Osseointegration and mechanical stability of pyrocarbon and titanium hand implants in a load-bearing in vivo model for small joint arthroplasty

Purpose: To test the mechanical stability and histologic osseointegration under load-bearing conditions of 2 different materials, pyrocarbon (Py) and titanium (Ti), in a rabbit model. Methods: Proximal interphalangeal implants (9 Ti, 8 Py) were placed into rabbit knees and the animals were killed after 3 months. Subsidence was assessed by monthly x-rays. Mechanical stability was measured with a nondestructive pullout test. Implant osseointegration was evaluated by an analysis of the relative implant-calcified bone contact surface on microradiographs and by a histomorphometric analysis of the percentage of bone and connective tissue contact with the implant surface. Histologic examination included assessment of bone apposition on the basis of fluorochromes. Results: Subsidence was found in all 8 Py implants but in none of the Ti group. All 9 Ti implants were mechanically stable; all 8 Py implants were loose. A significantly higher implant-bone contact was found for the Ti group compared with the Py group. Bone apposition increased with time and was highest for the Ti implants 6 weeks after implantation. Conclusions: In the rabbit model osseointegration of implants was highly dependent on the material. A reliable osseointegration was found for Ti implants. For Py implants no osseointegration or implant stability was achieved. For use of small joints of the hand we therefore recommend Ti-based implants.