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Goenka V, V K AD, Manikandan C, Jaiswal AK. Development of guar gum reinforced calcium magnesium phosphate-based bone biocement. J Biomed Mater Res B Appl Biomater 2024; 112:e35384. [PMID: 38400798 DOI: 10.1002/jbm.b.35384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/24/2023] [Accepted: 01/27/2024] [Indexed: 02/26/2024]
Abstract
This study aims at developing a calcium magnesium phosphate-based bone biocement that combines a natural polymer and regenerative properties of bone bonding materials. The formulation of this biocement consists of oxidized guar gum, polydopamine, and calcium magnesium phosphate. The oxidized guar gum is easily soluble in water and has a slightly basic pH, unlike unmodified guar gum, thus allowing a homogenous paste to form in the alkaline environment of calcium magnesium phosphate. Three different oxidized degrees of guar gum were made, and the impact on the biocement properties was studied. The modified guar gum-reinforced biocement (OGG C2) displayed higher mechanical strength and lower degradation rates than OGG B1 and OGG A0. Furthermore, samples with polydopamine exhibited better results, thus, improving the already reinforced biocement. Morphological studies of the biocement displayed a highly porous structure with porosity varying among biocement containing different oxidized guar gum and polydopamine levels.
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Affiliation(s)
- Vidul Goenka
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Anupama Devi V K
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
- Centre for Biomaterials, Cellular, and Molecular Theranostics, Vellore Institute of Technology, Vellore, India
| | - Ceera Manikandan
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
- Centre for Biomaterials, Cellular, and Molecular Theranostics, Vellore Institute of Technology, Vellore, India
| | - Amit Kumar Jaiswal
- Centre for Biomaterials, Cellular, and Molecular Theranostics, Vellore Institute of Technology, Vellore, India
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Tomasian A, Jennings JW. Benign Bone Tumors Beyond Osteoid Osteoma: Percutaneous Minimally Invasive Image-Guided Interventions. Cardiovasc Intervent Radiol 2023; 46:1483-1494. [PMID: 37532944 DOI: 10.1007/s00270-023-03515-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 07/09/2023] [Indexed: 08/04/2023]
Abstract
Painful benign bone tumors often adversely influence quality of life primarily due to skeletal-related events such as unremittable pain, pathologic fracture, neurologic deficit, as well as skeletal growth disturbance. Substantial advances in percutaneous minimally invasive interventions for treatment of painful benign bone tumors beyond osteoid osteoma have been established as safe, efficacious, and durable treatments to achieve definitive cure. This article details the available armamentarium and most recent advances in minimally invasive percutaneous interventions and the role of radiologists for the management of patients with benign bone tumors beyond osteoid osteoma.
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Affiliation(s)
- Anderanik Tomasian
- Department of Radiological Sciences, University of California, Irvine Medical Center, 101 The City Dr. S, Orange, CA, 92868, USA.
| | - Jack W Jennings
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 South Kingshighway Blvd, St. Louis, MO, 63110, USA
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Dai W, Zheng Y, Li B, Yang F, Chen W, Li Y, Deng Y, Bai D, Shu R. A 3D-printed orthopedic implant with dual-effect synergy based on MoS 2 and hydroxyapatite nanoparticles for tumor therapy and bone regeneration. Colloids Surf B Biointerfaces 2023; 228:113384. [PMID: 37320980 DOI: 10.1016/j.colsurfb.2023.113384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
Treatments for malignant bone tumors are urgently needed to be developed due to the dilemma of precise resection of tumor tissue and subsequent bone defects. Although polyether-ether-ketone (PEEK) has widely attracted attention in the orthopedic field, its bioinertness and poor osteogenic properties significantly restrict its applications in bone tumor treatment. To tackle the daunting issue, we use a hydrothermal technique to fabricate novel PEEK scaffolds modified with molybdenum disulfide (MoS2) nanosheets and hydroxyapatite (HA) nanoparticles. Our dual-effect synergistic PEEK scaffolds exhibit perfect photothermal therapeutic (PTT) property dependent on molybdous ion (Mo2+) concentration and laser power density, superior to conventional PEEK scaffolds. Under near-infrared (NIR) irradiation, the viability of MG63 osteosarcoma cells is significantly reduced by modified PEEK scaffolds, indicating a tumor-killing potential in vitro. Furthermore, the incorporation of HA nanoparticles on the surface of PEEK bolsters proliferation and adherence of MC3T3-E1 cells, boosting mineralization for further bone defect repair. The results of micro-computed tomography (micro-CT) and histological analysis of 4-week treated rat femora demonstrate the preeminent photothermal and osteogenesis capacity of 3D-printed modified scaffolds in vivo. In conclusion, the dual-effect synergistic orthopedic implant with photothermal anticancer property and osteogenic induction activity strikes a balance between tumor treatment and bone development promotion, offering a promising future therapeutic option.
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Affiliation(s)
- Wenyu Dai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics and Paediatric Dentistry, West China Hospital of Stomatology, School of Chemical Engineering, Sichuan University, Chengdu 610041, China
| | - Yunfei Zheng
- Department of Orthodontics, National Center of Stomatology; National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Bin Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics and Paediatric Dentistry, West China Hospital of Stomatology, School of Chemical Engineering, Sichuan University, Chengdu 610041, China
| | - Fan Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics and Paediatric Dentistry, West China Hospital of Stomatology, School of Chemical Engineering, Sichuan University, Chengdu 610041, China
| | - Wanxi Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics and Paediatric Dentistry, West China Hospital of Stomatology, School of Chemical Engineering, Sichuan University, Chengdu 610041, China
| | - Yunfei Li
- Department of Biomedical Engineering, The City College of the City University of New York, New York, United States
| | - Yi Deng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics and Paediatric Dentistry, West China Hospital of Stomatology, School of Chemical Engineering, Sichuan University, Chengdu 610041, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; Department of Mechanical Engineering, The University of Hong Kong, Hong Kong 999077, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics and Paediatric Dentistry, West China Hospital of Stomatology, School of Chemical Engineering, Sichuan University, Chengdu 610041, China.
| | - Rui Shu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics and Paediatric Dentistry, West China Hospital of Stomatology, School of Chemical Engineering, Sichuan University, Chengdu 610041, China.
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Oshiro H, Tome Y, Tsuha Y, Aoki Y, Mizuta K, Nishida K. Packing with alpha-tricalcium phosphate followed by curettage and phenol-ethanol ablation for appendicular giant cell tumor of bone. Medicine (Baltimore) 2022; 101:e32055. [PMID: 36626415 PMCID: PMC9750708 DOI: 10.1097/md.0000000000032055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Giant cell tumor of bone (GCTB) is an intermediate and locally aggressive bone tumor. Alpha-tricalcium phosphate (alpha-TCP) is an adjustable bone substitute used to fill various sizes of bone cavities after curettage for GCTB. This study aimed to evaluate the surgical outcome of packing with alpha-TCP followed by curettage and phenol-ethanol ablation. We retrospectively reviewed data of 16 patients with GCTB who underwent primary surgery in our institute between January 2009 and April 2021. Data of Campanacci grading system; number of local recurrences and distant metastases; local recurrence-free survival rate using the Kaplan-Meier method; oncological outcomes; and complications after surgery (secondary osteoarthritis and postoperative fracture) were evaluated in this study. Regarding the Campanacci grading system, 2 patients were classified as grade I, 14 as grade II, and none as grade III. The 5-year local recurrence-free survival rate was 77.8% in all cases. Lung metastasis was not detected in this study. Oncological outcomes were: continuous disease free, 13 patients; alive with disease, 3 patients; and no evidence of disease or death of disease, none of the patients. Secondary osteoarthritis after surgery was not detected in the present study. Packing with alpha-TCP followed by curettage and phenol-ethanol ablation for appendicular GCTB may be safe and effective in suppressing the risk of secondary osteoarthritis.
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Affiliation(s)
- Hiromichi Oshiro
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- * Correspondence: Yasunori Tome, Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0125, Japan (e-mail: )
| | - Yuichi Tsuha
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yusuke Aoki
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kohei Mizuta
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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Winge MI, Røkkum M. Calcium phosphate bone cement and metaphyseal -corrective osteotomies in the upper extremity: long-term follow-up of 10 children. Acta Orthop 2022; 93:769-774. [PMID: 36161337 PMCID: PMC9511366 DOI: 10.2340/17453674.2022.4589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/06/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE The evaluation of metaphyseal angular deformities in children includes indication and timing for corrective osteotomy, and possible need for several operations during growth. Gap-fillers are usually autologous bone grafts, which might cause donor site problems. Calcium phosphate (CaP) bone cement may be a possible alternative. PATIENTS AND METHODS We performed 15 corrective osteotomies from 2007 to 2013 in 10 children, ages 5 to 18, with Norian SRS bone cement as a gap-filler, in the distal radius (12), proximal radius (1), and proximal humerus (2). Due to growth arrest and gradually increasing malalignments 3/10 children needed 1-3 additional corrections. Locking plates and screws were used except in 1 case at first surgery, aged 5 (K-wires). 2 children needed additional limb lengthening with external fixator. RESULTS All osteotomies healed. Postoperative radiographs and CT scans showed good alignment and gradual transformation of cement into bone. Remodeling was visible intraoperatively in patients needing multiple surgeries. Return to earlier osteotomy sites was unproblematic. No adverse events from using CaP cement were experienced. INTERPRETATION CaP cement is an alternative to bone grafts in upper extremity metaphyseal corrective osteotomies in children, and also when greater corrections are necessary or several surgeries indicated during the growth period.
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Affiliation(s)
- Mona I Winge
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Magne Røkkum
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Phull SS, Yazdi AR, Ghert M, Towler MR. Bone cement as a local chemotherapeutic drug delivery carrier in orthopedic oncology: A review. J Bone Oncol 2021; 26:100345. [PMID: 33552885 PMCID: PMC7856326 DOI: 10.1016/j.jbo.2020.100345] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 01/05/2023] Open
Abstract
Metastatic bone lesions are common among patients with advanced cancers. While chemotherapy and radiotherapy may be prescribed immediately after diagnosis, the majority of severe metastatic bone lesions are treated by reconstructive surgery, which, in some cases, is followed by postoperative radiotherapy or chemotherapy. However, despite recent advancements in orthopedic surgery, patients undergoing reconstruction still have the risk of developing severe complications such as tumor recurrence and reconstruction failure. This has led to the introduction and evaluation of poly (methyl methacrylate) and inorganic bone cements as local carriers for chemotherapeutic drugs (usually, antineoplastic drugs (ANPDs)). The present work is a critical review of the literature on the potential use of these cements in orthopedic oncology. While several studies have demonstrated the benefits of providing high local drug concentrations while minimizing systemic side effects, only six studies have been conducted to assess the local toxic effect of these drug-loaded cements and they all reported negative effects on healthy bone structure. These findings do not close the door on chemotherapeutic bone cements; rather, they should assist in materials selection when designing future materials for the treatment of metastatic bone disease.
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Affiliation(s)
- Sunjeev S. Phull
- Department of Biomedical Engineering, Ryerson University, Toronto M5B 2K3, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto M5B 1W8, Ontario, Canada
| | - Alireza Rahimnejad Yazdi
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto M5B 1W8, Ontario, Canada
- Department of Mechanical Engineering, Ryerson University, Toronto M5B 2K3, Ontario, Canada
| | - Michelle Ghert
- Department of Surgery, McMaster University, Hamilton L8V 5C2, Ontario, Canada
| | - Mark R. Towler
- Department of Biomedical Engineering, Ryerson University, Toronto M5B 2K3, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto M5B 1W8, Ontario, Canada
- Department of Mechanical Engineering, Ryerson University, Toronto M5B 2K3, Ontario, Canada
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Combined construction of injectable tissue-engineered bone with CPC and BMMSCs and its study of repair effect on rabbit bone defect model. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:142-148. [PMID: 32131379 PMCID: PMC7104586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE to investigate the combined construction of injectable tissue-engineered bone with calcium phosphate bone cement composite (CPC) and bone marrow mesenchymal stem cells (BMMSCs). METHODS The proliferation activity of BMMSCs encapsulated was detected by CCK8 method on the 7th day after its self-coagulation by CPC. qRT-PCR was used to detect the expressions of mRNA. The microcapsules of BMMSCs combined with CPC were completely filled in the defect site in the experimental group, and the control group not filled. The two groups were sutured and routinely reared, double upper limb X-ray examination performed after operation. RESULTS Those of two groups were on the rise over time, which were higher at the 1st, 3rd, 5th and 7th days than those at the previous time points (all P<0.05). The relative expressions of ALP and CALCR at the 7th day were higher than those at the day in BMMSCs combined with the CPC group and BMMSCs group (all P<0.05). The relative expression of CALCR was significantly higher in BMMSCs combined with the CPC group than that in the BMMSCs group on the 7th day (P<0.05). CONCLUSION With good cell activity and biological activity, the combined construction of the tissue-engineered bone with BMMSCs and CPC can be used as an ideal treatment material for bone tissue repair and connection.
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Chen CJ, Brien EW. Early postoperative compilations of bone filling in curettage defects. J Orthop Surg Res 2019; 14:261. [PMID: 31419993 PMCID: PMC6698034 DOI: 10.1186/s13018-019-1297-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 07/29/2019] [Indexed: 12/28/2022] Open
Abstract
Background Curettage is widely used in orthopedic oncology; the defect created frequently requires filling for mechanical and functional stability for the bones and adjacent joint. Allograft, bone graft substitute, and polymethyl methacrylate (PMMA) are the most common substances used each with their benefits and drawbacks. The aim of the study is to show that good functional result can be achieved with curettage and bone filler, regardless of type. Methods A series of 267 cases were reviewed between 1994 and 2015 who received curettage treatment and placement of a bone filler. Endpoints included fracture, infection, cellulitis, pulmonary embolism, and paresthesia. Complication rates at our single institution were compared against literature values for three study cohorts: allograft, bone graft substitute, and PMMA bone fillers. Friedman test, Wilcoxon test, and Z-score for two populations were used to compare our subset against literature values and between different bone filling types. Results Our cases included 18 autografts, 74 allografts, 121 bone graft substitute, and 54 PMMA of which the bulk of complications occurred. Our overall complication rate was 3.37%. Allograft has a complication rate of 1.35%, bone graft substitute of 4.13%, and PMMA of 5.56%. Other techniques did not yield any complications. Combination filling techniques PMMA + allograft and PMMA + bone graft substitute had sample sizes too small for statistical comparison. Statistical comparison yielded no significant difference between complications in any of the filling groups (P = 0.411). Conclusions Some has even argued that bone defects following curettage do not require bone filling for good outcome. However, many structural or biologic benefits that aid in earlier return to functionality can be conferred by filling large bone defects. There was no significant difference in postoperative complication rates between allograft, bone graft substitute, and PMMA when compared at our institution and with literature values. Nevertheless, one complication with a large defect filled with allograft, requiring a subsequent reconstruction using vascularized fibular graft. Taking everything into account, we see bone graft substitute as a suitable alternative to other bone filling modalities.
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Affiliation(s)
- Clark J Chen
- Miller School of Medicine, University of Miami, Miami, FL, 33136, USA.
| | - Earl W Brien
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA, 90048, USA
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Takeuchi A, Suwanpramote P, Yamamoto N, Shirai T, Hayashi K, Kimura H, Miwa S, Higuchi T, Abe K, Tsuchiya H. Mid- to long-term clinical outcome of giant cell tumor of bone treated with calcium phosphate cement following thorough curettage and phenolization. J Surg Oncol 2018; 117:1232-1238. [PMID: 29315595 DOI: 10.1002/jso.24971] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/07/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Giant cell tumors of bone (GCTB) are intermediate and locally aggressive bone tumor. Calcium phosphate cement (CPC) is a bone void filler used in orthopaedic surgery. This study investigated the clinical outcome of GCTB treated with thorough curettage, phenolization, and CPC. METHODS We investigated 26 patients with at least 36 months of follow-up. The mean age and follow-up were 37 years (range: 19-63) and 87 months (range: 38-169), respectively. Radiological outcomes including consolidation of CPC to the surrounding bone, cortical bone defect remodeling, and clinical outcomes were investigated. RESULTS The consolidation of CPC to the surrounding bone was excellent in 22 cases (84.6%), good in three (11.5%), and acceptable in one (3.8%). Local recurrence occurred in three cases (11.5%). Pulmonary metastasis occurred in one case (3.8%). Cortical bone defect remodeling appeared in 22 cases (84.6%). The mean Musculoskeletal Tumour Society score was 28.7 (95.7%). Osteoarthritis, chronic synovitis, and fracture were observed in one case each (3.8%), which were managed conservatively. CONCLUSIONS Phenolization did not prevent the consolidation of CPC to the bone. CPC provided biological interface and long lasting stability without internal fixation, with comparable complication rates to other published series.
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Affiliation(s)
- Akihiko Takeuchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Prakrit Suwanpramote
- Department of Orthopaedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Toshiharu Shirai
- Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Takashi Higuchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kensaku Abe
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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Wang W, Yeung KWK. Bone grafts and biomaterials substitutes for bone defect repair: A review. Bioact Mater 2017; 2:224-247. [PMID: 29744432 PMCID: PMC5935655 DOI: 10.1016/j.bioactmat.2017.05.007] [Citation(s) in RCA: 854] [Impact Index Per Article: 122.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/19/2017] [Accepted: 05/19/2017] [Indexed: 02/08/2023] Open
Abstract
Bone grafts have been predominated used to treat bone defects, delayed union or non-union, and spinal fusion in orthopaedic clinically for a period of time, despite the emergency of synthetic bone graft substitutes. Nevertheless, the integration of allogeneic grafts and synthetic substitutes with host bone was found jeopardized in long-term follow-up studies. Hence, the enhancement of osteointegration of these grafts and substitutes with host bone is considerably important. To address this problem, addition of various growth factors, such as bone morphogenetic proteins (BMPs), parathyroid hormone (PTH) and platelet rich plasma (PRP), into structural allografts and synthetic substitutes have been considered. Although clinical applications of these factors have exhibited good bone formation, their further application was limited due to high cost and potential adverse side effects. Alternatively, bioinorganic ions such as magnesium, strontium and zinc are considered as alternative of osteogenic biological factors. Hence, this paper aims to review the currently available bone grafts and bone substitutes as well as the biological and bio-inorganic factors for the treatments of bone defect.
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Affiliation(s)
- Wenhao Wang
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong Shenzhen Hospital, 1 Haiyuan 1st Road, Futian District, Shenzhen, China
| | - Kelvin W K Yeung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong Shenzhen Hospital, 1 Haiyuan 1st Road, Futian District, Shenzhen, China
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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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12
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Salunke AA, Shah J, Warikoo V, Kumar R, Galande A, Pokharkar H, Pandit J. Salvage of the proximal femur following pathological fractures involving benign bone tumors. J Surg Oncol 2016; 114:254. [DOI: 10.1002/jso.24291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 03/31/2016] [Indexed: 11/09/2022]
Affiliation(s)
| | - Jaymin Shah
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
| | - Vikas Warikoo
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
| | - Ramesh Kumar
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
| | - Ashok Galande
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
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