Postoperative Abstinence Restores Osseointegration Impaired by Ethanol Consumption in a Murine Tibial Implant Model

Background: Alcohol negatively affects bone health and fracture repair, yet its effects on implant osseointegration remain poorly understood. This in vivo study utilized a previously developed murine model to evaluate implant osseointegration before and after continuous ethanol consumption. Methods: Adult mice were given regular drinking water (control group) or 10% to 15% ethanol in their drinking water for 3 months before undergoing surgical implantation of a load-bearing, porous titanium implant in the proximal tibia. Ethanol consumption was continued until euthanasia at 4 weeks post-implantation (ethanol group) or stopped immediately post-implantation (abstinence group) to mimic postoperative ethanol cessation. Osseointegration was assessed using micro-computed tomography (micro-CT), biomechanical pullout testing, and histological analysis. Results: Mice with continuous ethanol consumption exhibited significantly reduced peri-implant bone formation, as measured with histology and micro-CT, compared with controls. Biomechanical testing demonstrated a weaker bone-implant interface in the ethanol group compared with controls. In contrast, postoperative abstinence restored the peri-implant bone formation and bone-implant interface strength to levels similar to those in the control group. Conclusions: Ethanol consumption compromised implant osseointegration in mice, while postoperative abstinence promoted the recovery of peri-implant bone formation and interface strength. Clinical Relevance: Future clinical studies are needed to assess the impact of preoperative and postoperative abstinence of ethanol on osseointegration of orthopaedic implants.