Histological evaluation of the bone response to calcium phosphate cement implanted in cortical bone

Ooms, E.M.; Wolke, J.G.C.; Heuvel, M.T van de; Jeschke, B.; Jansen, John A.

doi:10.1016/s0142-9612(02)00438-6

Cited by 202 publications

(156 citation statements)

References 22 publications

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“…Considering the intervening fibrous tissue layer in areas where the coating is lacking, our findings corroborate with a previous study of Ooms et al [12]. They injected PMMA bone cement into cortical bone defects as made into the tibia of goats.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of bone response to titanium-coated polymethyl methacrylate resin (PMMA) implants by X-ray tomography

Shalabi

Wolke

Cuijpers

et al. 2007

J Mater Sci: Mater Med

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High-resolution three-dimensional data about the bone response to oral implants can be obtained by using microfocus computer tomography. However, a disadvantage is that metallic implants cause streaking artifacts due to scattering of X-rays, which prevents an accurate evaluation of the interfacial bone-to-implant contact. It has been suggested that the use of thin titanium coatings deposited on polymeric implants can offer an alternative option for analyzing bone contact using micro-CT imaging. Consequently, the aim of the current study was to investigate bone behavior to titanium-coated polymethylmethacrylate (PMMA) implants by micro-CT and histological evaluation. For the experiment titanium-coated PMMA implants were used. The implants had a machined threaded appearance and were provided with a 400-500 nm thick titanium coating. The implants were inserted in the right or left tibia of 10 goats. After an implantation period of 12 weeks the implants were retrieved and prepared for micro-computer tomography (lCT), light microscopy, and X-ray microanalysis. The micro-CT showed that the screwthreads and typical implant configuration were well maintained through the installation procedure. Overall, histological responses showed that the titanium-coated implants were well tolerated and caused no atypical tissue response. In addition, the bone was seen in direct contact with the titanium-coated layer. The X-ray microanalysis results confirmed the light microscopical data. In conclusion, the obtained results proof the final use of titanium-coated PMMA implants for evaluation of the bone-implant response using lCT. However, this study also confirms that for a proper analysis of the bone-implant interface the additional use of microscopical techniques is still required.

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Section: Discussionsupporting

confidence: 92%

Evaluation of bone response to titanium-coated polymethyl methacrylate resin (PMMA) implants by X-ray tomography

Shalabi

Wolke

Cuijpers

et al. 2007

J Mater Sci: Mater Med

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“…Several studies have been conducted to assess the strength and stiffness of vertebral compression fractures after vertebroplasty with polymethyl methacrylate cement and CPC [27][28][29][30][31]40]. In the cadaveric biomechanical study by Mermelstein et al they found that the injection of CPC in a burst fracture reduced the load on the pedicle screw construct that was inserted for fracture stabilization [32]. It was concluded by them that vertebroplasty with CPC after posterior instrumentation might reduce hardware failure and anterior column collapse and decrease the need for a secondary anterior approach.…”

Section: Discussionmentioning

confidence: 99%

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

Afzal¹,

Saleem²,

Dhar³

2008

Eur Spine J

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To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The postoperative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit.

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“…For instance, in vivo studies have been conducted in rats, 10,15,20 rabbits, 8,16,[21][22][23][24][25] dogs, 13,26,27 sheep, 9 and goats. 28 As these animals are different in terms of their metabolisms and bone physiology, direct and strict comparison between all these studies is difficult. The standardization and validation of animal models makes it possible to compare the osteointegration of several implants and thus to limit the number of animals that need to be euthanized for experimentation.…”

Section: Introductionmentioning

confidence: 99%

Small‐animal models for testing macroporous ceramic bone substitutes

et al. 2004

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The aim of this study was to compare the bone colonization of a macroporous biphasic calcium phosphate (MBCP) ceramic in different sites (femur, tibia, and calvaria) in two animal species (rats and rabbits). A critical size defect model was used in all cases with implantation for 21 days. Bone colonization in the empty and MBCP-filled defects was measured with the use of backscattered electron microscopy (BSEM). In the empty cavities, bone healing remained on the edges, and did not bridge the critical size defects. Bone growth was observed in all the implantation sites in rats (approx. 13.6 -36.6% of the total defect area, with ceramic ranging from 46.1 to 51.9%). The bone colonization appeared statistically higher in the femur of rabbits (48.5%) than in the tibia (12.6%) and calvaria (22.9%) sites. This slightly higher degree of bone healing was related to differences in the bone architecture of the implantation sites. Concerning the comparison between animal species, bone colonization appeared greater in rabbits than in rats for the femoral site (48.5% vs. 29.6%). For the other two sites (the tibia and calvaria), there was no statistically significant difference. The increased bone ingrowth observed in rabbit femurs might be due to the large bone surface area in contact with the MBCP ceramics. The femoral epiphysis of rabbits is therefore a favorable model for testing the bone-bonding capacity of materials, but a comparison with other implantation sites is subject to bias. This study shows that well-conducted and fully validated models with the use of small animals are essential in the development of new bone substitutes.

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Histological evaluation of the bone response to calcium phosphate cement implanted in cortical bone

Cited by 202 publications

References 22 publications

Evaluation of bone response to titanium-coated polymethyl methacrylate resin (PMMA) implants by X-ray tomography

Evaluation of bone response to titanium-coated polymethyl methacrylate resin (PMMA) implants by X-ray tomography

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

Small‐animal models for testing macroporous ceramic bone substitutes

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