Acceleration of Bone Fracture Healing through the Use of Natural Bovine Hydroxyapatite Implant on Bone Defect Animal Model

Abstract

Bone is an important organ for supports the body that stores reserve of calcium, phosphorus, and other minerals. In fracture conditions where bleeding, soft tissue edema, nerve damage, and blood vessels around the bone damage happen, they can cause the mobilization of these minerals in the surrounding tissue. One of the efforts made in the treatment of these fractures is reconnection, in which it works by filling of bone defect with a matrix and administration of anti-infection. Biomaterial filling in defective bone is thought to accelerate the healing process of bone fracture and prevent osteomyelitis. For this reason, this study evaluates the acceleration of bone fracture healing using natural hydroxyapatite (NHA) bone filler in rabbits with bone defect model. Fracture modeling was performed by surgical technique and drilling of bones with a 4.2 mm diameter to form a defect in the rabbit femur. Bone implant contained bovine hydroxyapatite-gelatin-glutaraldehyde (BHA implant) or bovine hydroxyapatite-gelatin-glutaraldehyde-gentamicin (BHA-GEN implant) that was inserted in bone defects. 27 rabbits were divided into 3 groups: the control group who had bone defect, the bone defect group was given BHA implant and the bone defect group was given BHA-GEN implant. Observation of osteoclast, osteoblast, osteocyte, BALP level, and bone morphological integrity was carried out on the 14th, 28th, and 42nd days after surgery. Histological observation of rabbit femur showed a significant difference on the number of osteoclast, osteoblast and osteocyte in all three groups. The BALP level also showed a significant difference in the group given the natural BHA bone implant compared to the control group on day 14 (p = 0.0361). Based on the result of the X-ray, there was also a better integration of rabbit femur bone in groups with the use of BHA or BHA-GEN bone implant. Thus, it can be concluded that the use of a natural BHA implant can accelerate the process of bone repair in the fracture of rabbit femur. In addition, BHA implants were compatible as a matrix for supporting the bone cell growth.

The Role Of Hydroxyapatite Materials On Collagen Synthesis In Alveolar Bone Defects Healing

“…The composition of bovine bone is 93% hydroxyapatite (Ca10 (PO4) 6 (OH) 2) and 7% β-tricalcium phosphate (Ca3 (PO4) 2, ß-TCP). The results of research conducted by Khotib et al (2019) with the object of research is rat's femur defect is showing the value of the bone alkaline phosphatase. On day 14 showed a significant increase of BALP in soft callus formation because there had been a reaction between osteoblast formation and type 1 collagen.…”

Signaling Pathway and Transcriptional Regulation in Osteoblasts during Bone Healing: Direct Involvement of Hydroxyapatite as a Biomaterial

“…As a composite with collagen or gelatin, HA exhibits similar compressive and tensile strength to that of human bones. These composites also mimic the inorganic-organic component naturally present in bone [ 11 , 32 ]. In addition, HA is an osteoinductive material able to induce osteogenesis, particularly when combined with growth factors and osteogenic cells [ 33 ].…”

“…Different extraction sources also determine the physical properties of HA powder, such as particle size and morphology [ 2 ]. Together with the chemical content, the physical properties of HA induce different molecular responses in osteoblasts, which also affect the in vivo performance of HA-based implants [ 11 , 28 ]. For instance, a smaller grain size of HA (nanomaterial) has been associated with better bone matrix synthesis than a larger grain size [ 46 ].…”

“…The application of HA as a biomaterial for bone regeneration depends on bone mineralizing cells termed osteoblasts. HA induces the activity of osteoblasts, which increases the synthesis of new bone matrix in bone defects [ 11 ]. For this purpose, osteoblasts must be differentiated from their precursor cells, termed multipotential stem cells (MSCs) from marrow [ 12 ].…”

“…HA is widely used because it contains similar physical and chemical components to those of natural HA present in bone tissue [2]. Moreover, studies reported that HA induced a favorable immune response [7], exerted an angiogenic effect on defective bone tissue [8,9], and activated osteoblasts and osteoclasts for bone tissue remodeling by accelerating the differentiation of these cells [10,11].…”