1
|
Keppler AM, Saller MM, Alberton P, Westphal I, Heidenau F, Schönitzer V, Böcker W, Kammerlander C, Schieker M, Aszodi A, Neuerburg C. Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement. J Orthop Surg Res 2020; 15:287. [PMID: 32727506 PMCID: PMC7391532 DOI: 10.1186/s13018-020-01801-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 07/14/2020] [Indexed: 01/09/2023] Open
Abstract
Background Reconstruction of metaphyseal fractures represents a clinical challenge for orthopedic surgeons. Especially in osteoporotic bone, these fractures are frequently accompanied by osseous substance defects. In order to ensure rapid mobilization of patients, high stability requirements must be met by osteosynthesis. Various bone graft materials have been introduced in the past, such as autologous bone or exogenous bone substitute materials. These are used as bone void fillers or as augmentation techniques to ensure safe fixation of osteosynthesis. New calcium phosphate-based bone void-filling materials could be a promising alternative to autologous bone or to the currently and widely used polymethylmethacrylate (PMMA)-based cement. The aim of this study was to evaluate a novel paste-like bone void filler in vivo and in vitro with regard to biocompatibility and osteoconductivity. Methods In addition to in vitro testing of cell compatibility using pre-osteoblasts (MC3T3-E1), 35 Wistar rats were treated in vivo with implantation of various material mixtures based on calcium phosphate and aluminum oxide reinforcement in a metaphyseal drill hole defect. After 4 weeks, an examination by micro-computed tomography (μCT) and histology was performed. Results The in vitro analysis showed good biocompatibility with a high cell survival of osteoblasts. In the in vivo experiments, a significantly higher bone ingrowth compared to the empty defect was shown by μCT and histological analysis. Here, the group receiving material reinforced with aluminum oxide (Al2O3) showed a bone volume/tissue volume (BV/TV) of 89.19% compared to a BV/TV of 83.14% for the empty defect (p = 0.0013). In the group treated with a polysaccharide matrix, no increase in BV/TV was observed given a mean ratio of 80.14%. Scoring of histological sections did not reveal a significant difference between CaP and CaP that was substituted with Al2O3. Conclusion The results of this study show an encouraging first step towards the development of new pasty, bone void-filling materials. We demonstrated that a new paste-like bone-filling material, based on calcium phosphate granulates and aluminum oxide to provide strength, exhibits good biocompatibility and osteoconductivity. Further biomechanical test in an osteoporotic animal model will have to be performed, to prove feasibility in metaphyseal defects.
Collapse
Affiliation(s)
- Alexander M Keppler
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Maximilian M Saller
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Paolo Alberton
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Ines Westphal
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.,LivImplant GmbH, Starnberg, Germany
| | | | - Veronika Schönitzer
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Wolfgang Böcker
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Christian Kammerlander
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Matthias Schieker
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.,Novartis Institute for Biomedical Research, Basel, Switzerland.,LivImplant GmbH, Starnberg, Germany
| | - Attila Aszodi
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Carl Neuerburg
- Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University Munich, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.
| |
Collapse
|