Basic Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2021; 12(4): 214-222
Published online Apr 18, 2021. doi: 10.5312/wjo.v12.i4.214
Osseointegration of porous titanium and tantalum implants in ovariectomized rabbits: A biomechanical study
Stanislav Bondarenko, Volodymyr Filipenko, Michael Karpinsky, Olena Karpinska, Gennadiy Ivanov, Valentyna Maltseva, Ahmed Amine Badnaoui, Ran Schwarzkopf
Stanislav Bondarenko, Volodymyr Filipenko, Ahmed Amine Badnaoui, Department of Joint Pathology, Sytenko Institute of Spine and Joint Pathology, Kharkiv 61124, Ukraine
Michael Karpinsky, Olena Karpinska, Department of Biomechanics, Sytenko Institute of Spine and Joint Pathology, Kharkiv 61124, Ukraine
Gennadiy Ivanov, Department of Experimental Pathology, Sytenko Institute of Spine and Joint Pathology, Kharkiv 61124, Ukraine
Valentyna Maltseva, Morphology of Connective Tissue Department, Sytenko Institute of Spine and Joint Pathology, Kharkiv 61124, Ukraine
Ran Schwarzkopf, Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, Hospital for Joint Diseases, New York, NY 10003, United States
Author contributions: All authors contributed to the study conception and design; Bondarenko S, Maltseva V, and Badnaoui AA wrote the first draft of the manuscript; Filipenko V supervised the study and performed critical revisions of the article; Karpinsky M and Karpinska O analyzed the data; Ivanov G performed experimental surgery, collected, and interpreted data; Schwarzkopf R performed critical revisions of the article; All authors revised and approved the final version of the manuscript.
Institutional review board statement: Sytenko Institute of Spine and Joint Pathology Review board.
Institutional animal care and use committee statement: All applicable national guidelines for the care and use of animals were followed. The in vivo study was approved by the Ethical Clearance Bioethics Committee State Institution “Sytenko Institute of Spine and Joint Pathology NAMS of Ukraine”, Kharkiv, Ukraine (Protocol No. 175 of 26 Feb 2018).
Conflict-of-interest statement: Bondarenko S, Filipenko V, Karpinsky M, Karpinska O, Ivanov G, Maltseva V, and Badnaoui AA declare that they have no conflict of interest. Schwarzkopf R has potential competing interests; he is a paid consultant of Smith & Nephew, Memphis, TN, United States.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Stanislav Bondarenko, DSc, MD, PhD, Associate Professor, Department of Joint Pathology, Sytenko Institute of Spine and Joint Pathology, Pushkinska St. 80, Kharkiv 61124. Ukraine.
Received: September 10, 2020
Peer-review started: September 10, 2020
First decision: January 27, 2021
Revised: February 1, 2021
Accepted: March 11, 2021
Article in press: March 11, 2021
Published online: April 18, 2021

Today, biological fixation of uncemented press-fit acetabular components plays an important role in total hip arthroplasty. Long-term stable fixation of these implants depends on the osseointegration of the acetabular cup bone tissue into the acetabular cup implant, and their ability to withstand functional loads.


To compare the strength of bone-implant osseointegration of four types of porous metal implants in normal and osteoporotic bone in rabbits.


The study was performed in 50 female California rabbits divided into non-ovariectomized (non-OVX) and ovariectomized groups (OVX) at 6 mo of age. Rabbits were sacrificed 8 wk after the implantation of four biomaterials [TTM, CONCELOC, Zimmer Biomet's Trabecular Metal (TANTALUM), and ATLANT] in a 5-mm diameter defect created in the left femur. A biomechanical evaluation of the femur was carried out by testing implant breakout force. The force was gradually increased until complete detachment of the implant from the bone occurred.


The breakout force needed for implant detachment was significantly higher in the non-OVX group, compared with the OVX group for all implants (TANTALUM, 194.7 ± 6.1 N vs 181.3 ± 2.8 N; P = 0.005; CONCELOC, 190.8 ± 3.6 N vs 180.9 ± 6.6 N; P = 0.019; TTM, 186.3 ± 1.8 N vs 172.0 N ± 11.0 N; P = 0.043; and ATLANT, 104.9 ± 7.0 N vs 78.9 N ± 4.5 N; P = 0.001). In the OVX group, The breakout forces in TANTALUM, TTM, and CONCELOC did not differ significantly (P = 0.066). The breakout force for ATLANT in the OVX group was lower by a factor of 2.3 compared with TANTALUM and CONCELOC, and by 2.2 compared with TTM (P = 0.001). In the non-OVX group, the breakout force for ATLANT was significantly different from all other implants, with a reduction in fixation strength by a factor of 1.9 (P = 0.001).


TANTALUM, TTM, and CONCELOC had equal bone-implant osseointegration in healthy and in osteoporotic bone. ATLANT had significantly decreased osseointegration (P = 0.001) in healthy and in osteoporotic bone.

Keywords: Animals, Bone-implant interface, Osteoporosis, Femur, Tantalum, Titanium

Core Tip: In an in vivo model of osteoporosis, it was found that some types of porous acetabular components are more compatible with osteoporotic bone. The study results can help to select the right choice of acetabular components for hip replacement in patients with low bone mass.