Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery

Abstract

BackgroundMany (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands.MethodsSeven calcium phosphate cements (BoneSource®, Calcibon®, ChronOS®, Eurobone®, HydroSet™, Norian SRS®, and Ostim®), one calcium sulphate cement (MIIG® X3), and one bioactive glass cement (Cortoss®) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests.ResultsEach bone substitute had unique characteristics. Mean total porosity ranged from 53% (Ostim®) to 0.5% (Norian SRS®). Mean pore size exceeded 100 μm only in Eurobone® and Cortoss® (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon®, Norian SRS®, HydroSet™, and MIIG® X3. Connectivity density ranged from 27/cm3 for HydroSet™ to 0.03/cm3 for Calcibon®. The ultimate compression strength was highest in Cortoss® (47.32 MPa) and lowest in Ostim® (0.24 MPa). Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).ConclusionsThe bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

Guided Bone Regeneration using Hydroxyapatite-Coated Titanium Fiber Web in Rabbit Mandible: Use of Molecular Precursor Method

“…Conversely, the compressive strengths of commercially available bone ceramics with a porosity of 0.93 and 53% were 33.9 and 0.24 MPa, respectively 27) . Although the compression strength is negatively correlated with the total porosity, it is generally accepted that the mechanical properties of TW are superior to those of ceramic bone substitutes.…”

The effect of water on the mechanical properties of soluble and insoluble ceramic cements

“…Over the past decades, strengths of newly developed ceramic cements have been frequently reported (Charriere et al, 2001;Drosos et al, 2012;Huan and Chang, 2007;Lewis et al, 2006;Liu et al, 2013;Morgan et al, 1997;Van Lieshout et al, 2011;Yamadi and Kobayashi, 2009;Yang et al, 2012, Zhang et al, 2011. Stiffnesses of ceramic cements are reported sporadically (Charriere et al, 2001, Drosos et al, 2012Morgan et al, 1997;Van Lieshout et al, 2011;Welch et al, 2002, Zhang et al, 2011, while only limited reports are available on the toughness and durability of ceramic cements (Morgan et al, 1997;Zhang et al, 2011). Although the strength of ceramic cements is commonly tested using watersaturated (wet) samples, the stiffness of ceramic cements is frequently determined using non-water-saturated (dry) samples.…”

Bone growth on Reticulated Vitreous Carbon foam scaffolds and implementation of Cellular Automata modeling as a predictive tool

“…Moldable bone grafts have been shown to be well suited for small defects and dental applications. Bone filling materials such as BoneSource â (Stryker) [12], a hydroxyapatite cement, offer formability and easy handling. However, this product is also contraindicated for load bearing applications.…”

“…However, this product is also contraindicated for load bearing applications. Similar bone graft products, ChronOS â (Synthes Inc.) and Cortoss â (Orthovita Inc.) have comparable benefits and shortcomings [12][13][14][15].…”