Article

Direct skeletal attachment of limb prostheses is associated with high
rate of transcutaneous infection and loosening of the fixture in the medullary
canal prompting for careful assessment of various means for enhancing the
skin-device and bone-device interface. The skin and bone integrated pylon system
constitutes a technological platform for different modifications being evaluated
previously. OBJECTIVES: The current study assessed the combination of
nano-treatment skin and bone integrated pylon with its pre-seeding with dermal
fibroblasts. We hypothesized that this combination will enhance cell interaction
with skin and bone integrated pylon compared to nano-treatment and the fibroblast
seeding when done separately. STUDY DESIGN: The feasibility and safety of in-bone
implantation of the skin and bone integrated pylon with nanotubes was
investigated in vitro and in vivo in the animal model.
METHODS: TiO2 nanotubes
were fabricated on the skin and bone integrated pylon, and the fibroblasts taken
from rabbit's skin were cultured on the pylons before implantation. RESULTS: The
in vitro experiments demonstrated higher cellular density in the samples with a
nanotubular surface than in the non-modified pylons used as control. There were
no postoperative complications in any of the animals during the 6-month
observation period. Subsequent scanning electron microscopy of the pylon
extracted from the rabbit's femur showed the stable contact between the pylon and
soft tissues in comparison to control samples where the patchy fibrovascular
ingrowth was detected. CONCLUSION: The promising results prompt further
investigation of the integrative properties of the nanotextured skin and bone
integrated pylon system seeded with dermal fibroblasts and its optimization for
clinical application. CLINICAL RELEVANCE: The study is devoted to the development
of more safe and efficient technology of direct skeletal attachment of limb
prostheses aimed in improving quality of life of people with amputations.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS