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WINGE MI, JOHANSSON CB, RØKKUM M. Biopsies from the Distal Radius after Implantation of Calcium Phosphate Cement. J Hand Surg Asian Pac Vol 2022; 27:852-863. [DOI: 10.1142/s2424835522500837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Calcium Phosphate (CaP) bone cement is gradually replaced by new bone when used as a gap-filler. Details of the re-modelling process are still unclear. Uncertainty is also present as to the possible release of cement particles during the resorption phase causing local soft tissue reactions. The objective of this study was to perform a comprehensive histological investigation of the injectable CaP bone cement used as a void filler in corrective radius osteotomies and adjacent tissue reactions. Methods: Fourteen patients, median age 56 years (18–72), 4 men/10 women, underwent removal of distal radius plates (11 dorsal/3 volar) due to tenosynovitis-like symptoms. Eleven study patients went through corrective osteotomies with CaP bone cement and three were control patients. Previous surgery in three controls consisted in (1) corrective osteotomy with bone graft (dorsal plate), and (2) plated distal radius fractures (1 dorsal/1 volar plate). Biopsies were taken of bone-cement-bone junctions (11), bone-bone graft-bone junctions (1), bone (2) and juxtaposing soft tissue (14). The interval from corrective CaP cement surgery to biopsy was median 1.1 (0.6–2.3) years. Results: Biopsies of bone-cement junctions showed the different stages of new bone formation from CaP to immature bone and later mature well-organised bone. The cement showed signs of osteoclast-mediated resorption. Cement particles, macrophages, multinucleated giant cells (MNGC) and plasma cells were observed in most soft tissue biopsies. MNGC with internalised particles were seen. Macrophages were found along and/or within tendon sheaths in all patients in both groups, but rarely containing cement particles. Conclusions: Gradual re-modelling of the cement into well-organised bone was observed confirming osteoclast–osteoblast coupling. There was no indication that cement particles were the cause of the tenosynovitis-like symptoms.
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Affiliation(s)
- Mona I. WINGE
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carina B. JOHANSSON
- Department of Prosthodontics/Dental Materials Science, University of Gothenburg, Sahlgrenska Academy, Göteborg, Sweden
| | - Magne RØKKUM
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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2
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Rational design and fabrication of monophasic bioceramic microspheres with enhanced mechanical and biological performances in reconstruction of segmental bone defect. Med Biol Eng Comput 2022; 60:1691-1703. [DOI: 10.1007/s11517-022-02571-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
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3
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Zhang H, Hu Y, Chen X, Wang S, Cao L, Dong S, Shi Z, Chen Y, Xiong L, Zhang Y, Zhang D, Yu B, Chen W, Wang Q, Tong P, Liu X, Zhang J, Zhou Q, Niu F, Yang W, Zhang W, Wang Y, Chen S, Jia J, Yang Q, Zhang P, Zhang Y, Miao J, Sun K, Shen T, Yu B, Yang L, Zhang L, Wang D, Liu G, Zhang Y, Su J. Expert consensus on the bone repair strategy for osteoporotic fractures in China. Front Endocrinol (Lausanne) 2022; 13:989648. [PMID: 36387842 PMCID: PMC9643410 DOI: 10.3389/fendo.2022.989648] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
Osteoporotic fractures, also known as fragility fractures, are prevalent in the elderly and bring tremendous social burdens. Poor bone quality, weak repair capacity, instability, and high failure rate of internal fixation are main characteristics of osteoporotic fractures. Osteoporotic bone defects are common and need to be repaired by appropriate materials. Proximal humerus, distal radius, tibia plateau, calcaneus, and spine are common osteoporotic fractures with bone defect. Here, the consensus from the Osteoporosis Group of Chinese Orthopaedic Association concentrates on the epidemiology, characters, and management strategies of common osteoporotic fractures with bone defect to standardize clinical practice in bone repair of osteoporotic fractures.
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Affiliation(s)
- Hao Zhang
- Institute of Translational Medicine, Shanghai University, Shanghai, China
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yan Hu
- Institute of Translational Medicine, Shanghai University, Shanghai, China
| | - Xiao Chen
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Sicheng Wang
- Department of Orthopedics, Shanghai Zhongye Hospital, Shanghai, China
| | - Liehu Cao
- Department of Orthopedics, Shanghai Baoshan Luodian Hospital, Shanghai, China
| | - Shiwu Dong
- Department of Biomedical Materials Science, Army Medical University, Chongqing, China
| | - Zhongmin Shi
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yanxi Chen
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liming Xiong
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunfei Zhang
- Tangdu Hospital, Air Force Medical University, Xi'an, China
| | | | - Baoqing Yu
- Department of Orthopedics, Shanghai Pudong Hospital, Shanghai, China
| | - Wenming Chen
- Institute of Biomedical Engineering, Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Qining Wang
- Department of Advanced Manufacturing and Robotics, College of Engineering, Peking University, Beijing, China
| | - Peijian Tong
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ximing Liu
- Department of Orthopedics, General Hospital of Central Theater Command, Wuhan, China
| | - Jianzheng Zhang
- Department of Orthopedic Surgery, People's Liberation Army (PLA), Army General Hospital, Beijing, China
| | - Qiang Zhou
- Department of Orthopedics, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Niu
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Weiguo Yang
- Li Ka Shing Faculty of Medicine, Hongkong University, Hong Kong, Hong Kong SAR, China
| | - Wencai Zhang
- Department of Orthopedics, The Third Affiliated Hospital of Guangzhou University of Traditional Chinese medicine (TCM), Guangzhou, China
| | - Yong Wang
- Department of Orthopedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
| | - Shijie Chen
- Department of Orthopedics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jinpeng Jia
- Department of Orthopedics, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Qiang Yang
- Department of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Peng Zhang
- Department of Orthopedics, Shandong Province Hospital, Jinan, China
| | - Yong Zhang
- Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Jun Miao
- Department of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Kuo Sun
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Shen
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Bin Yu
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China
| | - Lei Yang
- Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lei Zhang
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dongliang Wang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
| | - Guohui Liu
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
| | - Yingze Zhang
- Department of Orthopedics, Third Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
| | - Jiacan Su
- Institute of Translational Medicine, Shanghai University, Shanghai, China
- Changhai Hospital, Naval Medical University, Shanghai, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
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4
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Fuchs A, Kreczy D, Brückner T, Gbureck U, Stahlhut P, Bengel M, Hoess A, Nies B, Bator J, Klammert U, Linz C, Ewald A. Bone regeneration capacity of newly developed spherical magnesium phosphate cement granules. Clin Oral Investig 2021; 26:2619-2633. [PMID: 34686919 PMCID: PMC8898248 DOI: 10.1007/s00784-021-04231-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/13/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Magnesium phosphate-based cements begin to catch more attention as bone substitute materials and especially as alternatives for the more commonly used calcium phosphates. In bone substitutes for augmentation purposes, atraumatic materials with good biocompatibility and resorbability are favorable. In the current study, we describe the in vivo testing of novel bone augmentation materials in form of spherical granules based on a calcium-doped magnesium phosphate (CaMgP) cement. MATERIALS AND METHODS Granules with diameters between 500 and 710 μm were fabricated via the emulsification of CaMgP cement pastes in a lipophilic liquid. As basic material, two different CaMgP formulations were used. The obtained granules were implanted into drill hole defects at the distal femoral condyle of 27 New Zealand white rabbits for 6 and 12 weeks. After explantation, the femora were examined via X-ray diffraction analysis, histological staining, radiological examination, and EDX measurement. RESULTS Both granule types display excellent biocompatibility without any signs of inflammation and allow for proper bone healing without the interposition of connective tissue. CaMgP granules show a fast and continuous degradation and enable fully adequate bone regeneration. CONCLUSIONS Due to their biocompatibility, their degradation behavior, and their completely spherical morphology, these CaMgP granules present a promising bone substitute material for bone augmentation procedures, especially in sensitive areas. CLINICAL RELEVANCE The mostly insufficient local bone supply after tooth extractions complicates prosthetic dental restoration or makes it even impossible. Therefore, bone augmentation procedures are oftentimes inevitable. Spherical CaMgP granules may represent a valuable bone replacement material in many situations.
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Affiliation(s)
- Andreas Fuchs
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | - Dorothea Kreczy
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Theresa Brückner
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Philipp Stahlhut
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Melanie Bengel
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Andreas Hoess
- INNOTERE GmbH, Meissner Strasse 191, 01445, Radebeul, Germany
| | - Berthold Nies
- INNOTERE GmbH, Meissner Strasse 191, 01445, Radebeul, Germany
| | - Julia Bator
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Uwe Klammert
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Christian Linz
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Andrea Ewald
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
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5
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Fabrication of Drug-Loaded Calcium Phosphate Nanoparticles: An Investigation of Microbial Toxicity. J CLUST SCI 2021. [DOI: 10.1007/s10876-021-02104-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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Gao J, Su Y, Qin YX. Calcium phosphate coatings enhance biocompatibility and degradation resistance of magnesium alloy: Correlating in vitro and in vivo studies. Bioact Mater 2021; 6:1223-1229. [PMID: 33210020 PMCID: PMC7653207 DOI: 10.1016/j.bioactmat.2020.10.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/24/2022] Open
Abstract
Magnesium (Mg) and its alloys are promising biodegradable materials for orthopedic applications. However, one of the major problems is their rapid degradation rate with quick evolution of hydrogen gas. To overcome this problem, calcium phosphate (CaP) coatings have been used to improve the degradation resistance and the biocompatibility of Mg materials. This study focuses on the comparison and correlation of the in vitro and in vivo degradation and biocompatibility behaviors of these materials. A CaP coating consisting of dicalcium phosphate dihydrate (DCPD) was deposited on an AZ60 Mg alloy by the chemical conversion method. Then, the in vitro degradation testing including electrochemical and immersion tests, and in vivo implantation of the CaP coated Mg alloy were conducted to compare the degradation behaviors. Next, the in vitro cell behavior and in vivo bone tissue response were also compared on both uncoated and CaP-coated Mg samples. Data showed that the CaP coating provided the Mg alloy with significantly better biodegradation behavior and biocompatibility. The in vitro and in vivo biocompatibility tests exhibited good consistency while not the case for biodegradation. Results showed that the in vitro electrochemical test could be a quick screening tool for the biodegradation rate, while the in vitro immersion degradation rate was often 2-4 folds faster than the in vivo degradation rate.
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Affiliation(s)
- Julia Gao
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794, United States
| | - Yingchao Su
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794, United States
| | - Yi-Xian Qin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794, United States
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7
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Yousefi AM. A review of calcium phosphate cements and acrylic bone cements as injectable materials for bone repair and implant fixation. J Appl Biomater Funct Mater 2020; 17:2280800019872594. [PMID: 31718388 DOI: 10.1177/2280800019872594] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Treatment of bone defects caused by trauma or disease is a major burden on human healthcare systems. Although autologous bone grafts are considered as the gold standard, they are limited in availability and are associated with post-operative complications. Minimally invasive alternatives using injectable bone cements are currently used in certain clinical procedures, such as vertebroplasty and balloon kyphoplasty. Nevertheless, given the high incidence of fractures and pathologies that result in bone voids, there is an unmet need for injectable materials with desired properties for minimally invasive procedures. This paper provides an overview of the most common injectable bone cement materials for clinical use. The emphasis has been placed on calcium phosphate cements and acrylic bone cements, while enabling the readers to compare the opportunities and challenges for these two classes of bone cements. This paper also briefly reviews antibiotic-loaded bone cements used in bone repair and implant fixation, including their efficacy and cost for healthcare systems. A summary of the current challenges and recommendations for future directions has been brought in the concluding section of this paper.
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Affiliation(s)
- Azizeh-Mitra Yousefi
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, OH, USA
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8
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Hoellwarth JS, Al Muderis M, Rozbruch SR. Cementing Osseointegration Implants Results in Loosening: Case Report and Review of Literature. Cureus 2020; 12:e7066. [PMID: 32226668 PMCID: PMC7089626 DOI: 10.7759/cureus.7066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022] Open
Abstract
Skeletal transcutaneous osseointegration was performed on a 54-year-old female transfemoral amputee. None of the available osseointegration implants achieved press-fit stability, so an implant was cemented in position. Although initially stable, by six months the patient reported painful loading and radiographs revealed cement mantle lucency. The osseointegration implant was removed, antibiotics were delivered via implanted spacer and intravenously, and revision osseointegration three months later achieved appropriate immediate press-fit stability. Cemented transcutaneous osseointegration implants loosen within one year. Osseointegration is only successful when bone grows directly onto the implant.
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Affiliation(s)
| | - Munjed Al Muderis
- Orthopaedic Surgery, Macquarie University Hospital, Macquarie Park, AUS
| | - S Robert Rozbruch
- Limb Salvage and Amputation Reconstruction Center, Hospital for Special Surgery, New York, USA
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9
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De Gendt EEA, Kuperus JS, Foppen W, Oner FC, Verlaan JJ. Clinical, radiological, and patient-reported outcomes 13 years after pedicle screw fixation with balloon-assisted endplate reduction and cement injection. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:914-921. [PMID: 32036427 DOI: 10.1007/s00586-020-06321-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/03/2020] [Accepted: 01/25/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE In management of traumatic thoracolumbar burst fractures, short-segment pedicle screw fixation with balloon-assisted endplate reduction (BAER) and cement injection is a safe, feasible, and effective technique to maintain radiological alignment with minimum spinal segments involved. However, 20% of patients report daily discomfort despite good spinal alignment and fusion after this technique. This study provides clinical, radiological, and patient-reported outcomes after a minimum 13 years of follow-up. METHODS Eighteen patients were invited at the outpatient clinic for clinical/radiological examinations. The cohort (originally 20 patients) was treated 13-14 years earlier with pedicle screw fixation, BAER, and cement injection for traumatic thoracolumbar burst fractures. Patient-reported outcome measures were obtained at time of examinations. Current data were compared with data obtained at 6 years of follow-up. RESULTS Seventeen patients (median age 50; range 32-80) cooperated. No/minimal back pain was reported by 15 patients, and 12 patients returned to their previous heavy labor work. Median visual analog score of health (80%; 50-100%) was similar to results at 6 years (80%; 60-100% p = 0.259). An Oswestry Disability Index score of less than 20% (reflecting minimal disability) was reported by 14 patients, compared with 15 patients at 6 years of follow-up. No significant differences were found in wedge or Cobb angle between the time points. Intravertebral cement resorption was not observed. CONCLUSION Results from this study suggest that, 13 years after pedicle screw fixation with BAER and cement injection for traumatic thoracolumbar burst fractures, functional performance, pain and radiological outcomes of the current cohort were stable or had slightly improved. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Erin E A De Gendt
- Department of Orthopedics, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, The Netherlands.
| | - Jonneke S Kuperus
- Department of Orthopedics, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, The Netherlands
| | - Wouter Foppen
- Department of Radiology, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, The Netherlands
| | - F Cumhur Oner
- Department of Orthopedics, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, The Netherlands
| | - Jorrit-Jan Verlaan
- Department of Orthopedics, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, The Netherlands.
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Brückner T, Meininger M, Groll J, Kübler AC, Gbureck U. Magnesium Phosphate Cement as Mineral Bone Adhesive. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E3819. [PMID: 31766321 PMCID: PMC6926875 DOI: 10.3390/ma12233819] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022]
Abstract
Mineral bone cements were actually not developed for their application as bone-bonding agents, but as bone void fillers. In particular, calcium phosphate cements (CPC) are considered to be unsuitable for that application, particularly under moist conditions. Here, we showed the ex vivo ability of different magnesium phosphate cements (MPC) to adhere on bovine cortical bone substrates. The cements were obtained from a mixture of farringtonite (Mg3(PO4)2) with different amounts of phytic acid (C6H18O24P6, inositol hexaphosphate, IP6), whereas cement setting occurred by a chelation reaction between Mg2+ ions and IP6. We were able to show that cements with 25% IP6 and a powder-to-liquid ratio (PLR) of 2.0 g/mL resulted in shear strengths of 0.81 ± 0.12 MPa on bone even after 7 d storage in aqueous conditions. The samples showed a mixed adhesive-cohesive failure with cement residues on the bone surface as indicated by scanning electron microscopy and energy-dispersive X-ray analysis. The presented material demonstrated appropriate bonding characteristics, which could enable a broadening of the mineral bone cements' application field to bone adhesives.
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Affiliation(s)
- Theresa Brückner
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
| | - Markus Meininger
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
| | - Jürgen Groll
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
| | - Alexander C. Kübler
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany;
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
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11
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Percutaneous injection of calcium phosphate composite in pediatric unicameral bone cysts: a minimum 5-year follow-up study. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-018-0513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Pourdanesh F, Latifi N, Latifi F. Complications after craniofacial reconstruction with calcium phosphate cements: a case report and review of the literature. J Korean Assoc Oral Maxillofac Surg 2018; 44:207-211. [PMID: 30402411 PMCID: PMC6209695 DOI: 10.5125/jkaoms.2018.44.5.207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/31/2018] [Accepted: 02/12/2018] [Indexed: 11/27/2022] Open
Abstract
Among different graft materials for craniofacial reconstruction, calcium phosphate cements have the advantages of alloplastic grafts and wide use. The authors report a case of foreign body reaction following frontal reconstruction with JectOS (an injectable calcium orthophosphate cement; Kasios) and reviewed the literature on complications of this material after craniofacial reconstruction from 2002 to 2017. Complications were categorized into two groups: immunologic reactions (consisting of seroma collection, chronic sinus mucosa swelling, and foreign body reaction) and non-immune events (infection, fragmentation, and ejection). It is wise to use calcium phosphate-based material only in selected cases with small defects, and long-term follow-up is needed to observe their consequences.
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Affiliation(s)
- Fereydoun Pourdanesh
- Department of Oral and Maxillofacial Surgery, Taleghani Hospital, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noorahmad Latifi
- Department of Plastic and Reconstructive Surgery, Hazrate Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Latifi
- Department of Oral and Maxillofacial Surgery, Taleghani Hospital, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Sato T, Shirosaki Y, Nagaya M, Asano Y, Nakano K, Nagashima H, Aizawa M, Kikuchi M. Preparation of anti-decay self-setting pastes of hydroxyapatite/collagen utilizing (3-glycidoxypropyl)trimethoxysilane. JOURNAL OF ASIAN CERAMIC SOCIETIES 2018; 6:322-331. [DOI: 10.1080/21870764.2018.1517712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Affiliation(s)
- Taira Sato
- Department of Applied Chemistry, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Yuki Shirosaki
- Department of Materials Science, Faculty of Engineering, Kyushu Institute of Technology, Fukuoka, Japan
| | - Masaki Nagaya
- Meiji University International Institute for Bio-Resource Research, Meiji University, Kawasaki, Japan
| | - Yoshinori Asano
- Department of Life Sciences, School of Agriculture, Meiji University, Kawasaki, Japan
| | - Kazuaki Nakano
- Department of Life Sciences, School of Agriculture, Meiji University, Kawasaki, Japan
| | - Hiroshi Nagashima
- Meiji University International Institute for Bio-Resource Research, Meiji University, Kawasaki, Japan
- Department of Life Sciences, School of Agriculture, Meiji University, Kawasaki, Japan
| | - Mamoru Aizawa
- Department of Applied Chemistry, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Masanori Kikuchi
- Bioceramics Group, National Institute for Materials Science, Tsukuba, Japan
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15
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Zalzal P, Safir O, Alhalawani A, Papini M, Towler M. Percutaneous upper extremity fracture fixation using a novel glass-based adhesive. J Orthop 2018; 15:67-69. [PMID: 29657441 DOI: 10.1016/j.jor.2018.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 01/14/2018] [Indexed: 10/18/2022] Open
Abstract
Objective To develop a surgical technique for percutaneous upper extremity fracture fixation using a novel glass-based adhesive. Methods Three intact upper extremity cadaveric specimens with undisturbed soft tissues were obtained. Two were used to model a wrist fracture, and the third to model a proximal humerus fracture. Fractures were produced using a small osteotome in a percutaneous fashion. Banna Bone Adhesive (BBA) was delivered to the fracture site percutaneously using a 16 gauge needle under bi-planar fluoroscopic guidance. After setting of the adhesive, the specimens were dissected to qualitatively assess BBA delivery and placement. Results The adhesive could readily be delivered through the 16 gauge needle with an appropriate amount of pressure applied to the syringe. Using the fluoroscope, the adhesive could be seen to flow into the fracture site with minimal extravagation into the surrounding soft tissues. Successful bonding of the fracture fragments was observed. Conclusions Percutaneous delivery of BBA into a fracture of the distal radius and proximal humerus may be a feasible fracture fixation technique. Biomechanical testing and animal model testing are required to further develop this procedure.
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Affiliation(s)
- Paul Zalzal
- Oakville Trafalgar Memorial Hospital, Oakville, L6J 3L7, Ontario, Canada
| | - Oleg Safir
- Mount Sinai Hospital, Toronto, M5G 1X5, Ontario, Canada
| | - Adel Alhalawani
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, M5B 2K3, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, M5B 1W8, Ontario, Canada
| | - Marcello Papini
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, M5B 2K3, Ontario, Canada
| | - Mark Towler
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, M5B 2K3, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, M5B 1W8, Ontario, Canada
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16
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Self-Setting Calcium Orthophosphate (CaPO4) Formulations. SPRINGER SERIES IN BIOMATERIALS SCIENCE AND ENGINEERING 2018. [DOI: 10.1007/978-981-10-5975-9_2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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17
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Lodoso-Torrecilla I, van Gestel NAP, Diaz-Gomez L, Grosfeld EC, Laperre K, Wolke JGC, Smith BT, Arts JJ, Mikos AG, Jansen JA, Hofmann S, van den Beucken JJJP. Multimodal pore formation in calcium phosphate cements. J Biomed Mater Res A 2017; 106:500-509. [PMID: 28940662 DOI: 10.1002/jbm.a.36245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/08/2017] [Accepted: 09/21/2017] [Indexed: 01/05/2023]
Abstract
Calcium phosphate cements (CPCs) are commonly used as bone substitute materials. However, their slow degradation rate and lack of macroporosity hinders new bone formation. Poly(dl-lactic-co-glycolic acid) (PLGA) incorporation is of great interest as, upon degradation, produces acidic by-products that enhance CPC degradation. Yet, new bone formation is delayed until PLGA degradation occurs a few weeks after implantation. Therefore, the aim of this study was to accelerate the early stage pore formation within CPCs in vitro. With that purpose, we incorporated the water-soluble porogen sucrose at different weight percentages (10 or 20 wt %) to CPC and CPC/PLGA composites. The results revealed that incorporation of sucrose porogens increased mass loss within the first week of in vitro degradation in groups containing sucrose compared to control groups. After week 1, a further mass loss was observed related to PLGA and CPC degradation. Macroporosity analysis confirmed that macroporosity formation is influenced by the dissolution of sucrose at an early stage and by the degradation of PLGA and CPC at a later stage. We concluded that the combination of sucrose and PLGA porogens in CPC is a promising approach to promote early stage bone tissue ingrowth and complete replacement of CPC through multimodal pore formation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 500-509, 2018.
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Affiliation(s)
| | - Nicole A P van Gestel
- Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Luis Diaz-Gomez
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Department of Bioengineering, Rice University, Houston, Texas, 77030
| | | | | | - Joop G C Wolke
- Department of Biomaterials, Radboudumc, Nijmegen, The Netherlands
| | - Brandon T Smith
- Department of Bioengineering, Rice University, Houston, Texas, 77030
| | - Jacobus J Arts
- Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, Houston, Texas, 77030.,Department of Chemical and Biomolecular Engineering, Rice University, Houston, Texas, 77005
| | - John A Jansen
- Department of Biomaterials, Radboudumc, Nijmegen, The Netherlands
| | - Sandra Hofmann
- Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Biomechanics, Swiss Federal Institute of Technology Zürich (ETHZ), Zürich, Switzerland
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18
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Kitzen J, Schotanus MGM, Plasschaert HSW, Hulsmans FJH, Tilman PBJ. Treatment of thoracic or lumbar burst fractures with Balloon Assisted Endplate Reduction using Tricalcium Phosphate cement: histological and radiological evaluation. BMC Musculoskelet Disord 2017; 18:411. [PMID: 29017495 PMCID: PMC5635504 DOI: 10.1186/s12891-017-1770-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 10/03/2017] [Indexed: 11/18/2022] Open
Abstract
Background Short-segment pedicle-screw instrumentation is frequently used to stabilize thoracolumbar burst fractures. A recognized disadvantage of this procedure is recurrent kyphosis from intervertebral disc creep into the fractured central endplate. Balloon Assisted Endplate Reduction (BAER) using Tricalcium Phosphate bone cement (TCP) enables elevation of the centrally depressed endplate. Our objective was to evaluate the bone-tissue response to TCP and to analyse whether BAER using TCP can prevent recurrent kyphosis after removal of the instrumentation. Methods Fourteen patients with traumatic thoracolumbar burst fractures were operated with BAER using TCP in combination with short-segment instrumentation. Nine months after surgery, instrumentation was removed and transpedicular biopsies were taken for histological and histochemical analysis. Roentgenograms pre- and postoperatively and at latest follow-up after removal of the instrumentation were evaluated. Results Average follow-up was 2.6 years. Analysis of the biopsies showed a variable degree of bone remodelling with incorporation of TCP into newly formed bone matrix. No extensive foreign body reactions, inflammation, granulomatous responses or tissue necrosis were observed. Wedge-angle, kyphosis-angle and both the anterior-posterior and central-posterior vertebral body height ratios improved significant postoperatively (p < 0.001). After removal of the instrumentation no significant differences in wedge-angle or height ratios were seen (p = 0.12). The kyphosis-angle increased four degrees (p = 0.01). Conclusion TCP showed good histological osseointegration with no adverse events. TCP can therefore be safely used and could be beneficial in treatment of thoracolumbar burst fractures. BAER with TCP in combination with short-segment instrumentation might reduce recurrence of deformity even after removal of the instrumentation in comparison to short-segment instrumentation alone. Trial registration This study is registered at the at the Dutch Trial Registry (NTR3498).
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Affiliation(s)
- Joep Kitzen
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Postbus 5500, 6130 MB, Sittard-Geleen, the Netherlands.
| | - Martijn G M Schotanus
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Postbus 5500, 6130 MB, Sittard-Geleen, the Netherlands
| | | | - Frans-Jan H Hulsmans
- Department of Radiology, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| | - Pieter B J Tilman
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Postbus 5500, 6130 MB, Sittard-Geleen, the Netherlands
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19
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Murray KA, Collins MN, O'Sullivan RP, Ren G, Devine DM, Murphy A, Sadło J, O'Sullivan C, McEvoy B, Vrain O, O'Neill C, Insley G. Influence of gamma and electron beam sterilization on the stability of a premixed injectable calcium phosphate cement for trauma indications. J Mech Behav Biomed Mater 2017; 77:116-124. [PMID: 28898722 DOI: 10.1016/j.jmbbm.2017.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/31/2017] [Accepted: 09/03/2017] [Indexed: 11/29/2022]
Abstract
Premixed calcium phosphate cements (CPC's) are becoming the material of choice for injectable cements as a result of their effective delivery to the target implantation site. For orthopaedic use, it is of vital importance that the attributes of these CPC's are not compromised by irradiation sterilization. Therefore, the aim of this study is to determine the influence of irradiation sterilization on a range of premixed CPC's, with an emphasis on improving product shelf life through the use of optimal packaging configurations and annealing steps. Electron spin resonance (ESR) confirmed the presence of free radicals in the inorganic phase of the CPC paste following irradiation. The inclusion of a 24-h annealing step was the only successful method in reducing the degree of free radical formation. Based on the results of injectability force testing, it was revealed that an annealing step greater than 24-h significantly altered the viscosity, however; at 24-h the key attributes of the CPC paste were minimally effected. Overall, it was established that vacuum packing the CPC paste, placing the contents into a foil pouch, gamma irradiating at the minimal dose required and using an annealing step of ≤ 24-h, has the potential to extend the shelf life of the cement.
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Affiliation(s)
- Kieran A Murray
- CelgenTek Limited (part of the Zimmer Biomet group), Unit 4D, Western Business Park, Shannon, Co. Clare, Ireland.
| | - Maurice N Collins
- Stokes Laboratories, Bernal Institute, University of Limerick, Ireland.
| | | | - Guang Ren
- Stokes Laboratories, Bernal Institute, University of Limerick, Ireland.
| | - Declan M Devine
- Materials Research Institute, Athlone Institute of Technology, Dublin Road, Athlone, Co. Westmeath, Ireland.
| | - Alan Murphy
- Materials Research Institute, Athlone Institute of Technology, Dublin Road, Athlone, Co. Westmeath, Ireland.
| | - Jarosław Sadło
- Institute of Nuclear Chemistry and Technology, Dorodna 16, 03-195 Warsaw, Poland.
| | - Carol O'Sullivan
- CelgenTek Limited (part of the Zimmer Biomet group), Unit 4D, Western Business Park, Shannon, Co. Clare, Ireland.
| | - Brian McEvoy
- STERIS Applied Sterilization Technologies, IDA Business & Technology Park, Tullamore, Co. Offaly, Ireland.
| | - Olivier Vrain
- STERIS Applied Sterilization Technologies, IDA Business & Technology Park, Tullamore, Co. Offaly, Ireland.
| | - Cathriona O'Neill
- Bemis Healthcare Packaging, Kilbeggan Road, Clara, Co. Offaly, Ireland.
| | - Gerard Insley
- CelgenTek Limited (part of the Zimmer Biomet group), Unit 4D, Western Business Park, Shannon, Co. Clare, Ireland.
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20
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Qin T, Han Y, Zhang P, Hassan Wani I, Nikolajeff F, Leifer K, Engqvist H. Template-free synthesis of phosphate-based spheres via modified supersaturated phosphate buffer solutions. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:99. [PMID: 28534282 DOI: 10.1007/s10856-017-5911-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/05/2017] [Indexed: 06/07/2023]
Abstract
Modified supersaturated phosphate buffer solutions were used to synthesize phosphate-based spheres, including calcium phosphate (CaP), strontium phosphate (SrP) and barium phosphate (BaP). A series of ions concentrations in the modified phosphate buffer solutions were investigated in order to study their effects in precipitates morphologies. During synthesis, it was found that magnesium was the key factor in sphere formation. The morphologies of calcium phosphate, strontium phosphate and barium phosphate precipitates varied as the concentration of magnesium ions varied. When sufficient magnesium was provided, the precipitates appeared spherical, and the diameter was in range of 0.5-2 μm. The morphologies, compositions and structure of spheres were characterized by x-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and N2 adsorption analysis. Moreover, the application of magnesium substituted calcium phosphate spheres in dentin tubules occlusion was investigated.
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Affiliation(s)
- Tao Qin
- The Division for Applied Material Science, Department of Engineering Science, Uppsala University, Ångströmlaboratoriet, Lägerhyddsvägen 1,752 37, Uppsala, Sweden.
| | - Yuanyuan Han
- The Division for Applied Material Science, Department of Engineering Science, Uppsala University, Ångströmlaboratoriet, Lägerhyddsvägen 1,752 37, Uppsala, Sweden
| | - Peng Zhang
- The Division for Nanotechnology and Functional Materials, Department of Engineering Science, Uppsala University, Ångströmlaboratoriet, Lägerhyddsvägen 1,752 37, Uppsala, Sweden
| | - Ishtiaq Hassan Wani
- The Division for Applied Material Science, Department of Engineering Science, Uppsala University, Ångströmlaboratoriet, Lägerhyddsvägen 1,752 37, Uppsala, Sweden
| | - Fredrik Nikolajeff
- The Division for Applied Material Science, Department of Engineering Science, Uppsala University, Ångströmlaboratoriet, Lägerhyddsvägen 1,752 37, Uppsala, Sweden
| | - Klaus Leifer
- The Division for Applied Material Science, Department of Engineering Science, Uppsala University, Ångströmlaboratoriet, Lägerhyddsvägen 1,752 37, Uppsala, Sweden
| | - Håkan Engqvist
- The Division for Applied Material Science, Department of Engineering Science, Uppsala University, Ångströmlaboratoriet, Lägerhyddsvägen 1,752 37, Uppsala, Sweden
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21
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Strazic Geljic I, Melis N, Boukhechba F, Schaub S, Mellier C, Janvier P, Laugier J, Bouler J, Verron E, Scimeca J. Gallium enhances reconstructive properties of a calcium phosphate bone biomaterial. J Tissue Eng Regen Med 2017; 12:e854-e866. [DOI: 10.1002/term.2396] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 12/20/2016] [Accepted: 01/09/2017] [Indexed: 01/17/2023]
Affiliation(s)
- Ivana Strazic Geljic
- Université Nice Sophia AntipolisCNRS, Inserm, iBV Nice France
- GRAFTYS SA Aix en Provence France
| | - Nicolas Melis
- Université Nice Sophia AntipolisCNRS, Inserm, iBV Nice France
| | - Florian Boukhechba
- Université Nice Sophia AntipolisCNRS, Inserm, iBV Nice France
- GRAFTYS SA Aix en Provence France
| | | | | | | | | | | | - Elise Verron
- LIOADUniversité de Nantes Inserm UMR791 BP84215 Nantes France
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22
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Yamamoto S, Matsushima Y, Kanayama Y, Seki A, Honda H, Unuma H, Sakai Y. Effect of the up-front heat treatment of gelatin particles dispersed in calcium phosphate cements on the in vivo material resorption and concomitant bone formation. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:48. [PMID: 28176192 DOI: 10.1007/s10856-017-5861-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/30/2017] [Indexed: 06/06/2023]
Abstract
Calcium phosphate cements (CPCs), consisting of a mixture of calcium phosphate powders and setting liquid, have been widely used in orthopedic applications. One of the drawbacks of CPCs is their poor resorbability in the living body, which hinders substitution with natural bones. One of the strategies to facilitate the resorption of CPCs is the incorporation of bioresorbable or water-soluble pore-generating particles (porogens), such as gelatin, in the CPC matrices. In spite of numerous reports, however, little is known about the effect of the dissolution/resorption rate of the porogens on concomitant bone regeneration. In the present study, we prepared preset CPCs dispersed with 10 mass% of low-endotoxin gelatin particles 200-500 μm in diameter having different heat-treatment histories, therefore exhibiting different dissolution rate, and then the obtained CPC/gelatin composites were evaluated for in vivo resorption and concomitant in vivo bone formation behaviors. As the results, the dispersion of gelatin particles markedly promoted in vivo resorption of CPC, and enhanced concomitant bone formation, connective tissue formation, osteoblast proliferation, and vascularization. The dissolution/resorption rate was able to be controlled by changing the up-front heat-treatment temperature. In particular, when CPC/gelatin composites were implanted in distal metaphysis of rabbits, the optimum dissolution/resorption was attained by heat-treating gelatin particles at 383 K for 24 h before dispersing in CPC. Quick resorption of calcium phosphate cement and concomitant bone formation by dispersing properly heat-treated with gelatin particles.
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Affiliation(s)
- Shoko Yamamoto
- Central Research Laboratory, Jellice Co., Ltd., 4-4-1 Sakae, Tagajo, 985-0833, Japan
| | - Yuta Matsushima
- Graduate School of Science and Engineering, Yamagata University, 4-3-16 Jonan, Yonezawa, 992-8510, Japan
| | - Yoshitaka Kanayama
- Central Research Laboratory, Jellice Co., Ltd., 4-4-1 Sakae, Tagajo, 985-0833, Japan
| | - Azusa Seki
- Tsukuba Research Center, Hamri Co., Ltd., 2638-2 Ozaki, Koga, 306-0101, Japan
| | - Haruya Honda
- Tsukuba Research Center, Hamri Co., Ltd., 2638-2 Ozaki, Koga, 306-0101, Japan
| | - Hidero Unuma
- Graduate School of Science and Engineering, Yamagata University, 4-3-16 Jonan, Yonezawa, 992-8510, Japan.
| | - Yasuo Sakai
- Central Research Laboratory, Jellice Co., Ltd., 4-4-1 Sakae, Tagajo, 985-0833, Japan
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23
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O'Neill R, McCarthy HO, Montufar EB, Ginebra MP, Wilson DI, Lennon A, Dunne N. Critical review: Injectability of calcium phosphate pastes and cements. Acta Biomater 2017; 50:1-19. [PMID: 27838464 DOI: 10.1016/j.actbio.2016.11.019] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 11/03/2016] [Accepted: 11/08/2016] [Indexed: 12/26/2022]
Abstract
Calcium phosphate cements (CPC) have seen clinical success in many dental and orthopaedic applications in recent years. The properties of CPC essential for clinical success are reviewed in this article, which includes properties of the set cement (e.g. bioresorbability, biocompatibility, porosity and mechanical properties) and unset cement (e.g. setting time, cohesion, flow properties and ease of delivery to the surgical site). Emphasis is on the delivery of calcium phosphate (CaP) pastes and CPC, in particular the occurrence of separation of the liquid and solid components of the pastes and cements during injection; and established methods to reduce this phase separation. In addition a review of phase separation mechanisms observed during the extrusion of other biphasic paste systems and the theoretical models used to describe these mechanisms are discussed. STATEMENT OF SIGNIFICANCE Occurrence of phase separation of calcium phosphate pastes and cements during injection limits their full exploitation as a bone substitute in minimally invasive surgical applications. Due to lack of theoretical understanding of the phase separation mechanism(s), optimisation of an injectable CPC that satisfies clinical requirements has proven difficult. However, phase separation of pastes during delivery has been the focus across several research fields. Therefore in addition to a review of methods to reduce phase separation of CPC and the associated constraints, a review of phase separation mechanisms observed during extrusion of other pastes and the theoretical models used to describe these mechanisms is presented. It is anticipated this review will benefit future attempts to develop injectable calcium phosphate based systems.
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Affiliation(s)
- R O'Neill
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Rd, Belfast BT9 5AH, United Kingdom
| | - H O McCarthy
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom
| | - E B Montufar
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Universitat Politècnica de Catalunya. BarcelonaTech (UPC), Av. Diagonal 647, 08028 Barcelona, Spain; Institute for Bioengineering of Catalonia, C. Baldiri Reixach 10, 08028 Barcelona, Spain
| | - M-P Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Universitat Politècnica de Catalunya. BarcelonaTech (UPC), Av. Diagonal 647, 08028 Barcelona, Spain; Institute for Bioengineering of Catalonia, C. Baldiri Reixach 10, 08028 Barcelona, Spain
| | - D I Wilson
- Department of Chemical Engineering and Biotechnology, New Museums Site, Pembroke Street, University of Cambridge, CB2 3RA, United Kingdom
| | - A Lennon
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Rd, Belfast BT9 5AH, United Kingdom
| | - N Dunne
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom; Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Stokes Building, Collins Avenue, Dublin 9, Ireland; Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.
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24
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Bertol LS, Schabbach R, Dos Santos LAL. Dimensional evaluation of patient-specific 3D printing using calcium phosphate cement for craniofacial bone reconstruction. J Biomater Appl 2016; 31:799-806. [PMID: 27913653 DOI: 10.1177/0885328216682672] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The 3D printing process is highlighted nowadays as a possibility to generate individual parts with complex geometries. Moreover, the development of 3D printing hardware, software and parameters permits the manufacture of parts that can be not only used as prototypes, but are also made from materials that are suitable for implantation. In this way, this study investigates the process involved in the production of patient-specific craniofacial implants using calcium phosphate cement, and its dimensional accuracy. The implants were previously generated in a computer-aided design environment based on the patient's tomographic data. The fabrication of the implants was carried out in a commercial 3D powder printing system using alfa-tricalcium phosphate powder and an aqueous solution of Na2HPO4 as a binder. The fit of the 3D printed implants was measured by three-dimensional laser scanning and by checking the right adjustment to the patient's anatomical biomodel. The printed parts presented a good degree of fitting and accuracy.
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Affiliation(s)
- Liciane Sabadin Bertol
- Universidade Federal do Rio Grande do Sul, Laboratorio de Biomateriais, Porto Alegre, Brazil
| | - Rodrigo Schabbach
- Universidade Federal do Rio Grande do Sul, Laboratorio de Biomateriais, Porto Alegre, Brazil
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25
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Palmer I, Nelson J, Schatton W, Dunne NJ, Buchanan F, Clarke SA. Biocompatibility of calcium phosphate bone cement with optimised mechanical properties: an in vivo study. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:191. [PMID: 27844306 PMCID: PMC5108819 DOI: 10.1007/s10856-016-5806-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/31/2016] [Indexed: 06/06/2023]
Abstract
This work establishes the in vivo performance of modified calcium phosphate bone cements for vertebroplasty of spinal fractures using a lapine model. A non-modified calcium phosphate bone cement and collagen-calcium phosphate bone cements composites with enhanced mechanical properties, utilising either bovine collagen or collagen from a marine sponge, were compared to a commercial poly(methyl methacrylate) cement. Conical cement samples (8 mm height × 4 mm base diameter) were press-fit into distal femoral condyle defects in New Zealand White rabbits and assessed after 5 and 10 weeks. Bone apposition and tartrate-resistant acid phosphatase activity around cements were assessed. All implants were well tolerated, but bone apposition was higher on calcium phosphate bone cements than on poly(methyl methacrylate) cement. Incorporation of collagen showed no evidence of inflammatory or immune reactions. Presence of positive tartrate-resistant acid phosphatase staining within cracks formed in calcium phosphate bone cements suggested active osteoclasts were present within the implants and were actively remodelling within the cements. Bone growth was also observed within these cracks. These findings confirm the biological advantages of calcium phosphate bone cements over poly(methyl methacrylate) and, coupled with previous work on enhancement of mechanical properties through collagen incorporation, suggest collagen-calcium phosphate bone cement composite may offer an alternative to calcium phosphate bone cements in applications where low setting times and higher mechanical stability are important.
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Affiliation(s)
- Iwan Palmer
- School of Mechanical and Aerospace Engineering, Ashby Building, Queen's University of Belfast, 121 Stranmillis Road, Belfast, BT9 5AH, UK
| | - John Nelson
- Institute for Global Food Security, School of Biological Sciences, Medical Biology Centre, Queen's University of Belfast, Lisburn Road, Belfast, BT9 7BL, UK
| | - Wolfgang Schatton
- KliniPharm GmbH, Stephan Strasse 10, Frankfurt am Main, 60313, Germany
| | - Nicholas J Dunne
- School of Mechanical and Manufacturing Engineering, Stokes Building, Dublin City University, Collins Avenue, Dublin 9, Ireland
| | - Fraser Buchanan
- School of Mechanical and Aerospace Engineering, Ashby Building, Queen's University of Belfast, 121 Stranmillis Road, Belfast, BT9 5AH, UK.
| | - Susan A Clarke
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University of Belfast, Lisburn Road, Belfast, BT9 7BL, UK
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26
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Babo PS, Carvalho PP, Santo VE, Faria S, Gomes ME, Reis RL. Assessment of bone healing ability of calcium phosphate cements loaded with platelet lysate in rat calvarial defects. J Biomater Appl 2016; 31:637-649. [DOI: 10.1177/0885328216669474] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Injectable calcium phosphate cements have been used as a valid alternative to autologous bone grafts for bone augmentation with the additional advantage of enabling minimally invasive implantation procedures and for perfectly fitting the tissue defect. Nevertheless, they have low biodegradability and lack adequate biochemical signaling to promote bone healing and remodeling. In previous in vitro studies, we observed that the incorporation of platelet lysate directly into the cement paste or loaded in hyaluronic acid microspheres allowed to modulate the cement degradation and the in vitro expression of osteogenic markers in seeded human adipose derived stem cells. The present study aimed at investigating the possible effect of this system in new bone formation when implanted in calvarial bilateral defects in rats. Different formulations were assessed, namely plain calcium phosphate cements, calcium phosphate cements loaded with human platelet lysate, hybrid injectable formulations composed of the calcium phosphate cement incorporating hyaluronin acid non-loaded microparticles (20% hyaluronin acid) or with particles loaded with platelet lysate. The degradability and new bone regrowth were evaluated in terms of mineral volume in the defect, measured by micro-computed tomography and histomorphometric analysis upon 4, 8 and 12 weeks of implantation. We observed that the incorporation of hyaluronin acid microspheres induced an overly rapid cement degradation, impairing the osteoconductive properties of the cement composites. Moreover, the incorporation of platelet lysate induced higher bone healing than the materials without platelet lysate, up to four weeks after surgery. Nevertheless, this effect was not found to be significant when compared to the one observed in the sham-treated group.
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Affiliation(s)
- Pedro S Babo
- 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro P Carvalho
- 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Vítor E Santo
- 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Susana Faria
- CMAT – Centre of Mathematics, Department of Mathematics and Applications, University of Minho, Guimarães, Portugal
| | - Manuela E Gomes
- 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui L Reis
- 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Barros AA, Aroso IM, Silva TH, Mano JF, Duarte ARC, Reis RL. In vitro
bioactivity studies of ceramic structures isolated from marine sponges. Biomed Mater 2016; 11:045004. [DOI: 10.1088/1748-6041/11/4/045004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ostrowski N, Roy A, Kumta PN. Magnesium Phosphate Cement Systems for Hard Tissue Applications: A Review. ACS Biomater Sci Eng 2016; 2:1067-1083. [PMID: 33445235 DOI: 10.1021/acsbiomaterials.6b00056] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In the search for more ideal bone graft materials for clinical application, the investigation into ceramic bone cements or bone void filler is ongoing. Calcium phosphate-based materials have been widely explored and implemented for medical use in bone defect repair. Such materials are an excellent choice because the implant mimics the natural chemistry of mineralized bone matrix and in injectable cement form, can be implemented with relative ease. However, of the available calcium phosphate cements, none fully meet the ideal standard, displaying low strengths and acidic setting reactions or slow setting times, and are often very slow to resorb in vivo. The study of magnesium phosphates for bone cements is a relatively new field compared to traditional calcium phosphate bone cements. Although reports are more limited, preliminary studies have shown that magnesium phosphate cements (MPC) may be a strong alternative to calcium phosphates for certain applications. The goal of the present publication is to review the history and achievements of magnesium phosphate-based cements or bone void fillers to date, assess how these cements compare with calcium phosphate competitors and to analyze the future directions and outlook for the research, development, and clinical implementation of these cements.
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Affiliation(s)
- Nicole Ostrowski
- Swanson School of Engineering, University of Pittsburgh, 815C Benedum Hall, 3700 O'Hara Street, Pittsburgh, Pennsylvania 15261, United States
| | - Abhijit Roy
- Swanson School of Engineering, University of Pittsburgh, 815C Benedum Hall, 3700 O'Hara Street, Pittsburgh, Pennsylvania 15261, United States
| | - Prashant N Kumta
- Swanson School of Engineering, University of Pittsburgh, 815C Benedum Hall, 3700 O'Hara Street, Pittsburgh, Pennsylvania 15261, United States
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Zhang J, Liu W, Gauthier O, Sourice S, Pilet P, Rethore G, Khairoun K, Bouler JM, Tancret F, Weiss P. A simple and effective approach to prepare injectable macroporous calcium phosphate cement for bone repair: Syringe-foaming using a viscous hydrophilic polymeric solution. Acta Biomater 2016; 31:326-338. [PMID: 26631875 DOI: 10.1016/j.actbio.2015.11.055] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/28/2015] [Accepted: 11/25/2015] [Indexed: 11/18/2022]
Abstract
In this study, we propose a simple and effective strategy to prepare injectable macroporous calcium phosphate cements (CPCs) by syringe-foaming via hydrophilic viscous polymeric solution, such as using silanized-hydroxypropyl methylcellulose (Si-HPMC) as a foaming agent. The Si-HPMC foamed CPCs demonstrate excellent handling properties such as injectability and cohesion. After hardening the foamed CPCs possess hierarchical macropores and their mechanical properties (Young's modulus and compressive strength) are comparable to those of cancellous bone. Moreover, a preliminary in vivo study in the distal femoral sites of rabbits was conducted to evaluate the biofunctionality of this injectable macroporous CPC. The evidence of newly formed bone in the central zone of implantation site indicates the feasibility and effectiveness of this foaming strategy that will have to be optimized by further extensive animal experiments. STATEMENT OF SIGNIFICANCE A major challenge in the design of biomaterial-based injectable bone substitutes is the development of cohesive, macroporous and self-setting calcium phosphate cement (CPC) that enables rapid cell invasion with adequate initial mechanical properties without the use of complex processing and additives. Thus, we propose a simple and effective strategy to prepare injectable macroporous CPCs through syringe-foaming using a hydrophilic viscous polymeric solution (silanized-hydroxypropyl methylcellulose, Si-HPMC) as a foaming agent, that simultaneously meets all the aforementioned aims. Evidence from our in vivo studies shows the existence of newly formed bone within the implantation site, indicating the feasibility and effectiveness of this foaming strategy, which could be used in various CPC systems using other hydrophilic viscous polymeric solutions.
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Affiliation(s)
- Jingtao Zhang
- Université de Nantes, INSERM UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042 Nantes Cedex 1, France; Université de Nantes, Polytech Nantes, Institut des Matériaux Jean Rouxel, CNRS UMR 6502, Rue Christian Pauc, BP 50609, 44306 Nantes Cedex 3, France
| | - Weizhen Liu
- Université de Nantes, INSERM UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042 Nantes Cedex 1, France; Université de Nantes, Polytech Nantes, Institut des Matériaux Jean Rouxel, CNRS UMR 6502, Rue Christian Pauc, BP 50609, 44306 Nantes Cedex 3, France
| | - Olivier Gauthier
- ONIRIS - Ecole Nationale Veterinaire de Nantes, Atlanpole-La Chantrerie, BP 40706, 44307 Nantes cedex 3, France
| | - Sophie Sourice
- Université de Nantes, INSERM UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042 Nantes Cedex 1, France
| | - Paul Pilet
- Université de Nantes, INSERM UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042 Nantes Cedex 1, France; CHU de Nantes, Nantes University Hospital, PHU 4 OTONN, 1 Pl A. Ricordeau Nantes, France
| | - Gildas Rethore
- Université de Nantes, INSERM UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042 Nantes Cedex 1, France; CHU de Nantes, Nantes University Hospital, PHU 4 OTONN, 1 Pl A. Ricordeau Nantes, France
| | - Khalid Khairoun
- Université de Nantes, INSERM UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042 Nantes Cedex 1, France
| | - Jean-Michel Bouler
- Université de Nantes, CEISAM, CNRS UMR 6230, 2 rue de la Houssinière, BP 92208, 44322 Nantes Cedex 3, France
| | - Franck Tancret
- Université de Nantes, Polytech Nantes, Institut des Matériaux Jean Rouxel, CNRS UMR 6502, Rue Christian Pauc, BP 50609, 44306 Nantes Cedex 3, France
| | - Pierre Weiss
- Université de Nantes, INSERM UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042 Nantes Cedex 1, France; CHU de Nantes, Nantes University Hospital, PHU 4 OTONN, 1 Pl A. Ricordeau Nantes, France.
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Sa Y, Gao Y, Wang M, Wang T, Feng X, Wang Z, Wang Y, Jiang T. Bioactive calcium phosphate cement with excellent injectability, mineralization capacity and drug-delivery properties for dental biomimetic reconstruction and minimum intervention therapy. RSC Adv 2016. [DOI: 10.1039/c6ra02488b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
CPC could be used as a promising biomaterial to reconstruct the breached enamel on exposed dentin through a biomimetic and minimally invasive way.
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Affiliation(s)
- Yue Sa
- Department of Prosthodontics
- Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Yixue Gao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Man Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Tianfeng Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Xiaowei Feng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Zhejun Wang
- Department of Prosthodontics
- Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Yining Wang
- Department of Prosthodontics
- Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Tao Jiang
- Department of Prosthodontics
- Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
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Fabrication of Poly-l-lactic Acid/Dicalcium Phosphate Dihydrate Composite Scaffolds with High Mechanical Strength-Implications for Bone Tissue Engineering. J Funct Biomater 2015; 6:1036-53. [PMID: 26556380 PMCID: PMC4695909 DOI: 10.3390/jfb6041036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 10/28/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022] Open
Abstract
Scaffolds were fabricated from poly-l-lactic acid (PLLA)/dicalcium phosphate dihydrate (DCPD) composite by indirect casting. Sodium citrate and PLLA were used to improve the mechanical properties of the DCPD scaffolds. The resulting PLLA/DCPD composite scaffold had increased diametral tensile strength and fracture energy when compared to DCPD only scaffolds (1.05 vs. 2.70 MPa and 2.53 vs. 12.67 N-mm, respectively). Sodium citrate alone accelerated the degradation rate by 1.5 times independent of PLLA. Cytocompatibility of all samples were evaluated using proliferation and differentiation parameters of dog-bone marrow stromal cells (dog-BMSCs). The results showed that viable dog-BMSCs attached well on both DCPD and PLLA/DCPD composite surfaces. In both DCPD and PLLA/DCPD conditioned medium, dog-BMSCs proliferated well and expressed alkaline phosphatase (ALP) activity indicating cell differentiation. These findings indicate that incorporating both sodium citrate and PLLA could effectively improve mechanical strength and biocompatibility without increasing the degradation time of calcium phosphate cement scaffolds for bone tissue engineering purposes.
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Sarkar SK, Lee BY, Padalhin AR, Sarker A, Carpena N, Kim B, Paul K, Choi HJ, Bae SH, Lee BT. Brushite-based calcium phosphate cement with multichannel hydroxyapatite granule loading for improved bone regeneration. J Biomater Appl 2015; 30:823-37. [DOI: 10.1177/0885328215601938] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this work, we report brushite-based calcium phosphate cement (CPC) system to enhance the in vivo biodegradation and tissue in-growth by incorporation of micro-channeled hydroxyapatite (HAp) granule and silicon and sodium addition in calcium phosphate precursor powder. Sodium- and silicon-rich calcium phosphate powder with predominantly tri calcium phosphate (TCP) phase was synthesized by an inexpensive wet chemical route to react with mono calcium phosphate monohydrate (MCPM) for making the CPC. TCP nanopowder also served as a packing filler and moderator of the reaction kinetics of the setting mechanism. Strong sintered cylindrical HAp granules were prepared by fibrous monolithic (FM) process, which is 800 µm in diameter and have seven micro-channels. Acid sodium pyrophosphate and sodium citrate solution was used as the liquid component which acted as a homogenizer and setting time retarder. The granules accelerated the degradation of the brushite cement matrix as well as improved the bone tissue in-growth by permitting an easy access to the interior of the CPC through the micro-channels. The addition of micro-channeled granule in the CPC introduced porosity without sacrificing much of its compressive strength. In vivo investigation by creating a critical size defect in the femur head of a rabbit model for 1 and 2 months showed excellent bone in-growth through the micro-channels. The granules enhanced the implant degradation behavior and bone regeneration in the implanted area was significantly improved after two months of implantation.
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Affiliation(s)
- Swapan Kumar Sarkar
- Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, Cheonan, South Korea
| | - Byung Yeol Lee
- InoBone Corporate R&D Center, Soonchunhyang University, Asan-si, South Korea
| | - Andrew Reyas Padalhin
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan, South Korea
| | - Avik Sarker
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan, South Korea
| | - Nathaniel Carpena
- Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, Cheonan, South Korea
| | - Boram Kim
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan, South Korea
| | - Kallyanshish Paul
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan, South Korea
| | - Hwan Jun Choi
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Sang-Ho Bae
- Department of Surgery, College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Byong Taek Lee
- Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, Cheonan, South Korea
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan, South Korea
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Gao L, Li C, Chen F, Liu C. Fabrication and characterization of toughness-enhanced scaffolds comprising β-TCP/POC using the freeform fabrication system with micro-droplet jetting. ACTA ACUST UNITED AC 2015; 10:035009. [PMID: 26107985 DOI: 10.1088/1748-6041/10/3/035009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A novel elastomeric material, poly(1,8-octanediol-co-citrate) (POC), has demonstrated tremendous versatility because of its advantageous toughness, tunable degradation properties, and efficient drug release capability. In this study, POC was used to improve the mechanical performance of β-tricalcium phosphate (β-Ca3(PO4)2, β-TCP). (3D) β-TCP/POC composite scaffolds were fabricated by a 3D printing technique based on the freeform fabrication system with micro-droplet jetting (FFS-MDJ). The physiochemical properties, compressive modulus, drug release behavior, and cell response of β-TCP/POC composite scaffolds were systematically investigated. The results showed that β-TCP/POC scaffolds had uniform macropores of 300-400 μm, porosity of approximately 45%, biodegradability in phosphate-buffered saline, and high compressive modulus of 50-75 MPa. With the incorporation of POC into β-TCP, the toughness of the composite scaffolds was improved significantly. Moreover, β-TCP/POC scaffolds exhibited sustained drug (ibuprofen (IBU)) release capability. Additionally, β-TCP/POC scaffolds facilitated C2C12 cell attachment and proliferation. It was indicated that the 3D-printed porous β-TCP/POC scaffolds with high compressive modulus and good drug delivery performance might be a promising candidate for bone defect repair.
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Affiliation(s)
- Li Gao
- The State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, People's Republic of China. Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai 200237, People's Republic of China. Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai 200237, People's Republic of China
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Verlaan JJ, Somers I, Dhert WJA, Oner FC. Clinical and radiological results 6 years after treatment of traumatic thoracolumbar burst fractures with pedicle screw instrumentation and balloon assisted endplate reduction. Spine J 2015; 15:1172-8. [PMID: 24321130 DOI: 10.1016/j.spinee.2013.11.044] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 10/09/2013] [Accepted: 11/26/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT When used to fixate traumatic thoracolumbar burst fractures, pedicle screw constructs may fail in the presence of severe vertebral body comminution as the intervertebral disc can creep through the fractured endplates leading to insufficient anterior column support. Balloon-assisted endplate reduction (BAER) and subsequent calcium phosphate cement augmentation may prevent this event by restoring the disc space boundaries. The results of the first studies using BAER after pedicle screw fixation are encouraging, showing good fracture reduction, few complications, and minimal loss of correction at 2 years of follow-up. PURPOSE To present the clinical and radiological outcome of 20 patients treated for traumatic thoracolumbar burst fractures with pedicle screws and BAER after a minimum of 6 years follow-up. STUDY DESIGN Prospective trial. PATIENT SAMPLE Twenty consecutive neurologically intact adult patients with traumatic thoracolumbar burst fractures were included. OUTCOME MEASURES Radiological parameters (wedge/Cobb angle on plain radiographs and mid-sagittal anterior/central vertebral body height on magnetic resonance imaging scans) and patient reported parameters (EQ-5D and Oswestry Disability Index) were used. METHODS All patients had previously undergone pedicle screw fixation and BAER with calcium phosphate cement augmentation. The posterior instrumentation was removed approximately 1.5 years after index surgery. Radiographs were obtained preoperatively, postoperatively, after removal of the pedicle screws, and at final follow-up (minimum 6 years post-trauma). Magnetic resonance imaging scans were obtained preoperatively, 1 month after index surgery, and 1 month after pedicle screw removal. Health questionnaires were filled out during the last outpatient visit. RESULTS The pedicle screw instrumentation was removed uneventfully in all patients and posterolateral fusion was observed in every case. The mean wedge and Cobb angle converged to almost identical values (5.3° and 5.8°, respectively) and the mid-sagittal anterior and central endplates were reduced to approximately 90% and 80% of the estimated preinjury vertebral body height, respectively; this reduction was sustained at follow-up. Patient-reported outcomes showed favorable results in 79% of the patients. One patient required (posterior) reoperation due to adjacent osteoporotic vertebral body collapse after pedicle screw removal. CONCLUSIONS Balloon-assisted endplate reduction is a safe and low-demanding adjunct to pedicle screw fixation for the treatment of traumatic thoracolumbar burst fractures. It may help achieve minimal residual deformity and reduce the number of secondary (anterior) procedures. Despite these positive findings, one in five patients experienced daily discomfort and disability.
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Affiliation(s)
- Jorrit-Jan Verlaan
- Department of Orthopaedics, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands.
| | - Inne Somers
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands
| | - Wouter J A Dhert
- Department of Orthopaedics, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands
| | - F Cumhur Oner
- Department of Orthopaedics, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands
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Emilov-Velev K, Clemente-de-Arriba C, Alobera-García M, Moreno-Sansalvador E, Campo-Loarte J. Bone regeneration in experimental animals using calcium phosphate cement combined with platelet growth factors and human growth hormone. Rev Esp Cir Ortop Traumatol (Engl Ed) 2015. [DOI: 10.1016/j.recote.2015.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yang J, Zhang K, Zhang S, Fan J, Guo X, Dong W, Wang S, Chen Y, Yu B. Preparation of calcium phosphate cement and polymethyl methacrylate for biological composite bone cements. Med Sci Monit 2015; 21:1162-72. [PMID: 25904398 PMCID: PMC4418284 DOI: 10.12659/msm.893845] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background We studied the biological safety, biomechanics, and tissue compatibility of calcium phosphate cement and Polymethyl Methacrylate composite bone cement mixed in different ratios. Material/Methods CPC and PMMA were mixed in different ratios (3: 1, 2: 1, 1: 1, 1: 2, 1: 5, 1: 10, 1: 15, and 1: 20). PMMA solvent is a general solvent containing a dissolved preparation of the composite bone cement specific to a given specimen to determine biological safety, biomechanics, and tissue compatibility. Results The CPC/PMMA (33%) group, CPC/PMMA (50%) group, CPC/PMMA (67%) group, and CPC/PMMA (75%) group were more in line with the composite bone cement without cytotoxicity requirements. The compressive strength of the CPC/PMMA (67%) group and CPC/PMMA (75%) group was 20Mpa–30Mpa, while that of the CPC/PMMA (4.8%) group, CPC/PMMA (6.25%) group, CPC/PMMA (9.1%) group, CPC/PMMA (16.7%) group, CPC/PMMA (33%) group, and CPC/PMMA (50%) group was 40Mpa–70Mpa. Curing time was longer in the CPC group (more than 11 min) and shorter in the PMMA group (less than 2 min). The results of weight loss rate showed that there were no significant differences between the CPC/PMMA group (4.8%, 6.25%, 9.1%, 16.7%, 33%) and PMMA control group (p>0.05). With the decrease of CPC content, the rate of weight loss gradually decreased. Conclusions The CPC/PMMA (50%) group, CPC/PMMA (67%) group, and CPC/PMMA (75%) group provide greater variability and selectivity for the composite bone cement in obtaining better application.
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Affiliation(s)
- Jun Yang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Kairui Zhang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Sheng Zhang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Jiping Fan
- Department of Orthopaedics, 421 hospital of PLA, Guangzhou, Guangdong, China (mainland)
| | - Xinhui Guo
- Department of Orthopaedics, 421 Hospital of PLA, Guangzhou, Guangdong, China (mainland)
| | - Weiqiang Dong
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Shengnan Wang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Yirong Chen
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Bin Yu
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
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Khajuria DK, Razdan R, Mahapatra DR. Development, in vitro and in vivo characterization of zoledronic acid functionalized hydroxyapatite nanoparticle based formulation for treatment of osteoporosis in animal model. Eur J Pharm Sci 2015; 66:173-83. [DOI: 10.1016/j.ejps.2014.10.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 09/29/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
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El-Fiqi A, Kim JH, Perez RA, Kim HW. Novel bioactive nanocomposite cement formulations with potential properties: incorporation of the nanoparticle form of mesoporous bioactive glass into calcium phosphate cements. J Mater Chem B 2015; 3:1321-1334. [DOI: 10.1039/c4tb01634c] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Novel calcium phosphate cements incorporated with bioactive glass nanoparticles demonstrate excellent properties for bone injectables.
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Affiliation(s)
- Ahmed El-Fiqi
- Department of Nanobiomedical Science and BK21 PLUS NBM Global Research Center for Regenerative Medicine
- Dankook University
- Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN)
- Dankook University
| | - Joong-Hyun Kim
- Department of Nanobiomedical Science and BK21 PLUS NBM Global Research Center for Regenerative Medicine
- Dankook University
- Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN)
- Dankook University
| | - Roman A. Perez
- Department of Nanobiomedical Science and BK21 PLUS NBM Global Research Center for Regenerative Medicine
- Dankook University
- Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN)
- Dankook University
| | - Hae-Won Kim
- Department of Nanobiomedical Science and BK21 PLUS NBM Global Research Center for Regenerative Medicine
- Dankook University
- Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN)
- Dankook University
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Li N, Jiang C, Zhang X, Gu X, Zhang J, Yuan Y, Liu C, Shi J, Wang J, Li Y. Preparation of an rhBMP-2 loaded mesoporous bioactive glass/calcium phosphate cement porous composite scaffold for rapid bone tissue regeneration. J Mater Chem B 2015; 3:8558-8566. [PMID: 32262696 DOI: 10.1039/c5tb01423a] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
An rhBMP-2/MBG/CPC scaffold is beneficial for rapid bone tissue regeneration in the early stage.
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Affiliation(s)
- Nan Li
- Key Laboratory for Ultrafine Materials of Ministry of Education
- East China University of Science and Technology
- Shanghai 200237
- China
| | - Chuan Jiang
- Shanghai Key Laboratory of Orthopedic Implant
- Department of Orthopedic Surgery
- Shanghai Ninth People’s Hospital Affiliated Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Xingdi Zhang
- Key Laboratory for Ultrafine Materials of Ministry of Education
- East China University of Science and Technology
- Shanghai 200237
- China
| | - Xinfeng Gu
- Shanghai Key Laboratory of Orthopedic Implant
- Department of Orthopedic Surgery
- Shanghai Ninth People’s Hospital Affiliated Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Jingwei Zhang
- Shanghai Key Laboratory of Orthopedic Implant
- Department of Orthopedic Surgery
- Shanghai Ninth People’s Hospital Affiliated Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Yuan Yuan
- Key Laboratory for Ultrafine Materials of Ministry of Education
- East China University of Science and Technology
- Shanghai 200237
- China
| | - Changsheng Liu
- Key Laboratory for Ultrafine Materials of Ministry of Education
- East China University of Science and Technology
- Shanghai 200237
- China
| | - Jianlin Shi
- State Key Lab of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics
- Chinese Academy of Sciences
- Shanghai 200050
- China
| | - Jinwu Wang
- Shanghai Key Laboratory of Orthopedic Implant
- Department of Orthopedic Surgery
- Shanghai Ninth People’s Hospital Affiliated Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Yongsheng Li
- Key Laboratory for Ultrafine Materials of Ministry of Education
- East China University of Science and Technology
- Shanghai 200237
- China
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40
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Yomoda M, Sobajima S, Kasuya A, Neo M. Calcium phosphate cement – gelatin powder composite testing in canine models: Clinical implications for treatment of bone defects. J Biomater Appl 2014; 29:1385-93. [DOI: 10.1177/0885328214565935] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Previous studies have reported the excellent biocompatibility of calcium phosphate cement. However, calcium phosphate cement needs further improvement in order for it to promote bone replacement and eventual bone substitution, as it exhibits slow biodegradability and thus remains in the body over an extended period of time. In this study, we mixed calcium phosphate cement with gelatin powder in order to create a composite containing macropores with interconnectivity, and we then implanted it into canine femurs from the diaphysis to the distal metaphysis. Eight dogs were divided into the sham group, the control (C0) group with 100 wt% calcium phosphate cement, the C10 group with 90 wt% calcium phosphate cement and 10 wt% gelatin powder, and the C15 group with 85 wt% calcium phosphate cement and 15 wt% gelatin powder. Bone replaceability in C10 and C15 at 3 and 6 months was evaluated by radiography, micro-CT, histomorphometry, and mineral apposition rate. New bone formation was seen in C10 and C15 although that was not seen in C0 at six months. The mineral apposition rate was significantly higher in C15 than in C10 in both the diaphysis and metaphysis, and the composite was found to have excellent biodegradability and bone replaceability in canine subjects. As the composite is easily and rapidly prepared, it is likely to become a new bone substitute for use in clinical settings.
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Affiliation(s)
- Mitsuhiro Yomoda
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | | | - Akihiro Kasuya
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Masashi Neo
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
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Emilov-Velev K, Clemente-de-Arriba C, Alobera-García MÁ, Moreno-Sansalvador EM, Campo-Loarte J. Bone regeneration in experimental animals using calcium phosphate cement combined with platelet growth factors and human growth hormone. Rev Esp Cir Ortop Traumatol (Engl Ed) 2014; 59:200-10. [PMID: 25440455 DOI: 10.1016/j.recot.2014.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/21/2014] [Accepted: 07/22/2014] [Indexed: 01/22/2023] Open
Abstract
UNLABELLED Many substances (growth factors and hormones) have osteoinduction properties and when added to some osteoconduction biomaterial they accelerate bone neoformation properties. MATERIALS The materials included 15 New Zealand rabbits, calcium phosphate cement (Calcibon(®)), human growth hormone (GH), and plasma rich in platelets (PRP). METHODS Each animal was operated on in both proximal tibias and a critical size bone defect of 6mm of diameter was made. The animals were separated into the following study groups: Control (regeneration only by Calcibon®), PRP (regeneration by Calcibon® and PRP), GH (regeneration by Calcibon® and GH). All the animals were sacrificed at 28 days. An evaluation was made of the appearance of the proximal extreme of rabbit tibiae in all the animals, and to check the filling of the critical size defect. A histological assessment was made of the tissue response, the presence of new bone formation, and the appearance of the biomaterial. Morphometry was performed using the MIP 45 image analyser. ANOVA statistical analysis was performed using the Statgraphics software application. RESULTS The macroscopic appearance of the critical defect was better in the PRP and the GH group than in the control group. Histologically greater new bone formation was found in the PRP and GH groups. No statistically significant differences were detected in the morphometric study between bone formation observed in the PRP group and the control group. Significant differences in increased bone formation were found in the GH group (p=0.03) compared to the other two groups. CONCLUSION GH facilitates bone regeneration in critical defects filled with calcium phosphate cement in the time period studied in New Zealand rabbits.
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Affiliation(s)
- K Emilov-Velev
- Servicio de Traumatología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
| | - C Clemente-de-Arriba
- Unidad de Embriología y Anatomía Humana, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | | | | | - J Campo-Loarte
- Servicio de Traumatología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
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Yatongchai C, Wren AW, Curran DJ, Hampshire S, Towler MR. Investigating the effect of SiO2-TiO 2-CaO-Na 2O-ZnO bioactive glass doped hydroxyapatite: characterisation and structural evaluation. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:1645-1659. [PMID: 24748516 DOI: 10.1007/s10856-014-5215-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 04/06/2014] [Indexed: 06/03/2023]
Abstract
The effects of increasing bioactive glass additions, SiO2-TiO2-CaO-Na2O-ZnO up to 25 wt% in increments of 5 wt%, on the physical and mechanical properties of hydroxyapatite (HA) sintered at 900, 1000, 1100 and 1200 °C for 2 h was investigated. Increasing both the glass content and the temperature resulted in increased HA decomposition. This resulted in the formation of a number of bioactive phases. However the presence of the liquidus glass phase did not result in increased densification levels. At 1000 and 1100 °C the additions of 5 wt% glass resulted in a decrease in density which never recovered with increasing glass content. At 1200 °C a cyclic pattern resulted from increasing glass content. There was no direct relationship between strength and density with all samples experiencing no change or a decrease in strength with increasing glass content. Weibull statistics displayed no pattern with increasing glass content.
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43
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Sariibrahimoglu K, An J, van Oirschot BAJA, Nijhuis AWG, Eman RM, Alblas J, Wolke JGC, van den Beucken JJJP, Leeuwenburgh SCG, Jansen JA. Tuning the degradation rate of calcium phosphate cements by incorporating mixtures of polylactic-co-glycolic acid microspheres and glucono-delta-lactone microparticles. Tissue Eng Part A 2014; 20:2870-82. [PMID: 24819744 DOI: 10.1089/ten.tea.2013.0670] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Calcium phosphate cements (CPCs) are frequently used as synthetic bone graft materials in view of their excellent osteocompatibility and clinical handling behavior. Hydroxyapatite-forming CPCs, however, degrade at very low rates, thereby limiting complete bone regeneration. The current study has investigated whether degradation of apatite-forming cements can be tuned by incorporating acid-producing slow-resorbing poly(D,L-lactic-co-glycolic) acid (PLGA) porogens, fast-resorbing glucono-delta-lactone (GDL) porogens, or mixtures thereof. The physicochemical, mechanical, and degradation characteristics of these CPC formulations were systematically analyzed upon soaking in phosphate-buffered saline (PBS). In parallel, various CPC formulations were implanted intramuscularly and orthotopically on top of the transverse process of goats followed by analysis of the soft tissue response and bone ingrowth after 12 weeks. In vitro degradation of GDL was almost completed after 2 weeks, as evidenced by characterization of the release of gluconic acid, while PLGA-containing CPCs released glycolic acid throughout the entire study (12 weeks), resulting in a decrease in compression strength of CPC. Extensive in vitro degradation of the CPC matrix was observed upon simultaneous incorporation of 30% PLGA-10% GDL. Histomorphometrical evaluation of the intramuscularly implanted samples revealed that all CPCs exhibited degradation, accompanied by an increase in capsule thickness. In the in vivo goat transverse process model, incorporation of 43% PLGA, 30% PLGA-5% GDL, and 30% PLGA-10% GDL in CPC significantly increased bone formation and resulted in higher bone height compared with both 10% GDL and 20% GDL-containing CPC samples.
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Affiliation(s)
- Kemal Sariibrahimoglu
- 1 Department of Biomaterials, Radboud University Nijmegen Medical Center , Nijmegen, The Netherlands
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44
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Calvo-Guirado JL, Ramírez-Fernández MP, Maté-Sánchez JE, Bruno N, Velasquez P, de Aza PN. Enhanced bone regeneration with a novel synthetic bone substitute in combination with a new natural cross-linked collagen membrane: radiographic and histomorphometric study. Clin Oral Implants Res 2014; 26:454-464. [PMID: 24720519 DOI: 10.1111/clr.12399] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES 4Bone is a fully synthetic bioactive bone substitute composed of 60% hydroxyapatite (HA) and 40% beta-tricalcium phosphate (ß-TCP). This study aimed to investigate the effect of resorbable collagen membranes (RCM) on critical size defects in rabbit tibiae filled with this novel biphasic calcium phosphate at 15, 30, 45, and 60 days by radiological and histomorphometric analysis. MATERIAL AND METHODS Three critical size defects of 6 mm diameter were created in both tibiae of 20 New Zealand rabbits and divided into three groups according to the filling material: Group A (4Bone), Group B (4Bone plus RCM), and Group C (unfilled control group). At each of the four study periods, five rabbits were sacrificed. Anteroposterior and lateral radiographs were taken. Samples were processed for observation under light microscopy. RESULTS At the end of treatment, radiological analysis found that cortical defect closure was greater in Group B than Group A, and radiopacity was clearly lower and more heterogeneous in Group A cortical defects than in Group B. There was no cortical defect closure in Group C. Histomorphometric evaluation showed significant differences in newly formed bone and cortical closure in Group B compared with Groups A and C, with the presence of higher density newly formed bone in cortical and medullar zones. CONCLUSIONS Biphasic calcium phosphate functioned well as a scaffolding material allowing bone ingrowth and mineralization. The addition of absorbable collagen membranes enhanced bone gain compared with non-membrane-treated sites. This rabbit study provides radiological and histological evidence confirming the suitability of this new material for guided tissue regeneration of critical defects.
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Affiliation(s)
- José Luis Calvo-Guirado
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Maria P Ramírez-Fernández
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Jose E Maté-Sánchez
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Negri Bruno
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Pablo Velasquez
- Bioengineering Institute, Miguel Hernandez University, Elche, Spain
| | - Piedad N de Aza
- Bioengineering Institute, Miguel Hernandez University, Elche, Spain
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45
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Maestretti G, Sutter P, Monnard E, Ciarpaglini R, Wahl P, Hoogewoud H, Gautier E. A prospective study of percutaneous balloon kyphoplasty with calcium phosphate cement in traumatic vertebral fractures: 10-year results. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 23:1354-60. [PMID: 24509773 DOI: 10.1007/s00586-014-3206-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/16/2014] [Accepted: 01/17/2014] [Indexed: 01/24/2023]
Abstract
STUDY DESIGN This is a prospective study to investigate the clinical and radiological results 10 years after percutaneous balloon kyphoplasty and cement augmentation with calcium phosphate cement (CPC) in traumatic vertebral fractures type A. OBJECTIVES Evaluation of a 10-year follow-up with radiological and computed tomography results, calculated by 2 independent radiologists, VAS, Roland Morris score, Oswestry Disability Index (ODI) score and Denis work scale and clinical examination in patients with traumatic compression fractures type A, who were treated with a balloon kyphoplasty with CPC (Calcibon™ from Biomed). METHODS In this study, we evaluated 21 patients (8 female and 13 male) clinically and radiologically 10 years postoperative and compared them with the same group of 28 patients we operated between August 2002 and August 2003 for traumatic vertebral fractures type A with balloon kyphoplasty and CPC. Over the 10 years, 7 patients were lost to follow-up. 3 of them were not clinically impaired but did not want to participate in the study and 4 patients were untraceable. All 21 patients underwent standard X-ray (standing) and a CT. We measured the volume of the cement, the resorption the last 10 years and the disc height in the CT and the segmental and vertebral kyphosis angle in the X-ray and compared them with the X-ray (standing) and CT done directly postoperatively. To assess the pain level we used the VAS, ODI score, Roland Morris score and the Denis work scale and compared them with the same scores we recorded in the past. RESULTS The VAS score demonstrated an increase over time from a mean of 1 (0-5) at the 2-year follow-up to 2.3 (0-8) at the 10-year follow-up. The Roland Morris disability score also increased over time from 2 (0-8) 2 years postoperative to a mean of 3.6 (0-18) at the 10 years follow-up. We recognized no complications and no reoperations were necessary. We recognized an increase of the median value for the vertebral kyphosis angle about 1° (0°-4°) (p < 0.0001). The median value of the disc height diminution over the 10 years was 0.7 mm (0-3.9) (p < 0.0001). For the anterior wall of the fractured VB the decrease of the median value was about 1 mm (0-3) (p < 0.0001) and for the posterior wall it was 0 mm (0-2) (p < 0.0039). So the beck index decreased from 0.80 (0.65-0.97) to 0.77 (0.62-0.97) at the 10-year follow-up, which means a decrease of the median value of 0.03 (0-0.07) (p < 0.0039). We noticed a median value for the cement volume of 4.2 cc (2.0-8.6) postoperative and at the 10-year follow-up of 3.2 cc (1.3-7.8), which means a resorption of the cement volume about 22.9 % (0.8-55.5 %) (p < 0.0001). CONCLUSIONS In our 10-year follow-up, we did not recognize any high loss of correction of the vertebral and segmental kyphosis angle. We also did not recognize a high diminution of the disc height without degeneration of the disc over the last 10 years. There was a partial resorption of the cement but not as much as we expected with variable bone formation. In summary, the long follow-up about 10 years of kyphoplasty show us very good clinical and radiological results and in our opinion we consider this to be a treatment option for traumatic selected vertebral type A fractures also in young patients.
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Duarte Campos DF, Vogt M, Lindner M, Kirsten A, Weber M, Megens RTA, Pyta J, Zenke M, Van Zandvoort M, Fischer H. Two-photon laser scanning microscopy as a useful tool for imaging and evaluating macrophage-, IL-4 activated macrophage- and osteoclast-basedIn Vitrodegradation of beta-tricalcium phosphate bone substitute material. Microsc Res Tech 2013; 77:143-52. [DOI: 10.1002/jemt.22321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/24/2013] [Accepted: 11/11/2013] [Indexed: 02/01/2023]
Affiliation(s)
- Daniela F. Duarte Campos
- Department of Dental Materials and Biomaterials Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
| | - Michael Vogt
- Interdisciplinary Centre for Clinical Research (IZKF Aachen), RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
| | - Markus Lindner
- Department of Dental Materials and Biomaterials Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
| | - Armin Kirsten
- Department of Dental Materials and Biomaterials Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
| | - Michael Weber
- Department of Dental Materials and Biomaterials Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
| | - Remco T. A. Megens
- Interdisciplinary Centre for Clinical Research (IZKF Aachen), RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
- Institute for Molecular Cardiovascular Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
- Institute for Cardiovascular Prevention; Ludwig-Maximilians University; Munich 80336 Germany
| | - Jürgen Pyta
- Institute for Molecular Cardiovascular Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
- Institute for Cardiovascular Prevention; Ludwig-Maximilians University; Munich 80336 Germany
| | - Martin Zenke
- Institute for Biomedical Engineering; Department of Cell Biology; Helmholtz Institute for Biomedical Engineering; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
| | - Marc Van Zandvoort
- Institute for Molecular Cardiovascular Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
- Department of Genetics and Cell Biology, Sector Molecular Cell Biology, CARIM; Maastricht University; Universiteitssingel 50; 6229 ER Maastricht The Netherlands
| | - Horst Fischer
- Department of Dental Materials and Biomaterials Research; RWTH Aachen University Hospital; Pauwelsstrasse 30 52074 Aachen Germany
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Dorozhkin SV. Self-setting calcium orthophosphate formulations. J Funct Biomater 2013; 4:209-311. [PMID: 24956191 PMCID: PMC4030932 DOI: 10.3390/jfb4040209] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 10/18/2013] [Accepted: 10/21/2013] [Indexed: 01/08/2023] Open
Abstract
In early 1980s, researchers discovered self-setting calcium orthophosphate cements, which are bioactive and biodegradable grafting bioceramics in the form of a powder and a liquid. After mixing, both phases form pastes, which set and harden forming either a non-stoichiometric calcium deficient hydroxyapatite or brushite. Since both of them are remarkably biocompartible, bioresorbable and osteoconductive, self-setting calcium orthophosphate formulations appear to be promising bioceramics for bone grafting. Furthermore, such formulations possess excellent molding capabilities, easy manipulation and nearly perfect adaptation to the complex shapes of bone defects, followed by gradual bioresorption and new bone formation. In addition, reinforced formulations have been introduced, which might be described as calcium orthophosphate concretes. The discovery of self-setting properties opened up a new era in the medical application of calcium orthophosphates and many commercial trademarks have been introduced as a result. Currently such formulations are widely used as synthetic bone grafts, with several advantages, such as pourability and injectability. Moreover, their low-temperature setting reactions and intrinsic porosity allow loading by drugs, biomolecules and even cells for tissue engineering purposes. In this review, an insight into the self-setting calcium orthophosphate formulations, as excellent bioceramics suitable for both dental and bone grafting applications, has been provided.
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Van der Stok J, Weinans H, Kops N, Siebelt M, Patka P, Van Lieshout EMM. Properties of commonly used calcium phosphate cements in trauma and orthopaedic surgery. Injury 2013; 44:1368-74. [PMID: 23876622 DOI: 10.1016/j.injury.2013.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 05/07/2013] [Accepted: 06/02/2013] [Indexed: 02/02/2023]
Affiliation(s)
- Johan Van der Stok
- Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Montazerolghaem M, Engqvist H, Karlsson Ott M. Sustained release of simvastatin from premixed injectable calcium phosphate cement. J Biomed Mater Res A 2013; 102:340-7. [DOI: 10.1002/jbm.a.34702] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 11/19/2012] [Accepted: 03/04/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Maryam Montazerolghaem
- Division of Applied Materials Science, Department of Engineering Sciences; Uppsala University; Uppsala Sweden
| | - Håkan Engqvist
- Division of Applied Materials Science, Department of Engineering Sciences; Uppsala University; Uppsala Sweden
| | - Marjam Karlsson Ott
- Division of Applied Materials Science, Department of Engineering Sciences; Uppsala University; Uppsala Sweden
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50
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Reardon PJT, Huang J, Tang J. Morphology controlled porous calcium phosphate nanoplates and nanorods with enhanced protein loading and release functionality. Adv Healthc Mater 2013; 2:682-6. [PMID: 23404951 DOI: 10.1002/adhm.201200276] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/27/2012] [Indexed: 11/10/2022]
Abstract
Calcium phosphate nanoplates and nanorods with controllable pores and enhanced protein loading and tuneable release characteristics are first synthesized without the use of any toxic surfactants by an energy efficient microwave assisted chemical process, hence demonstrating their viability as a tool for controllable drug delivery in biomaterial systems.
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