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0267-6605(94)00009-3
Clinical Materials 16 (1994) 201-210
© 1994 Elsevier Science Limited
Printed in Great Britain. All rights reserved
0267-6605/94/$7.00
Human Osteoblast Response to PTFE Surfaces
W. R. Walsh, * M. Olmedo, H. D. Kim, L. Zou & A.-P. C. Weiss
Department of Orthopaedics, Brown University, Biomechanics Laboratory and Hand-Microsurgical Laboratory,
Rhode Island Hospital, Providence, RI 02903, USA
(Received 6 June 1994; sent for revision 29 July 1994; accepted 19 August 1994)
Abstract: Recently, expanded polytetrafluoroethylene (ePTFE, Gortex) vascular
grafts have been rolled and used for interpositional arthroplasties of the carpus
in the wrist. Little data, however, are available on the response of human osteo-
blasts to ePTFE. In-vitro cell culture is a useful method to determine initial
cell-biomaterial interactions. The present study explores the morphological and
mitogenic response of human bone cells cultured on vascular grade ePTFE
grafts. The present findings suggest that neither the inner nor the outer surface
of ePTFE, in its present form, support osteoblast growth. PTFE may be a suitable
material to act as a space filler for carpal bone interpositional arthroplasties.
INTRODUCTION
Anatomical, clinical, functional and biomechanical
requirements have motivated the development of
biomaterials and prosthetic devices for a number
of soft tissue (vascular, skin, ligament prosthetics)
and hard tissue (total joint replacements, bone sub-
stitutes) applications. A greater understanding of
cell-material surface interactions has become
increasingly important in the development and
modification of existing materials for new clinical
applications. One example involves prosthetic
replacements for bones of the carpus, most com-
monly the trapezium, in the treatment of traumatic
or degenerative disorders of the wrist which has
become an essential component of hand surgery
today.
Biomaterials used for carpal bone replacements
need to provide pain relief and allow normal load
transmission for proper wrist kinematics. Arthro-
plasty of the carpal bones with silicone rubber
implants has been used clinically since 1965.
1
More than 130000 patients in 83 countries have
* To whom correspondence should be addressed at: Centre for
Biomedical Engineering, University of New South Wales, Syd-
ney, NSW 2052, Australia.
201
had silicone implant arthroplasty of carpal bones
with successful pain relief and increased function. I
However, recent long-term studies have demon-
strated failure of silicone carpal bone replacements
and the presence of wear debris, apparently due to
fragmentation from repeated cyclical loading.
1
Sili-
cone has also been implicated as a causative agent
of one type of particular synovitis. Silicone parti-
cles, however, are not affected by the lysosomal
enzymes in a normal macrophage foreign body
giant cell response.
1
The silicone particles may be
'regurgitated' and the unused enzymes released
into the joint space inducing a reactive synovitis.
1
Recently, rolled vascular grafts of expanded poly-
tetrafluoroethylene (ePTFE, Gortex, W. L. Gore
and Assoc. Flagstaff, AZ) have been used clinically
for interpositional arthroplasty of the carpometa-
carpal joint. PTFE has also been successfully
applied as a vascular graft due to its strength, flexi-
bility and bioinertness.' The mechanical properties
and biocompatibility of PTFE may lend itself as
an ideal material for use as carpal bone replace-
ments. The ability of PTFE to function as a carpal
bone replacement requires an understanding of
cell-biomaterial interactions and whether or not
osteoblasts have an affinity to PTFE. Long-term
use of PTFE in this type of arthroplasty may