Page 370 - Demo

Chapter 14368damage and the confocal laser microscope analysis revealed that the uncoated condyles had a significantly higher surface roughness. In comparison, the coated condyles performed so well that their surface roughness did not differ significantly from a pristine condyle. Whereas chapter 5 evaluated the prosthetic wear, in chapter 6 a quantitative analysis of the inflammatory cell types in the peri-articular tissues was performed, to determine if a SLIM Type I synovitis, SLIM Type VI reaction or chronic inflammation occurred. A comparison was made between both the coated and uncoated system’s tissue samples. To prevent any bias, each tissue sample was blinded and a 20mm² digital grid was projected at five random locations per tissue sample. These five grids were then manually analyzed. A significantly higher number of lymphocytes was found in the peri-articular tissues of both sample groups compared to the control group. This increased number of lymphocytes was more pronounced in the uncoated sample, yet no significant difference was seen between both prosthetic sample groups. Although the coated sample group revealed more macrophages, the difference between both implant types was once again not significant. The criteria for a SLIM Type I synovitis or SLIM Type VI reaction were not met and although there was a higher lymphocyte count, this was still within acceptable bounds and more outspoken in the uncoated samples. Both next chapters focused on the insertion and reattachment of the LPM. In chapter 7, we performed a radiological evaluation of the LPM’s enthesis using a CT scan. Four types of outcomes were found. In four sheep, there was no reconstruction between the implant and the LPM. Three sheep revealed a purely soft tissue connection of 0.5-0.9 mm between the ostectomized bony LPM insertion and the implant’s lattice structure. A combination of partial bony and partial soft tissue enthesis attachment (0.3-0.5 mm) was found in three sheep. A bony ingrowth of the enthesis into the scaffold occurred in two sheep. A secondary bony connection between the mandible and the insertion of the LPM was found in 10 out of 13 sheep. A displacement of the fossa component was seen in 4 sheep, yet no loss of TMJ function was noted in these ewes. Nikolas de Meurechy NW.indd 368 05-06-2024 10:15