Zentrum für Orthopädische Wissenschaften, Gabriel-Max-Strasse 3, D 81545 München, Germany.
Injury. 2011 Sep;42 Suppl 2:S47-55. doi: 10.1016/j.injury.2011.06.007. Epub 2011 Jul 13.
The behaviour of physiological biomaterials, β-tricalciumphosphate and hydroxyapatite, is analysed based on current literature and our own experimental work. The properties of graft substitutes based on ceramic materials are clearly defined according to their scientific efficiency. The strength of the materials and their biodegradability are still not fully evaluated. Strength and degradability have a direct proportional relationship and are considered the most efficient way to be adapted by their properties to the needs for the treatment of bone defects. New technologies for the manufacturing process are presented that increase those properties and thus open up new indications and easier application of the ceramic materials. The implantation process as well is carefully validated by animal experiments to avoid failures. Based on the experiments, a completely new approach is defined as to how primary bone formation with osteoconductive ceramics can be achieved. The milestones in that approach comprise a synthetically manufactured replica of the bone marrow spaces as osteoconductive ladder, whereas the bead is defined as bone-forming element. As a result, materials are available with high strength if the ceramic is solid or highly porous and possesses a micro-structure. The injection moulding process allows for the combination of high strength of the material with high porosity. Based on the strong capillary forces, micro-chambered beads fulfil most expectations for primary bone formation in cancellous bone defects, including drug delivery, mechanical strengthening if necessary, and stable implantation in situ by coagulation of the blood and bone marrow suctioned in.
基于现有文献和我们自己的实验工作，分析了生理生物材料β-磷酸三钙和羟基磷灰石的行为。根据其科学效率，明确界定了基于陶瓷材料的移植物替代品的特性。材料的强度及其生物降解性仍未得到充分评估。强度和生物降解性呈直接比例关系，被认为是通过其特性来适应治疗骨缺损的需求的最有效方法。介绍了新的制造工艺技术，这些技术提高了这些特性，从而开辟了新的适应症，并使陶瓷材料的应用更加容易。还通过动物实验仔细验证了植入过程，以避免失败。基于实验，定义了一种全新的方法，即在具有骨诱导性陶瓷的情况下如何实现原发性骨形成。该方法的里程碑包括合成制造的骨髓空间的复制品作为骨诱导梯，而珠粒则定义为成骨元素。因此，如果陶瓷是实心的或高度多孔的并且具有微观结构，则具有高强度的材料是可用的。注塑成型工艺允许材料的高强度与高孔隙率相结合。基于强大的毛细作用力，微孔腔珠粒满足松质骨缺损中原发性骨形成的大多数期望，包括药物输送、必要时的机械增强以及通过血液的凝结和抽吸骨髓原位稳定植入。
