In-vivo study of osseointegration in Prestige LP cervical disc prosthesis

Abstract

Background: A study was designed to quantify the extent of porous osseointegration at the prosthesis-bone interface in the Prestige LP prosthesis containing a plasma-sprayed titanium coating. Methods: Using an anterior surgical approach, cervical disc arthroplasty was performed in 8 mature male goats at the C3-C4 segment, followed by implantation of the Prestige LP prosthesis. The vertebral specimens were examined using microcomputed tomograph for histomorphometric quantification, and proceeded by routine paraffin processing for histological observation. Hence, the porous osseointegration at the prosthesis-bone interface was evaluated based on histologic and histomorphometric analyses. Results: At 6 months after surgery, there was no evidence of prosthesis migration, loosening, subsidence, or neurologic or vascular complications. Based on gross histologic analysis, there was excellent porous ingrowth at the prosthesis-bone interface, without significant histopathologic changes. Histomorphometric analysis at the prosthesis-bone interface indicated the mean porous ingrowth of 48.5% ± 10.4% and the total ingrowth range of 36.6 to 59.8%. Conclusions: As the first comprehensive in vivo investigation into the Prestige LP prosthesis, this project established a successful animal model in the evaluation of cervical disc arthroplasty. Moreover, histomorphometric analysis of porous ingrowth at the prosthesis-bone interface was more favorable for cervical disc arthroplasty with the Prestige LP prosthesis compared to historical reports of appendicular total joint arthroplasty.