Long bone defects can be managed by the induced membrane technique together with autologous bone graft. However, graft harvest is associated with donor site morbidity. This study investigates if a tricalcium phosphate hydroxyapatite scaffold can be used alone or in combination with bone active drugs to improve healing. Sprague Dawley rats (n ¼ 40) were randomized into four groups. (A) scaffold, (B) BMP-7, (C) BMP-7 þ scaffold, and (D) BMP-7 þ scaffold þ systemic bisphosphonate at 2 weeks. Locked femoral nailing was followed by 6 mm segment removal and implantation of an epoxy spacer. At 4 weeks, the spacers were removed and the defects grafted. Eleven weeks later, the bones were explanted for evaluation with radiography, manual assessment, micro-CT, histology, and Fourier Transform Infrared spectroscopy (FTIR). Isolated scaffolds (A) did not heal any defects, whereas the other treatments led to healing in 7/10 (B), 10/10 (C), and 9/10 (D) rats. Group D had greater volume of highly mineralized bone (p < 0.01) and higher bone volume fraction (p < 0.01) compared to all other groups. A synthetic scaffold þ BMP-7 combined with a bisphosphonate improved the callus properties in a rat femoral critical size defect, compared to both BMP-7 and scaffold alone or the two combined.

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Calcite growth experiments using atomic force microscopy (AFM) were conducted at two constant values of supersaturation (Ω 1 = 5.248 and Ω 2 = 6.457) while varying the Ca 2þ to CO 3 2concentration ratio. The calcite growth rate and the morphology of growth depend on the solution stoichiometry. At a constant degree of supersaturation, the growth rate was highest when the cation/total carbonate anion ratio, r*, was equal to 1 but decreased nonsymmetrically for higher or lower values of r*. The observed dependence of growth rates on solution stoichiometry can be explained by nonequivalent attachment frequencies of cation and anion at ratios that differ from 1. At the same time, the morphology of the closing etch pits and of the forming nuclei was different when the rate changed, suggesting a change in the crystal growth mechanism.

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