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Malaysiana 54(3)(2025): 827-838
http://doi.org/10.17576/jsm-2025-5403-17
The Impact of Diabetes Mellitus on the
Osseointegration of Absorbable Screws: An Animal Experimental Investigation
(Kesan
Diabetes Melitus terhadap Osseointegrasi Skru Boleh Serap: Suatu Penyelidikan
Uji Kaji Haiwan)
1Department of Sports Medicine, The First Affiliated Hospital,
Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key
Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, Guangzhou 510630, China
2Department of Rheumatology and Immunology, Guangdong
Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern
Medical University, Guangzhou 510080, China
3Department of Traditional Chinese Orthopedics and
Traumatology, Center for Orthopaedic Surgery, The
Third Affiliated Hospital of Southern Medical University, Guangzhou 510630,
China
4Department of Orthopedics, The Third Hospital of
Shijiazhuang, Shijiazhuang 050011, China
5Department of Orthopedics, The Affiliated Shunde Hospital of Jinan University, Foshan 528000, China
6The Second Affiliated Hospital of Guangzhou
University of Chinese Medicine (Guangdong Provincial Hospital of Chinese
Medicine), Guangzhou 510120, China
7Department of Psychology, Li Ka Shing Faculty of
Medicine, State Key Laboratory of Brain and Cognitive Sciences, The University
of Hong Kong, Hong Kong SAR 999077, China
8The City University of Hong Kong, Hong Kong SAR
999077, China
9Department of Orthopedics, Foshan Fosun Chancheng Hospital, Foshan 528031, China
10Department of Orthopaedic,
Hainan Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou
University of Chinese Medicine, Affiliated Hospital of Chinese Medicine, Hainan
Medical University, Haikou 570100, China
Diserahkan: 23 September 2024/Diterima:
26 November 2024
Abstract
This study aims to explore the
correlation between alterations in blood glucose levels and the
osseointegration as well as biomechanical properties of nHA/PLLA
absorbable screws, and elucidate the
impact of DM on bone metabolism surrounding nHA/PLLA
absorbable screws. 75 rats were randomly assigned to either the Diabetes
mellitus (DM) group and the control group. DM was induced in rats through
intraperitoneal injection of 1% streptozotocin. A single nHA/PLLA
absorbable screw was surgically implanted into the medial tibia of each rat in
both groups. Rats were euthanized at 4 weeks, 8 weeks and 12 weeks
post-implantation, and tissue specimens were subjected to histological, histomorphological, Micro-CT scan, biomechanical, microindentation mechanical testing of trabeculae bone,
Raman spectroscopy, and Western blot analyses. Changes in bone mass, trabeculae
structure, composition, mechanical properties, and expression of bone
formation-related proteins around the absorbable screws were compared between
the two groups at the microscopic, biomechanical, and molecular levels. The
results show that DM disrupts the trabeculae structure surrounding absorbable
screws, leading to alterations in trabeculae bone composition, diminished
mechanical properties, and impaired bone metabolism. DM significantly
compromises osseointegration at the absorbable screw-bone interface and
diminishes bone quality in the vicinity of the absorbable screw.
Keywords:
Absorbable screw; diabetes mellitus; nHA/PLLA;
osseointegration
Abstrak
Penyelidikan ini bertujuan untuk meneroka korelasi antara perubahan paras glukosa darah dan osseointegrasi serta sifat biomekanikal skru boleh diserap nHA/PLLA dan menjelaskan kesan DM pada metabolisme tulang di sekeliling skru boleh diserap nHA/PLLA. Tujuh puluh lima tikus secara rawak ditandatangani sama ada kepada kumpulan Diabetes melitus (DM) dan kumpulan kawalan. DM telah diinduksi pada tikus melalui suntikan intraperitoneal
1% streptozotocin. Satu skru boleh diserap nHA/PLLA telah ditanam secara pembedahan ke dalam tibia medial setiap tikus dalam kedua-dua kumpulan. Tikus telah dikorbankan pada 4 minggu, 8 minggu dan 12 minggu selepas implantasi dan spesimen tisu tertakluk kepada histopologi, histomorfologi, imbasan Mikro-CT, biomekanikal, ujian mekanikal lekukan mikro tulang trabekula, spektroskopi Raman dan analisis pemblotan Western. Perubahan dalam jisim tulang, struktur trabekula, komposisi, sifat mekanikal dan ekspresi protein berkaitan pembentukan tulang di sekeliling skru yang boleh diserap dibandingkan antara kedua-dua kumpulan pada tahap mikroskopik, biomekanikal dan molekul. Keputusan menunjukkan bahawa DM mengganggu struktur trabekula di sekeliling skru yang boleh diserap yang membawa kepada perubahan dalam komposisi tulang trabekula, sifat mekanikal yang berkurangan dan metabolisme tulang terjejas. DM secara ketara menjejaskan proses osseointegrasi pada antara muka skru boleh serap-tulang dan merendahkan kualiti tulang di sekitar skru tersebut.
Kata kunci: Diabetes melitus; nHA/PLLA; osseointegrasi; skru yang boleh diserap
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*Pengarang untuk surat-menyurat; email: zhengxiaofei12@163.com
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