Chris Arts J J, Verdonschot Nico, Schreurs Berend W, Buma Pieter
Orthopaedic Research Laboratory, Department Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Biomaterials. 2006 Mar;27(7):1110-8. doi: 10.1016/j.biomaterials.2005.07.024. Epub 2005 Aug 10.
Calcium phosphates such as TCP-HA granules are considered promising bone graft substitutes. In the future, they may completely replace allograft bone for impaction grafting procedures. Mechanically, acetabular reconstructions with TCP-HA granules show high stability, however this is partly caused by excessive cement penetration, which is unfavourable from a biological perspective. It has been hypothesised that mixtures of morselised cancellous bone grafts (MCB) and/or TCP-HA granules with a nano-crystalline hydroxyapatite paste (Ostim) may reduce cement penetration while maintaining adequate implant stability and biocompatibility of the graft mixture. To investigate this hypothesis, destructive lever-out tests and in vivo animal test were performed with various combinations of materials. Mechanically, the addition of 10% Ostim to mixtures of MCB and/or TCP-HA granules reduced cement penetration and resulted in a mechanical stability comparable to pure allograft (the current gold standard). Biologically, the application of Ostim with MCB or TCP-HA granules did not hamper the biocompatibility of the materials. Ostim was mostly osseous-integrated with MCB or TCP-HA granules after 8 weeks. Also, non-osseous-integrated Ostim remnants were observed. In tartrate resistant acid phosphatase stained sections, these few non-osseous integrated Ostim remnants were actively being resorbed by osteoclasts. In conclusion, Ostim HA-paste could be a valuable addition when TCP-HA ceramic granules are being used for acetabular bone impaction grafting procedures.
磷酸钙，如TCP - HA颗粒，被认为是很有前景的骨移植替代物。未来，它们可能会完全取代同种异体骨用于打压植骨手术。从力学角度看，用TCP - HA颗粒进行髋臼重建显示出高稳定性，然而这部分是由骨水泥过度渗透引起的，从生物学角度来看这是不利的。据推测，碎松质骨移植（MCB）和/或TCP - HA颗粒与纳米晶羟基磷灰石糊剂（Ostim）的混合物可能会减少骨水泥渗透，同时保持植入物的足够稳定性和移植混合物的生物相容性。为了研究这一假设，对各种材料组合进行了破坏性撬出试验和体内动物试验。从力学角度看，向MCB和/或TCP - HA颗粒混合物中添加10%的Ostim可减少骨水泥渗透，并产生与纯同种异体骨（当前的金标准）相当的机械稳定性。从生物学角度看，将Ostim与MCB或TCP - HA颗粒一起应用不会妨碍材料的生物相容性。8周后，Ostim大多与MCB或TCP - HA颗粒骨整合。此外，还观察到未骨整合的Ostim残余物。在抗酒石酸酸性磷酸酶染色切片中，这些少量未骨整合的Ostim残余物正被破骨细胞积极吸收。总之，当TCP - HA陶瓷颗粒用于髋臼骨打压植骨手术时，Ostim HA糊剂可能是一种有价值的添加物。
