The efficacy of acrylic acid grafting and arginine-glycine-aspartic acid peptide immobilization on fibrovascular ingrowth into porous polyethylene implants in rabbits

Purpose: To determine the effects of acrylic acid (AA) grafting by argon plasma treatment and of immobilization of arginine-glycine-aspartic acid (RGD) peptides on fibrovascular ingrowth rate into high-density porous polyethylene (HPPE) anophthalmic orbital implants. Materials and methods: Sixty rabbits were divided into three groups, with 20 rabbits in each group: (1) control group, rabbits implanted with unmodified HPPE; (2) PAA group, rabbits implanted with HPPE grafted with poly(AA) by argon plasma treatment; (3) RGD group, rabbits implanted with HPPE grafted with AA by argon plasma treatment and subsequently immobilized with RGD peptide. An HPPE spherical implant was put in the abdominal muscles of rabbit. After implantation for 4 weeks, the retrieved implants were sectioned and stained with hematoxylin and eosin (H&E). Blood vessels were counted using CD-31 immunostaining. Cross-sectional areas of fibrovascular ingrowth, blood vessel densities, and host inflammatory response scores were determined for all three groups. Results: The mean cross-sectional areas of fibrovascularization at 2 and 3 weeks after implantation were the greatest in the RGD group, followed by the PAA group. While minimal fibrovascular ingrowths were noted in all implants at 1 week, all the implants showed nearly complete ingrowth at 4 weeks. Blood vessel densities were the highest in the RGD group, followed by the PAA group at 2, 3, and 4 weeks. The mean inflammation scores of the PAA and RGD groups were less than that of the control group. Conclusion: Fibrovascularization into HPPE implants was enhancedby surface grafting of AA and further improved by immobilizing RGD peptides onto the grafted AA surfaces. The inflammatory reactions were mild by either technique of surface modification.