from dogs treated with calcitonin withstood significantly less maximum torque until failure, required less torsional energy to reach the maximum torque, and had less torsional stiffness than the tibiae from dogs treated with vehicle (p < 0.05). Cancellous cores of vertebrae from calcitonin-treated dogs withstood less compressive mechanical loading than did vertebral cores from vehicle-treated animals (p < 0.05). Dogs treated with calcitonin had less BMD of both tibiae and vertebrae than vehicle-treated animals (p < 0.05). Bones from calcitonin-treated dogs had significantly less ash content, which correlated with the lower phosphate-to-amide I (detected by FTIR) and greater carbonate-to-phosphate ratios than did bones from vehicle-treated dogs (p < 0.05). Calcitonin-treated dogs exhibited a decrease in bone formation and mineralization rates and an increase in mineralization lag time. These results point to a negative effect of calcitonin on bone quality. These findings are intriguing and call for further studies addressing whether the observed abnormalities are transient or permanent.

Molecular genetics of the apolipoprotein B gene in pigs in relation to atherosclerosis.

Immunologically defined alleles of the pig apolipoprotein B (ApoB) locus (apoB) are correlated with different blood cholesterol levels and predisposition towards premature coronary heart disease. We show here that these alleles are associated with differences in the apoB gene by identifying six restriction fragment length polymorphisms at the pig apoB locus. We have sequenced a 2.4-kb fragment encompassing exons 11 through 14 of one allele, and 7.1 kb from the 3' one-third of exon 26 to about 1 kb past the last exon from another allele. The decoded amino acids of the pig and human ApoB proteins are identical at 70% of these positions. One region close to the C-terminus of the protein is surprisingly different in pigs and humans (57% identity) but the C-terminal region is relatively well conserved (74% identity). Neither of the two putative low-density lipoprotein (LDL) receptor-binding sites is completely conserved in pigs and humans, but identical stretches of amino acids occur near these sites more frequently than in the other sequenced regions. We compare the nucleotide sequences of the region encompassing the putative LDL receptor-binding sites from four pig alleles, including one implicated directly in atherosclerosis. None of the differences appears to account for the hypercholesterolemic phenotype. We conclude that significant differences in the physiology of LDL particles result from changes outside the putative receptor-binding region.